协和医学杂志

2020, v.11(01) 16-20

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CT纹理分析对腹主动脉瘤腔内修补术后瘤体体积变化的评价意义
Value of CT Texture Analysis for Volumetric Changes of Abdominal Aortic Aneurysm after Endovascular Repair

郝云秀;王志伟;薛华丹;金征宇;
HAO Yun-xiu;WANG Zhi-wei;XUE Hua-dan;JIN Zheng-yu;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

目的探讨CT纹理分析对腹主动脉瘤腔内修补术(endovascular aneurysm repair,EVAR)后瘤体体积变化的评价意义。方法回顾性收集2014年7月至2019年6月于北京协和医院放射科行腹盆部增强CT血管造影(computed tomography angiography,CTA)随访的EVAR术后患者的临床及影像学资料,患者于术后第3、12个月分别接受两次腹盆部CTA检查,以传统测量方法为分组依据,根据动脉瘤体积变化情况将患者分为动脉瘤体积增大组和体积未增大组。采用分割软件,手动勾勒所有动脉瘤术后第1次随访时轴位最大截面,提取动脉瘤支架外血栓部分的纹理特征,同时采用灰度共生矩阵(grey level co-occurrence matrix,GLCM)、灰度游程矩阵(grey level run length matrix,GLRLM)和灰度差分矩阵(grey level difference matrix,GLDM) 3种方法,分析其与动脉瘤体积增大的关系。结果共70例符合纳入和排除标准的患者入选本研究,其中29例(41. 4%,29/70) EVAR术后腹主动脉瘤体积增大,41例(58. 6%,41/70)瘤体未增大。GLCM、GLRLM和GLDM 3种方法预测动脉瘤体积增大的曲线下面积分别为0. 892、0. 888和0. 800,GLCM的预测效能最佳,灵敏度和特异度分别为86. 2%和85. 4%,GLDM的曲线下面积最小,灵敏度和特异度分别为86. 2%和68. 3%。结论 CT纹理分析能有效预测EVAR术后动脉瘤的体积变化。
Objective The aim of this study was to investigate the value of CT texture analysis for volumetric changes of abdominal aortic aneurysm( AAA) after endovascular aneurysm repair( EVAR). Methods Clinical and imaging data of patients with AAA undergoing CT angiography( CTA) at the 3 rd and 12 th months after EVAR in the Department of Radiology,Peking Union Medical College Hospital between July 2014 and June 2019 were retrospectively collected. Using the traditional measurement as the grouping basis,patients were divided into increased and no-increased groups according to the volume changes during the follow-up. Segmentation software was used to manually outline the maximum axial sections of all aneurysms and extract the texture features of the thrombus. The grey level co-occurrence matrix( GLCM),the grey level run length matrix( GLRLM),and the grey level difference matrix( GLDM) were calculated to analyzed their relationship with the enlargement of the aneurysm volume. Results A total of 70 patients meeting the inclusive and exclusive criteria were enrolled in this study,29 cases( 41. 4%,29/70) in the increased group and 41( 58. 6%,41/70) in the non-increased group. The areas under the ROC curve of GLCM,GLRLM,and GLDM for the diagnosis of increased volumes were 0. 892,0. 888,and 0. 800,respectively. The best prediction efficiency was shown in GLCM with the sensitivity and specificity of 86. 2% and 85. 4% respectively. GLDM had the worst pridiction efficiency with a sensitivity of 86. 2% and a specificity of 68. 3%. Conclusion CT texture analysis might predict the volumetric change of AAA after EVAR.

关键词(KeyWords): 纹理分析;腹主动脉瘤;体积;腔内修补术
texture analysis;abdominal aortic aneurysm;volume;endovascular aneurysm repair

Abstract:

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基金项目(Foundation): 中央级公益性科研院所基本科研项目(2017PT32004);; 国家自然科学基金(81401496)

作者(Author): 郝云秀;王志伟;薛华丹;金征宇;
HAO Yun-xiu;WANG Zhi-wei;XUE Hua-dan;JIN Zheng-yu;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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