肝泡型棘球蚴病门静脉期增强CT纹理分析预测其肝外转移

Portovenous phase enhanced CT texture analysis of hepatic alveolar echinococcosis for predicting extrahepatic metastasis

目的观察肝泡型棘球蚴病(HAE)门静脉期增强CT纹理分析预测其发生肝外转移的价值。方法回顾性收集经病理确诊的105例HAE患者,根据术前影像学所见分为转移组(n=55)及非转移组(n=50)。采用MaZda软件于术前腹部门静脉期增强CT中提取肝内病灶灰度直方图纹理特征参数,包括均值、方差、偏度、峰度及第1、10、50、90、99百分位数(记为Perc1、Perc10、Perc50、Perc90、Perc99),以单因素及多因素logistic回归进行分析,筛选HAE肝外转移的独立预测因素;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估各独立预测因素单一及其联合预测HAE肝外转移的效能。结果肝内病灶的均值及偏度均为HAE肝外转移的独立预测因素(P均<0.05),其预测HAE肝外转移的AUC分别为0.853及0.850,二者联合的AUC达0.902。结论HAE门静脉期增强CT纹理分析可有效预测其肝外转移。

Objective To explore the value of portovenous phase enhanced CT texture analysis of hepatic alveolar echinococcosis(HAE)for predicting extrahepatic metastasis.Methods A total of 105 patients with HAE confirmed by pathology were retrospectively collected.The patients were divided into metastatic group(n=55)and non-metastatic group(n=50)according to findings of preoperative imaging.Based on preoperative abdominal portovenous phase enhanced CT images,the grayscale histogram texture feature parameters of intrahepatic lesions,including mean,variance,skewness,kurtosis,and the 1,10,50,90,and 99th percentiles(recorded as Perc1,Perc10,Perc50,Perc90,and Perc99)were extracted using MaZda software.Univariate and multivariate logistic regression were used to analyze the histogram texture parameters and screen independent predictors of extrahepatic metastasis of HAE.Then receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each independent predictor alone and their combination for predicting extrahepatic metastasis of HAE.Results The mean and skewness were both independent predictors of extrahepatic metastasis of HAE(both P<0.05),with AUC of 0.853 and 0.850 for predicting HAE extrahepatic metastasis,respectively,while the AUC of their combination was 0.902.Conclusion Portovenous phase enhanced CT texture analysis of HAE could be used to effectively predict extrahepatic metastasis.