| 摘要: |
| 目的 探讨超声影像组学方法在鉴别诊断甲状旁腺腺瘤（PA）和甲状旁腺增生（PH）中的临床应用价值。方法 选取2019年1月至2023年6月我院收治的133例甲状旁腺功能亢进症患者（共181枚病灶），其中腺瘤66例（67枚），增生67例（114枚），比较两组临床资料及病灶常规超声特征。所有病灶按7:3分为训练集（126枚）和验证集（55枚），基于灰阶超声图像勾画感兴趣区（ROI）并提取影像组学特征。应用最小绝对收缩和选择算子（LASSO）回归筛选特征并构建影像组学模型；应用多因素Logistic回归筛选重要的常规超声特征并构建常规超声模型；应用多因素Logistic回归构建基于影像组学特征和常规超声特征的联合模型。绘制受试者工作特征曲线（ROC）以评估各模型的效能并在验证集中进行验证；绘制校准曲线分析影像组学模型和联合模型预测结果与实际结果的一致性。结果 基于LASSO算法筛选出8个影像组学特征用于构建影像组学模型。单因素和多因素Logistic回归分析显示，病灶最大径、外周线状高回声和极性供支血管征为鉴别PA和PH的重要常规超声特征（均P＜0.05）。在训练集和验证集中，影像组学模型曲线下面积（AUC）分别为0.764和0.750，常规超声模型AUC分别为0.812和0.838，联合模型AUC分别为0.825和0.856。联合模型AUC在训练集和验证集中均高于影像组学模型，差异均有统计学意义（均P＜0.05）；其余各模型间AUC比较差异均无统计学意义。结论 影像组学联合模型能较准确地鉴别甲状旁腺腺瘤和甲状旁腺增生，可为临床制定手术方案提供一定的参考价值。 |
| 关键词: 超声检查 影像组学 甲状旁腺 诊断，鉴别 |
| DOI： |
| 投稿时间：2023-07-29修订日期：2023-10-09 |
| 基金项目: |
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| Differential diagnostic value of ultrasound radiomics in parathyroid adenoma and parathyroid hyperplasia |
| Makexin,Yangyuwei,Lvfajin,Liuliping |
| (Department of Ultrasound，the First Affiliated Hospital of Chongqing Medical University) |
| Abstract: |
| Objective To explore the clinical value of ultrasound radiomics in differentiating parathyroid adenoma (PA) and parathyroid hyperplasia (PH). Methods Totally 133 patients with hyperparathyroidism (181 lesions in total) in our hospital from January 2019 to June 2023 were selected, including 66 cases of adenoma (67 lesions) and 67 cases of hyperplasia (114 lesions). The clinical data and conventional ultrasound characteristics of the two groups were compared. A 7:3 ratio was used to divide the lesions into two sets: training set (126 lesions) and validation set (55 lesions). The region of interest (ROI) was delineated based on ultrasound images and the ultrasound radiomics features were extracted. The least absolute shrinkage and selection operator (LASSO) regression was used to screen feature and construct the radiomics model. Multivariate Logistic regression was used to screen important conventional ultrasound features and construct the conventional ultrasound model. Multivariate Logistic regression was applied to construct the combined model based on radiomics features and conventional ultrasound features. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficiency of each model and to verify them in the validation set. The calibration curve was drawn to analyze the consistency between the effect and the actual result of the radiomics model and the combined model. Results A total of 8 radiomics features were selected for constructing the radiomics model based on LASSO. Multivariate Logistic regression analysis showed that lesion maximum diameter, peripheral high-eco bright line and polar vascular sign were important ultrasound features for differential diagnosis of PA and PH (both P<0.05). In the training set and validation set, the area under the curve (AUC) of the radiomics model AUC was 0.764 and 0.750, the AUC of the conventional ultrasound model was 0.812 and 0.838, and the AUC of the combined model was 0.825 and 0.856. The AUC of the combined model was higher than that of the radiomics model in both the training set and validation set, and the differences were statistically significant (both P<0.05). The comparison of the AUC among other models showed no statistical significance. Conclusion The combined model constructed by combining radiomics features and conventional ultrasound features can accurately discriminate parathyroid adenoma and parathyroid hyperplasia, which can provide a certain reference for clinical surgical planning. |
| Key words: Ultrasonography Radiomics Parathyroid glands Diagnosis, differential |
