CT纹理分析对醛固酮腺瘤与皮质醇腺瘤的鉴别诊断价值  

Differential diagnostic value of aldosterone-producing adenoma and cortisol-producing adenoma by CT texture analysis

作　　者：刘欣[1] 郑伊能 钟毅 杨海涛[1] 周素颖 LIU Xin;ZHENG Yineng;ZHONG Yi;YANG Haitao;ZHOU Suying(Department of Radiology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中国中西医结合影像学杂志》2021年第1期60-64,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：重庆市自然科学基金(csct2019jcyj-msxmX0395);重庆医科大学附属第一医院2019学术带头人储备人才基金项目。

摘　　要：目的:探讨CT纹理分析在功能性肾上腺腺瘤即醛固酮腺瘤(APA)与皮质醇腺瘤(CPA)亚型鉴别中的临床应用。方法:回顾性分析经临床病理确诊的41例APA与42例CPA的资料。提取2组CT平扫、动脉期、静脉期CT图像纹理特征,并行统计分析。结果:CT平扫、动脉期及静脉期分别有18、16、21个纹理特征,差异均有统计学意义(均P<0.05),各期基于灰度区域大小矩阵提取的差异有统计学意义的纹理特征最多。平扫、动脉期及静脉期CT纹理特征分析鉴别APA和CPA的AUC值分别为0.854、0.804、0.827(均P<0.05),而多期相联合分析鉴别诊断效能(AUC=0.866)并无明显提高(P=0.83)。结论:CT纹理分析能有效鉴别功能性肾上腺腺瘤的常见临床亚型APA和CPA;基于平扫的CT纹理分析的鉴别诊断效能高于动脉及静脉期图像,多期联合CT纹理分析的鉴别效能并无明显提高。Objective:To evaluate the clinical value of CT texture analysis in differentiating aldosterone-producing adenoma(APA)from cortisol-producing adenoma(CPA).Methods:Retrospective analysis of 41 patients with APA and 42 patients with CPA was made.Texture features were extracted from the CT images in multiple phases including plain scan,arterial and venous phase,and the texture features with good consistency in each period were selected for statistical analysis.Results:There were significant differences in 18,16,and 21 texture features at the plain scan,arterial phase and venous phase,respectively(P<0.05),and the gray level size zone matrix(GLSZM)extracted the most statistically significant texture features.The AUC values of the texture features extracted from plain scan,arterial and venous phase images in identifying APA and CPA were 0.854,0.804 and 0.827,respectively(P<0.05).But the multi-phase combined analysis(AUC=0.866)had not significantly improved the identification efficiency(P=0.83).Conclusions:CT texture analysis can effectively identify the common clinical subtypes of functional adrenal adenoma including APA and CPA.The diagnostic efficiency of texture analysis based on plain scan is higher than other phases,and multi-phase combined texture analysis shows no significantly improvement.

关 键 词：肾上腺皮质腺瘤 纹理分析 体层摄影术 X线计算机 

分 类 号：R736.6[医药卫生—肿瘤] R730.44[医药卫生—临床医学]