基于增强T_(1)WI和ADC图的纹理分析鉴别儿童鞍区生殖细胞瘤和星形细胞瘤的价值  

The Value of Texture Analysis Based on Enhancement T_(1)WI and ADC in Differentiating Germinoma from Astrocytoma in Sellarregion of Children

作　　者：王瑞珠 席艳丽[1] 徐化凤[1] 朱佳 杨明[1] WANG Ruizhu;XI Yanli;XU Huafeng(Department of Radiology,Children’s Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210008,P.R.China)

机构地区：[1]南京医科大学附属儿童医院放射科,210008

出　　处：《临床放射学杂志》2022年第5期940-945,共6页Journal of Clinical Radiology

摘　　要：目的探究基于增强T_(1)WI和表观扩散系数(ADC)图的纹理分析在鉴别儿童鞍区生殖细胞瘤和星形细胞瘤的可行性,评价它们的诊断效能。方法回顾性分析南京医科大学附属儿童医院手术病理证实的鞍区生殖细胞瘤38例,星形细胞瘤40例,采用LIFEx 3.4软件在增强T_(1)WI及ADC图像上勾画感兴趣区(ROI),经软件自动计算得到共39个参数,并对两组间参数进行统计分析;对有统计学意义的参数采用受试者工作特征曲线(ROC),评价各参数诊断效能。结果两组受试者性别、年龄无显著性差异。增强T_(1)WI图像中17个纹理参数在两组中有统计学差异(P<0.05),其中生殖细胞瘤的11个参数高于星形细胞瘤,其余6个参数值低于星形细胞瘤。ADC图像中,13个纹理参数有差异,生殖细胞瘤的10个参数高于星形细胞瘤,其余3个参数值低于星形细胞瘤。ROC曲线显示增强T_(1)WI图像中,以灰度行程矩阵(GLRIM)中参数行程百分比(RP)鉴别鞍区生殖细胞瘤和星形细胞瘤的曲线下面积(AUC)最大(AUC=0.944),截断值为0.923,敏感度和特异度分别为92.8%和91.2%,长行程因子(LRE)的诊断效能次之(AUC=0.905)。ADC图像中,以灰度共生矩阵特征(GLCM)中异质性鉴别两者的曲线下面积最大(AUC=0.941),截断值为166.72,敏感度和特异度分别为93.4%和92.1%,行程百分比(RP)的诊断效能次之(AUC=0.937)。联合增强T_(1)WI和ADC图进行ROC曲线分析,诊断效能提高(AUC=0.976)。结论基于增强T_(1)WI和ADC图的纹理分析在鉴别儿童鞍区星形细胞瘤和生殖细胞瘤中可提供更多量化的、可重复性的信息,可改善现阶段儿童鞍区生殖细胞瘤和星形细胞瘤仅靠临床表现及常规图像鉴别的情况,联合这两个序列图像可以获得更高的诊断效能。Objective To explore the feasibility of texture analysis based on T_(1)WI enhancement and ADC in differentiating germinoma and astrocytoma in sellar region of children,and to evaluate their diagnostic efficacy.Methods A retrospective analysis of 38 cases of germinoma and 40 cases of astrocytoma in sellar region was performed in Children’s Hospital of Nanjing Medical University.LIFEx 3.4 software was used to map the region of interest(ROI)on T_(1)WI enhanced and ADC diagrams.A total of 39 parameters were automatically calculated by the software,and the parameters between the two groups were statistically analyzed.For statistically significant parameters,receiver operating characteristic curve(ROC)was used to evaluate the diagnostic efficacy of each parameter.Results There were no significant differences in gender and age between the two groups.In T_(1) WI enhanced diagrams,there were statistical differences in 17 parameters between two groups(P<0.05),among which 11 parameters of germinoma were higher than those of astrocytoma,and the other 6 parameters were lower.In ADC diagram,10 parameters of germinoma were higher than those of astrocytoma,and the remaining 3 parameters were lower.ROC curve showed in T_(1) enhanced images,the area under the curve of RP in GLRIM was the largest(AUC=0.944,cut-off=0.923),the sensitivity and specificity were 92.8%and 91.2%respectively.The diagnostic efficiency of long run emphasis(LRE)was the second(AUC=0.905).In the ADC diagram,the area under the curve of Dissimilarity in GLCM was the largest(AUC=0.941,cut-off=166.72),the sensitivity and specificity were 93.4%and 92.1%respectively,and the diagnostic efficiency of RP was the second(AUC=0.937).Combined T_(1)WI enhancement with ADC image,the diagnostic efficiency was improved,with AUC=0.976.Conclusion Texture analysis based on T_(1)WI enhancement and ADC diagram can provide more quantitative and repeatable information in the differentiation of germinoma and astrocytoma in sellar region of children,it can improve the situation of dif

关 键 词：鞍区 生殖细胞瘤 星形细胞瘤 纹理分析 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]