CT纹理分析用于自身免疫性胰腺炎及胰腺癌鉴别诊断的可行性  

Feasibility of CT Texture Analysis for Differential Diagnosis of Autoimmune Pancreatitis and Pancreatic Cancer

作　　者：张亚 彭乐 刘桐宇 薛朝辉[3] Zhang Ya;Peng Le;Liu Tongyu;Xue Chaohui(The Health Team of the First Detachment of the Beijing Armed Police Force,Beijing 100006;Department of Gastroenterology,Beijing Armed Police Corps Hospital,Beijing 100006;Department of Imaging,Beijing North Asia Orthopedic Hospital,Beijing 100006)

机构地区：[1]武警北京总队执勤第一支队卫生队,北京100006 [2]武警北京总队医院消化内科,北京100009 [3]北京北亚骨科医院影像科,北京100006

出　　处：《现代医用影像学》2021年第3期407-411,共5页Modern Medical Imageology

摘　　要：目的:探讨CT纹理分析(CTTA)鉴别诊断自身免疫性胰腺炎(AIP)及胰腺癌可行性。方法:将2018年1月至2019年12月本在本院行CT增强扫描的28例AIP和32例胰腺癌患者纳入对比研究,分析两组患者图像纹理特征,通过A.K软件获得各期直方图参数,比较两组直方图参数的差异。结果:两组密度均匀度、增强后静脉期病灶密度强化、腊肠样改变、截断征、延迟强化、被膜样边缘等方面存在差异(P<0.05),而两组在胰管扩张、合并淋巴肿大、胰周血管受累、增强扫描动脉期病灶强化密度方面比较差异不显著(P>0.05)。AIP组在动脉期、门静脉期、延迟期中CT平均值、中位数、第25百分位数、均匀性均高于胰腺癌组(P<0.05),而各期熵值均低于胰腺癌组(P<0.05)。结论:CT增强造影可作为AIP与胰腺癌的定性分析,而CTTA可作为AIP与胰腺癌的定量分析。通过定性及定量分析可为临床医生鉴别AIP与胰腺癌及临床治疗方案的选择提供参考依据。Objective:To explore the feasibility of differential diagnosis of autoimmune pancreatitis(AIP) and pancreatic cancer by CT texture analysis(CTTA).Methods:28 cases of patients with AIP and 32 cases of patients with pancreatic cancer who underwent CT enhanced scanning in our hospital were included in a comparative study from January 2018 to December 2019.The texture characteristics of two groups of patients were analyzed. The differences of histogram parameters of two groups were compared.Results:The density uniformity, enhanced venous lesion density after enhancement, salami-like changes, focal density reduction, delayed enhancement, and capsule-like margins of two groups were differences(P<0.05), while the dilated pancreatic ducts, combination of pseudocysts, peripancreatic vascular involvement, and enhanced scanning density of arterial phase lesions of two grouos were no significant difference(P>0.05).The mean value, median CT, and uniformity of CT in the arterial phase, portal vein phase, and delayed phase of the AIP group were higher than pancreatic cancer group(P<0.05), and the entropy values of each phase were lower than pancreatic cancer group(P<0.05).Conclusion:CT enhanced contrast can be used as a qualitative analysis of AIP and pancreatic cancer, while CTTA can be used as a quantitative analysis of AIP and pancreatic cancer. Qualitative and quantitative analysis can provide a reference for clinicians to identify AIP and pancreatic cancer and choose clinical treatment options.

关 键 词：CT纹理分析 计算机体层成像 自身免疫性胰腺炎 胰腺癌 

分 类 号：R576[医药卫生—消化系统] R735.8[医药卫生—内科学]