MRI纹理分析对高原藏区脑囊虫病所致颅内囊性变的鉴别诊断价值  

The Value of MRI Texture Analysis in Differential Diagnosis of Intracranial Cystic Lesions Caused by Cysticercosis in Tibetan Plateau

作　　者：胡柯嘉 卜玉莲[4] 冯崇义 杜时巍 和正英 张伊冰 赵俊文 潘自来[4] HU Kejia;BU Yulian;FENG Chongyi;DU Shiwei;HE Zhengying;ZHANG Yibing;ZHAO Junwen;PAN Zilai(Division of Neurosurgery,Department of Surgery III,Diqing Tibetan Autonomous Prefecture People's Hospital;Department of Neurosurgery,Rujin Hospital,Shanghai Jiao Tong University School of Medicine;Laboratory of Digital Medicine,Wuxi People's Hospital,Nanjing Medical University;Department of Radiology,Ruijin Hospital North Campus,Shanghai Jiao Tong University School of Medicine,Shanghai200025,China;Department of Radiology,Diqing Tibetan Autonomous Prefecture People's Hospital)

机构地区：[1]迪庆藏族自治州人民医院外三科神经外科组 [2]上海交通大学医学院附属瑞金医院神经外科 [3]南京医科大学附属无锡人民医院数字医学实验室 [4]上海交通大学医学院附属瑞金医院北部院区放射科,上海200025 [5]迪庆藏族自治州人民医院放射科

出　　处：《中国医学计算机成像杂志》2022年第5期449-456,共8页Chinese Computed Medical Imaging

基　　金：“十四五”期间上海交通大学医学院附属瑞金医院对口支援迪庆藏族自治州人民医院项目。

摘　　要：目的:探讨常规MRI纹理分析在高原地区脑囊虫病和其他病因引起的颅内囊性病变的鉴别诊断价值。方法:纳入30例脑囊虫病(脑囊虫病组)和20例其他病因(对照组)引起的颅内囊性变患者的病例资料,所有患者均接受常规MRI检查进行诊断,包括T1WI、T2WI、液体衰减反转恢复(FLAIR)序列及T1WI增强。利用3D-slicer软件手动勾画囊性变囊腔的感兴趣区(ROI),并提取相应的影像组学纹理参数数据,包括第10和第90百分位数、四分位距、最小值、最大值、平均值、中位数、偏度、峰度、方差、均匀性、值域、均方根、能量和熵。使用独立样本t检验或秩和检验比较不同来源囊性变的MRI图像纹理参数的差异,并绘制受试者工作特征(ROC)曲线,评价其鉴别诊断囊性变病理来源的效能。结果:FLAIR的纹理参数对鉴别诊断价值最大,其脑囊虫组的熵、四分位距、最大值、值域、方差均显著大于对照组,而均匀性显著小于对照组(P<0.05),其中方差的ROC曲线下面积(AUC)最大,为0.8455,其灵敏度为90.91%,特异度为80%。增强T1WI纹理参数中,脑囊虫病组的熵和四分位距显著大于对照组,而偏度和均匀性显著小于对照组(P<0.05),其中均匀性的AUC最大,为0.875,其灵敏度为100%,特异度为83.33%。T2WI纹理参数中,脑囊虫病组的峰度和均匀性都显著小于对照组(P<0.05),其中峰度的AUC最大,为0.84,其灵敏度为70%,特异度为90%。而2组的T1WI的纹理参数中未见显著差异。结论:高原藏区不同来源颅内囊性变的常规MRI纹理参数间存在显著差异,纹理分析能为脑囊虫病所致颅内囊性变的鉴别诊断提供可靠、量化的客观依据。Purpose:To explore the value of conventional MRI texture analysis in the differential diagnosis of intracranial cystic lesions caused by cerebral cysticercosis and other etiologies in the Tibetan plateau area.Methods:With intracranial cystic lesions,30 patients caused by cerebral cysticercosis(cerebral cysticercosis group)and 20patients caused by other etiologies(control group)were included in this study.All the patients were diagnosed by conventional MRI,including T1WI,T2WI,fluid-attenuated inversion recovery(FLAIR)sequences,and enhanced T1WI.The region of interest(ROI)of the cystic lesion cavity was manually outlined using 3D-slicer software,and the corresponding radionics data on histological texture parameters,including 10th and 90th percentile,interquartile range,minimum,maximum,mean,median,skewness,kurtosis,variance,homogeneity,range,root mean square,energy,and entropy were extracted.Independent sample t-test or rank-sum test were used to compare the differences in texture parameters of MRI images from different sources of cystic lesions,and ROC curves were plotted to evaluate the efficacy in the differential diagnosis of the pathological origin of cystic lesions.Results:The texture parameters of FLAIR were the most valuable for differential diagnosis,and the entropy,interquartile distance,maximum value,range,and variance of the cerebral cysticercosis group were significantly greater than those of the control group,while the homogeneity was significantly less than that of the control group(P<0.05),the AUC of variance was the largest(0.8455),with a sensitivity of 90.91%and the specificity was 80%.Among the enhanced T1WI texture parameters,the entropy and quartile distance of the cysticercosis group were significantly higher than those of the control group,while the skewness and homogeneity were significantly smaller than those of the control group(P<0.05)and the AUC of homogeneity was the largest(0.875),with a sensitivity of 100%and specificity of83.33%.Among the T2WI texture parameters,kurtosis and homogene

关 键 词：颅内囊性变 磁共振成像 纹理分析 影像组学 

分 类 号：R445.2[医药卫生—影像医学与核医学]