基于多期增强CT的直方图分析鉴别胃肠道间质瘤和神经鞘瘤

Differentiation of Gastrointestinal Stromal Tumors and Schwannomas Based on Histogram Analysis of Multiphase Enhanced CT

目的探讨基于增强CT动脉期、静脉期及动静脉期联合的直方图分析在鉴别胃肠道间质瘤和神经鞘瘤的诊断价值。方法回顾性分析行腹部多期增强CT扫描且经手术病理证实的40例胃肠道间质瘤及19例胃肠道神经鞘瘤患者的临床及影像学资料。在uAI Research Portal平台上手动勾画肿瘤感兴趣区并进行直方图分析,获得肿瘤动脉期、静脉期及动静脉期联合直方图特征参数,对各参数进行比较并研究各参数的诊断效能。结果动脉期的直方图特征参数,90%像素值、熵、四分位距、最大值、平均偏差、范围、相对偏差、偏度、均匀性差异具有统计学意义,静脉期的直方图特征参数,熵、四分位距、最大值、平均偏差、相对偏差、均匀性、方差差异具有统计学意义。分别建立动脉期、静脉期及动静脉期联合的鉴别诊断模型,得出动脉期(AUC=0.855)及动静脉期联合(AUC=0.899)诊断效能均高于静脉期模型(AUC=0.751)。结论基于多期增强CT的直方图分析可用于术前鉴别胃肠道间质瘤和神经鞘瘤,动脉期及动静脉期联合的诊断效能更高。

Objective To explore the diagnostic value of histogram analysis based on arterial phase,venous phase and combined arteriovenous phase CT images in differentiating gastrointestinal stromal tumors from schwannomas.Methods The clinical and imaging data of 40 patients with gastrointestinal stromal tumors and 19 patients with gastrointestinal schwannomas confirmed by surgery and pathology who underwent abdominal multiphase enhanced CT scanning were retrospectively analyzed.Manually draw the tumor ROI on the uAI Research Portal platform and conduct histogram analysis to obtain the histogram characteristic parameters of the arterial phase,venous phase and combined arteriovenous phase of the tumor,and compare each parameter and study the diagnostic efficiency of each parameter.Results The histogram characteristic parameters of arterial phase,such as 90%pixel value,entropy,interquartile range,maximum value,average deviation,range,relative deviation,skewness and uniformity,have statistical significance.The histogram characteristic parameters of venous phase,such as entropy,interquartile range,maximum value,average deviation,relative deviation,uniformity and variance,have statistical significance.The differential diagnosis models of arterial phase,venous phase and combined arteriovenous phase were established respectively.The results showed that the diagnostic efficiency of arterial phase(AUC=0.855)and combined arteriovenous phase(AUC=0.899)were higher than that of venous phase(AUC=0.751).Conclusion Histogram analysis based on multiphase enhanced CT can be used to identify gastrointestinal stromal tumors and schwannomas before operation,and the diagnostic efficacy of arterial phase and combined arteriovenous phase is higher.