腹膜区CE-MDCT纹理分析预测胃癌腹膜转移的探讨  

CE-MDCT Texture Analysis of Peritoneotome in Predicting Peritoneal Carcinomatosis of Gastric Cancer

作　　者：陈淑香 陈晓芳[1] 张惠娟[1] CHEN Shuxiang;CHEN Xiaofang;ZHANG Huijuan(Department of Radiology,Fujian Province Hospital Jinshan Branch,Fuzhou,Fujian Province 350028,P.R.China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院/福建省立金山医院放射科,福州350028

出　　处：《临床放射学杂志》2021年第10期1963-1968,共6页Journal of Clinical Radiology

基　　金：福建医科大学启航基金项目(编号:2018QH1138)。

摘　　要：目的初步探讨腹膜区增强多排螺旋CT(CE-MDCT)纹理分析参数在预测胃癌腹膜转移中的应用。方法回顾性分析263例(男180例,女83例)胃癌病例的术前增强CT图像及手术、病理资料,应用Firevoexl软件对其静脉期CE-MDCT图像进行腹膜区纹理分析,获得Mean、StDev、Inhomogenity、Skewness、Kurtosis、Entropy等纹理特征参数。根据病理结果分为腹膜转移组与无转移组,统计分析两组的腹膜区纹理特征参数对腹膜转移与否的预测价值。结果腹膜转移组与无转移组Mean对比的P值为0.4,差异无统计学意义,而两组的StDev、Inhomogenity、Skewness、Kurtosis、Entropy的P值均<0.05,差异均有统计学意义,其及综合纹理参数的受试者工作特征曲线(ROC)曲线下面积(AUC)分别为0.677、0.681、0.875、0.727、0.876、0.897,在诊断阈值分别为0.392、15.73、0.034、3.002、32.55和0.57时,敏感度和特异度分别为50.53%、88.69%,46.32%、89.29%,72.63%、94.05%,70.53%、72.02%,69.47%、93.45%和69.47%、95.83%。Inhomogenity、StDev、纹理综合与Entropy、Skewness、Kurtosis的AUC对比的P值均<0.0001,说明其对胃癌腹膜转移与否的预测价值前三者高于后三者,但纹理综合、Inhomogenity、StDev三者之间的的AUC差异无统计学意义,说明单纯Inhomogenity或StDev即能达到较高的诊断价值。CT阅片与纹理分析两种方法诊断腹膜转移与否的检验结果基本一致(Kappa值0.577,P值=0.000),纹理分析诊断的准确率高于CT阅片方法(配对卡方检验,P值=0.036)。结论腹膜区纹理特征参数对胃癌腹膜转移有一定的预测价值,其中Inhomogenity、StDev的诊断效能相对较高且高于CT阅片,进一步探讨或可提高术前预测腹膜转移的准确性,为术前制定治疗方案提供参考,避免不必要的手术。Objective To investigate the value of CE-MDCT texture analysis parameters in predicting peritoneal carcinomatosis of gastric cancer.Methods 263 cases(180 men and 83 women)of gastric cancer were analyzed retrospectively,including preoperative CE-MDCT images,clinical and pathological data.It was divided into peritoneal metastasis group and no metastasis group according to pathological results.CE-MDCT texture analysis of peritoneum was analyzed by Firevoexl software to obtain texture features such as Mean,St Dev,Inhomogenity,Skewness,Kurtosis and Entropy.The prediction value of peritoneal texture parameters in the two groups on peritoneal metastasis was analyzed.Results The P value of Mean in peritoneal metastasis group and non-metastatic group was 0.4.The P value of St Dev,Inhomogenity,Skewness,Kurtosis,Entropy and integration of the two groups were 0.00,with the area under the ROC curves were 0.677,0.681,0.875,0.727,0.876 and 0.897(P=0.00<0.05),at diagnostic thresholds of 0.392,15.73,0.034,3.002,32.55 and0.57,the sensitivity and specificity were 50.53%and 88.69%,46.32%and 89.29%,72.63%and 94.05%,70.53%and72.02%,69.47%and 93.45%,69.47%and 95.83%respectively.The P values of AUCs between Inhomogenity,St Dev,integration and Kurtosis,Entropy,Skewness were all litter than 0.0001,indicating that Inhomogenity,St Dev and Integration have higher predictive value for peritoneal metastasis of gastric cancer,and their predictive efficacy was similar.The results of CT images reading and texture analysis in the diagnosis of peritoneal metastasis were basically consistent(Kappa value0.577,P=0.000),and the accuracy of texture analysis was higher than that of CT images reading(P=0.036 for paired chi-square test).Conclusion Peritoneum CE-MDCT texture parameters showed a favorable performance for the prediction of peritoneal metastasis in gastric cancer,and the diagnostic efficacy of Inhomogenity and St Dev were higher than that of other texture parameters and CT images reading,which the further study may improve the accuracy of preo

关 键 词：胃癌 腹膜转移 纹理分析 体层摄影术 X线计算机 

分 类 号：R735.2[医药卫生—肿瘤]