CT纹理分析评估直肠癌患者腹腔镜全直肠系膜切除术后吻合口复发的价值  

Value of CT texture information in evaluating anastomotic recurrence after laparoscopic total rectal mesenteric resection for rectal cancer

作　　者：张鹏[1] 姚红霞[1] 张国富 Zhang Peng;Yao Hongxia;Zhang Guofu(Department of Medical Imaging,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China)

机构地区：[1]河南科技大学附属许昌市中心医院医学影像科,许昌461000

出　　处：《中国实用医刊》2022年第4期69-73,共5页Chinese Journal of Practical Medicine

摘　　要：目的观察直肠癌腹腔镜全直肠系膜切除术后吻合口复发患者的CT纹理信息,分析纹理参数评估腹腔镜全直肠系膜切除术后吻合口复发的价值。方法抽取2017年1月至2020年1月河南科技大学附属许昌市中心医院收治的90例直肠癌患者为研究对象。入组患者均于直肠癌腹腔镜全直肠系膜切除术后进行为期18个月的随访,其中吻合口复发者22例纳入复发组,未复发者68例纳入未复发组。比较两组患者的CT纹理参数,分析CT纹理参数评估腹腔镜全直肠系膜切除术后吻合口复发的价值。结果与未复发组比较,复发组患者CT纹理分析参数中均值、峰度、熵、短径水平均较高,差异有统计学意义(P<0.05)。回归分析检验结果显示,CT纹理分析参数(均值、峰度、熵、短径)异常与直肠癌患者腹腔镜全直肠系膜切除术后吻合口复发有关(OR>1,P<0.05);绘制受试者工作特征曲线发现,直肠癌患者CT纹理分析参数(均值、峰度、熵、短径)预测术后吻合口复发的曲线下面积分别为0.903、0.746、0.889、0.864,均有一定的预测价值,最佳截断值分别取158.720、4.855、6.385、4.500 mm时可以获得最佳预测效能。结论直肠癌患者CT纹理分析参数对腹腔镜全直肠系膜切除术后吻合口复发风险有一定的评估价值,临床可通过直肠癌患者CT纹理分析参数评估术后吻合口复发风险,并据此给予针对性的干预措施,降低术后吻合口复发率。Objective To observe the CT texture information of patients with anastomotic recurrence after laparoscopic total rectal mesenteric resection for rectal cancer,and analyze the value of CT texture information in evaluating anastomotic recurrence after laparoscopic total mesenteric resection.Methods Ninety patients with rectal cancer admitted to Xuchang Central Hospital Affiliated to Henan University of Science and Technology from January 2017 to January 2020 were selected as the research objects.All patients were followed up for 18 months after laparoscopic total mesenteric resection for rectal cancer.Among them,22 cases with anastomotic recurrence were included in the recurrence group,and 68 cases without recurrence were included in the non recurrence group.The CT texture parameters of the two group were compared,and the value of CT texture information in evaluating anastomotic recurrence after laparoscopic total mesenteric resection was analyzed.Results Compared with non recurrence group,the mean,kurtosis,entropy and short diameter of CT texture analysis parameters in the recurrence group were higher,and the difference was statistically significant(P<0.05).The results of regression analysis showed that the abnormal CT texture analysis parameters(mean,kurtosis,entropy,and short diameter)were associated with anastomotic recurrence after laparoscopic total rectal mesenteric resection in patients with rectal cancer(OR>1,P<0.05).It was found that the areas under the receiver operating characteristic curve of CT texture analysis parameters(mean,kurtosis,entropy and short diameter)for predicting postoperative anastomotic recurrence in patients with rectal cancer were 0.903,0.746,0.889 and 0.864,respectively,all of which had certain prediction value.The best prediction efficiency can be obtained when the cut-off values were 158.720,4.855,6.385 and 4.500 mm,respectively.Conclusions CT texture analysis parameters of rectal cancer patients have a certain evaluation value for the risk of anastomotic recurrence after laparosc

关 键 词：直肠癌 腹腔镜 全直肠系膜切除术 吻合口复发 CT纹理分析 

分 类 号：R735.37[医药卫生—肿瘤] R730.44[医药卫生—临床医学]