Page 119 - 南京医科大学学报自然科学版

第41卷第9期 高思远，冯章志，杨 明，等. 分析T1WI信号强度直方图对儿童急性淋巴细胞白血病的诊断价值［J］.
2021年9月 南京医科大学学报（自然科学版），2021，41（09）：1383-1387 ·1385 ·

表1 两组直方图图形及数值参数差异性比较 （×10 mm /s）
-3
2
T1WI直方图参数 ALL组（n=49） 对照组（n=49） t值 P值
峰度 4.31 ± 3.25 0.21 ± 0.93 8.49 <0.001
偏度 -1.58 ± 0.790 -0.32 ± 0.560 -9.03 <0.001
熵 5.73 ± 0.36 5.58 ± 0.43 1.85 0.070
方差 13 166.85 ± 20 909.42 42 156.26 ± 19 711.50 -7.06 <0.001
平均值 498.57 ± 104.22 649.19 ± 96.390 -7.43 <0.001
最小值 87.29 ± 74.11 82.37 ± 81.06 0.31 0.760
最大值 707.94 ± 182.94 1 099.3 ± 195.54 -10.23 <0.001
10th T1WI 362.92 ± 74.080 394.85 ± 77.190 -2.09 0.040
15th T1WI 417.12 ± 62.100 442.00 ± 76.660 -1.77 0.080
20th T1WI 450.93 ± 65.300 481.15 ± 77.660 -2.09 0.040
25th T1WI 470.73 ± 78.570 517.71 ± 81.920 -2.89 0.010
30th T1WI 485.32 ± 91.520 551.56 ± 87.250 -3.67 <0.001
35th T1WI 496.68 ± 100.43 584.77 ± 94.130 -4.48 <0.001
40th T1WI 506.62 ± 109.44 611.99 ± 96.520 -5.06 <0.001
45th T1WI 515.38 ± 118.06 638.12 ± 101.28 -5.52 <0.001
50th T1WI 522.45 ± 124.18 662.42 ± 105.81 -6.01 <0.001
55th T1WI 529.30 ± 128.82 687.06 ± 108.81 -6.55 <0.001
60th T1WI 536.00 ± 132.34 710.60 ± 111.79 -7.06 <0.001
65th T1WI 542.60 ± 135.10 732.15 ± 115.38 -7.47 <0.001
70th T1WI 550.03 ± 137.10 758.44 ± 119.37 -8.03 <0.001
75th T1WI 557.48 ± 139.58 784.83 ± 126.36 -8.45 <0.001
80th T1WI 565.91 ± 141.75 815.78 ± 134.91 -8.94 <0.001
85th T1WI 576.11 ± 143.31 853.26 ± 145.01 -9.52 <0.001
90th T1WI 590.40 ± 148.22 900.17 ± 156.96 -10.04 <0.001
95th T1WI 612.48 ± 157.08 955.84 ± 166.60 -10.50 <0.001

曲线来源 表2 直方图对ALL患儿和正常儿童的鉴别诊断效能
1.0
10th
20th T1WI值 AUC 95% 置信区间 P值
30th
0.8 40th 10th 0.633 0.522~0.745 0.023
50th 20th 0.670 0.561~0.778 0.004
60th
0.6 70th 30th 0.789 0.696~0.881 <0.001
灵敏度 80th 40th 0.852 0.772~0.932 <0.001
90th
0.4 25th 50th 0.894 0.825~0.964 <0.001
35th
45th 60th 0.914 0.849~0.979 <0.001
55th
0.2 65th 70th 0.927 0.867~0.987 <0.001
75th
85th 80th 0.944 0.892~0.995 <0.001
95th
0.0 90th 0.956 0.910~1.000 <0.001
0.0 0.2 0.4 0.6 0.8 1.0 参考线
1-特异度 25th 0.729 0.627~0.830 <0.001
35th 0.819 0.732~0.907 <0.001
95th T1WI值的曲线下面积最大。
图3 有统计学意义数值参数的ROC曲线图 45th 0.877 0.803~0.951 <0.001
55th 0.905 0.837~0.973 <0.001
和治疗，依旧致命。ALL 的诊断通常采用骨髓穿刺 65th 0.920 0.856~0.983 <0.001
和外周血全血细胞计数等，为人工操作的有创性检 75th 0.935 0.879~0.991 <0.001
查，患儿痛苦较大，家长在患儿进行此类有创性操 85th 0.952 0.905~0.999 <0.001
95th 0.956 0.908~1.000 <0.001
作时亦十分焦虑。近年来，陆续有研究者提出计算