MRI纹理分析评价前列腺癌Gleason评分7分肿瘤异质性的初步研究  

Evaluation of tumor heterogeneity in prostate cancer with Gleason score 7 points by MRI texture analysis:a preliminary study

作　　者：张宏江[1] 毕国力[1] 李洪亮[1] 陈瑜晖 李阳丽[2] 袁会梅 吴昆华[1] ZHANG Hongjiang;BI Guoli;LI Hongliang;CHEN Yuhui;LI Yangli;YUAN Huimei;WU Kunhua(Department of MRI,the First People's Hospital of Yunnan,Kunming 650032,China;Department of Radiology,the Maternal and Children Health Hospital of Kunming,Kunming 650032,China)

机构地区：[1]云南省第一人民医院磁共振科,云南昆明650032 [2]昆明市妇幼保健院放射科,云南昆明650032

出　　处：《实用放射学杂志》2019年第11期1794-1796,1820,共4页Journal of Practical Radiology

摘　　要：目的探讨基于T2WI和ADC图纹理参数鉴别诊断前列腺癌(PCa)Gleason评分(GS)(3+4)与(4+3)的可行性.方法回顾性分析经病理证实77例PCa GS 7分的患者,GS(3+4)组45例,GS(4+3)组32例.在轴位T2 WI和ADC图上选择肿瘤最大层面手动勾画ROI,并提取角二阶矩(ASM)、对比、相关、逆差距及熵(entropy)5个纹理参数,再进行组间纹理参数统计学分析,并对有统计学差异的纹理参数采用ROC曲线评价其诊断效能.结果GS(3+4)与GS(4+3)组患者年龄和前列腺特异性抗原(PSA)浓度差异均无统计学意义(P>0.05);T2WI和ADC图的ASM及熵值差异均有统计学意义(P<0.05);而对比、相关及逆差距差异无统计学意义(P>0.05).除T2WIASM的AUC无统计学差异外,T2WIentropy、ADCASM及ADCentropy均有统计学差异,且ADCASM和ADCentropy的AUC均大于T2 WIASM和T2 WIentropy.其中ADCentropy的AUC最大,为0.732,以5.71为诊断阈值,敏感度为97.6%,特异度为59.5%.结论MRI纹理分析可用于鉴别PCa GS(3+4)与GS(4+3),其中ADCentropy鉴别二者的诊断效能最佳.Objective To explore the feasibility of differential diagnosis of Gleason score(GS)(3+4)and(4+3)in prostate cancer(PCa)based on texture parameters of T2 WI and ADC maps.Methods A total of 77 patients with GS 7 points in PCa confirmed by pathology were enrolled in this retrospective study,including 45 GS(3+4)cases and 32 GS(4+3)cases.ROI was manually drew on the largest section of tumor on the axial T2WI and ADC maps,and five texture parameters were extracted,namely,angular second moment(ASM),contrast,correlation,inverse difference moment and entropy,and the texture parameters between groups were analyzed statistically,then ROC curve was used to evaluate the diagnostic efficiency of texture parameters with statistical differences.Results There was no significant difference in age and prostate specific antigen(PSA)between GS(3+4)and GS(4+3)groups(P>0.05).There were significant differences in ASM and entropy between T2WI and ADC(P<0.05),but there was no statistical difference in contrast,correlation and inverse difference moment(P>0.05).Except for the AUC of T2WIASM,there were statistical differences among T2WIentropy,ADCASM and ADCentropy.The AUC of ADCASM and ADCentropy were larger than that of T2WIASM and T2 WIentropy.The AUC of ADCentropy had the largest AUC(0.732),the cut off value was 5.71,with the sensitivity was 97.6%and specificity was 59.5%.Conclusion MRI texture analysis can be used to differentiate GS(3+4)from GS(4+3)in PCa,and the ADCentropy have the best diagnostic efficacy.

关 键 词：前列腺癌 GLEASON评分 磁共振成像 纹理分析 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]