基于增强MRI全肿瘤影像组学鉴别四脑室室管膜瘤和髓母细胞瘤的应用研究  

Clinical study on the differentiation of fourth ventricle ependymoma and medulloblastoma based on enhanced MRI whole-tumor radiomics

作　　者：廖建勇 张洁 高培毅[2] LIAO Jian-yong;ZHANG Jie;GAO Pei-yi(Department of Radiology,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China;Department of Radiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100160,China)

机构地区：[1]首都医科大学大兴教学医院放射科,北京102600 [2]首都医科大学附属北京天坛医院放射科,北京100160

出　　处：《中国临床医学影像杂志》2025年第1期1-5,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨基于增强MRI影像组学在鉴别四脑室室管膜瘤(EP)和髓母细胞瘤(MB)的应用价值,并将其结果与人工阅片进行对比分析。方法:回顾性分析经手术病理证实为四脑室EP和MB的临床及影像资料,其中EP和MB分别为80例及135例,并按7∶3随机划分为训练集(n=150)和测试集(n=65)。基于T1WI增强图像筛选的18个影像组学特征和有统计学意义的临床影像特征,通过逻辑回归分类器分别建立影像组学模型、临床影像特征模型、联合模型。通过曲线下面积(AUC)、决策曲线分析分别评估模型的鉴别效能、实用性。结果:联合模型诊断效能最佳,其AUC值、灵敏度、特异性、准确率和F1分数分别为0.981、92.68%、91.67%、92.31%和0.938。联合模型的诊断效能优于临床影像特征模型(P<0.05)。联合模型的净收益最高。3种模型的灵敏度、特异性、准确率和F1分数较人工阅片的结果均有不同程度提高。结论:基于增强MRI影像组学对鉴别EP和MB具有较高的临床应用价值,特别是联合模型,有助于提高术前诊断准确率。Objective:To investigate the application value of radiomics based on enhanced MRI in differentiating fourth ventricle ependymomas(EP)from medulloblastomas(MB),and to compare it with the manual film reading.Methods:A retrospective analysis was conducted on clinical and imaging data from surgically confirmed cases of EP and MB in the fourth ventricle,with 80 EP cases and 135 MB cases respectively.They were randomly divided into a training set(n=150)and a testing set(n=65)in a 7∶3 ratio.Based on 18 radiomics features selected from T_1WI enhanced images and statistically significant clinical and imaging features,models were constructed using Logistic regression classifiers,including a radiomics model,a clinical imaging features model,and a combined model.The model performance was assessed by the area under the curve(AUC),and decision curve analysis.Results:The combined model exhibited the best diagnostic performance with an AUC of0.981,and sensitivity,specificity,accuracy,and F1 score of 92.68%,91.67%,92.31%,and 0.938 respectively.The diagnostic performance of the combined model was superior to that of the clinical-imaging features model(P<0.05).The combined model also showed the highest net benefit.All three models demonstrated improvements in sensitivity,specificity,accuracy,and F1score compared to manual film reading to varying degrees.Conclusion:Radiomics based on enhanced MRI is highly valuable for differentiating EP from MB,particularly the combined model,which can help to improve preoperative diagnostic accuracy.

关 键 词：室管膜瘤 髓母细胞瘤 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R739.45[医药卫生—临床医学] R445.2