摘要
目的:探讨全病灶MRI纹理分析对不同病理亚型肾细胞癌的鉴别诊断价值。方法:将92例经病理证实的肾细胞癌患者纳入本研究,其中透明细胞癌51例、嫌色细胞癌24例、乳头状癌17例。分析MR压脂序列T2WI上全病灶的纹理特征,包括最小值(Min)、最大值(Max)、中位值(M)、峰度(kurtosis)、偏度(skewness)、均匀度(uniformity)、能量(energy)和熵(entropy)。比较三组间各项纹理参数值的差异,对组间差异有统计学意义的参数进行ROC曲线分析。结果:透明细胞癌的均匀度(0.73±0.11)和能量(2.78±1.38)显著低于嫌色细胞癌和乳头状癌,熵(5.97±0.48)显著高于嫌色细胞癌和乳头状癌,差异均有统计学意义(P<0.05)。联合三项参数鉴别透明细胞癌与非透明细胞癌,AUC为0.84(95%CI:0.76~0.93),敏感度和特异度分别为88.2%和73.2%;鉴别透明细胞癌与嫌色细胞癌,AUC为0.92(95%CI:0.85~0.99,敏感度和特异度分别为90.2%和83.3%。结论:全病灶磁共振纹理分析对鉴别不同病理类型肾细胞癌有重要的临床价值。
Objective:To explore the diagnostic value of whole-lesion MRI texture analysis in differentiating various histopathological subtypes of renal cell carcinoma.Methods:92 patients with renal cell carcinoma proved by pathology were included in this study,including 51 cases with clear cell renal cell carcinoma(ccRCCs),24 cases with chromphobe renal cell carcinoma(chRCCs),and 17 cases with papillary renal cell carcinoma(pRCCs).For each patient,whole-lesion texture features on MR FS T 2WI were extracted and analyzed,including minimum(Min),maximum(Max),median(M),kurtosis,skewness,uniformity,energy and entropy.The texture features among the three groups were compared statistically,and ROC analysis was made for the texture parameters with statistically significant difference among the three groups.Results:Statistically significant difference was found in uniformity,energy and entropy among the three groups.ccRCCs showed the lowest uniformity(0.73±0.11)and energy(2.78±1.38),and the highest entropy(5.97±0.48).Area under curve(AUC)of the three parameters combined for differentiating ccRCC and non-ccRCC was 0.84(0.76~0.93)with sensitivity of 88.2%and specificity of 73.2%.AUC of the three parameters combined for differentiating ccRCC and chRCC was 0.92(0.85~0.99)with sensitivity of 90.2%and specificity of 83.3%.Conclusion:Whole-lesion MRI texture analysis can play an important role in differentiating various histopathological subtypes of renal cell carcinoma.
作者
王绎忱
张瑾
张连宇
陈雁
WANG Yi-chen;ZHANG Jing;ZHANG Lian-yu;CHEN Yan(Department of Radiology,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《放射学实践》
北大核心
2018年第8期785-788,共4页
Radiologic Practice
关键词
肾细胞癌
磁共振成像
纹理分析
病理类型
Renal cell carcinoma
Magnetic resonance imaging
Texture analysis
Histopathological type
