本文選題：亞實(shí)性結(jié)節(jié)　切入點(diǎn)：腺癌　出處：《中國肺癌雜志》2017年05期 　論文類型：期刊論文

【摘要】：背景與目的肺內(nèi)亞實(shí)性結(jié)節(jié)(subsolid nodule,SSN)實(shí)性成分的識(shí)別與定量對(duì)SSN的鑒別診斷,病理預(yù)測(cè)和預(yù)后評(píng)估具有重要價(jià)值,但目前缺乏公認(rèn)且客觀的標(biāo)準(zhǔn)。本研究旨在應(yīng)用計(jì)算機(jī)斷層掃描(computed tomography,CT)閾值分割方法確定用于SSN實(shí)性成分識(shí)別與定量的最佳閾值。方法回顧性分析102例SSN的CT圖像。由觀察者確定SSN內(nèi)是否存在實(shí)性成分并借助軟件確定實(shí)性成分的體積,以此作為參照標(biāo)準(zhǔn)。應(yīng)用CT閾值分割方法對(duì)所有SSN進(jìn)行分析,測(cè)量其內(nèi)不同CT閾值對(duì)應(yīng)的體素體積,假定該體積即為實(shí)性成分體積,計(jì)算實(shí)性成分與結(jié)節(jié)整體的體積比率。所得結(jié)果與相應(yīng)參照標(biāo)準(zhǔn)進(jìn)行比較,應(yīng)用受試者工作特征曲線及Wilcoxon檢驗(yàn)篩選最佳閾值。結(jié)果閾值設(shè)為-250 HU時(shí),識(shí)別SSN內(nèi)實(shí)性成分的診斷價(jià)值最大(曲線下面積為0.982),以體積比率1.10%作為確認(rèn)實(shí)性成分存在的界限值,其診斷效能最高。閾值設(shè)為-300 HU時(shí)診斷效能次之,對(duì)應(yīng)曲線下面積和體積比率界限值分別為0.977、6.14%。閾值設(shè)為-250 HU、-300 HU時(shí)所得實(shí)性成分中位體積分別為202.7 mm~3(598.2 mm~3)、247.1 mm~3(696.0 mm~3),與參照標(biāo)準(zhǔn)199.5 mm~3(743.1mm~3)間無顯著差異(P=0.125,1,0.061,3)。結(jié)論 CT閾值分割方法可對(duì)SSN實(shí)性成分進(jìn)行準(zhǔn)確識(shí)別與定量,閾值可設(shè)為-250 HU或-300 HU。
[Abstract]:Background & objective the identification and quantification of solid components of subsolid nodules of the lung have important value in differential diagnosis, pathological prediction and prognosis evaluation of SSN. The purpose of this study is to determine the best threshold for identifying and quantifying real components of SSN by using computed tomography threshold segmentation method. Methods the CT images of 102 cases of SSN were retrospectively analyzed. . the observer determines whether there is a real component in the SSN and the volume of the real component is determined by software, Using CT threshold segmentation method to analyze all SSN and measure the volume of voxels corresponding to different CT thresholds, the volume is assumed to be the volume of real components. The volume ratio of solid components to the whole nodule was calculated. The results were compared with the corresponding reference criteria. The optimal threshold was screened by using the operating characteristic curve and Wilcoxon test. When the threshold value was -250HU, the optimal threshold was obtained. The diagnostic value of identifying the real components in SSN is the greatest (the area under the curve is 0.982g). The diagnostic effectiveness is the highest when the volume ratio is 1.10%, and the diagnostic efficacy is the second when the threshold is -300HU. The threshold values of area and volume ratio under the corresponding curve are 0.977 鹵6.14, respectively. When the threshold value is -250hu -300HU, the median volume of solid component is 202.7 mm~3(598.2 / mm, respectively, and there is no significant difference between the threshold value of real component and the reference standard (199.5 mm~3(598.2 / 3). Conclusion CT threshold segmentation method can be used for CT segmentation. Accurate identification and quantification of SSN real components, The threshold can be set to -250 Hu or -300 Hu.
【作者單位】： 天津醫(yī)科大學(xué)總醫(yī)院醫(yī)學(xué)影像科;
【基金】：國家自然科學(xué)基金面上項(xiàng)目(No.81171345) 中央補(bǔ)助地方公共衛(wèi)生專項(xiàng)資金肺癌早診早治項(xiàng)目 高等學(xué)校博士學(xué)科點(diǎn)專項(xiàng)科研基金(No.20121202110005)資助~~
【分類號(hào)】：R730.44;R734.2

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