术前常规MRI影像学表现及纹理分析对功能性垂体腺瘤术后预后的预测价值

术前常规MRI影像学表现及纹理分析对功能性垂体腺瘤术后预后的预测价值术前常规MRI影像学表现及纹理分析对功能性垂体腺瘤术后预后的预测价值

摘要：目的：探究术前常规MRI影像学表现及纹理分析对功能性垂体腺瘤术后预后的预测价值。方法：收集2010年1月至2018年12月山东大学中心医院神经外科收治的功能性垂体腺瘤55例患者的术前常规MRI影像学表现及纹理分析资料，记录手术治疗方式、病理学分型、术后随访及延长期辅助治疗情况等数据。通过Cox比例风险模型分析影响患者预后的相关因素。结果：MRI影像学表现及纹理分析分别为功能性垂体腺瘤预测预后的独立风险因素。MRI表现以病变最大径和肿瘤容积为主要参数，纹理分析以熵和对比度为主要参数。结论：术前常规MRI影像学表现及纹理分析对功能性垂体腺瘤术后预后有着一定的预测价值，可以为患者的临床治疗提供参考。

关键词：MRI影像学表现；纹理分析；功能性垂体腺瘤；预测价值；术后预后

Abstract:Objective:ToexplorethepredictivevalueofpreoperativeroutineMRIimagingandtextureanalysisforthepostoperativeprognosisoffunctionalpituitaryadenoma.Methods:FromJanuary2010toDecember2018,dataof55patientswithfunctionalpituitaryadenomaadmittedtotheDepartmentofNeurosurgery,ShandongUniversityQiluHospitalwerecollected,includingpreoperativeroutineMRIimagingandtextureanalysis,surgicaltreatment,pathologicalclassification,postoperativefollow-upandadjuvanttherapy.Coxproportionalhazardmodelswereusedtoanalyzethefactorsinfluencingpatients'prognosis.Results:MRIimagingandtextureanalysiswereindependentriskfactorsforpredictingtheprognosisoffunctionalpituitaryadenoma.ThemainparametersofMRIpresentationwerethemaximumdiameterofthelesionandtumorvolume,whiletheparametersoftextureanalysiswereentropyandcontrast.Conclusion:PreoperativeroutineMRIimagingandtextureanalysishavecertainpredictivevalueforthepostoperativeprognosisoffunctionalpituitaryadenoma,whichcanprovidereferenceforclinicaltreatmentofpatients.

Keywords:MRIimaging;textureanalysis;functionalpituitaryadenoma;predictivevalue;postoperativeprognosiFunctionalpituitaryadenomasareatypeoftumorthatdevelopsfromthecellsofthepituitarygland.Thesetumorsmayproducehormonesthatcancauseavarietyofsymptoms,includingheadaches,visionproblems,andhormonalimbalances.Thetreatmentoffunctionalpituitaryadenomasusuallyinvolvessurgery,radiationtherapy,ormedication,dependingonthetypeandsizeofthetumor.

PreoperativeimagingwithMRIisastandarddiagnostictoolforfunctionalpituitaryadenomas.Inadditiontoprovidinginformationaboutthelocationandsizeofthetumor,MRIcanalsorevealthecharacteristicsofthetumortissue.Textureanalysisisatechniquethatcanbeusedtoanalyzetheimagedataandextractfeaturesthatmaynotbevisibletothehumaneye.ByanalyzingthetextureoftheMRIimages,researcherscanidentifypatternsandrelationshipsthatmayberelatedtotheprognosisofthepatient.

Inarecentstudy,researchersinvestigatedthepredictivevalueofpreoperativeMRIimagingandtextureanalysisforthepostoperativeprognosisoffunctionalpituitaryadenoma.Thestudyincluded45patientswhounderwentsurgeryforafunctionalpituitaryadenoma.TheresearchersanalyzedtheMRIimagesandperformedtextureanalysisontheimagestoidentifyfeaturesthatmayberelatedtotheprognosisofthepatient.

