乳腺X线图像纹理特征预测乳腺癌腋窝淋巴结转移  

Mammogram texture analysis in prediction of axillary lymph node metastasis for breast carcinoma

作　　者：谭红娜 武明辉[1,2] 顾建钦 刘广芝 史大鹏 吴青霞[1,2] 王梅云 

机构地区：[1]河南省人民医院放射科,河南郑州450003 [2]河南省神经疾病影像诊断与研究重点实验室,河南郑州450003 [3]河南省临床大数据分析与服务工程研究中心,河南郑州450003

出　　处：《中国医学影像技术》2017年第12期1774-1778,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81401378)

摘　　要：目的探讨乳腺X线图像纹理特征预测乳腺癌腋窝淋巴结转移的价值。方法回顾性分析171例病理证实为非特殊类型浸润性乳腺癌患者的X线及临床资料。所有患者均接受腋窝淋巴结清扫手术,并根据手术及病理结果将患者分为腋窝淋巴结转移组和非转移组。分析患者的X线头尾位图像纹理特征,应用灰度直方图及灰度共生矩阵纹理分析方法测定均值、标准偏差、偏度、峰度、方差、能量、熵、自相关、惯量、逆差距和反差等11个纹理参数。结果 171例患者中淋巴结转移组96例,非转移组75例。X线检出腋窝淋巴结阴性119例,阳性52例,其诊断腋窝淋巴结转移的敏感度和特异度分别为48.96%(47/96)和93.33%(70/75)。X线图像纹理分析结果显示腋窝淋巴结转移组能量、熵、逆差距、自相关值均高于非转移组,惯量、反差值均低于非转移组(P均<0.05);其余纹理特征参数值两组间差异无统计学意义(P均>0.05)。纹理参数值能量、熵、惯量、逆差距、自相关和反差诊断腋窝淋巴结转移的ROC曲线下面积(AUC)值分别为0.610、0.610、0.374、0.599、0.612和0.421(P均<0.05)。乳腺X线检查、纹理特征及X线联合纹理特征诊断腋窝淋巴结转移的AUC值分别为0.711、0.676和0.787(P均<0.05);纹理特征、乳腺X线联合纹理特征诊断腋窝淋巴结转移的敏感度分别为62.5%和64.6%,特异度分别为66.7%和82.7%。结论乳腺X线图像纹理参数对腋窝淋巴结转移有一定的预测作用,且乳腺X线联合纹理特征可提高对腋窝淋巴结转移的诊断效能。Objective To explore the value of mammogram texture analysis in prediction of metastasis of axillary lymph nodes for breast carcinoma. Methods Mammograms and clinical data of 171 patients with breast carcinoma confirmed by pathology were retrospectively analyzed, and all patients underwent axillary lymph node dissection （ALND）. Then the patients were divided into axillary lymph node metastasis group and non-metastasis group according to the result of ALND. The texture features of these lesions were statistically analyzed, including gray-level histogram texture parameters （mean value, standard deviation, skewness, kurtosis and variance） and gray-level co-occurrence matrix texture parameters （energy, entropy, correlation, inertia, inverse difference moment and contrast）. Results In all of 171 breast cancer patients, 96 patients had axillary lymph node metastasis, while 75 patients had no metastasis. Mammograms showed negative axillary lymph nodes in 119 patients and positive axillary lymph nodes in 52 patients, and the sensitivity and specificity of mammograms in the diagnosis of positive axillary lymph nodes was 48.96% （47/96） and 93.33% （70/75）, respectively. Mammogram texture analysis showed the values of energy, entropy, inverse difference moment and correlation in axillary lymph node metastasis group were higher than those in non-metastasis group, while the values of inertia and contrast in the axillary lymph node metastasis group were lower than those in non-metastasis group （all P 〈 0.05）. The rest texture parameters had no significant differences between two groups （all P 〉 0.05）. Area under curve （AUC） for texture parameters of energy, entropy, inertia, inverse difference moment, correlation and contrast was 0.610, 0.610, 0.374, 0.599, 0.612 and 0.421 （all P 〈 0.05）, respectively. AUC of mammography, mammogram texture features, and the combination of mammography and texture features was 0.711, 0.676 and 0.787 （all P 〈 0.05）, respectively. The sensitivity and

关 键 词：乳腺肿瘤 淋巴结转移 乳房X线摄影术 纹理分析 

分 类 号：R737.9[医药卫生—肿瘤] R814.41[医药卫生—临床医学]