MRI T2WI图像纹理分析预测甲状腺乳头状癌颈部淋巴结转移的诊断价值

doi:10.12117/jccmi.2020.08.010

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摘要目的：探讨MRI纹理分析在预测甲状腺乳头状癌（Papillary thyroid carcinoma，PTC）颈部淋巴结转移方面的诊断价值。材料和方法：回顾性分析54例经手术病理确诊为PTC的患者的影像学及临床资料，以手术病理为金标准将患者分为颈部淋巴结转移组（34例）和无颈部淋巴结转移组（20例），术前均行甲状腺MRI检查，在肿瘤最大截面的T2WI轴面图像上手动勾画ROI，利用纹理分析软件提取纹理参数（熵、标准差、对比、偏度、峰态、逆差矩、角二阶矩、均值、相关）。计量资料符合正态分布且方差齐采用独立样本t检验比较两组间差异，非正态分布或方差不齐则采用Mann-Whitney U检验比较两组间的差异。计数资料采用χ2检验比较差异。采用ROC曲线评价具有统计学意义的纹理参数预测颈部淋巴结转移的效能。P<0.05为差异有统计学意义。结果：PTC颈部淋巴结转移组和无颈部淋巴结转移组的T2WI图像熵（t=-5.64）、相关（Z=-2.67）、角二阶矩（Z=-3.53）以及标准差（Z=-2.67）间差异具有统计学意义（P均<0.05），其中熵的ROC曲线下面积（AUC）最大，为0.884，阈值为5.59，敏感度为97.1%，特异度为70%；对比、偏度、峰态、逆差矩、均值间差异均无统计学意义（P>0.05）。影像医师诊断颈部淋巴结转移的敏感度为64.7%（22/34），特异度为60.0%（12/20）。结论：MRI T2WI图像纹理分析对PTC颈部淋巴结转移有一定的预测意义。

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	张衡1
	张慧慧1
	舒政2
	葛琛瑾2
	邓小飞2
	孙凤2
	曹胜男2

关键词 ：甲状腺肿瘤, 癌, 乳头状, 淋巴转移, 磁共振成像

Abstract：Objective: To evaluate the value of MRI texture analysis in predicting cervical lymph node metastasis of papillary thyroid carcinoma(PTC). Materials and Methods: The imaging and clinical data of 54 patients with PTC diagnosed by operation and pathology were retrospectively analyzed, according to the result of surgical pathology, the patients were divided into lymph node metastasis group(34 cases) and no lymph node metastasis group(20 cases). Preoperative thyroid MRI examination was performed on all patients, ROI was manually delineated on the T2WI axial image of the largest section of the tumor, texture parameters(entropy, standard deviation, contrast, skewness, kurtosis, deficit moment, angular second moment, mean, correlation) were extracted by texture analysis software. The independent sample t-test(normal distribution with homogeneity of variance) and Mann-Whitney U test(non-normal distribution without homogeneity of variance) were used to compare the differences of measurement data between the two groups. The difference of enumeration data was compared by χ2 test. The ROC curve was used to evaluate the texture parameters with statistical significance and to predict the efficacy of cervical lymph node metastasis. P<0.05 was considered statistically significant. Results: The T2WI image entropy(t=-5.64), correlation(Z=-2.67), angular second-order moment(Z=-3.53) and standard deviation(Z=-2.67) between PTC cervical lymph node metastasis group and non-metastasis group were statistically significant(P<0.05). The maximum of the area under ROC curve(AUC) of entropy was 0.884, threshold was 5.59, sensitivity was 97.1%, and specificity was 70%. Contrast, skewness, kurtosis, deficit moment and mean were not statistically significant(P>0.05). Conclusion: MRI T2WI image texture analysis has certain significance for prediction of PTC cervical lymph node metastasis.

Key words： Thyroid neoplasms Carcinoma, papillary Lymphatic metastasis Magnetic resonance imaging

收稿日期: 2019-12-11

PACS:	Ｒ736.1
	Ｒ445.2

基金资助:上海市虹口区卫计委重大科研课题基金项目（编号：虹卫1801－04）；蚌埠医学院研究生科研创新计划项目（编号：Byycxz1816）。

通讯作者: 舒政，上海中医药大学附属上海市中西医结合医院影像科，200082。E-mail：shu6808@hotmail.com

作者简介: 张衡（1987-），男，安徽明光人，在读硕士研究生。E-mail：qingfengplayer@163.com

引用本文:

张衡1，张慧慧1，舒政2，葛琛瑾2，邓小飞2，孙凤2，曹胜男2. MRI T2WI图像纹理分析预测甲状腺乳头状癌颈部淋巴结转移的诊断价值 [J]. 中国临床医学影像杂志, 2020, 31(8): 568-571.
ZHANG Heng1, ZHANG Hui-hui1, SHU Zheng2, GE Chen-jin2, DENG Xiao-fei2, SUN Feng2, CAO Sheng-nan2. The diagnostic value of MRI T2WI image texture analysis for predicting cervical lymph node metastasis of papillary thyroid carcinoma. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(8): 568-571.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.08.010 或 http://www.jccmi.com.cn/CN/Y2020/V31/I8/568

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