基于增强CT扫描成像的灰度共生矩阵纹理分析不同T分期食管鳞状细胞癌

Assessment of T Staging of Esophageal Squamous Cell Carcinoma by Using GLCM Texture Analysis: Contrast-Enhanced CT Texture

目的探究提取增强CT图像的灰度共生矩阵纹理参数的方法分期食管鳞状细胞癌的可行性。方法选取本院36例经内镜活检病理确诊的食管鳞状细胞癌患者36例,在采取治疗方案之前,行胸、腹部CT增强扫描。两位资深CT诊断医师将患者增强CT图像导入Omni-kinetics软件对肿瘤组织进行勾画。勾画完成后,使用OmniKinetics软件进行纹理参数计算。结果随着T分期的增加,Energy值降低,且不同T分期的Energy差异具有统计学意义(P=0.001);随着T分期的增加,Entropy值升高,且不同T分期的Entropy差异具有统计学意义(P=0.007);随着T分期的增加,IDM值逐渐变小,且不同分期的IDM值具有统计学意义(P=0.000)。T1期Energy值的95%置信区间为(0.037,0.052),T2期Energy值的95%置信区间为(0.009,0.035),T3期Energy值的95%置信区间为(0.002,0.007);T1期Entropy值的95%置信区间为(4.104,4.562),T2期Entropy值的95%置信区间为(4.577,4.926),T3期Entropy值的95%置信区间为(5.001,5.221);T1期IDM值的95%置信区间为(0.019,0.027),T2期IDM值的95%置信区间为(0.011,0.014),T3期IDM值的95%置信区间为(0.003,0.010)。结论基于增强CT扫描成像的灰度共生矩阵纹理分析分期食管鳞状细胞癌的方法具有一定价值,未来可尝试作为建立食管鳞状细胞癌分期鉴别的无侵入性方法。

Objective To explore the feasibility of staging esophageal squamous cell carcinoma by extracting the gray level co-occurrence matrix texture parameters of enhanced CT images. Methods 36 patients in our hospital with esophageal squamous cell carcinoma diagnosed by endoscopic biopsy were selected. Before taking the treatment program,the chest and abdomen enhanced CT scans were acquired. Two senior CT diagnostics imported the enhanced CT of the patients into Omni-kinetics software to delineate tumor tissues. After the delineation,the texture parameters were calculated with OmniKinetics software. Results In this study,the Energy value decreased with the increase of T stage,and the difference of Energy in different T stages had statistical significance（ P = 0. 001）. With the increase of T stage,Entropy value increased,and the difference of Entropy in different T stages was statistically significant（ P = 0. 007）. As the T stage in-creased,the IDM value became smaller gradually,and the IDM values in different stages had statistical significance（ P =0. 000）. The 95% confidence interval of Energy value in T1 stage was（ 0. 037,0. 052）,in T2 stage it was（ 0. 009,0. 035）,and that in T3 stage was（ 0. 002,0. 007）. The 95% confidence interval of Entropy value in T1 stage was（ 4. 104,4. 562）,that in T2 stage was（ 4. 577,4. 926）,and that in T3 stage was（ 5. 001,5. 221）. The 95% confidence interval of IDM value in T1 stage was（ 0. 019,0. 027）,that in T2 stage was（ 0. 011,0. 014）,and that in T3 stage was（ 0. 003,0. 010）. Conclusion The method of staging esophageal squamous cell carcinoma based on the texture analysis of gray level co-occurrence matrix of enhanced CT scan imaging has certain value,and can be regarded as a noninvasive method for establishing the stage differentiation of esophageal squamous cell carcinoma in the future.