基于增强CT影像组学预测急性胰腺炎后糖尿病的发生  

Contrast-enhanced CT-based radiomics in predicting post-acute pancreatitis diabetes mellitus incidence

作　　者：钟舒婷 黄小华[1] 杜青林 陈雨薇 秦石泽 蒋雨 ZHONG Shuting;HUANG Xiaohua;DU Qinglin;CHEN Yuwei;QIN Shize;JIANG Yu(Department of Radiology,the Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan Province 637000,China)

机构地区：[1]川北医学院附属医院放射科,四川南充637000

出　　处：《实用放射学杂志》2024年第3期385-389,共5页Journal of Practical Radiology

基　　金：南充市市校科技合作战略合作项目-重要研发平台基金项目(19SXHZ0429,20SXQT0303)。

摘　　要：目的探讨双期增强CT影像组学预测急性胰腺炎后糖尿病(PPDM-A)的价值.方法回顾性选取145例急性胰腺炎(AP)患者,PPDM-A组62例,非PPDM-A组83例,以7︰3的比例随机分为训练集和测试集,勾画动脉期及静脉期胰腺实质并提取影像组学特征,采用方差阈值法、单变量选择法和最小绝对收缩和选择算子(LASSO)进行影像组学特征筛选.通过曲线下面积(AUC)评估模型预测性能,使用DeLong检验比较模型之间预测效能,并采用校准曲线和决策曲线评价模型预测效能.结果动脉期模型、静脉期模型、动静脉期联合模型、临床模型、影像组学联合临床模型在训练集中AUC分别为0.845、0.792、0.829、0.656、0.862.DeLong检验结果显示5种模型的预测效能只有影像组学联合临床模型与临床模型在训练集和测试集之间的差异有统计学意义(P<0.05).决策曲线显示在一定范围区间影像组学联合临床模型的临床实用性高,校准曲线显示影像组学联合临床模型与实际观察值的拟合度最好.结论基于双期增强CT影像组学联合临床模型可以较准确地预测PPDM-A,并能为临床制订个性化治疗方案提供一定的参考价值.Objective To explore the value of dual-phase enhanced CT radiomics in predicting post-acute pancreatitis diabetes mellitus(PPDM-A).Methods A total of 145 patients with acute pancreatitis(AP)were retrospectively collected,including 62 patients in PPDM-A group and 83 patients in non-PPDM-A group.The patients were randomly divided into training set and test set at a ratio of 7︰3,the pancreatic parenchyma in arterial phase and venous phase was delineated and the radiomics features were extracted.Vari-ance threshold method,univariate selection method and least absolute shrinkage and selection operator(LASSO)were used to screen radiomics features.The prediction performance of the model was evaluated by the area under the curve(AUC).The DeLong test was used to compare the prediction efficiency between the models,and the calibration curve and decision curve were used to evaluate the prediction efficiency of the model.Results The AUC of arterial phase model,venous phase model,combined arterial venous phase model,clinical model and radiomics combined clinical model in the training set were 0.845,0.792,0.829,0.656 and 0.862,respec-tively.The DeLong test results showed that only the difference between the radiomics combined clinical model and the clinical model in the training set and the test set was statistically significant(P<0.05).The decision curve showed that the radiomics combined clinical model had high clinical practicability in a certain range,and the calibration curve showed that the radiomics combined clinical model had the best fitting degree with the actual observation value.Conclusion Based on the dual-phase enhanced CT radiomics combined clinical model,PPDM-A can be predicted more accurately,and it can provide a certain reference value for the clinical development of per-sonalized treatment programs.

关 键 词：急性胰腺炎后糖尿病 急性胰腺炎 影像组学 计算机体层成像 

分 类 号：R587.1[医药卫生—内分泌] R657.51[医药卫生—内科学] R814.2[医药卫生—临床医学]