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目的探究提取增强CT图像的灰度共生矩阵纹理参数的方法分期食管鳞状细胞癌的可行性。方法选取本院36例经内镜活检病理确诊的食管鳞状细胞癌患者36例,在采取治疗方案之前,行胸、腹部CT增强扫描。两位资深CT诊断医师将患者增强CT图像导入Omni-kinetics软件对肿瘤组织进行勾画。勾画完成后,使用OmniKinetics软件进行纹理参数计算。结果随着T分期的增加,Energy值降低,且不同T分期的Energy差异具有统计学意义(P=0.001);随着T分期的增加,Entropy值升高,且不同T分期的Entropy差异具有统计学意义(P=0.007);随着T分期的增加,IDM值逐渐变小,且不同分期的IDM值具有统计学意义(P=0.000)。T1期Energy值的95%置信区间为(0.037,0.052),T2期Energy值的95%置信区间为(0.009,0.035),T3期Energy值的95%置信区间为(0.002,0.007);T1期Entropy值的95%置信区间为(4.104,4.562),T2期Entropy值的95%置信区间为(4.577,4.926),T3期Entropy值的95%置信区间为(5.001,5.221);T1期IDM值的95%置信区间为(0.019,0.027),T2期IDM值的95%置信区间为(0.011,0.014),T3期IDM值的95%置信区间为(0.003,0.010)。结论基于增强CT扫描成像的灰度共生矩阵纹理分析分期食管鳞状细胞癌的方法具有一定价值,未来可尝试作为建立食管鳞状细胞癌分期鉴别的无侵入性方法。
Objective To investigate the feasibility of staging esophageal squamous cell carcinoma (ESCC) by extracting grayscale co-occurrence matrix texture parameters from enhanced CT images. Methods Thirty-six patients with esophageal squamous cell carcinoma diagnosed by endoscopic biopsy were enrolled in this study. CT and CT scan of thorax and abdomen were performed before treatment. Two experienced CT physicians imported the patient-enhanced CT images into the Omni-kinetics software to outline the tumor tissue. After sketching, use OmniKinetics software for texture parameter calculations. Results With the increase of T stage, the Energy value decreased, and the Energy difference in different T stages was statistically significant (P = 0.001). The Entropy value increased with the increase of T stage, and the Entropy difference in different T stages was statistically significant (P = 0.007). With the increase of T stage, the IDM value became smaller and the IDM values of different stages were statistically significant (P = 0.000). The 95% confidence interval of the energy value of T1 phase was (0.037,0.052), the 95% confidence interval of energy value of T2 phase was (0.009,0.035), and the 95% confidence interval of energy value of T3 phase was (0.002,0.007) The 95% confidence interval of Entropy value was (4.104,4.562), the 95% confidence interval of Entropy value of T2 phase was (4.577, 4.926), and the 95% confidence interval of Entropy value of T3 phase was (5.001,5.221) The 95% confidence interval (0.019,0.027) for the T2 phase IDM value was (0.011,0.014), and the 95% confidence interval for the T3 IDM value was (0.003,0.010). Conclusion The method of staging esophageal squamous cell carcinoma with grayscale co-occurrence matrix texture based on enhanced CT scanning is of some value and may be used as a noninvasive method to establish staging of esophageal squamous cell carcinoma in the future.