直肠癌肠旁淋巴结CT图像相关影像学参数定量化分析  

Quantitative Parameters Analysis of Lymph Node Status in Rectal Cancer Based on Computed Tomography Imaging

作　　者：崔春艳[1] 李立[1] 蔡宏民[2] 田海英[2] 刘立志[1] 张敏[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心医学影像介入中心,广东广州510060 [2]中山大学信息科学与技术学院,广东广州510275

出　　处：《中国CT和MRI杂志》2011年第4期35-38,共4页Chinese Journal of CT and MRI

基　　金：国家自然基金(No.10875178;60902076);中央高校基本科研业务费专项资金(No.10ykjcll);广州市科技支撑计划(2010J-E151);广东省科技计划项目(No.2010A030500004)

摘　　要：目的应用计算机辅助的定量化分析方法,分析直肠癌肠旁转移和非转移淋巴结的CT影像学定量化参数,探讨转移和非转移淋巴结相关的影像学参数。方法搜集2008年1月-2008年12月中山大学肿瘤防治中心术前行盆腔CT检查的直肠癌病例147例,以病理学诊断转移淋巴结阳性为标准,采用影像工作站对两组病人图像进行复阅,观察肠旁淋巴结情况,由2位放射医生盲法阅片并达成一致。用Matlab软件对肠旁淋巴结的CT图像进行量化分析,计算淋巴结的最大短径、密度、分形维和异质性。统计方法选用χ2检验或t检验。结果单以大小为标准区分淋巴结,转移和非转移两组间有重叠。转移和非转移淋巴结在分形维、密度和异质性方面差异均有统计学意义(分形维:转移1.1244,非转移1.0878;P<0.05;密度:转移108.4,非转移98.9;P<0.05;异质性:转移0.3035,非转移0.2225;P<0.05)。结论直肠癌淋巴结有无转移大小有重叠,但转移和非转移淋巴结在分形维、密度和异质性参数有差异。综合分析CT检出淋巴结的大小、分形维、密度和异质性相关因素有助于提高CT直肠癌判断淋巴结转移的准确性。Objective To evaluate lymph nodes in rectal cancer patients quantitatively using a computer-aided automated approach,and assess its accuracy in differentiating benign and malignant lymph nodes. Methods Patients（147） with newly diagnosed rectal cancer,under- went enhanced computed tomography（CT） examination.Patients were assigned to the benign node or malignant node group according to histopathological analysis of node samples. Images were reviewed by two radiologists blindly on workstation and making the consensus. All CT-detected lymph nodes were segmented using the Matlab software,and short-axis diameter,nodal density,fractal dimension and heterogeneity quantitative parameters of each node were measured.The relationships between lymph node metastases and CT findings were analyzed statistically using t test and X2 test. Results Benign and malignant lymph nodes were found in each size group（3,5,8 or l0 mm short-axis diameter）.The fractal dimension,density and heterogeneity were higher in malignant nodes than in benign nodes, and there was a significant difference in heterogeneity between metastatic and non-meta- static lymph nodes（fractal dimension~~metastasis 1.1244, non-metastasis 1.0878; P〈0. 05; density：metastasis 108.4, non-metastasis 98.9; P〈0.05; heterogeneity：metastasis 0. 3035, non-metastasis 0.2225; P〈0.05）. Conclusion The involvement of lymph nodes in rectal carcinoma were found in each size group,but also the nodal density,fractal dimension and heterogeneity quantitative parameters of the lymph nodes were helpful to consider these lymph nodes stasus.Computer-aided quantitative analysis can improve the prediction of node status in rectal cancer.

关 键 词：直肠肿瘤 淋巴结 定量化分析 

分 类 号：R735.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]