CT纹理分析预测下肢肌肉缺血的可行性研究

发布时间：2018-03-05 15:32

本文选题：下肢动脉　切入点：外周动脉闭塞性疾病　出处：《放射学实践》2017年12期 　论文类型：期刊论文

【摘要】：目的:探讨使用CT纹理分析评估下肢动脉闭塞性疾病所致下肢肌肉缺血的可行性。方法:30例单侧下肢动脉闭塞性疾病患者中,15例伴侧支循环形成,15例不伴侧支循环形成。所有患者行双下肢动脉CTA检查,使用TexRad商业研究软件进行图像分析和后处理,空间缩放因子(SSF)分别取0~6,测量闭塞动脉起始层面、中间层面及结束层面以及对侧下肢相应层面上肌肉的6个纹理参数,包括灰度强度平均值、正像素平均值(MPP)、熵、标准差(SD)、偏度和峰度,对两组间各参数值的差异进行统计学分析。结果:在SSF取0和2~6条件下闭塞侧下肢肌肉的SD分别为17.0、117.1、193.3、290.2、363.2、439.0,均高于未闭塞侧对应值(16.4、101.0、179.0、242.4、298.3和350.7),差异均有统计学意义(P0.05);闭塞侧下肢肌肉的熵分别为4.1、5.5、5.8、6.1、6.4和6.7,分别高于未闭塞侧对应值(4.0,5.4,5.7,6.0,6.3和6.6),差异均有统计学意义(P0.05)。在SFF为0时,闭塞侧下肢肌肉的偏度和峰度均低于未闭塞侧(偏度分别为2.2和3.2;峰度分别为24.3和26.7)。SSF=5时SD值的阈值取333.4时的ROC曲线下面积(AUC)最大(0.75,95%CI 0.70~0.85),诊断敏感度为69.0%、特异度为68.1%。而在SFF分别取0~6时,侧支循环组与无侧支循环组的6个纹理参数间的差异均无统计学意义(P0.05)。结论:CT纹理分析可以作为一个辅助诊断手段对下肢动脉闭塞性疾病下肢肌肉的血供情况进行评价。
[Abstract]:Objective: to evaluate the feasibility of using CT texture analysis to evaluate lower extremity muscle ischemia caused by arterial occlusive disease of lower extremity. Methods: 15 cases of 15 patients without collateral circulation formation of collateral circulation in 30 patients with unilateral arterial occlusion disease of lower extremity were studied. All patients underwent CTA examination of the lower extremity arteries. TexRad commercial research software was used for image analysis and post-processing. The spatial scaling factor (SSF6) was used to measure the six texture parameters of muscle on the initial, middle and end layers of occlusive artery, and on the corresponding level of contralateral lower extremity. It includes the average gray intensity, the average positive pixel, the entropy, the standard deviation, the bias and the kurtosis. Results: the SD of the lower extremity muscle of the occluded side was 17.0117.1 / 293.290.2363.2439.0 respectively under the condition of 0 and 2 of SSF, which was higher than the corresponding value of the non-occlusive side (16.4) 101.0179.0242.4298.3 and 350.7, respectively (P 0.05). The entropy of lower extremity muscle was 4.1U 5.5g 5.8g 6.1g 6.4 and 6.7, respectively, which was higher than that of non-occlusive side by 4.0g 5.45.7C 6.0C and 6.6g, respectively. The difference was statistically significant (P 0.05). The SFF was 0:00, and the difference was significant (P < 0.05), and the difference was significant (P < 0.05), and the difference was significant (P < 0.05). The deviation and kurtosis of the obliterated lower extremity muscle were lower than those of the unoccluded side (deviations were 2.2 and 3.2, respectively; the threshold values of kurtosis 24.3 and 26.7U 路SSF = 5:00 SD = 333.4), the maximum area under the ROC curve was 333.4, the diagnostic sensitivity was 69.0 and the specificity was 68.1. In SFF, 0 ~ 6:00, There was no significant difference in the six texture parameters between the collateral circulation group and the non-collateral circulation group (P 0.05). Conclusion the blood supply of lower extremity muscle with arterial occlusive disease of lower extremity can be evaluated by using the texture analysis of 1% CT as an auxiliary diagnostic tool.
【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;
【基金】：卫生公益性行业科研专项项目(201402019)
【分类号】：R543.5;R816.2

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