Thijssen J M, Verbeek A M, Romijn R L, de Wolff-Rouendaal D, Oosterhuis J A
Institute of Ophthalmology, University of Nijmegen, The Netherlands.
Ultrasound Med Biol. 1991;17(2):127-38. doi: 10.1016/0301-5629(91)90120-l.
The aim of this study was to assess the differentiation of histologically different types of choroidal melanomas by means of clinical and quantitative acoustic/texture parameters of echograms. Clinical parameters were graded by morphological, kinetic and quantitative statements about the A- and B-mode echograms by a skilled diagnostician. Acoustic/texture parameters were obtained by processing and analysing radio frequency, AM-demodulated and FM-demodulated echograms. The data were preprocessed to remove influences induced by beam diffraction and focusing. The correlations between the clinical parameters were lower than 0.5 but significant in a few cases. The best set of four clinical echographic parameters enabled a retrospective classification of spindle type melanomas vs. mixed + epithelioid type melanomas with an accuracy of 77% (area under the ROC-curve of 86%). These figures do not enable, however, a prospective diagnosis. The correlations of the clinical parameters with the acoustic/texture parameters were investigated. The mutual correlations between the latter parameters were also assessed, the most significant (0.70) being between the speckle size and the slope of the linearized backscattering spectrum. The discriminant analysis performed with the best four acoustic/texture parameters (n = 30) yielded a sensitivity of 89%, a specificity of 92% and an area under the ROC-curve corresponding to a probability of correct classification of 96.6%. When using these data prospectively to classify tumours of unknown cell type (n = 21), this classification could be performed in 86% of cases.
本研究的目的是通过超声图的临床和定量声学/纹理参数来评估组织学上不同类型脉络膜黑色素瘤的差异。临床参数由熟练的诊断医生根据A模式和B模式超声图的形态、动力学和定量描述进行分级。声学/纹理参数通过对射频、调幅解调及调频解调超声图进行处理和分析获得。对数据进行预处理以消除束衍射和聚焦产生的影响。临床参数之间的相关性低于0.5，但在少数情况下具有显著性。最佳的四个临床超声参数组合能够对梭形黑色素瘤与混合+上皮样黑色素瘤进行回顾性分类，准确率为77%（ROC曲线下面积为86%）。然而，这些数据无法进行前瞻性诊断。研究了临床参数与声学/纹理参数之间的相关性。还评估了后者参数之间的相互相关性，其中最显著的（0.70）是散斑大小与线性化后向散射光谱斜率之间的相关性。使用最佳的四个声学/纹理参数（n = 30）进行判别分析，敏感性为89%，特异性为92%，ROC曲线下面积对应正确分类概率为96.6%。当使用这些数据对未知细胞类型的肿瘤（n = 21）进行前瞻性分类时，86%的病例可以完成分类。
