CT影像组学对肾上腺乏脂腺瘤与结节样增生的诊断价值

Diagnostic value of CT radiomics nomogram for adrenal lipid-poor adenoma and nodular hyperplasia

目的探讨基于CT平扫图像建立的影像组学诺模图对鉴别肾上腺乏脂腺瘤和肾上腺结节样增生的诊断价值。方法回顾性分析经病理学检查证实的44例肾上腺乏脂腺瘤与55例肾上腺结节样增生患者。从CT平扫图像提取并筛选出有诊断价值的影像组学参数,计算影像组学评分构建影像组学模型,分析筛选临床因素构建临床模型并联合临床因素和影像组学模型构建诺模图。分析比较上述3种模型的诊断效能。结果13项影像组学参数被筛选用于建立影像组学诊断模型。影像组学模型验证集曲线下面积为0.91,敏感度和特异度分别为84.6%和81.3%。单因素及多因素二分类Logistic回归分析结果显示,肾素和最大径为鉴别二者的独立影响因子,临床模型验证集曲线下面积为0.57,敏感度和特异度分别为53.9%和68.8%。诺模图验证集AUC为0.94,敏感度和特异度分别为84.6%和93.8%。影像组学模型及诺模图的诊断效能均大于临床模型(z=3.188,P<0.001;z=3.409,P<0.001)。结论基于CT平扫图像的影像组学诺模图对鉴别肾上腺乏脂腺瘤和肾上腺结节样增生有较高的诊断效能,具有较高的临床价值。

Objective To investigate the value of radiomics nomogram based on non-contrast CT in the differential diagnosis of adrenal lipid-poor adenoma and adrenal nodular hyperplasia.Methods Clinical data of 44 patients with adrenal lipid-poor adenoma and 55 with nodular hyperplasia confirmed by pathology were retrospectively analyzed.Radiomics features extracted from non-contrast CT and radiomics score(Radscore)were calculated to construct a radiomics model.Clinical factors were selected to construct a clinical model.Radiomics nomogram was constructed combining clinical factors and Radscore.The diagnostic values of the three models were compared.Results A total of 13 features were selected to establish the radiomics model.The area under the receiver operator characteristic curve(AUC),sensitivity and specificity of the radiomics model were 0.91,84.6%and 81.3%,respectively.Both univariate and multivariate Logistic regression showed that renin and maximum diameter were the independent influencing factors in the differential diagnosis of adrenal lipid-poor adenoma and adrenal nodular hyperplasia.The AUC,sensitivity and specificity of the clinical model were 0.57,53.9%and 68.8%.respectively.The AUC,sensitivity and specificity of the radiomics nomogram were 0.94,84.6%and 93.8%,respectively.The diagnostic efficiency of the radiomics model and nomogram was significantly higher than that of the clinical model(z=3.188,P<0.001;z=3.409,P<0.001).Conclusion The radiomics nomogram based on non-contrast CT has a high efficiency in the differential diagnosis of adrenal lipid-poor adenoma and nodular hyperplasia.