双源CT双能量成像联合影像组学在鉴别甲状腺良恶性结节中的应用价值

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Applicationvalueofdual-source dual-energy CTcombinedwithradiomicsindiferentialdiagnosisofbenignand malignant thyroid nodules

FENGQiao1，2，YUEZhibin’，SUNYinghan1²，QUAN Jianghail，²，CHENGLiuhui’

1DepartmentofRdiolgyFirstAfliatedHospitalofHnanUniversityofineseMeicine，Zhengzou4ooohna;st Clinical Medical Colege，Henan University of Chinese Medicine，Zhengzhou 45oooo，China.

[Abstract]Objective：Toinvestigatethevalueofdual-sourcedual-energyCcombinedwithradiomicsindiferentialdiagnosis ofbenignandmalignantthyroidnodules.Methods：Atotalof118patientswith128thyroidnodulesconfirmedbypathology wereretrospectivelyanalyzed，inlcuding6Obenignnodulesand68malignantnodules.Allnoduleswererandomlydividedinto atrainingset（85nodules）andavalidationset（43nodules）.Theclinicalandimaging featuresanddual-energyquantitative parameterswerecolected.Clinicalindependentpredictorswerescrenedandtheclinical modelwasconstructedthrough multivariatelogisticregresionanalysis.Theradiomicsfeaturesofnon-enhancedandenhancedimageswereextracted，ndthe LASSOalgorithmwasused toselecttheoptimal features toconstructtheradiomics model.Theclinicalindependentpredictors andradiomicsfeatureswereselectedtoconstructtheclinical-radiomicsmodelandanomogramwasdrawn.ROC curve wasusedtoevaluatedthediagnosiseficiency，DeLong testwasusedtocomparetheAUCvaluesofdiferentmodels，and calibrationcurveanddecisioncurvewereuesdtoevaluatethecalibrationofthemodelanditsclinicalbenefis.Results： Nodulecalcification，aspectratioandnormalizediodineconcentration（NIC）inthearterialphasewereindependentpredictors formalignant thyroidnodulesandwereusedtoconstructtheclinicalmodel.TheAUCvaluesoftheclinicalmodel inthe trainingsetandvalidationsetwere0.86OandO.848，thoseoftheradiomicsmodelwereO.937andO.918，andthoseof the clinical-radiomicsmodelwereO.967andO.937，thehighest.DeLongtestshowedthattherewasasignificantiference between the clinical-radiomics model and the clinical model in the training set（ P⩽0.05 ）.The calibration curve showed that thepredictionresultsoftheclinical-radiomicsmodelwereconsistentwiththeactualresults，andthedecisioncurveanalysis showedahighclinicalbeneft.Conclusion：Theclinical-radiomicsmodelinthepreoperativeidentificationofbenignand malignant thyroid nodules have high clinical value.

[Keywords] Thyroid nodules;Radiomics;Iodine concentration;Tomography，X-ray computed

甲状腺结节指甲状腺内滤泡细胞由于异常增生而形成的组织团块，是临床常见的内分泌疾病，其检出率呈逐年上升趋势[1]。（剩余8334字）