Li Chuang, Dong Weihong, Li Yawei
Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou University People's Hospital Zhengzhou 450003, Henan, China.
Am J Cancer Res. 2024 Oct 15;14(10):4935-4945. doi: 10.62347/AQSJ3784. eCollection 2024.
Kaposiform hemangioendothelioma (KHE) is a rare neoplasm of the newborn, but has a very high mortality rate. In this study, we explore the application value of ultrasound radiomics in the differential diagnosis of KHE so as to provide reference for early diagnosis of KHE. We selected 194 cases of children with suspected KHE admitted to Henan Provincial People's Hospital from March 2016 to April 2024 for this retrospective analysis. All children completed ultrasound examinations in our hospital. After pathological biopsy, 132 cases were diagnosed with KHE. Taking pathological biopsy as the gold standard, the diagnostic rate of ultrasound examination was determined. Our results showed that ultrasound examination diagnosed 124 cases with KHE. Compared with pathological biopsy, the diagnostic sensitivity, specificity, and accuracy of ultrasound were 81.82, 77.42, and 80.41%, respectively (Kappa = 0.725). Most of the children had a single lesion, often involving the skin. The tumor was hard in texture and red or purple in color and did not fade when pressed. The two-dimensional sonogram showed a solid heterogeneous echo mass in the soft tissue. The lesion was generally large, irregular in shape, and unclear in boundaries, extending to the adipose layer and forming a "tree root-like" change. Microscopically, crossed spindle-shaped cell bundles could be seen, showing diffuse multinodular infiltrative growth. Children with the Kasabach-Merritt phenomenon (KMP) generally had larger lesions. Subsequently, the children with KHE were assigned to a training set and a validation set in a ratio of 7:3. High-throughput data acquisition of the regions of interest (ROIs) on the ultrasound images was carried out to construct a KEH prediction model based on ultrasound radiomics, and validation analysis was conducted. We found the diagnostic accuracy rate of ultrasound radiomics was 91.41%, the sensitivity was 77.44%, and the specificity was 97.21%, which were better than those of the conventional ultrasound. In conclusion, ultrasound radiomics analysis is highly effective in the diagnosis of KHE, which can contribute to the early diagnosis rate of KHE.
卡波西样血管内皮瘤（KHE）是一种罕见的新生儿肿瘤，但死亡率很高。在本研究中，我们探讨超声影像组学在KHE鉴别诊断中的应用价值，为KHE的早期诊断提供参考。我们选取了2016年3月至2024年4月在河南省人民医院收治的194例疑似KHE患儿进行回顾性分析。所有患儿均在我院完成超声检查。经病理活检后，132例被诊断为KHE。以病理活检为金标准，确定超声检查的诊断率。我们的结果显示，超声检查诊断出124例KHE。与病理活检相比，超声的诊断敏感性、特异性和准确性分别为81.82%、77.42%和80.41%（Kappa = 0.725）。大多数患儿为单发病变，常累及皮肤。肿瘤质地硬，颜色为红色或紫色，按压不褪色。二维超声图像显示软组织内实性不均匀回声团块。病变一般较大，形态不规则，边界不清，延伸至脂肪层并形成“树根样”改变。显微镜下可见交叉的梭形细胞束，呈弥漫性多结节浸润性生长。患有卡萨巴赫-梅里特现象（KMP）的患儿病变通常较大。随后，将KHE患儿按7:3的比例分为训练集和验证集。对超声图像上的感兴趣区域（ROI）进行高通量数据采集，构建基于超声影像组学的KEH预测模型，并进行验证分析。我们发现超声影像组学的诊断准确率为91.41%，敏感性为77.44%，特异性为97.21%，均优于传统超声。综上所述，超声影像组学分析在KHE诊断中具有很高的效能，有助于提高KHE的早期诊断率。
