摘要
目的探讨基于多模态磁共振成像(MRI)的影像组学特征在肝恶性肿瘤与肝良性富血供病变鉴别诊断中的应用价值。方法选择上海健康医学院附属崇明医院外科2023年1月至2024年6月收治的肝恶性肿瘤50例和肝良性富血供病变60例作为研究对象。提取T2加权成像(T_(2)WI)和扩散加权成像(DWI)的影像组学特征,并结合临床风险因素,利用多元逻辑回归和5-FCV建立诺模图模型。通过受试者工作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)评估模型的效能。结果肝恶性肿瘤组的男性比例、年龄、合并肝硬化、肿瘤直径、甲胎蛋白(AFP)和血管内皮生长因子(VEGF)水平分别为70.00%、(65.1±5.0)岁、40.00%、(5.06±1.02)cm、(100.01±50.06)ng/mL、(5.01±1.56)pg/mL,高于肝良性富血供病变组的48.33%、(50.3±14.5)岁、5.00%、(3.04±1.06)cm、(5.14±1.02)ng/mL、(2.02±0.01)pg/mL,差异均有统计学意义(t/χ^(2)值分别为4.510、6.862、5.337、10.123、14.710、14.860,均P<0.05)。多因素分析显示,男性比例、年龄、肝硬化病史、肿瘤直径、AFP和VEGF升高为肝恶性肿瘤的独立预测因子(95%CI分别为1.295~1.570、0.923~1.146、1.517~1.748、1.159~1.405、1.826~2.269、2.058~2.536,均P<0.05)。训练集和测试集的校准曲线展示两者基本重合,DCA显示模型在区分肝恶性肿瘤与肝良性富血供病变方面具有临床应用价值。结论多模态MRI影像组学特征在肝恶性肿瘤与肝良性富血供病变鉴别诊断中具有重要应用价值,结合临床风险因素的预测模型能够有效区分肝恶性肿瘤和肝良性富血供病变,具有良好的临床应用前景。
Objective To explore the application value of multimodalnuclear magnetic resonance(MRI)based imaging features in the differential diagnosis of malignant hepatic tumor and benign rich of blood supply hepatic lesions.Methods A total of 50 cases of hepatic malignant tumor(liver cancer group)and 60 cases of benign rich of blood supply hepatic lesions(liver hypertrophic lesion group)were selected from the Surgical Department of Chongming Hospital Affiliated to Shanghai Health Medical College from January 2023 to June 2024.The image omics features of T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)were extracted,and combined with clinical risk factors.Multiple logistic regression and 5-FCV were used to establish a nomogram model.The model performance was evaluated by receiver operating characteristic(ROC)curve,calibration curve and decision-curve-analysis(DCA)method.Results The male ratio,age,cirrhosis,tumor diameter,alpha fetoprotein(AFP)and vascular endothelial growth gactor(VEGF)levels in the liver cancer group were 70.00%,(65.1±5.0)years old,40.00%,(5.06±1.02)cm,(100.01±50.06)ng/mL,and(5.01±1.56)pg/mL,respectively,which were higher than those of 48.33%,(50.3±14.5)years old,5.00%,(3.04±1.06)cm,(5.14±1.02)ng/mL,and(2.02±0.01)pg/mL in the benign liver hypertrophic lesion group.The differences were statistically significant(t/χ^(2)=4.510,6.862,5.337,10.123,14.710,14.860,all P<0.05).A multi-factor analysis showed that male,age,history of cirrhosis,tumor diameter,increased AFP and VEGF levels were independent predictors of liver malignancy(95%CI:1.295~1.570,0.923~1.146,1.517~1.748,1.159~1.405,1.826~2.269,2.058~2.536,95%CI;1.295~1.570,0.923~1.146,1.517~1.748,1.159~1.405,1.826~2.269,2.058~2.536).All(P<0.O5).The calibration curves of the training set and the test set show that the two are basically identical,and the DCA display model has clinical application value in distinguishing liver malignant tumor from benign rich of blood supply hepatic lesions.Conclusion Multimodal MRI imaging features have important application value in the differential diagnosis of liver malignant tumors from benign hypertrophic liver lesions.The prediction model combined with clinical risk factors can effectively distinguish liver malignant tumors and benign hypertrophic liver lesions,and has a good clinical application prospect.
作者
黄磊
李君
胡刚峰
章波
HUANG Lei;LI Jun;HU Gang-feng;ZHANG Bo(Department of Surgery,Chongming Hospital,Shanghai Health Medical College,Shanghai 202150,China)
出处
《肝脏》
2025年第11期1492-1497,共6页
Chinese Hepatology
基金
上海市崇明区科技项目(CKY2023-21)。
