不同类型结肠息肉患者舌象图像特征客观化分析

Objective analysis of tongue image features of patients with different types of colon polyps

关键词:  舌象  结肠息肉  中医  舌诊客观化

Key words:  tongue image  colorectal polyps  traditional Chinese medicine  objectification of tongue diagnosis

摘要:

[目的] 探究不同病理类型的结肠息肉患者舌象特征规律，实现无创辅助诊断不同病理类型的结肠息肉。[方法] 使用舌象采集系统，纳入44例腺瘤型息肉（CAP）患者与36例非腺瘤型息肉（NCAP）患者的舌象图像数据，使用RGB、HSI、Lab、YCrCb颜色空间指标以及对比度（CON）、角度方向二阶矩（ASM）、熵值（ENT）、平均值（MEAN）纹理特征指标，分析NCAP与CAP患者舌象图像特征，根据舌诊脏腑学说，对舌象图像进行分区，舌根、舌左侧、舌右侧、舌中、舌尖，并对其分区进行颜色、纹理特征提取与显著性差异分析。[结果] CAP患者与NCAP患者在舌质的Lab颜色空间的a通道、YCrCb颜色空间的Cb通道，以及舌左侧Lab颜色空间的b通道存在显著性差异，YCrCb颜色空间的Cr通道存在差异。[结论] CAP与NCAP患者的舌象特征之间存在一定的差异性，可以为结肠息肉的不同类型鉴别诊断提供一种客观化的参考依据。

Abstract:

[Objective] This study aims to investigate the tongue image characteristics of patients with different pathological types of colorectal polyps to establish a non-invasive auxiliary method for their differentiation. [Methods] Tongue images were collected from 44 patients with colorectal adenomatous polyps（CAP）and 36 patients with non colorectal adenomatous polyps（NCAP）using a standardized acquisition system. Color features were extracted from RGB，HSI，Lab，and YCbCr color spaces，and texture features， including contrast（CON），angular second moment（ASM），entropy（ENT），and MEAN，were calculated. Based on the zang-fu-organs theory of tongue diagnosis，the tongue was segmented into five regions：root，left，right，center，and tip. Feature extraction and significance analysis were performed for each region. [Results] Significant differences（P<0.05）were identified between CAP and NCAP patients in tongue image features，including the“a”（tongue body）and“b”（left side of tongue）channels in Lab space，and the Cb（tongue body）channel in YCbCr space，while a difference was also noted in the Cr（left side of tongue）channel of YCbCr space. [Conclusion] Distinct differences in tongue characteristics exist between patients with CAP and NCAP. Tongue image analysis provides an objective and non-invasive reference for the differential diagnosis of colorectal polyp types.