超声影像纹理分析预测甲状腺癌颈部淋巴结转移的价值-东南大学学报医学版

超声影像纹理分析预测甲状腺癌颈部淋巴结转移的价值

单位：江苏省人民医院浦口分院超声科, 江苏南京 211800

分类号：R736.1;R445.1

出版年·卷·期（页码）：2021·40·第二期（219-224）

摘要：

目的：探讨超声影像纹理分析预测甲状腺癌颈部淋巴结转移的价值。方法：回顾性分析106例经病理证实的甲状腺癌患者的临床资料，所有患者均经颈部淋巴结清扫并根据术后病理结果分为转移组和非转移组，将患者的术前甲状腺超声二维影像导入MaZda 4.6软件中，手动勾画病变的感兴趣区（ROI），分别通过Fisher系数、分类错误概率联合平均相关系数（POE+ACC）、交互信息（MI）以及3种方法的联合（Fisher+POE+ACC+MI）选择最具鉴别价值的纹理特征参数，构建人工神经网络模型（ANN），比较转移组和非转移组甲状腺癌纹理特征的差异，并评估4种纹理分析方法和超声医师的误判率。结果：106例甲状腺癌患者分为转移组39例，非转移组67例。对于总的误判率，Fisher系数、POE+ACC、MI以及3种方法的联合与超声医师的误判率之间差异均无明显统计学意义（χ²值分别为2.652、2.141、0.897、0.175，均P>0.05）。超声医师对转移组的误判率明显高于非转移组（χ²=14.265，P<0.05），但MI和3种方法联合分析对转移组的误判率明显低于超声医师（χ²值分别为5.032、8.705，均P<0.05）。结论：超声影像纹理分析对甲状腺癌颈部淋巴结转移具有很好的预测价值。

Objective: To investigate the value of ultrasonic images texture analysis in predicting the metastasis of cervical lymph node for thyroid carcinoma. Methods: A total of 106 thyroid carcimoma patients were enrolled in this study. All patients underwent cervical lymph node dissection and confirmed by pathology. Then the patients were divided into two groups, including metastasis group and non-metastasis group. The ultrasonic images of the thyroid carcinama were imported into Mazda 4.6 software and reqin of interest (ROIs) were manually drawed. The optimum texture parameters were selected through Fisher coefficient, probability of classification error and average correction coefficient (POE+ACC), Mutual information (MI) and the combination of three methods (Fisher+POE+ACC+MI) respectively.The model of artificial neural network was builded. The difference of texture features between metastasis group and non-metastasis group was compared. And misdiagnostic rates were analyzed between texture analysis and ultrasonic doctors. Results: There was no significant difference in misdiagnosti rates between Fisher coefficient, POE+ACC, MI, Fisher+Poe+ACC+MI and ultrasound doctors (χ² values were 2.652, 2.141, 0.897, 0.175, P>0.05). The misdiagnosis rate of ultrasound doctors in the metastasis group was significantly higher than that in the non metastasis group(χ²=14.265, P<0.05), but in the metastasis group the misdiagnostic rates of MI and three methods combination were significantly lower than that of ultrasound doctors (χ² values were 5.032, 8.705, P<0.05). Conclusion: Ultrasonic images texture analysis has a good predictive value for cervical lymph node metastasis of thyroid carcinoma.

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