基于DWI的影像组学对急性缺血性卒中患者功能结局的预测  

DWI-Based Radiomics Nomogram for Predicting Functional Outcome of Acute Ischemic Stroke

作　　者：孙祎 王浩[1] 朱杰[1] 张远[1] 宋彬[1] SUN Yi;WANG Hao;ZHU Jie;ZHANG Yuan;SONG Bin(Department of Radiology,Minhang Hospital,Fudan University,Shanghai 201100,China)

机构地区：[1]复旦大学附属闵行医院上海市闵行区中心医院放射科,上海201100

出　　处：《中国医学影像学杂志》2021年第7期676-681,共6页Chinese Journal of Medical Imaging

摘　　要：目的探讨基于扩散加权成像(DWI)影像组学特征预测急性缺血性卒中(AIS)患者临床功能结局的价值。资料与方法回顾性分析409例经DWI证实的AIS患者资料,根据90 d改良Rankin量表(m RS)评分将患者分为良好结局(m RS≤2分)和较差结局(m RS>2分)组。在DWI序列上手动勾画梗死区域,提取影像组学特征并构建影像组学评分。将影像组学评分与临床危险因素相结合,建立临床-影像组学列线图,并验证其预测效能。使用决策曲线分析评估列线图的临床应用价值。结果最终包含了16个最优影像组学特征的预测模型在训练组和验证组的曲线下面积(AUC)为0.79(95%CI 0.70~0.87,P<0.01)和0.84(95%CI 0.71~0.98,P<0.01)。临床-影像组学列线图在训练组和验证组的AUC为0.82(95%CI 0.73~0.91)和0.85(95%CI0.72~0.97)。当阈值概率约在0.05~0.55时,列线图的净受益率高于其他模型。结论基于DWI影像组学的临床-影像组学列线图预测AIS患者临床功能结局具有较高的价值。Purpose To investigate the value of DWI-based radiomics in predicting clinical functional outcome in patients with acute ischemic stroke(AIS).Materials and Methods A total of 409 patients with AIS confirmed by DWI were retrospectively enrolled.According to the 90-day modified Rankin scale(mRS)score,all patients were divided into two groups,including good outcome(mRS≤2)group and poor outcome(mRS>2)group.Infarction regions were manually delineated on DWI,extracting features of radiomics and constructing scores of radiomics.The radiomics was combined with clinical risk factors to establish a clinical-radiomics nomogram,verifying its predictive efficacy.Decision curve analysis was performed to assess the clinical application value of the nomogram.Results The radiomics model that included 16 radiomics features showed that the area under curve(AUC)in training and testing cohort were 0.79(95%CI 0.70-0.87)and 0.84(95%CI 0.71-0.98),respectively.The AUC of clinical-radiomics nomogram in training and testing cohort was 0.82(95%CI 0.73-0.91)and 0.85(95%CI 0.72-0.97),respectively.Decision curve analysis showed that the radiomics nomogram was superior to the other clinical model when the threshold probability was limited within the 0.05-0.55 range.Conclusion The DWI-based clinical-radiomics nomogram shows the good performances in predicting the prognosis of functional outcome in patients with AIS.

关 键 词：缺血性卒中 磁共振成像 扩散加权成像 表观扩散系数 功能结局 影像组学 列线图 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]