定量CT纹理分析鉴别诊断透明细胞型与非透明细胞型肾癌

摘要

目的 探讨定量CT纹理分析鉴别透明细胞型肾癌和非透明细胞型肾癌的可行性.方法 回顾性分析100个透明细胞型肾癌和27个非透明细胞型肾癌病灶的CT图像,应用TexRAD软件分析各扫描期相两种类型肾癌的纹理特征.结果 增强图像上,非透明细胞型肾癌的平均灰度值、标准差、熵、正像素的平均值明显低于透明细胞型肾癌,而峰度高于透明细胞型肾癌(P均＜0.001),偏度差异无统计学意义(P＞0.05).在皮髓质期的粗糙纹理上,正像素的平均值鉴别两种类型肾癌的ROC曲线下面积为0.92±0.04,敏感度为0.85,特异度为0.93,准确率为0.87.结论 透明细胞型肾癌与非透明细胞型肾癌的CT纹理特征间存在显著差异,定量CT纹理分析鉴别诊断这两种类型肾癌具有临床价值.%Objective To explore the value of CT texture analysis (CTTA) in differential diagnosis of non clear-cell renal cell carcinoma (non-ccRCC) and clear-cell renal cell carcinoma (ccRCC).Methods A total of 100 ccRCC and 27 nonccRCC lesions were retrospectively analyzed.CTTA was performed on multiphasic CT images by using TexRAD software,and texture features were compared between ccRCC and non-ccRCC.Results Compared with ccRCC,the mean and standard deviation,entropy as well as the mean of positive pixels (MPP) were significantly lower,while kurtosis was higher in non-ccRCC lesions on enhanced CT images (P＜0.001).No significant difference was observed in skewness between nonccRCC and ccRCC (P＞0.05).MPP at coarse texture scale on corticomedullary images identified non-ccRCC from ccRCC with an AUC of 0.92±0.04,the sensitivity was 0.85,specificity was 0.93 and accuracy was 0.87.Conclusion There are significant differences in CTTA parameters between non-ccRCC and ccRCC.CTTA has clinical value in differential diagnosis of non-ccRCC and ccRCC.