目的探讨基于多参数MRI(multiparametric magnetic resonance imaging,mpMRI)影像组学列线图预测子宫内膜癌(endometrial cancer,EC)淋巴血管侵犯(lymphatic vascular space invasion,LVSI)的价值。材料与方法回顾性分析术前行盆腔mpMR...
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目的探讨基于多参数MRI(multiparametric magnetic resonance imaging,mpMRI)影像组学列线图预测子宫内膜癌(endometrial cancer,EC)淋巴血管侵犯(lymphatic vascular space invasion,LVSI)的价值。材料与方法回顾性分析术前行盆腔mpMRI检查的202例经手术病理证实为EC患者的病例资料,并按7∶3随机分为训练集和验证集。运用开源的ITK-SNAP软件勾画兴趣区(region of interest,ROI),使用Pyradiomics软件从mpMRI影像图中提取EC影像组学特征。采用单因素分析临床基本资料和影像组学特征,通过最小绝对收缩和选择算法(least absolute shrinkage and selection operator,LASSO)回归筛选影像组学特征并计算影像组学分数(radiomics score,Rad-score),多因素logistic回归用于筛选LVSI独立危险因素,使用R语言建立模型并绘制列线图,模型的预测效能采用C指数(C-index)评价,比较影像组学模型和列线图对LVSI的预测效能。结果321个影像组学特征经LASSO回归筛选出13个影像组学特征并计算Rad-score。单因素和多因素logistic回归分析发现年龄、病理学分级以及Rad-score为LVSI的独立危险因素。联合LVSI危险因素构建的列线图在训练集和验证集中C-index分别为0.871(95%CI:0.803~0.940)和0.810(95%CI:0.698~0.917);影像组学模型在训练集和验证集中C-index分别为0.854(95%CI:0.784~0.925)和0.756(95%CI:0.619~0.892)。列线图和影像组学模型对LVSI均具有较高的预测效能,并且列线图高于影像组学模型。结论基于mpMRI影像组学列线图对EC的LVSI术前评估具有较高的诊断效能。
多形性透明变性血管扩张瘤(PHAT)是由Smith等人在1996年提出的一种罕见的低级别间叶源性肿瘤。WHO在2020年将其归类于分化未定的低度恶性肿瘤。组织学上PHAT的显着特征是存在扩张血管簇、条索状分布于扩张性血管之间的梭形和圆形瘤细胞及血管壁、血管周围及瘤细胞之间基质明显透明样变性。现报告我院1例大腿多形性透明变性血管扩张瘤患者,并分析此例患者的相关资料,汇总临床、影像及病理特点。病例男,56岁。发现左大腿内侧皮下肿物4年,近1年来自觉肿块较前明显增大。Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare low grade mesenchymal origin tumour proposed by Smith et al. in 1996. WHO classified it as a low grade malignant tumour with undifferentiated differentiation in 2020. Histologically the distinguishing features of PHAT are the presence of clusters of dilated blood vessels, strips of spindle shaped and rounded tumour cells distributed between dilated blood vessels and marked hyaline-like degeneration of the vascular wall, perivascular area and stroma between tumour cells. We report a case of pleomorphic hyaline degenerative angiodysplasia of the thigh in our hospital, and analyse the relevant data of this patient, summarizing the clinical, imaging and pathological features. The case was a 56-year-old man. A subcutaneous mass was found in the left inner thigh for 4 years, and in the past 1 year, the mass had increased significantly compared with the previous one.
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