基于肿瘤标记物、钙化或脂肪分布，可区分成熟和未成熟的畸胎瘤。然而，目前没有研究客观量化这些肿瘤之间的钙化和脂肪分布差异。本研究旨在评估基于CT的纹理分析在鉴别<20岁患者成熟和未成熟畸胎瘤之间的诊断潜力。32例病理证实的成熟囊性（n=28）和未成熟畸胎瘤（n=4）患者在手术前进行经腹部超声和/或腹部盆腔CT检查。两位有经验的读者评估了CT对肿瘤图像特征的评估性能，包括主观手动测量和针对肿瘤中脂肪和钙化分布进行的客观纹理分析。组织病理结果被用作黄金标准。使用Mann-Whitney U检验进行统计分析。我们评估了32例患者（平均年龄14.5岁；年龄范围6-19岁）。未成熟畸胎瘤的平均最大直径和钙化数目均显著大于成熟囊性畸胎瘤（p<0.01）。未成熟畸胎瘤的脂肪数目显著大于成熟囊性畸胎瘤（p<0.01），然而在脂肪最大直径方面没有显著差异。针对肿瘤中钙化分布的CT纹理特征显示，成熟囊性畸胎瘤具有更高的均匀性和能量，相比之下，未成熟畸胎瘤在灰度共生矩阵（GLCM）衍生特征中表现出更高的相关性、熵和不相似性（p<0.05）。从GLCM中衍生的脂肪CT特征没有显著差异。我们的结果表明，CT上的钙化分布是鉴别成熟和未成熟畸胎瘤的潜在诊断生物标志物，因此可以为<20岁患者选择最佳治疗手段。© 2023年。BioMed Central Ltd.，Springer Nature的一部分。

Mature and immature teratomas are differentiated based on tumor markers and calcification or fat distribution. However, no study has objectively quantified the differences in calcification and fat distributions between these tumors. This study aimed to evaluate the diagnostic potential of CT-based textural analysis in differentiating between mature and immature teratomas in patients aged < 20 years.Thirty-two patients with pathologically proven mature cystic (n = 28) and immature teratomas (n = 4) underwent transabdominal ultrasound and/or abdominal and pelvic CT before surgery. The diagnostic performance of CT for assessing imaging features, including subjective manual measurement and objective textural analysis of fat and calcification distributions in the tumors, was evaluated by two experienced readers. The histopathological results were used as the gold standard. The Mann-Whitney U test was used for statistical analysis.We evaluated 32 patients (mean age, 14.5 years; age range, 6-19 years). The mean maximum diameter and number of calcifications of immature teratomas were significantly larger than those of mature cystic teratomas (p < 0.01). The mean number of fats of immature teratomas was significantly larger than that of mature cystic teratomas (p < 0.01); however, no significant difference in the maximum diameter of fats was observed. CT textural features for calcification distribution in the tumors showed that mature cystic teratomas had higher homogeneity and energy than immature teratomas. However, immature teratomas showed higher correlation, entropy, and dissimilarity than mature cystic teratomas among features derived from the gray-level co-occurrence matrix (GLCM) (p < 0.05). No significant differences were observed in the CT features of fats derived from GLCM.Our results demonstrate that calcification distribution on CT is a potential diagnostic biomarker to discriminate mature from immature teratomas, thus enabling optimal therapeutic selection for patients aged < 20 years.© 2023. BioMed Central Ltd., part of Springer Nature.