目的 基于多模态磁共振成像纹理特征分析鉴别肝细胞癌(HCC)与肝脏局灶性结节性增生(FNH)。方法 回顾性分析解放军总医院海南医院2012-04至2022-06经病理确诊的38例肝细胞癌和14例肝脏局灶性结节性增生患者,分别对两组患者的横轴位磁共振T2加权成像(T2WI)及扩散加权成像(DWI)图像进行纹理特征分析,参数包括角二阶矩(ASM)、对比度(contrast)、自相关(correlation)、逆差距(IDM)、熵(entropy)。采用Kolmogorov-Smirnov检验及Mann-Whitney检验比较两组间纹理特征参数差异,并应用多元回归分析法获得整体模型拟合中入选变量及其值,得到回归方程,最终选择受试者工作曲线分析评估HCC与FNH的诊断效能。结果 基于DWI图像纹理特征参数证实FNH组ASM、correlation、IDM显著大于HCC组,而FNH组的contrast、entropy则显著小于HCC组。基于T2WI图像纹理特征参数证实FNH组的ASM、correlation显著大于HCC组,而FNH组的contrast、IDM、entropy则显著小于HCC组。DWI组在整体模型拟合中入选变量是entropy、contrast和常量,得到回归方程Y=-1.621×entropy-0.031×contrast+12.410;T2WI组、T2WI联合DWI(T2WI-DWI)组入选变量及其值均相同,入选变量为entropy和常量,得到回归方程Y=-2.595×entropy+16.419。DWI组受试者工作特征曲线下面积(0.945)最大。结论 基于多模态磁共振成像的图像纹理特征分析可以有效鉴别HCC与FNH。
Abstract
Objective To distinguish hepatic cell carcinoma (HCC) from focal nodular hyperplasia (FNH)based on the texture features of multimodal magnetic resonance imaging (MRI). Methods A retrospective analysis was performed on 38 HCC cases and 14 FNH cases diagnosed pathologically in Hainan Hospital of PLA General Hospital from April 2012 to June 2022. Axial T2 weighted imaging (T2WI) and diffusion weighted imaging (DWI) were used for texture analysis, and the texture features included angular second moment (ASM), contrast, correlation, inverse difference moment (IDM) and entropy. Kolmogorov-Smirnov test and Mann-Whitney text were used to compare the differences of textural feature paraments between the two groups, and multiple regression analysis was used to select the variables and their values in the overall model fit, then the regression equation was constructed. Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of the regression equation. Results Based on the texture features of DWI images, it was proved that ASM, correlation and IDM of the FNH group were significantly larger than those in the HCC group, while the contrast and entropy of the FNH group were significantly smaller than those in the HCC group. Based on the texture features of T2WI images, it was confirmed that ASM and correlation of the FNH group were significantly larger than those in the HCC group, while the contrast, IDM and entropy of the FNH group were significantly smaller than those in the HCC group The selected variables of the DWI group in the overall model fitting were entropy, contrast and constant, and the regression equations Y=-1.621×Entropy-0.031×Contrast+12.410 was obtained. The selected variables and their values in T2WI group was the same with the T2WI combined DWI (T2WI-DWI) group. The selected variables were entropy and constant, and the regression equation Y=-2.595×Entropy+16.419 was obtained. The largest area under the receiver operating characteristic curve was 0.945 for the DWI group. Conclusions Texture features of multimodal MRI can effectively distinguish HCC from FNH.
关键词
肝细胞癌 /
肝脏局灶性结节性增生 /
扩散加权成像 /
T2加权成像 /
纹理特征
Key words
hepatic cell carcinoma /
focal nodular hyperplasia /
diffusion weighted imaging /
T2 weighted imaging /
texture feature
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