肾透明细胞癌与肾嗜酸性细胞腺瘤的MRI纹理分析与鉴别

MRI texture analysis and identification of clear cell renal cell carcinoma and renal oncocytoma

目的探究磁共振成像(magnetic resonance imaging,MRI)纹理分析在肾透明细胞癌(clear-cell renal cell carcinomas,ccRCC)与肾嗜酸性细胞腺瘤(renal oncocytoma,RO)中鉴别价值。材料与方法对2012年5月至2019年11月期间收治的42例ccRCC与15例RO患者资料予以回顾性分析,分别作为ccRCC组与RO组,患者接受MRI常规扫描与增强扫描后行纹理扫描分析。ccRCC与RO鉴别三维纹理特征选择频率,MRI纹理分析鉴别ccRCC与RO诊断效能,ccRCC与RO患者COM纹理参数比较,COM纹理参数在ccRCC与RO患者鉴别上价值分析。结果ccRCC与RO鉴别所筛选纹理特征多来自共生矩阵(co occurrence matrix,COM),ccRCC与RO鉴别中肾实质增强T1加权成像(T1 weighted imaging,T1WI)序列筛选出层间纹理特征最多;通过非线性判别分析方法进行MRI纹理分析来鉴别ccRCC与RO,在肾实质期增强纹理特征诊断效能最佳,诊断敏感度、特异度以及准确度分别为92.86%、73.33%以及87.72%;ccRCC组患者T1WI增强COM纹理参数如熵、逆差距以及相关显著低于RO患者(P<0.05),而对比与能量差异无统计学意义(P>0.05);受试者工作特征(receiver operating characteristic,ROC)曲线应用COM纹理参数熵、逆差距、相关鉴别ccRCC与RO患者曲线下面积(area under curve,AUC)分别为0.883、0.752、0.806,熵在鉴别ccRCC与RO患者价值最佳,敏感度与特异度分别为88.5%和83.6%。结论MRI纹理分析尤其是COM可以有效鉴别出ccRCC与RO。

Objective:To explore the identification value of magnetic resonance imaging(MRI)texture analysis in clear-cell renal cell carcinoma(ccRCC)and renal oncocytoma(RO).Materials and Methods:The data of 42 ccRCC patients(ccRCC group)and 15 RO patients(RO group)who were admitted to the hospital from May 2012 to November 2019 were retrospectively analyzed.After patients underwent routine MRI scan and enhanced scan,texture scan analysis was conducted.The selection frequency of three-dimensional texture features was identified by ccRCC and RO.The diagnostic efficiency of ccRCC and RO was identified by MRI texture analysis.COM texture parameters were compared between ccRCC and RO patients.The identification value of COM texture parameters in ccRCC and RO patients was analyzed.Results:The texture features screened by ccRCC and RO identification were mostly from the co-occurrence matrix(COM).In the identification of ccRCC and RO,interlayer texture features screened by renal parenchymal enhancement T1 weighted imaging(T1WI)sequence were the most.By nonlinear discriminant analysis,the diagnostic efficiency of MRI texture analysis for identifying ccRCC and RO in terms of enhancement texture features during renal parenchymal stage was the best,its diagnostic sensitivity,specificity and accuracy were 92.86%,73.33%and 87.72%,respectively.T1WI enhancement COM texture parameters such as entropy,homogeneity and correlation in ccRCC group were significantly lower than those in RO patients(P<0.05),while there had no significant difference in the contrast and energy(P>0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under curve(AUC)values of COM texture parameters such as entropy,homogeneity and correlation for identifying ccRCC and RO patients were 0.883,0.752 and 0.806,respectively.The value of entropy for identifying ccRCC and RO was the best,its sensitivity and specificity were 88.5%and 83.6%,respectively.Conclusions:MRI texture analysis,especially COM,can effectively identify ccRCC and RO.