实用医学杂志 ›› 2020, Vol. 36 ›› Issue (23): 3273-3278.doi: 10.3969/j.issn.1006⁃5725.2020.23.022

• 医学检查与临床诊断 • 上一篇    下一篇

基于CT图像的神经网络模型鉴别纯磨玻璃样微浸润性腺癌和浸润性腺癌

车思雨,蒋依宁, 韩广庆, 赵文静, 李国生, 李智勇   

  1. 大连医科大学附属第一医院1放射科,2 病理科(辽宁大连116011)
  • 出版日期:2020-12-10 发布日期:2020-12-23
  • 通讯作者: 李智勇E⁃mail:zjy_lzy@126.com

A neural network model based on CT image used to differentiate minimally invasive adenocarcinoma and invasive adenocarcinoma presenting as pure ground⁃glass nodules

CHE Siyu,JIANG Yining,HAN Guangq⁃ ing,ZHAO Wenjing,LI Guosheng,LI Zhiyong.   

  1. Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China
  • Online:2020-12-10 Published:2020-12-23
  • Contact: LI Zhiyong E⁃mail:zjy_lzy@126.com

摘要:

目的 基于CT 图像建立神经网络模型鉴别呈纯磨玻璃结节(pure ground⁃glass nodules,pGGN)的微浸润腺癌(minimally invasive adenocarcinoma,MIA)和浸润性腺癌(invasive adenocarcinoma,IAC)。方法 回顾性收录2015年1月至2018年1月期间于大连医科大学附属第一医院薄层CT上显示为pGGN,经手术病理证实为单发MIA 151 例、IAC 127 例。收集所有患者临床及影像特征,比较MIA 组与IAC组之间临床及影像特征的差异性并建立神经网络模型,通过分析受试者操作特征曲线(subject operat⁃ing characteristic,ROC),计算并比较受试者工作特征曲线下面积(area under the curve,AUC)评估IAC的预测价值。结果 临床特征上,MIA组患者年龄低于IAC组(P < 0.001);影像形态上,MIA组中类圆形多见,但是,分叶征、血管集束征、空气支气管征、空泡征和胸膜凹陷征均少于IAC组(均P < 0.001);定量上,MIA组的mCT⁃LP、mCT⁃W、直径、体积和质量均低于IAC组(均P < 0.001)。利用神经网络模型预测IAC的ROC曲线明显优于各项定量指标,其AUC、总体预测准确率、敏感度和特异度分别为0.91、81.00%、78.81%和86.61%。结论 神经网络模型有助于鉴别呈现pGGN的MIA与IAC。

关键词: 磨玻璃结节, 腺癌, CT, 神经网络模型

Abstract:

Objective To differentiate minimally invasive adenocarcinoma(MIA)from invasive adenocar⁃cinoma(IAC)presenting as pure ground⁃glass nodules(pGGNs)using CT imaging features and a neural networkmodel. Methods We retrospectively collected 151 patients with single MIA and 127 patients with single IACpresenting as pGGN on thin⁃slice CT surgically and pathologically confirmed in our hospital from January 2015 toJanuary 2018. The clinical and imaging features of all patients were collected and the differences of these featureswere compared between MIA group and IAC group. The input variables and factors based on p value less than 0.05with univariable analysis were used to establish a neural network model. The subject operating characteristic(ROC)curve was used to analyze,calculate and compare for predicting the diagnostic efficiency of IAC. Results Clinically,the average age of patients in MIA group was lower than that in IAC group(P < 0.001). In imagingmorphology,the incidence of circular in MIA group was higher,but the incidences of lobulated sign,vesselconvergence sign,air bronchogram,cavitation and pleural indentation sign were less than in IAC group(all P <0.001). In imaging quantitative analysis,mCT⁃LP,mCT⁃W,diameter,volume and mass were significantly lowerin MIA group than in IAC group(all P < 0.001). The ROC curve of the neural network model was significantlybetter than the quantitative variables,with an AUC of 0.91,accuracy,sensitivity and specificity of 81.00% ,78.81% and 86.61%,respectively. Conclusions It is helpful to differentiate MIA from IAC presenting as pGGNsusing the neural network model.

Key words: ground?glass nodule, lung adenocarcinoma, CT, neural network