TheresultsofthestudyshowedthatthemaximumdiameterofthelesionandtumorvolumewerethemostimportantparametersoftheMRIpresentationforpredictingthepostoperativeprognosisoffunctionalpituitaryadenoma.Inaddition,theparametersoftextureanalysis,includingentropyandcontrast,werealsofoundtobepredictiveofthepostoperativeprognosis.

Overall,thestudysuggeststhatpreoperativeroutineMRIimagingandtextureanalysiscanprovidevaluableinformationforpredictingthepostoperativeprognosisoffunctionalpituitaryadenoma.Thisinformationcouldbeusedtoguideclinicaltreatmentdecisionsandimproveoutcomesforpatientswiththistypeoftumor.FurtherresearchisneededtoconfirmthesefindingsandtoinvestigatethepotentialclinicalapplicationsoftextureanalysisforothertypesoftumorsInconclusion,functionalpituitaryadenomascanhavevaryingresponsestosurgicaltreatment,andpredictingpostoperativeprognosiscanbedifficult.However,preoperativeMRIimagingandtextureanalysisofferapromisingapproachforimprovingprognosticaccuracy.Byanalyzingthetexturesofthetumorandsurroundingtissues,clinicianscanobtainamoredetailedunderstandingofthetumor'scharacteristics,includingitssize,shape,anddegreeofinvasiveness.Thisinformationcanhelpguidetreatmentdecisions,suchastheextentofresectionandtheneedforadjuvanttherapy.

Itisimportanttonotethattextureanalysisisarelativelynewandevolvingfield,anditsclinicalapplicationsarestillbeingexplored.Furtherresearchisneededtovalidatethefindingsofthisstudyandtoinvestigatethepotentialutilityoftextureanalysisforothertypesoftumors.Additionally,largerstudieswithlongerfollow-upperiodswillbenecessarytofullyevaluatethepredictiveabilityofthesetechniques.

Overall,theuseofpreoperativeMRIimagingandtextureanalysisrepresentsapromisingapproachforimprovingprognosticaccuracyandguidingclinicaldecision-makingforpatientswithfunctionalpituitaryadenomas.Astechnologyandunderstandingoftextureanalysiscontinuetoadvance,itmaybecomeavaluabletoolforimprovingoutcomesforpatientswithavarietyoftumorsInadditiontopituitaryadenomas,textureanalysishasalsoshownpromiseinpredictingoutcomesandguidingtreatmentdecisionsforothertypesofbraintumors,suchasgliomas.Gliomasarethemostcommontypeofprimarybraintumor,andcanrangefromlow-gradetohigh-grademalignancies.

OnestudyanalyzedMRIsofpatientswithglioblastoma,themostaggressivetypeofglioma,andfoundthattexturefeaturesofthetumorsweresignificantlyassociatedwithsurvivaloutcomes.Specifically,tumorswithhigherheterogeneity(variabilityintexture)wereassociatedwithpoorersurvival.Thisinformationcouldpotentiallybeusedtoguidetreatmentdecisions,suchastheuseofmoreaggressivetherapiesforpatientswithtumorsshowinghighheterogeneity.

Textureanalysishasalsobeenexploredasatoolforpredictingresponsetotreatmentingliomas.Onestudyanalyzedpre-treatmentMRIsofpatientswithglioblastomawhoreceivedstandardchemotherapyandradiationtherapy,andfoundthattexturefeaturesofthetumorswereassociatedwithresponsetotreatment.Specifically,tumorswithhigherheterogeneityandlowercontrast(differencesinbrightnessbetweentumorandnormalbraintissue)weremorelikelytoshowapoorresponsetotreatment.

Thesefindingshighlightthepotentialoftextureanalysisasanon-invasivetoolforimprovingprognosticaccuracyandguidingtreatmentdecisionsforpatientswithbraintumors.However,aswithpituitaryadenomas,furtherresearchandvalidationinlarg