| 张加辉.基于MRI弥散成像的直方图纹理分析鉴别肝脏局灶性结节性增生和少脂型肝血管平滑肌脂肪瘤[J].浙江中西医结合杂志,2021,31(11): |
| 基于MRI弥散成像的直方图纹理分析鉴别肝脏局灶性结节性增生和少脂型肝血管平滑肌脂肪瘤 |
| Differentiation of liver focal nodular hyperplasia and low-fat hepatic angiomyolipoma based on histogram texture analysis of MRI diffusion image. |
| 投稿时间：2021-02-22 修订日期：2021-10-08 |
| DOI： |
| 中文关键词: 肝局灶性结节性增生 肝脏血管平滑肌脂肪瘤 纹理特征 直方图 磁共振成像 |
| 英文关键词:liver focal nodular hyperplasia hepatic angiomyolipoma texture feature histogram magnetic resonance imaging |
| 基金项目: |
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| 摘要点击次数: 728 |
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| 中文摘要: |
| 肝局灶性结节性增生(focal nodular hyperplasia, FNH)是一种较少见的良性富血供肿瘤样病变，是肝细胞对局部血管异常产生的一种反应性增生，而非真正意义上的肿瘤[1]。肝脏血管平滑肌脂肪瘤是肝脏内少见的肿瘤，由增生的厚壁血管、平滑肌及成熟的脂肪组织构成，且3种成分构成比例、分布各不相同，且具有潜在的恶性转化和自发破裂的危险，应该积极手术治疗[2]。肝脏血管平滑肌脂肪瘤可分为4 种类型：脂瘤型（脂肪含量≥ 70%）、肌样型（脂肪含量≤ 10%，上皮样型及梭形细胞型）、血管型（以多发粗大、扭曲的畸形血管为主）及混合型（3 种组成成分比例相近）[3]。肌样型及血管型是含微量成熟脂肪的少脂型血管平滑肌脂肪瘤（Low-fat hepatic angiomyolipoma,LF-HAML)，与肝癌、肝腺瘤及FNH等肝脏富血供病变鉴别困难，术前FNH和LF-HAML在临床和影像表现存在较多的重叠[4]，目前国内外对此研究较少，因此准确诊断并鉴别对确定治疗方案和改善患者预后至关重要, 纹理分析是影像组学研究的基础，在肿瘤病灶提取、定性、疗效评估及预后预测方面具有较高的价值[5-6]。笔者旨在探讨基于直方图的MRI-DWI纹理特征方法鉴别两种病变的价值。 |
| 英文摘要: |
| Objective To explore the differential diagnosis value of the histogram texture analysis method of MRI diffusion image in liver focal nodular hyperplasia and low-fat hepatic angiomyolipoma, and evaluate the diagnostic efficacy of different histogram models. Methods A retrospective analysis of 66 patients with focal nodular hyperplasia (FNH) and Low-fat hepatic angiomyolipoma (LF-HAML) confirmed by surgery pathology from February 2014 to October 2019, all All patients underwent magnetic resonance DWI examination, and the b value was selected as 800s/mm2DWI images. AI software was used to manually mark the largest diameter cross-section of the tumor calculate the texture feature parameters in each group of histograms, there are 7 clinical features, including gender, age, lesion size and tumor indicators (ferritin, AFP, CA19-9, CEA),and the independent sample t test and ROC curve analysis were performed on the texture characteristic parameters of the two groups of lesions. Results There were 66 patients enrolled in this study, including 39 FNH and 27 LF-HAML. The t-test analysis showed that the texture characteristics of the lesions in the FNH and LF-HAML groups were statistically different in the four groups of histogram models (p<0.05). ROC curve analysis showed that the mean and skewness diagnostic efficiency in the histogram of LBP window width and window level was the highest, with AUC values of 0.825 and 0.827, there are statistical differences in gender and age in clinical features (p<0.05). Conclusion The analysis of texture characteristics based on histogram and clinical features were helpful for the differential diagnosis of FNH and HAML, and the histogram of LBP window width and window level was the best in differential diagnosis. |
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