纹理分析在前庭神经鞘瘤和桥脑小脑角脑膜瘤鉴别中的应用价值
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摘要
目的探讨磁共振成像(MRI)的三维纹理和形状特征在前庭神经鞘瘤和桥脑小脑角脑膜瘤鉴别诊断中的价值。方法回顾性分析2011年1月至2018年11月徐州医科大学附属医院收治的35例前庭神经鞘瘤和桥脑小脑角脑膜瘤患者的临床资料。采用基于核磁共振成像(MRI)的三维纹理和形状分析评价两种恶性肿瘤的可检测性差异。用单因素独立t检验和受试者操作特性(ROC)曲线分析计算相应的敏感性、特异性、准确性和曲线下面积(AUC)。结果从T1加权像中提取均数、异质性、偏度、丰度等特征,发现异质性和偏度具有较高的鉴别能力。最佳预测因子是异质性(AUC=0. 87),其次是偏度(AUC=0. 72)。异质性的灵敏度和特异性分别为0. 84和0. 75,偏度的结果分别为0. 74和0. 63。结论纹理分析的异质性、偏度参数结合常规MRI平扫表现,对鉴别前庭神经鞘瘤和桥脑小脑角脑膜瘤具有一定的临床应用价值。
Objective To explore the value of three-dimensional texture and shape features of magnetic resonance imaging( MRI) in the differential diagnosis of vestibular schwannoma and cerebellopontine angle meningioma. Methods The data of 35 patients were retrospectively analyzed,of whom 19 patients with vestibular schwannoma and 16 patients with cerebellopontine angle meningioma. Three-dimensional texture and shape analysis based on MRI was used to evaluate the detectable differences between the two malignancies. Single factor independent t test and receiver operating characteristic( ROC) curve were used to analyze and calculate the corresponding sensitivity,specificity,accuracy and area under the curve( AUC). Results The characteristics of mean,heterogeneity,skewness and kurtosis were extracted from T1 images,the results showed that the heterogeneity and skewness had high identified ability. The best predictive factor was heterogeneity( AUC = 0. 87),the skewness followed closely( AUC = 0. 72). The sensitivity and specificity of inhomogeneity were 0. 84 and 0. 75,and the skewness were 0. 74 and 0. 63,respectively. Conclusion Texture analysis of inhomogeneity and skewness parameters combined with conventional MRI plain scan manifestations has certain clinical application value for the differentiation of vestibular schwannoma and cerebellopontine angle meningioma.
Objective To explore the value of three-dimensional texture and shape features of magnetic resonance imaging( MRI) in the differential diagnosis of vestibular schwannoma and cerebellopontine angle meningioma. Methods The data of 35 patients were retrospectively analyzed,of whom 19 patients with vestibular schwannoma and 16 patients with cerebellopontine angle meningioma. Three-dimensional texture and shape analysis based on MRI was used to evaluate the detectable differences between the two malignancies. Single factor independent t test and receiver operating characteristic( ROC) curve were used to analyze and calculate the corresponding sensitivity,specificity,accuracy and area under the curve( AUC). Results The characteristics of mean,heterogeneity,skewness and kurtosis were extracted from T1 images,the results showed that the heterogeneity and skewness had high identified ability. The best predictive factor was heterogeneity( AUC = 0. 87),the skewness followed closely( AUC = 0. 72). The sensitivity and specificity of inhomogeneity were 0. 84 and 0. 75,and the skewness were 0. 74 and 0. 63,respectively. Conclusion Texture analysis of inhomogeneity and skewness parameters combined with conventional MRI plain scan manifestations has certain clinical application value for the differentiation of vestibular schwannoma and cerebellopontine angle meningioma.
引文
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[20]钱银锋,张诚,宫希军,等.增强FLAIR成像在听神经瘤诊断和鉴别诊断中的价值[J].中国医学影像技术,2008,24(1):33-36.doi:10.3321/j.issn:1003-3289.2008.01.010.
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[22]Park CK,Kim DC,Park SH,et al.Microhemorrhage,a possible mechanism for cyst formation in vestibular schwannomas[J].J Neurosurg,2006,105:576-580.doi:10.3171/jns.2006.105.4.576.
[23]Bonneville F,Savatovsky J.Imaging of cerebellopontine angle lesions:an update.Part 1:enhancing extra-axial lesions[J].Eur Radiol,2007,17:2472-2482.doi:10.1007/s00330-007-0679-x.
[2]Ishikawa K,Haneda J.Decreased vestibular signal intensity on 3D-FI-ESTA in vestibular schwannomas differentiating from meningiomas[J].Neuroradiology,2013,55(3):261-270.doi:10.1007/s00234-012-1100-2.
