CT纹理参数对结直肠癌患者术后复发的预测价值  

Predictive Value of CT Texture Parameters for Postoperative Recurrence in Patients with Colorectal Cancer

作　　者：赵瑞琛 潘媛媛 熊慧勤 ZHAO Rui-chen;PAN Yuan-yuan;XIONG Hui-qin(Department of Medical Imaging,Henan Provincial People's Hospital,Zhengzhou,Henan 450003)

机构地区：[1]河南省人民医院医学影像科,河南郑州450003

出　　处：《中国肛肠病杂志》2024年第11期31-33,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨CT纹理参数对结直肠癌患者术后复发的预测价值。方法:回顾2021年10月至2022年12月于我院接受腹腔镜全系膜切除术治疗且术前行增强CT检查的70例结直肠癌患者资料,将增强CT图像(动脉期和静脉期)进行纹理分析,并提取相关纹理参数。根据术后1年随访结果分为复发组和未复发组,比较2组患者纹理参数,分析影响结直肠癌患者术后复发的危险因素,绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评估CT纹理参数对术后复发的预测价值。结果:70例患者中,术后1年复发16例(22.86%),未复发54例(77.14%)。复发组动脉期熵值、静脉期不均匀度、静脉期熵值均高于未复发组,P<0.05。多因素分析显示,动脉期熵值(OR=5.109,95%CI 1.354~8.864)、静脉期不均匀度(OR=4.943,95%CI 1.235~8.661)、静脉期熵值(OR=5.171,95%CI 1.554~8.987)是影响结直肠癌患者术后复发的危险因素,P<0.05。ROC曲线分析显示,动脉期熵值(AUC=0.768)、静脉期不均匀度(AUC=0.702)、静脉期熵值(AUC=0.873)对结直肠癌患者术后复发的预测均具有一定的准确性,三者联合对术后复发的预测效能更高,敏感度、特异度、AUC分别为80.25%、98.20%和0.921。结论:CT纹理参数动脉期熵值、静脉期不均匀度及熵值联合对结直肠癌患者术后复发具有一定预测价值。Objective To investigate the value of CT texture parameters in predicting postoperative recurrence of colorectal cancer(CRC)patients.Methods The data of 70CRC patients who received laparoscopic total mesenterectomy in our hospital from October 2021to December 2022and underwent enhanced CT examination before operation were retrospectively analyzed.The enhanced CT images(arterial and venous phases)were analyzed for texture analysis,and the relevant texture parameters were extracted.According to the 1-year follow-up results,patients in the two groups were divided into recurrence group and non-recurrence group.The texture parameters of the two groups were compared.The risk factors concerned with postoperative recurrence of CRC patients were analyzed.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was used to evaluate the predictive value of CT texture parameters on postoperative recurrence.Results Among the 70patients,16cases(22.86%)recurred one year after operation,and 54cases(77.14%)had no recurrence.The arterial phase entropy,venous phase inhomogeneity and venous phase entropy in the recurrent group were higher than those in the non-recurrent group(P<0.05).Multivariate analysis showed that arterial phase entropy(OR=5.109,95%CI 1.354-8.864),venous phase inhomogeneity(OR=4.943,95%CI 1.235-8.661),venous phase entropy(OR=5.171,95%CI 1.554~8.987)were risk factors for postoperative recurrence of CRC patients(P<0.05).ROC curve analysis showed that arterial phase entropy(AUC=0.768),venous phase inhomogeneity(AUC=0.702)and venous phase entropy(AUC=0.873)all had certain accuracy in predicting postoperative recurrence of CRC patients,and the combination of the three had higher predictive efficacy.Sensitivity,specificity and AUC were 80.25%,98.20%and 0.921,respectively.Conclusion The combination of arterial phase entropy,venous phase inhomogeneity and entropy of CT texture parameters has certain predictive value for postoperative recurrence of CRC patients.

关 键 词：结直肠癌 CT 纹理 复发 动脉期熵值 静脉期不均匀度 静脉期熵值 预测 

分 类 号：R735.34[医药卫生—肿瘤] R730.44[医药卫生—临床医学]