基于MRI T_(2)WI与ADC图像的纹理分析鉴别直肠癌T_(3)亚分期的价值  

Value of texture analysis based on MRI T_(2)WI and ADC images in differentiating T3 substage of rectal cancer

作　　者：程世德[1] 陆超 姚鸿欢 倪小云 陆志华 CHENG Shide;LU Chao;YAO Honghuan;NI Xiaoyun;LU Zhihua(Department of Radiology,Huangshan Shoukang Hospital,Huangshan 245400,China;不详)

机构地区：[1]黄山首康医院医学影像科,245400 [2]常熟市第一人民医院影像科 [3]苏州大学附属第四医院(苏州市独墅湖医院)放射科

出　　处：《浙江医学》2024年第11期1163-1167,共5页Zhejiang Medical Journal

基　　金：苏州市卫健委科技项目(LCZX202346)。

摘　　要：目的探讨基于MRI T2WI和表观扩散系数(ADC)图像的纹理分析鉴别直肠癌T3亚分期的价值。方法回顾性选取2016年7月至2020年9月经手术病理检查证实为T3期直肠癌的109例患者为研究对象,包括黄山首康医院20例和常熟市第一人民医院89例。所有患者行MRI检查,分别在T2WI和ADC图像上勾画整个肿瘤体积,并提取一阶纹理参数(平均值、标准差、P5、P10、P90、偏度、峰度、均匀性)和二阶纹理参数(能量、熵、惯性、相关)。比较T_(3a)期和T_(3b-c)期直肠癌患者各纹理参数的差异,并绘制ROC曲线分析各纹理参数对T_(3a)期与T_(3b-c)期直肠癌的诊断效能。结果T_(3a)期53例,T_(3b)期42例,T_(3c)期14例。在T2WI图像纹理参数中,T_(3a)期直肠癌患者峰度明显低于T_(3b-c)期患者,而均匀性、能量均明显高于T_(3b-c)期患者,差异均有统计学意义(均P<0.05);峰度、均匀性、能量鉴别T_(3a)与T_(3b-c)期直肠癌的AUC分别为0.668、0.638、0.806。在ADC图像纹理参数中,T_(3a)期直肠癌患者偏度、熵均明显低于T_(3b-c)期患者(均P<0.05);偏度、熵鉴别T_(3a)与T_(3b-c)期直肠癌的AUC分别为0.626、0.731。结论基于MRI T2WI和ADC图像的纹理分析鉴别T_(3a)与T_(3b-c)期直肠癌具有一定的临床价值,其中T2WI图像纹理参数能量的诊断效能最高。Objective To investigate the value of texture analysis based on MRI T2WI and apparent diffusion coefficient(ADC)images in differentiating T3 substages of rectal cancer.Methods Clinical and imaging data of 109 patients with pathologically confirmed rectal cancer admitted in Huangshan Shoukang Hospital and Changshu First People's Hospital from July 2016 to September 2020 were analyzed retrospectively.All patients underwent MRI examination,the contour of tumor was drawn on T2WI and ADC images,first-order texture features(mean value,standard deviation,P5,P10,P90,skewness,kurtosis and uniformity)and second-order texture features(energy,entropy,inertia and correlation)were measured.The differences in first-and second-order texture features between T_(3a) and T_(3b-c) stage were compared.The value of texture features for differentiating between T_(3a) and T_(3b-c) stage of rectal cancer was analyzed by ROC curve.Results There were 53 cases of T_(3a) stage,42 cases of T_(3b) stage,and 14 cases of T_(3c) stage.On T2WI images,the kurtosis in patients with T_(3a) stage was significantly lower than that in T_(3b-c) stage,while uniformity and energy were significantly higher than those in T_(3b-c) stage(all P<0.05).The AUC of kurtosis,uniformity and energy in differentiating T_(3a) and T_(3b-c) stage was 0.668,0.638 and 0.806,respectively.On ADC images,skewness and entropy in T_(3a) stage were significantly lower than those in T_(3b-c) stage(all P<0.05).The AUC of skewness and entropy in differentiating T_(3a) and T_(3b-c) stage was 0.626 and 0.731,respectively.Conclusion The texture analysis based on MRI T2WI and ADC images is useful in differentiating T_(3a) and T_(3b-c) stage of rectal cancer,and the diagnostic efficacy of energy based on T2WI images is the highest.

关 键 词：直肠癌 磁共振成像 纹理分析 T2加权成像 表观扩散系数 

分 类 号：R735.37[医药卫生—肿瘤]