本文選題：乳腺腫瘤　切入點：淋巴結轉移　出處：《中國醫(yī)學影像技術》2017年12期

【摘要】：目的探討乳腺X線圖像紋理特征預測乳腺癌腋窩淋巴結轉移的價值。方法回顧性分析171例病理證實為非特殊類型浸潤性乳腺癌患者的X線及臨床資料。所有患者均接受腋窩淋巴結清掃手術,并根據(jù)手術及病理結果將患者分為腋窩淋巴結轉移組和非轉移組。分析患者的X線頭尾位圖像紋理特征,應用灰度直方圖及灰度共生矩陣紋理分析方法測定均值、標準偏差、偏度、峰度、方差、能量、熵、自相關、慣量、逆差距和反差等11個紋理參數(shù)。結果 171例患者中淋巴結轉移組96例,非轉移組75例。X線檢出腋窩淋巴結陰性119例,陽性52例,其診斷腋窩淋巴結轉移的敏感度和特異度分別為48.96%(47/96)和93.33%(70/75)。X線圖像紋理分析結果顯示腋窩淋巴結轉移組能量、熵、逆差距、自相關值均高于非轉移組,慣量、反差值均低于非轉移組(P均0.05);其余紋理特征參數(shù)值兩組間差異無統(tǒng)計學意義(P均0.05)。紋理參數(shù)值能量、熵、慣量、逆差距、自相關和反差診斷腋窩淋巴結轉移的ROC曲線下面積(AUC)值分別為0.610、0.610、0.374、0.599、0.612和0.421(P均0.05)。乳腺X線檢查、紋理特征及X線聯(lián)合紋理特征診斷腋窩淋巴結轉移的AUC值分別為0.711、0.676和0.787(P均0.05);紋理特征、乳腺X線聯(lián)合紋理特征診斷腋窩淋巴結轉移的敏感度分別為62.5%和64.6%,特異度分別為66.7%和82.7%。結論乳腺X線圖像紋理參數(shù)對腋窩淋巴結轉移有一定的預測作用,且乳腺X線聯(lián)合紋理特征可提高對腋窩淋巴結轉移的診斷效能。
[Abstract]:Objective to evaluate the value of mammographic texture features in predicting axillary lymph node metastasis of breast cancer.Methods the X-ray and clinical data of 171 cases of non-special invasive breast cancer confirmed by pathology were retrospectively analyzed.All patients underwent axillary lymph node dissection and were divided into axillary lymph node metastasis group and non-metastasis group according to the surgical and pathological results.The texture features of the patients were analyzed. The mean value, standard deviation, deviation, kurtosis, variance, energy, entropy, autocorrelation, inertia were measured by gray histogram and gray co-occurrence matrix texture analysis.Inverse disparity and contrast are 11 texture parameters.Results among 171 cases, 96 cases were lymph node metastasis group, 75 cases were non-metastasis group, 119 cases were axillary lymph node negative, 52 cases were positive.The sensitivity and specificity of the diagnosis of axillary lymph node metastasis were 48.96 / 96) and 93.33% 70 / 75 / 75, respectively. The results of texture analysis showed that the energy, entropy, inverse difference and autocorrelation of axillary lymph node metastasis group were higher than those of non-metastasis group.The contrast value was lower than that in the non-transfer group (P < 0.05), while the other texture parameters had no significant difference between the two groups (P < 0.05).The values of energy, entropy, inertia, inverse disparity, autocorrelation and contrast in the ROC curve of texture parameters for diagnosis of axillary lymph node metastasis were 0. 610 ~ 0. 610 ~ 0. 374 ~ 0. 599 ~ 0. 612 and 0. 421 ~ (-1) P respectively.The AUC values of mammography, texture feature and X-ray combined texture feature in diagnosis of axillary lymph node metastasis were 0.7110.676 and 0.787 (P < 0.05), respectively.The sensitivity of mammography combined with texture in the diagnosis of axillary lymph node metastasis was 62.5% and 64.6%, and the specificity was 66.7% and 82.7%, respectively.Conclusion the texture parameters of mammography can predict axillary lymph node metastasis to some extent, and the combination of mammography and texture features can improve the diagnostic efficiency of axillary lymph node metastasis.
【作者單位】： 河南省人民醫(yī)院放射科;河南省神經(jīng)疾病影像診斷與研究重點實驗室;河南省臨床大數(shù)據(jù)分析與服務工程研究中心;
【基金】：國家自然科學基金(81401378)
【分類號】：R730.44;R737.9

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