增强CT图像纹理参数在评估食管鳞状细胞癌分化程度中的价值

Value of image texture parameters of enhanced CT in evaluating differentiation severity of esophageal squamous cell cancer

目的探讨增强CT图像纹理参数在评估食管鳞状细胞癌分化程度的价值。方法纳入经病理确诊为食管鳞状细胞癌的60例患者,其中低分化组、中-高分化组各30例。所有患者在治疗前均行胸部CT增强扫描。将动脉期和静脉期增强CT图像数据导入FireVoxel软件进行纹理分析,记录各纹理参数值(包括均值、中位数、标准差、不均匀度、偏度、峰度、熵值)。比较两组的纹理参数,利用受试者工作特征曲线分析增强CT图像纹理参数评估食管鳞状细胞癌分化程度的效能。结果低分化组动脉期的不均匀度以及静脉期的标准差、不均匀度、熵值均大于中-高分化组(均P<0.05)。鉴别低、中-高分化食管鳞状细胞癌时,动脉期的不均匀度以及静脉期的标准差、不均匀度、熵值的曲线下面积分别为0.685、0.775、0.780、0.685,敏感度分别为40.0%、75.0%、75.0%、45.0%,特异度分别为95.0%、80.0%、85.0%、90.0%。结论增强CT图像参数,尤其是静脉期的标准差和不均匀度,在评估食管癌分化程度上可发挥重要作用。

Objective To explore the value of image texture parameters of enhanced CT in assessing the differentiation severity of esophageal squamous cell carcinoma.Methods Sixty patients pathologically diagnosed as esophageal squamous cell carcinoma were recruited,including 30 cases in the low-differentiation group and 30 cases in the moderate/high-differentiation group.All the patients underwent enhanced chest CT scanning before treatment.The data of enhanced CT(including arterial phase and venous phase)images were imported into the FireVoxel software for texture analysis,then various texture parameters consisting of mean,median,standard deviation,heterogeneity,skewness,kurtosis and entropy were recorded.The texture parameters of both groups were compared,and the receiver operating characteristic curve was employed to analyze the efficiency of enhanced CT image texture parameters for evaluating differentiation of esophageal squamous cell carcinoma.Results Compared with the moderate/high-differentiation group,the low-differentiation group yielded larger heterogeneity at arterial phase,as well as larger standard deviation,heterogeneity,and entropy at venous phase(all P<0.05).For differentiation between low and moderate/high-differentiation esophageal squamous cell carcinoma,heterogeneity at arterial phase,standard deviation,heterogeneity and entropy at venous phase possessed areas under the curve of 0.685,0.775,0.780 and 0.685 with sensitivities of 40.0%,75.0%,75.0%and 45.0%,and specificities of 95.0%,80.0%,85.0%and 90.0%,respectively.Conclusion The parameters of enhanced CT images,especially standard deviation and heterogeneity at venous phase,play an important role in assessing the differentiation of esophageal carcinoma.