小儿MB、PA和室管膜细胞瘤的灰度直方图分析
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摘要
目的分析T_2加权像(T_2WI)全域灰度直方图在小儿髓母细胞瘤(MB)、毛细胞星形细胞瘤(PA)和室管膜细胞瘤鉴别诊断中的价值。方法采用回顾性研究,收集2014年1月至2018年7月浙江省丽水市中医院、丽水市人民医院72例后颅窝肿瘤患儿,按病情分为MB组(27例)、PA组(19例)、室管膜细胞瘤组(26例)。比较三组患儿磁共振成像(MRI)中T_2WI灰度全域直方图参数特征的差异,分析T_2WI灰度全域直方图参数特征在鉴别小儿MB、PA和室管膜细胞瘤中的诊断价值。结果三组患儿T_2WI灰度全域直方图峰度、均值、偏度和变异度的比较差异均存在统计学意义(F值分别为82.27、11.94、56.73、60.90,均P<0.01)。峰度在鉴别和诊断小儿MB与室管膜细胞瘤中的受试者工作特征(ROC)曲线下面积最大为0.92,其敏感度为88.46%,特异度为92.59%;峰度在鉴别和诊断小儿MB与PA中的ROC曲线下面积最大为0.96,其敏感度为96.30%,特异度为94.74%;偏度在鉴别和诊断小儿PA与室管膜细胞瘤中的ROC曲线下面积最大为0.75,其敏感度为73.68%,特异度为73.08%。结论 T_2WI全域灰度直方图分析是鉴别与诊断小儿MB、PA和室管膜细胞瘤的重要方法,峰度在鉴别小儿MB与室管膜细胞瘤中具有较高的诊断价值,偏度、变异度在小儿MB与PA中具有较高的诊断价值,而偏度在小儿PA与室管膜细胞瘤中的诊断价值较高。
Objective To analyze the value of T_2-weighted image(T_2WI) global gray histogram in differential diagnosis of medulloblastoma(MB), pilocytic astrocytoma(PA) and ependymoma in children. Methods A retrospective study was conducted to collect 72 children with posterior cranial fossa tumors admitted in Lishui Traditional Chinese Medicine Hospital and Lishui People's Hospital from January 2014 to July 2018. They were divided into MB group(27 cases), PA group(19 cases) and ependymoma group(26 cases) in accordance with condition of diseases. Differences of parameters of T_2WI global gray histogram in three groups of children's magnetic resonance imaging(MRI) were compared, and diagnostic value of parameters of T_2WI global gray histogram in differentiating children's MB, PA and ependymoma was analyzed. Results There were significant differences in kurtosis, mean, skewness and variability of global gray histogram of T_2WI among three groups(F value was 82.27, 11.94, 56.73 and 60.90, respectively, all P<0.01). Maximum area under receiver operating characteristic(ROC) curve of kurtosis in differentiating children's MB and ependymoma was 0.92 with sensitivity of 88.46% and specificity of 92.59%. Maximum area under ROC curve of kurtosis in differentiating children's MB and PA was 0.96 with sensitivity of 96.30% and specificity of 94.74%. Maximum area under ROC curve of skewness in differentiating children's PA and ependymoma was 0.75 with sensitivity of 73.68% and specificity of 73.08%. Conclusion Global gray histogram analysis of T_2WI is an important method for differentiating and diagnosing MB, PA and ependymoma in children. Kurtosis shows high diagnostic value in differentiating MB from ependymoma in children, skewness and variability show high diagnostic value in MB and PA, and skewness shows high diagnostic value in PA and ependymoma in children.
Objective To analyze the value of T_2-weighted image(T_2WI) global gray histogram in differential diagnosis of medulloblastoma(MB), pilocytic astrocytoma(PA) and ependymoma in children. Methods A retrospective study was conducted to collect 72 children with posterior cranial fossa tumors admitted in Lishui Traditional Chinese Medicine Hospital and Lishui People's Hospital from January 2014 to July 2018. They were divided into MB group(27 cases), PA group(19 cases) and ependymoma group(26 cases) in accordance with condition of diseases. Differences of parameters of T_2WI global gray histogram in three groups of children's magnetic resonance imaging(MRI) were compared, and diagnostic value of parameters of T_2WI global gray histogram in differentiating children's MB, PA and ependymoma was analyzed. Results There were significant differences in kurtosis, mean, skewness and variability of global gray histogram of T_2WI among three groups(F value was 82.27, 11.94, 56.73 and 60.90, respectively, all P<0.01). Maximum area under receiver operating characteristic(ROC) curve of kurtosis in differentiating children's MB and ependymoma was 0.92 with sensitivity of 88.46% and specificity of 92.59%. Maximum area under ROC curve of kurtosis in differentiating children's MB and PA was 0.96 with sensitivity of 96.30% and specificity of 94.74%. Maximum area under ROC curve of skewness in differentiating children's PA and ependymoma was 0.75 with sensitivity of 73.68% and specificity of 73.08%. Conclusion Global gray histogram analysis of T_2WI is an important method for differentiating and diagnosing MB, PA and ependymoma in children. Kurtosis shows high diagnostic value in differentiating MB from ependymoma in children, skewness and variability show high diagnostic value in MB and PA, and skewness shows high diagnostic value in PA and ependymoma in children.
引文
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[2]D’Arco F,Khan F,Mankad K,et al.Differential diagnosis of posterior fossa tumours in children:new insights[J].Pediatr Radiol,2018,48(13):1955-1963.
[3]Wagner M W,Narayan A K,Bosemani T,et al.Histogram analysis of diffusion tensor imaging parameters in pediatric cerebellar tumors[J].J Neuroimaging,2016,26(3):360-365.
[4]Ren J L,Yuan Y,Li X X,et al.Histogram analysis of apparent diffusion coefficient maps in the prognosis of patients with locally advanced head and neck squamous cell carcinoma:comparison of different region of interest selection methods[J].Eur J Radiol,2018,106(1):7-13.
[5]Woo S,Cho J Y,Kim S Y,et al.Histogram analysis of apparent diffusion coefficient map of diffusion-weighted MRI in endometrial cancer:a preliminary correlation study with histological grade[J].Acta Radiol,2014,55(10):1270-1277.
[6]Suo S T,Chen X X,Fan Y,et al.Histogram analysis of apparent diffusion coefficient at 3.0 T in urinary bladder lesions:correlation with pathologic findings[J].Acad Radiol,2014,21(8):1027-1034.
[7]Surov A,Meyer H J,Leifels L,et al.Histogram analysis parameters of dynamic contrast-enhanced magnetic resonance imaging can predict histopathological findings including proliferation potential,cellularity,and nucleic areas in head and neck squamous cell carcinoma[J].Oncotarget,2018,9(30):21070-21077.
[8]Wang W,Cheng J,Zhang Y,et al.Use of apparent diffusion coefficient histogram in differentiating between medulloblastoma and pilocytic astrocytoma in children[J].Med Sci Monit,2018,24(1):6107-6112.