全体积CT纹理分析在泌尿系结石的临床应用研究

张艳; 李纲

doi:10.13201/j.issn.1001-1420.2021.07.008

全体积CT纹理分析在泌尿系结石的临床应用研究

张艳¹,
李纲^2, ,

- 1. 南京医科大学附属无锡人民医院泌尿外科(江苏无锡, 214023);
- 2. 苏州大学附属第一医院泌尿外科

详细信息

通讯作者: 李纲,E-mail:gangli@suda.edu.cn

中图分类号: R691.4

收稿日期: 2020-11-20

Research on clinical application of whole volume CT texture analysis in urinary stones

ZHANG Yan¹,
LI Gang^2, ,

- 1. Department of Urology, Affiliated Wuxi People's Hospital, Nanjing Medical University, Wuxi, Jiangsu, 214023, China;
- 2. Department of Urology, First Affiliated Hospital of Soochow University

More Information

Corresponding author: LI Gang, E-mail: gangli@suda.edu.cn

Received Date: 20 November 2020

摘要

摘要: 目的:提取泌尿系结石的全体积CT纹理参数,分析全体积CT纹理参数与结石成分和钬激光碎石手术时间的关系,探讨全体积CT纹理分析在泌尿系结石的临床应用价值。方法:回顾性分析2018年1月—2019年10月在无锡市人民医院住院接受钬激光碎石手术治疗并进行结石成分分析的104例泌尿系结石患者的临床资料。用相关软件处理CT中的结石图像、转换为数值。提取整个结石全体积的每一个像素CT值,计算出全体积CT纹理参数,包括均值、中值、和、25百分位数、75百分位数、极大值、极小值、全距、峰度、偏度和熵(Entropy)。比较尿酸结石、草酸钙结石和混合结石三组患者之间全体积CT纹理参数的差异;分析全体积CT纹理参数和钬激光碎石手术时间的相关性。结果:全体积CT纹理参数中,尿酸结石组的均值、中值、全距、极大值、25百分位数、75百分位数显著低于草酸钙结石组和混合结石组(P＜0.05),熵、峰度和偏度在尿酸结石组、草酸钙结石组和混合结石组中无明显差异(P＞0.05);全体积CT纹理参数中Entropy、25百分位数、和、中值和偏度在钬激光碎石手术时间两组比较差异有统计学意义(P＜0.05)。其中Entropy、25百分位数及和与钬激光碎石手术时间成正相关性;偏度呈负相关性。Entropy呈最强的正相关性(r＞0.5,Pearson和Spearman相关系数同时满足),25百分位数与和呈现较强的正相关性(0.3＜r＜0.5,Pearson和Spearman相关系数同时满足),偏度呈现中等强度负相关性(r=-0.351,Pearson相关系数;r=-0.345,Spearman相关系数)。结论:全体积CT纹理参数中,均值、中值、全距、极大值、25百分位数和75百分位数在尿酸结石组中明显低于非尿酸结石组,这些纹理参数有望被选用来帮助区分尿酸结石和非尿酸结石;Entropy、25百分位数及和与钬激光碎石手术时间正相关,偏度与钬激光碎石手术时间负相关,这些纹理参数的测量有助于术前评估钬激光碎石手术的难易程度。
- 结石 /
- 纹理参数 /
- CT /
- 手术 /
- 成分
Abstract: Objective: To extract the whole volume CT texture parameters of urinary stones, to analyze the relationship between the whole volume CT texture parameters and the composition of the urinary stones as well as the operation time of holmium laser lithotripsy, and to discuss the clinical application of the whole volume CT texture analysis in urinary stones.Methods: The data of 104 patients with urinary stones who were hospitalized in Wuxi People's Hospital and received both holmium laser lithotripsy and stone composition analysis from January 2018 to October 2019 were retrospectively collected. Relevant softwares were used to process the urinary stone images in CT and then were converted to numerical values. The CT values of every pixel in the whole stone volume were extracted and the whole volume CT texture parameters including the mean, median, sum, 25 th percentile, 75 th percentile, maximum, minimum, full range, kurtosis, skewness and entropy were calculated. Comparing the difference of the whole volume CT texture parameters between every two of the three groups of patients with uric acid stones, calcium oxalate stones and mixed stones and analysis of the correlation between the whole volume CT texture parameters and the operation time of holmium laser lithotripsy were conducted.Results: Among the whole volume CT texture parameters, the mean, median, full range, maximum, 25 th percentile and 75 th percentile of the uric acid stone group were significantly lower than those of the calcium oxalate stone group and the mixed stone group(P＜0.05). Entropy, kurtosis and skewness had no significant difference among the uric acid stone group, the calcium oxalate stone group and the mixed stone group(P＞0.05). Among the whole volume CT texture parameters, entropy, 25 th percentile, sum, median and skewness were all related to the two groups of the operation time of holmium laser lithotripsy(P＜0.05), of which entropy, 25 th percentile and sum showed positive correlation while skewness showed negative correlation. Entropy showed the strongest positive correlation(r＞0.5, Pearson and Spearman correlation coefficients), 25 th percentile and sum showed strong positive correlation(0.3＜r＜0.5, Pearson and Spearman correlation coefficients), the skewness showed a medium intensity negative correlation(r=-0.351 Pearson correlation coefficient; r=-0.345, Spearman correlation coefficient).Conclusion: Among the whole volume CT texture parameters, the mean, median, full range, maximum, 25 th percentile and 75 th percentile are significantly lower in the uric acid stone group than those in the non-uric acid stone groups. These texture parameters have potential to be selected to help distinguish uric acid stones from non-uric acid stones. Entropy, 25 th percentile and sum are positively related to the operation time of holmium laser lithotripsy, but skewness showed a negative correlation with the operation time of holmium laser lithotripsy. The measurements of the whole volume CT texture parameters were helpful to pre-evaluate the difficulty of the holmium laser lithotripsy.
- stone /
- texture parameters /
- CT /
- operation /
- composition

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