基于CT增强图像纹理分析对急性胰腺炎合并急性肾损伤的诊断价值

Value of CT enhanced image texture analysis in diagnosis of acute pancreatitis with acute kidney injury

目的探讨以CT增强图像为基础的图像纹理分析技术对急性胰腺炎(AP)合并急性肾损伤(AKI的诊断价值。方法回顾性分析2016年9月至2018年9月期间四川大学华西医院放射科收治的39例AP合并AKI及23例AP未合并AKI患者的CT动脉期及静脉期图像,利用ITK-Snap软件手动勾画双侧肾脏,再用A.K.分析软件提取纹理特征,采用单因素方差分析、曼-惠特尼秩和检验、Spearman相关性分析及LASSO回归进行特征降维并用logistic回归筛选出纹理特征,采用受试者操作者特征(ROC)曲线来评价筛选出的纹理特征诊断AP合并AKI的效能。结果提取得到396个影像组学特征,经降维最终筛选出相关性、惯性、平均像素值、集群突出、短游程高灰阶矩及表面面积6个纹理特征,其诊断AP是否合并AKI的ROC曲线下面积、截断值、灵敏度、特异度和准确率在纹理特征相关性分别为0.926、0.619、89.4%、71.4%和82.7%,惯性分别为0.790、0.665、59.6%、82.1%、68.0%,平均像素值分别为0.983、0.662、89.4%、100%、93.3%,集群突出分别为0.903、0.696、80.9%、85.7%、82.7%,短游程高灰阶矩分别为0.980、0.778、76.6%、100%、85.3%,表面面积分别为0.819、0.604、78.7%、75.0%、77.3%。结论 CT增强图像的纹理特征在诊断AP是否合并AKI时具有较好的辨别能力与较高准确度,其中平均像素值的诊断效能最优。

Objective To determine value of texture analysis based on bi-phasic enhanced CT images in diagnosis of acute pancreatitis(AP) with acute renal injury(AKI). Methods A total of 62 patients with clinically proven AP including 39 patients with AKI and 23 patients without AKI were analyzed retrospectively. The region of interest(ROI) was chosen at the axial CT-enhanced images of bilateral kidneys using the ITK-Snap software and the texture analysis was performed by the Analysis-Kinetics(A.K.) analysis software. Using the Analysis of Variance, Mann-Whitney U test, Spearman correlation analysis and LASSO regression to reduce the features dimension, and screening out the textures by the logistic regression. The receiver operating characteristic(ROC) curve was established to determine the diagnostic performance of the features. Results In the total of 396 image histological features originally extracted from the texture analysis, 6 features were finally screened out through the dimensionality reduction, involving the Haralick correlation, Inertia, Mean value, Cluster prominence, Short run high grey level emphasis, and Surface area. The area under curve(AUC), threshold, sensitivity, specificity, and accuracy in diagnosing of AP with AKI respectively was 0.926, 0.619,89.4%, 71.4% and 82.7% by the Haralick correlation; which respectively was 0.790, 0.665, 59.6%, 82.1%, 68.0% by the Inertia; which respectively was 0.983, 0.662, 89.4%, 100%, 93.3% by the Mean value; which respectively was 0.903,0.696, 80.9%, 85.7%, 82.7% by the Cluster prominence; which respectively was 0.980, 0.778, 76.6%, 100%, 85.3% by the Short run high grey level emphasis; which respectively was 0.819, 0.604, 78.7%, 75.0%, 77.3% by the Surface area.Conclusion Textures of contrast-enhanced CT images have better resolving ability and higher accuracy in diagnosis of AP with AKI and diagnostic efficiency of Mean value is the best.