| 摘要: |
| 目的：探讨多模态超声联合影像组学鉴别肺鳞癌与肺结核的临床价值。方法：回顾性分析经病理确诊的112例肺鳞癌及肺结核患者，共121个病灶，其中肺鳞癌病灶71个，肺结核病灶50个，均行灰阶超声及超声造影检查，并进行对比分析；按照7:3的比例将其随机划分为训练集（85个）和验证集（36个），并分别从这两类图像中提取相应的影像组学特征，经过标准化处理特征筛选降维，建立多模态超声影像组学标签。采用Logistic回归分别建立临床诊断、多模态超声影像组学及联合诊断模型。采用受试者的工作特征（receiver operating characteristic, ROC）曲线评价各模型性能，曲线下面积（area under the curve, AUC）比较采用Delong检验。绘制临床决策曲线评估其临床实用价值，绘制校准曲线分析联合诊断模型鉴别肺鳞癌与肺结核中的一致性。结果：多因素Logistic回归结果显示，病灶形态、大小以及超声造影增强模式为肺鳞癌与肺结核鉴别诊断的独立危险因素。利用灰阶超声及超声造影图像建立多模态影像组学模型以及联合模型，联合模型在训练集和验证集中的AUC分别为0.995、0.908，均高于单一分类模型。结论：基于多模态超声影像组学构建的联合模型可以较好地鉴别诊断肺鳞癌和肺结核，具有良好的应用前景。 |
| 关键词: 超声检查 超声造影 影像组学 肺结核 肺鳞癌 诊断，鉴别 |
| DOI： |
| 投稿时间：2024-05-13修订日期：2024-07-02 |
| 基金项目: |
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| The value of multimodal ultrasound radiomics in differentiating lung squamous cell carcinoma from pulmonary tuberculosis |
| ZHAO Jie,ZHU Lijing,HAO Lei,CHEN Zezheng,WANG Xinghua |
| (Shanxi Medical University, School of Medical Imaging;Department of Ultrasonography,the Second Hospital of Shanxi Medical University) |
| Abstract: |
| Objective: To explore the clinical value of multimodal ultrasound combined with radiomics in the differential diagnosis of lung squamous cell carcinoma and pulmonary tuberculosis. Methods: A total of 113 patients with lung squamous cell carcinoma and pulmonary tuberculosis confirmed by pathology were retrospectively analyzed, with a total of 121 lesions, including 71 lesions of lung squamous cell carcinoma and 50 lesions of pulmonary tuberculosis. All patients underwent gray scale ultrasound and contrast-enhanced ultrasound, and the results were compared and analyzed. According to the ratio of 7: 3, it was randomly divided into a training set（85 cases）and a validation set（36 cases）, and the corresponding radiomics features were extracted from these two types of images, respectively. After standardization, the features were filtered and the dimension was reduced to establish a multimodal ultrasound radiomics label. Logistic regression was used to establish clinical diagnosis, multimodal ultrasound imaging group and combined diagnosis model. The receiver operating characteristic（ROC）curve was used to evaluate the performance of each model, and the area under the curve（AUC）was compared by Delong test. The clinical decision curve was drawn to evaluate its clinical practical value, and the calibration curve was drawn to analyze the consistency of the combined diagnostic model in identifying lung squamous cell carcinoma and pulmonary tuberculosis. Results: Multivariate Logistic regression analysis showed that the lesion shape, size and contrast-enhanced ultrasound enhancement mode were independent risk factors for the differential diagnosis of lung squamous cell carcinoma and pulmonary tuberculosis. The multimodal radiomics model and the joint model were established by using two-dimensional ultrasound and contrast-enhanced ultrasound images. The AUC of the joint model in the training set and the validation set were 0.995 and 0.908, respectively, which were higher than those of the single classification model. Conclusion: The combined model based on multimodal ultrasound radiomics can better identify and diagnose lung squamous cell carcinoma and pulmonary tuberculosis, and has a good application prospect. |
| Key words: Ultrasonography Contrast-enhanced Ultrasound Radiomics Tuberculosis Lung Squamous Cell Carcinoma Diagnosis differential |
