肝脏超声图像纹理特征对肝硬化患者高风险食管胃底静脉曲张的诊断价值

Diagnostic value of texture features of liver ultrasound images for high-risk esophageal and gastric varices in patients with cirrhosis

目的评估肝脏超声图像纹理特征对肝硬化患者高风险食管胃底静脉曲张的诊断价值。方法回顾性分析本院2019年1月至2022年12月收治的102例代偿性肝硬化患者的临床资料。根据门静脉高压症临床分期将患者分为高风险组(n=36)和低风险组(n=66)。利用影像组学方法提取肝脏超声图像的纹理特征,筛选有意义特征后计算纹理评分。对纹理评分进行受试者操作特征(ROC)曲线分析,并计算曲线下面积(AUC)。Youden方程用于确定纹理评分的最佳截断值,并计算诊断灵敏度、特异度。结果高风险组的男性比例、天冬氨酸氨基转移酶水平、国际标准化比率(INR)及纹理特征评分高于低风险组,差异具有统计学意义(P<0.05)。共筛选出5个有意义的纹理特征用于计算纹理评分。纹理评分诊断高风险食管胃底静脉曲张的AUC为0.92,95%CI为0.85~0.96。Youden指数为0.65,对应最佳截断值为-0.01,其诊断灵敏度、特异度分别为80.56%、84.85%。结论肝脏超声图像纹理特征对肝硬化患者高风险食管胃底静脉曲张具有良好的诊断价值。

Objective To evaluate the diagnostic value of texture features of liver ultrasound images for high-risk esophageal and gastric varices in patients with cirrhosis.Methods The clinical data of 102 patients with compensatory cirrhosis admitted in our hospital from January 2019 to December 2022 were retrospectively analyzed.According to the clinical stage of portal hypertension,the patients were divided into high-risk group(n=36)and low-risk group(n=66).The texture features of liver ultrasound images were extracted by radiomics method,and the texture score was calculated after screening meaningful features.Receiver operating characteristic(ROC)curve analysis was performed on the texture score,and the area under the curve(AUC)was calculated.The Youden equation was used to determine the optimal cut-off value of the texture score,and the diagnostic sensitivity and specificity were calculated.Results The proportion of males,aspartate aminotransferase level,international normalization ratio(INR)and texture feature score in the high-risk group were higher than those in the low-risk group,and the differences were statistically significant(P<0.05).A total of 5 meaningful texture features were selected to calculate the texture score.The AUC of texture score in the diagnosis of high-risk esophageal and gastric varices was 0.92,and the 95%CI was 0.85-0.96.The Youden index was 0.65,and the corresponding optimal cut-off value was-0.01.The diagnostic sensitivity and specificity were 80.56%and 84.85%,respectively.Conclusion The texture features of liver ultrasound images have good diagnostic value for high-risk esophageal and gastric varices in patients with cirrhosis.