目的构建一种基于多层螺旋CT（multisliecs helieal CT,MSCT）征象的逐步判别分析模型,并评价此逐步判别分析模型对鉴别良、恶性胆囊壁增厚病变的有效性。方法回顾分析经病理证实良恶性厚壁胆囊病变共92例,根据疾病分为慢性胆囊炎组（n=61）,厚壁型胆囊癌组（n=31）,对两组病例的MSCT影像征象进行分组比较,并采用Fisher-Bayes逐步判别法分析不同CT征象对鉴别胆囊良、恶性厚壁胆囊病变的价值。结果逐步判别分析筛选得到以下6个方面对于鉴别良、恶性胆囊壁增厚最具诊断价值的征象：（1）胆囊壁强化方式;（2）胆囊腔内壁结节;（3）胆道梗阻;（4）胆囊周围渗出程度;（5）邻近肝组织受累;（6）肝转移情况。回顾性自身验证得出MSCT影像征象Fisher判别模型在鉴别慢性胆囊炎和厚壁型胆囊癌中的正确率与误判率分别为98.90%、1.10%;交互验证得出Fisher判别模型鉴别二者的正确率及误判率分别为95.70%、4.30%。结论基于MSCT影像征象分析的Fisher判别模型有助于慢性胆囊炎及厚壁型胆囊癌的鉴别诊断。
Objective To establish a stepwise discriminant analysis model based on the multislices helieal CT（ MSCT） signs,and evaluate the effectiveness of this model for differential diagnosis between benign and malignant gallbladder wall thickening diseases. M ethods Ninety-two cases with pathology-confirm ed benign and m alignant gallbladder wall thickening diseases were analyzed retrospectively. According to the disease classification,all patients were divided into chronic cholecystitis group（ n = 6 1） and thick-wall gallbladder carcinom a group（ n = 3 1）.The M SCT im aging features between two groups were com pared. M oreover,Fisher-Bayes stepwise discrim inant analysis m odel was used to analyze the value of different CT signs for identifying benign and balignant thick-walled gallbladder lesions. Results The following six aspects were screened and obtained by stepwise discrim inant analysis for the m ost diagnostic value in the benign and m alignant gallbladder wall thickening：（1） gallbladder wall enhancem ent,（2） gallbladder cavity intraluminal nodule,（3） biliary obstruction,（4） gallbladder surrounding exudation,（5） adjacent liver tissue involvem ent,（6） liver m etastasis. The retrospective self-validation results showed that the correct and m isjudgm ent rates of the M SCT im agings in Fisher discrim inant m odel were 9 8. 9 0 % and 1. 1 0 %,respectively. The cross validation results showed that the correct and m isjudgm ent rates of Fisher discrim irant m odel were 9 5. 7 0 % and4. 3 0 %,respectively. Conclusion The Fisher discrim inant m odel basing on M SCT im aging contributes to differential diagnosis between chronic cholecystitis and thick-walled gallbladder carcinom a.
Military Medical Journal of South China
Multislice helieal CT