[3]陈怀宾,张健,衡雪源,等.脑膜瘤硬膜尾征的研究进展[J].中华神经医学杂志,2014,13(6):643-644.doi:10.3760/cma.j.issn.1671-8925.2014.06.024.
[4]余滋润.变换不变低秩纹理特征提取与恢复算法的研究[D].安徽大学,2017.
[5]Mayerhoefer ME,Schima W,Trattnig S,et al.Texture-based classification of focal liver lesions on MRI at 3.0 Tesla:a feasibility study in cysts and hemangiomas[J].J Magn Reson Imaging,2010,32:352-359.doi:10.1002/jmri.22268.
[6]Holli K,Laaperi AL,Harrison L,et al.Characterization of breast cancer types by texture analysis of magnetic resonance images[J].Acad Radiol,2010,17(2):135-141.doi:10.1016/j.acra.2009.08.012.
[7]Yan PF,Yan L,Hu TT,et al.The potential value of preoperative MRItexture and shape analysis in grading meningiomas:a preliminary investigation[J].Transl Oncol,2017,10:570-577.doi:10.1016/j.tranon.2017.04.006.
[8]Waugh SA,Purdie CA,Jordan LB,et al.Magnetic resonance imaging texture analysis classification of primary breast cancer[J].Eur Radiol,2016,26(2):322-330.doi:10.1007/s00330-015-3845-6.
[9]Sogawa K,Nodera H,Takamatsu N,et al.Neurogenic and myogenic diseases:quantitative texture analysis of muscle US data for differentiation[J].Radiology,2017,283(2):492-498.doi:10.1148/radiol.2016160826.
[10]Hainc N,Stippich C,Stieltjes B,et al.Experimental texture analysis in glioblastoma:a methodological study[J].Invest Radiol,2017,52:367-373.doi:10.1097/RLI.0000000000000354.
[11]Ng F,Kozarski R,Ganeshan B.Assessment of tumor heterogeneity by CT texture analysis:can the largest cross-sectional area be used as an alternative to whole tumor analysis[J].Eur J Radiol,2013,82:342-348.doi:10.1016/j.ejrad.2012.10.023.
[12]Suoranta S,Holli-Helenius K,Koskenkorva P,et al.3D texture analysis reveals imperceptible MRI textural alterations in the thalamus and putamen in progressive myoclonic epilepsy type 1,EPM1[J].PLo S One,2013,8:e69905.doi:10.1371/journal.pone.0069905.
[13]岑武.桥小脑角肿瘤切除术中神经电生理监测保护面神经的应用[J].医药前沿,2015,5(9):306-307.doi:10.3969/j.issn.2095-1752.2015.09.255.
[14]刘付广.桥小脑角区肿瘤MR诊断价值[J].医学信息,2015,(26):320-320.doi:10.3969/j.issn.1006-1959.2015.26.506.
[15]Voss NF,Vrionis FD,Heilman CB.Meningiomas of the cerebellopontine angle[J].Surg Neurol,2000,53:439-446.
[16]徐庚,魏宇魁,杜建新,等.小脑幕脑膜瘤显微外科治疗[J].中国医刊,2016,51(2):60-63.doi:10.3969/j.issn.1008-1070.2016.02.019.
[17]Lalwani AK.Preoperative differentiation between meningioma of the cerebellopontine angle and acoustic neuroma using MRI[J].Otolaryngol Head Neck Surg,1993,109:88-95.
[18]Grey PL,Moffat DA.Surgical results in unusual cerebellopontine angle tumours[J].Clin Otolaryngol Allied Sci,1996,21:237-243.
[19]沈爱国,夏雷,张宏伟,等.MRI液平显像对囊性前庭神经鞘瘤手术效果的评价[J].中国综合临床,2014,30(11):1194-1196.10.3760/cma.j.issn.1008-6315.2014.11.024.
[20]钱银锋,张诚,宫希军,等.增强FLAIR成像在听神经瘤诊断和鉴别诊断中的价值[J].中国医学影像技术,2008,24(1):33-36.doi:10.3321/j.issn:1003-3289.2008.01.010.
[21]Thomas B,Somasundaram S,Thamburaj K,et al.Clinical applications of susceptibility weighted MR imaging of the brain:a pictorial review[J].Neuroradiology,2008,50:105-116.doi:10.1007/s00234-007-0316-z.
[22]Park CK,Kim DC,Park SH,et al.Microhemorrhage,a possible mechanism for cyst formation in vestibular schwannomas[J].J Neurosurg,2006,105:576-580.doi:10.3171/jns.2006.105.4.576.
[23]Bonneville F,Savatovsky J.Imaging of cerebellopontine angle lesions:an update.Part 1:enhancing extra-axial lesions[J].Eur Radiol,2007,17:2472-2482.doi:10.1007/s00330-007-0679-x.