能谱CT图像直方图纹理分析对骨岛与成骨性骨转移瘤的鉴别价值

doi:10.3969/j.issn.1004-583X.2025.08.007

摘要/Abstract

摘要：

目的比较双层探测器能谱电子计算机断层扫描(computer tomography,CT)图像结合直方图纹理分析区分成骨性骨转移瘤(osteoblastic bone metastasis, OBM)和骨岛(bone island, BI)的诊断性能。方法纳入2023年3月21日-2023年9月1日于广州市红十字会医院接受能谱CT检查的患者94例,共计216个病灶。其中81例共有125个BI病灶(BI组),13例共有91个OBM病灶(OBM组)。应用能谱分析平台重建40~200 keV的9个不同单能图像(以20 keV为间隔)和传统图像。采用Pyromics进行直方图纹理分析,选择病灶的最大层面并提取每个病变数据的灰度直方图纹理参数(熵、平均值、最大值)。比较两组数据,并采用受试者工作特征曲线评价各参数的鉴别价值,利用Delong检验比较各参数的诊断性能。结果 40 keV条件下,灰度直方图纹理分析的熵区分OBM和BI时表现出较高性能,曲线下面积为0.934(95%CI: 0.895~0.973);能谱CT重建的传统图像中,灰度直方图纹理分析中的熵表现出较高性能,曲线下面积为0.910(95%CI:0.872~0.949)。Delong检验结果显示,40 keV条件下熵在区分BI和OBM方面高于能谱CT重建的传统图像(P<0.05)。结论基于能谱CT平扫40 keV图像的直方图纹理参数的熵能有效鉴别OBM和BI,且高于能谱CT重建的传统图像。

关键词: 能谱CT, 成骨性骨转移瘤, 骨岛

Abstract:

Objective To compare the diagnostic performance of dual-energy computed tomography (CT) images combined with histogram texture analysis in differentiating osteoblastic bone metastases (OBM) from bone islands (BI). Methods Ninety-four patients (216 lesions) undergoing spectral CT in Guangzhou Red Cross Hospital from March 21, 2023 to September 1, 2023 were enrolled. They were divided into BI group (n=81, 125 lesions) and OBM group (n=13, 91 lesions). Spectral images were reconstructed using a spectral analysis platform, generating nine monochromatic images (40-200 keV, 20 keV intervals) and conventional polychromatic images. Histogram texture parameters (entropy, mean, and maximum) were extracted from the maximal cross-sectional area of each lesion using Pyromics software. Diagnostic performance was evaluated via the receiver operating characteristic (ROC) curves, and DeLong's test compared parameter efficacy. Results At 40 keV, entropy in gray-level histogram texture analysis demonstrated a superior discrimination of OBM from BI, with an area under the curve (AUC) of 0.934(95%CI: 0.895-0.973). Entropy of conventional images by reconstructed spectral CT yielded an AUC of 0.910(95%CI: 0.872-0.949). DeLong's test confirmed significant superiority of 40 keV entropy over conventional CT (P<0.05). Conclusion Entropy of histogram texture parameters based on a 40 keV image of a plain spectral CT scan can effectively distinguish OBMs from BIs, which is higher than that of traditional images reconstructed from spectral CT.

Key words: spectral CT, osteoblastic bone metastasis, bone island

中图分类号:

R738
R730.44

王博焕, 黄俊斌, 李志琼, 熊玉超, 郭威, 曾旭文. 能谱CT图像直方图纹理分析对骨岛与成骨性骨转移瘤的鉴别价值[J]. 临床荟萃, 2025, 40(8): 711-716.

