ISSN 1004-4140
CN 11-3017/P
李民, 刘长春, 张喆, 周楠, 张建增, 徐辉, 闫玉昌, 赵丽琴. 基于肝段CT影像组学特征评估肝硬化食管静脉曲张程度[J]. CT理论与应用研究, 2021, 30(6): 717-726. DOI: 10.15953/j.1004-4140.2021.30.06.07
引用本文: 李民, 刘长春, 张喆, 周楠, 张建增, 徐辉, 闫玉昌, 赵丽琴. 基于肝段CT影像组学特征评估肝硬化食管静脉曲张程度[J]. CT理论与应用研究, 2021, 30(6): 717-726. DOI: 10.15953/j.1004-4140.2021.30.06.07
LI Min, LIU Changchun, ZHANG Zhe, ZHOU Nan, ZHANG Jianzeng, XU Hui, YAN Yuchang, ZHAO Liqin. Evaluation of the Severity Degree of Esophageal Varices in Cirrhosis Based on Radiomics Features of Hepatic Segment CT Imaging[J]. CT Theory and Applications, 2021, 30(6): 717-726. DOI: 10.15953/j.1004-4140.2021.30.06.07
Citation: LI Min, LIU Changchun, ZHANG Zhe, ZHOU Nan, ZHANG Jianzeng, XU Hui, YAN Yuchang, ZHAO Liqin. Evaluation of the Severity Degree of Esophageal Varices in Cirrhosis Based on Radiomics Features of Hepatic Segment CT Imaging[J]. CT Theory and Applications, 2021, 30(6): 717-726. DOI: 10.15953/j.1004-4140.2021.30.06.07

基于肝段CT影像组学特征评估肝硬化食管静脉曲张程度

Evaluation of the Severity Degree of Esophageal Varices in Cirrhosis Based on Radiomics Features of Hepatic Segment CT Imaging

  • 摘要: 目的:探讨肝硬化患者不同肝段的CT影像组学特征在预测食管静脉曲张(EV)严重程度中的价值。方法:回顾性选取2018年2月至2021年2月间经临床确诊并行胃镜检查的肝硬化门静脉高压EV患者143例,参照胃镜下EV严重程度分成重度组(61例)及非重度组(82例),所有病例于胃镜检查前2周内行肝脏CT增强检查,选择门静脉期图像,应用Shukun Radiomics v94软件,于轴位图像门静脉主干分叉层面按照Couinaud分段提取肝脏尾叶、左外叶、左内叶及右叶(后上段+前上段)影像组学特征,分别建立预测EV程度的模型,对比不同肝段影像组学特征预测EV严重程度的价值。结果:肝硬化患者基于不同肝段CT图像影像组学特征分别建立的预测EV程度的模型均能识别重度与非重度食管静脉曲张,其中右叶上段模型训练集及验证集的AUC值分别为:0.85(0.78~0.92)、0.79(0.64~0.93),尾叶模型训练集及验证集AUC值分别为:0.78(0.69~0.87)、0.62(0.44~0.79);左外叶模型训练集及验证集AUC值分别为:0.80(0.71~0.88)、0.64(0.46~0.82);左内叶模型训练集及验证集AUC值分别为:0.71(0.61~0.81)、0.73(0.58~0.88);以肝右叶模型训练集及验证集的AUC值最大。结论:肝硬化患者不同肝段CT图像影像组学特征均能够鉴别重度食管静脉曲张,肝右叶模型性能最佳。

     

    Abstract: Objective: To investigate the value of CT imaging radiomics features of different hepatic segments in predicting the severity of esophageal varices in cirrhotic patients. Methods: A total of 143 cirrhotic patients with portal hypertension and EV who were clinically confirmed and underwent gastroscopy from February 2018 to February 2021 were retrospectively selected. According to the severity of EV under gastroscopy, they were divided into severe group (61 cases) and non-severe group (82 cases). All patients received enhanced liver CT examination within 2 weeks before gastroscopy examination. The images of portal vein phase were selected and Shukun Radiomics V94 software was applied to extract the image radiomics features of caudate lobe, left lateral lobe, left inner lobe and right lobe (posterior upper segment + anterior upper segment) of liver at the level of bifurcations of portal vein in axial image according to Couinaud segmentation. Models to predict EV degree of different segments were established respectively. The value of radiomic features of different liver segments in predicting EV severity were compared. Results: Both severe and non-severe esophageal varices could be identified by the radiomics models established for predicting EV degree based on the CT imaging features of different hepatic segments in cirrhotic patients. The AUC values of the training set and verification set of the model of upper right lobe were:0.85 (0.78~0.92), 0.79 (0.64~0.93), respectively. That of caudate lobe, left lateral lobe, left inner lobe model training set and validation set were 0.78 (0.69~0.87) and 0.62 (0.44~0.79), 0.80 (0.71~0.88) and 0.64 (0.46~0.82), and 0.71 (0.61~0.81) and 0.73 (0.58~0.88), respectively. The AUC values of training set and validation set were the highest in the right lobe of liver model. Conclusion: All the CT images based radiomics features of different hepatic segments in cirrhotic patients could distinguish severe EV, among which the model of right hepatic lobe produces the best results.

     

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