偏头痛患者经颅多普勒超声检查与头颈部计算机体层摄影血管造影放射组学特征差异的临床研究  

Clinical study on the differences between transcranial Doppler ultrasonography and radiomics features of head-neck computed tomography angiography in migraine patients

作　　者：马彩虹 赖敏 梅利 郑炎 胡萍 马海云 冯博健 Ma Caihong;Lai Min;Mei Li;Zheng Yan;Hu Ping;Ma Haiyun;Feng Bojian(Department of Electrophysiology,3Department of Geriatrics,the First People's Hospital of Xining,Xining 810000,China;The Second Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310000,China;Experimental Research Center,Zhejiang Cancer Hospital,Key Laboratory of Head&Neck Cancer Translational Research of Zhejiang Province,Hangzhou 310022,China)

机构地区：[1]青海省西宁市第一人民医院电生理科,810000 [2]浙江中医药大学第二临床医学院,杭州310000 [3]青海省西宁市第一人民医院老年病科,810000 [4]浙江省肿瘤医院实验研究中心,浙江省头颈肿瘤转化医学研究重点实验室,杭州310000

出　　处：《心脑血管病防治》2023年第12期11-15,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：2020年西宁市医疗卫生科技计划项目(2020-M-32)。

摘　　要：目的通过对比增强经颅多普勒超声(c-TCD)检查探索偏头痛患者不同心脏右向左分流(RLS)情况与头颈计算机体层摄影血管造影(CTA)放射组学特征。方法连续性收集2021年4月至2022年4月于西宁市第一人民医院确诊的偏头痛患者75例,均行c-TCD及头颈CTA检查,根据c-TCD试验结果分为c-TCD阳性组29例及c-TCD阴性组46例,比较有无RLS的偏头痛患者头颈CTA放射组学特征的差异;根据RLS的程度分为大量分流组6例和少量分流组23例,比较不同RLS分流程度偏头痛患者头颈CTA放射组学特征的差异。结果c-TCD阳性组直方图指标的峰度、最大灰度强度、偏度、方差和均方根的特征值均低于c-TCD阴性组(t/Z=2.476、2.568、2.655、2.045、2.328,均P<0.05),纹理指标中的高依赖低灰度分布、短运行长度灰度分布、小区域高灰度分布、粗糙度和自相关性的特征值均低于c-TCD阴性组(t/Z=1.969、2.187、2.198、2.013、2.045,均P<0.05),提示c-TCD阳性组中头颈血管区域中管壁钙化或斑块区域占比较高,血管光滑程度较低、血管粗细及其走行变化较不规则,狭窄区域更多。大量分流组患者部分直方图指标中的均值和纹理指标中的相关性信息度量、大面积高灰度分布的特征值低于少量分流组(Z=1.674、1.674、1.790,均P<0.05),提示大量分流组中头颈部血管区域中管壁钙化或斑块部分占比较高,血管光滑程度较低、血管粗细及其走行变化较不规则。结论心脏RLS可能是偏头痛脑血管性病变的潜在因素,c-TCD及CTA检查在合并RLS偏头痛患者的诊疗过程中具有重要价值。Objective To explore different degrees of right-to-left shunt(RLS)in the heart using contrast-enhanced transcranial Doppler ultrasonography(c-TCD)and radiomics features of head-neck computed tomography angiography(CTA)in patients with migraine.Methods A total of 75 migraine patients diagnosed in the First People's Hospital of Xining were consecutively collected from April 2021 to April 2022.All patients underwent c-TCD and head-neck CTA examinations.Based on c-TCD results,patients were categorized into the c-TCD positive group(29 cases)and the c-TCD negative group(46 cases).Differences in radiomics features of head-neck CTA were compared between migraine patients with and without RLS.Patients were further divided into a large shunt group(6 cases)and a small shunt group(23 cases)based on the degree of RLS,and differences in radiomics features of head-neck CTA were compared among migraine patients with different RLS shunt degree.Results Features such as kurtosis,maximum gray intensity,skewness,variance,and root mean square of histogram indices in the c-TCD positive group were lower compared to those in the c-TCD negative group(t/Z=2.476,2.568,2.655,2.045,2.328;all P<0.05).Texture features including large dependence low gray-level emphasis,short run high gray-level emphasis,small area high gray-level emphasis,coarseness,and autocorrelation were also lower than those in the c-TCD positive group(t/Z=1.969,2.187,2.198,2.013,2.045;all P<0.05).This suggested that in the c-TCD positive group,there was a higher proportion of calcification or plaque areas in the head-neck vascular region,lower vascular smoothness,irregular changes in vascular diameter and course,and more narrow areas.In the large shunt group,features including mean values of histogram indices,and informational measure of correlation,and large area high gray-level emphasis of texture features were lower than those in the small shunt group(Z=1.674,1.674,1.790;all P<0.05).This indicated that in the large shunt group,there was a higher proportion of calcificati

关 键 词：经颅多普勒超声 放射组学 偏头痛 右向左分流 

分 类 号：R747.2[医药卫生—神经病学与精神病学]