Wang Bohuan, Huang Junbin, Li Zhiqiong, Xiong Yuchao, Guo Wei, Zeng Xuwen. Value of texture analysis of histograms of energy spectrum CT images in differentiating bone islands from osteoblastic bone metastases[J]. Clinical Focus, 2025, 40(8): 711-716.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2025.08.007

https://www.lchc.cn/CN/Y2025/V40/I8/711

图/表 8

参考文献 29

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组别	例数	病灶数	男性[例(%)]	年龄(岁)	单发[例(%)]	ROI大小(cm²)
BI组	81	125	43(53.1)	65.56±12.74	54(66.7)	18.75±13.53
OBM组	13	91	5(38.5)	67.15±6.50	3(23.1)	65.16±51.12
统计值			χ²=0.959	t=0.442	χ²=8.948	t=58.437
P值			0.381	0.660	0.003	0.001

组别	例数	病灶数	男性[例(%)]	年龄(岁)	单发[例(%)]	ROI大小(cm²)
BI组	81	125	43(53.1)	65.56±12.74	54(66.7)	18.75±13.53
OBM组	13	91	5(38.5)	67.15±6.50	3(23.1)	65.16±51.12
统计值			χ²=0.959	t=0.442	χ²=8.948	t=58.437
P值			0.381	0.660	0.003	0.001

组别	例数		传统图像		40 keV		60 keV		80 keV		100 keV
BI组	81		1 166(1 068,1 244)		2 686(2 466,2 884)		1 471(1 326,1 566)		1 027(924,1 090)		830(740,888)
OBM组	13		892(661,1 028)		2 087(1 550,2 451)		1 144(841,1 335)		804(584,943)		662(476,768)
Z值			21.663		35.466		22.971		21.065		18.917
P值			<0.001		<0.001		<0.001		<0.001		<0.001
组别		120 keV		140 keV		160 keV		180 keV		200 keV
BI组		734(655,790)		679(606,741)		648(579,709)		627(560,687)		610(548,671)
OBM组		591(422,686)		549(393,638)		524(375,609)		509(364,592)		498(356,578)
Z值		17.115		15.859		15.005		14.405		13.948
P值		<0.001		<0.001		<0.001		<0.001		<0.001

组别	例数		传统图像		40 keV		60 keV		80 keV		100 keV
BI组	81		1 166(1 068,1 244)		2 686(2 466,2 884)		1 471(1 326,1 566)		1 027(924,1 090)		830(740,888)
OBM组	13		892(661,1 028)		2 087(1 550,2 451)		1 144(841,1 335)		804(584,943)		662(476,768)
Z值			21.663		35.466		22.971		21.065		18.917
P值			<0.001		<0.001		<0.001		<0.001		<0.001
组别		120 keV		140 keV		160 keV		180 keV		200 keV
BI组		734(655,790)		679(606,741)		648(579,709)		627(560,687)		610(548,671)
OBM组		591(422,686)		549(393,638)		524(375,609)		509(364,592)		498(356,578)
Z值		17.115		15.859		15.005		14.405		13.948
P值		<0.001		<0.001		<0.001		<0.001		<0.001

组别	例数		传统图像		40 keV		60 keV		80 keV		100 keV
BI组	81		4.30(4.11,4.50)		3.94(2.92,4.36)		4.30(4.11,4.50)		4.22(4.04,4.42)		4.20(4.01,4.42)
OBM组	13		5.12(4.80,5.65)		5.49(4.99,6.05)		5.27(4.89,5.72)		5.03(4.66,5.53)		4.96(4.67,5.34)
Z值			15.009		4.467		14.252		17.437		13.065
P值			<0.001		0.036		<0.001		<0.001		<0.001
组别		120 keV		140 keV		160 keV		180 keV		200 keV
BI组		4.20(4.02,4.42)		4.17(4.01,4.36)		4.16(4.00,4.38)		4.17(3.97,4.33)		4.11(3.94,4.33)
OBM组		4.89(4.59,5.35)		4.80(4.47,5.27)		4.85(4.54,5.26)		4.77(4.48,5.27)		4.74(4.52,5.23)
Z值		15.086		16.862		14.758		17.174		17.533
P值		<0.001		<0.001		<0.001		<0.001		<0.001