摘要
目的评价CT直方图(CTH)分析方法在甲状腺乳头状癌(PTC)的术前诊断及预测病理分期中的价值。方法回顾性分析2017年1月至2019年7月经手术病理确诊的88例PTC患者资料,男22例,女66例,平均年龄(41.18±12.04)岁,所有患者术前接受甲状腺双期CT增强扫描。两位放射医师分别对图像进行处理并获取直方图参数,数据处理采用GE公司Omni Kinetics软件。采用Logistic回归和受试者工作特征曲线(ROC),评价CTH定量参数及参数联合对PTC的诊断价值和效能;采用Spearman相关分析,评估直方图参数和术后分期之间的相关性。结果动脉期参数最小强度(MinIntensity)、偏度(skewness)、峰度(kurtosis)和静脉期MinIntensity、体素值总和(VoxelValueSum)、skewness可作为独立预测因子用于PTC的诊断,动脉期直方图参数联合的诊断效能最高,曲线下面积(AUC)0.976。容积数(VolumeCount)和VoxelValueSum与PTC的术后分期具有统计学相关。结论CTH参数可用于PTC的术前诊断及预测病理分期。
Objective To assess the performance of computed tomography(CT)histogram analysis for diagnosis and prediction of histopathological staging of papillary thyroid carcinoma(PTC).Methods From January2017 to July 2019,this retrospective study comprised of 88 patients with confirmed histopathological PTC(22 men,66 women,mean age 41.18.04±12.04 years)who had undergone preoperative contrast-enhanced CT imaging before surgery.Two radiologists blinded to the histopathological outcome independently segmented lesions for quantitative histogram analysis.Histogram features were extracted from arterial and portal phase CT images using GE company software(OmniKinetics,OK).Logistic regression and receiver operating characteristic(ROC)analysis were used to identify histogram parameters to discriminate PTC from normal thyroid tissue.Spearman analysis was constructed to predict the pathological staging of PTC based on preoperative CT features.Results There were significant differences between PTC and normal thyroid tissue on histogram features.Histogram features in arterial phase including MinIntensity,skewness and kurtosis were independent predictors.Features in portal phase including MinIntensity,VoxelValueSumand skewnesswere independent predictors.Areas under the curve of the combined arterial phase parameters were 0.976.Volume Count and VoxelValueSumw ere correlated with histopathological staging of PTC.Conclusion CT histogram analysis demonstrates great potential for the diagnosis of PTC and predicts histopathological differentiation staging of PTC.
作者
唐庆昆
朱建国
李海歌
吕牧
周志超
TANG Qingkun;ZHU Jianguo;LI Haige(Department of Medical Imaging,The Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210011,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第12期2388-2393,共6页
Journal of Clinical Radiology
基金
江苏省高等学校大学生创新创业训练计划项目(编号:201810312065X)
关键词
甲状腺乳头状癌
诊断
分期
体层摄影术
X线计算机
直方图
定量分析
Papillary thyroid carcinoma
Diagnosis
Staging
Tomography,X-ray computed
Histogram
Quantitative analysis
