CT纹理分析对结直肠癌与炎症性结直肠壁增厚的鉴别诊断价值  

CT Texture Analysis in Differentiating Colorectal Cancer from Inflammatory Colorectal Wall Thickening

作　　者：马永青 王志璐 王帝 董婷宇 宋德领 丁新 MA Yongqing;WANG Zhilu;WANG Di;DONG Tingyu;SONG Deling;DING Xin(Endoscopic Center of the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;不详)

机构地区：[1]河北北方学院附属第一医院医学影像部,河北张家口075000 [2]河北北方学院附属第一医院内镜中心,河北张家口075000

出　　处：《中国医学影像学杂志》2021年第12期1222-1226,共5页Chinese Journal of Medical Imaging

摘　　要：目的对比分析CT纹理参数在结直肠癌(CRC)与炎症性结直肠壁增厚中的差异及其临床应用价值。资料与方法纳入行CT扫描并经病理证实的局限性结直肠壁增厚患者103例,根据病理结果分为CRC组与炎性肠病(IBD)组,将平扫CT图像导入Firevoxel软件提取均值、标准差、偏度、不均匀度、峰度和熵值等纹理参数,并进行对比分析。利用受试者工作特征曲线评估存在差异的参数对CRC与IBD的鉴别诊断效能。结果CRC组患者熵值、不均匀度和峰度明显高于IBD组,差异有统计学意义(Z=6.002、4.608、2.808,P均<0.01);熵值的诊断效能最高(AUC=0.852,95%CI 0.773~0.931),敏感度和特异度分别为98.40%、65.00%,其次为不均匀度(AUC=0.770,95%CI 0.680~0.860)。熵值与不均匀度联合应用可以明显提高诊断效能(AUC=0.915,95%CI 0.861~0.968),其敏感度及特异度分别为80.00%、98.40%。结论CT纹理分析可以作为一种鉴别CRC与炎症性结直肠壁局限性增厚的有效工具,熵值联合不均匀度具有一定的临床应用价值。Purpose To compare and analyze the difference of CT texture indexes between colorectal cancer(CRC)and inflammatory colorectal wall thickening,and to explore the clinical application value of different indicators.Materials and Methods A total of 103 patients with localized colonic wall thickening confirmed by pathology were retrospectively enrolled.According to the pathological results,all cases were divided into the CRC group and the inflammatory bowel disease(IBD)group.All CT images were imported into Firevoxel software to extract and compare the texture parameters,including mean,standard deviation,skewness,inhomogenity,kurtosis and entropy.Receiver operator characteristic curve was used to evaluate the diagnostic efficacy of differential parameters in differentiating CRC from IBD.Results The entropy,inhomogenity and kurtosis of CRC group were significantly higher than those of IBD group,the differences were statistically significant(Z=6.002,4.608 and 2.808,P<0.01).Entropy presented the highest diagnostic efficiency(AUC=0.852,95%CI 0.773-0.931),the sensitivity and specificity were 98.40%and 65.00%,respectively,followed by inhomogeneity(AUC=0.770,95%CI 0.680-0.860).The combined application of entropy and non-uniformity could significantly improve the identification efficiency(AUC=0.915,95%CI 0.861-0.968),the sensitivity and specificity were 80.00%and 98.40%,respectively.Conclusion CT texture analysis could be used as an effective tool to distinguish CRC from inflammatory colorectal wall thickening.The combination of entropy and inhomogeneity could be with important application value in clinical practice.

关 键 词：结直肠肿瘤 体层摄影术 X线计算机 图像处理 计算机辅助 纹理分析 炎性肠病 肠壁增厚 病理学 外科 诊断 鉴别 

分 类 号：R445.3[医药卫生—影像医学与核医学] R735.35[医药卫生—诊断学]