基于腰椎CT影像组学列线图对骨质疏松的诊断价值  

Diagnostic value of lumbar spine CT radiomics nomogram in osteoporosis

作　　者：刘斋[1] 高婷[1] 许慧 任庆云[1] LIU Zhai;GAO Ting;XU Hui;REN Qingyun(Department of Radiology,the First Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第一医院放射科,河北石家庄050000

出　　处：《实用放射学杂志》2024年第7期1133-1137,共5页Journal of Practical Radiology

基　　金：河北省财政厅基金项目(LS201804)。

摘　　要：目的探讨基于腰椎CT影像组学列线图对骨质疏松(OP)的诊断价值。方法回顾性选取行腹部CT和定量CT(QCT)检查414例患者,按照7︰3的比例将患者随机分为训练组(n=290)和验证组(n=124)。从腰椎CT图像中提取影像组学特征,采用最小绝对收缩和选择算子(LASSO)算法对影像组学特征进行降维、选择。应用多元逻辑回归构建影像组学标签和影像组学列线图。应用受试者工作特征(ROC)曲线的曲线下面积(AUC)分析影像组学分数(Radscore)和影像组学列线图对诊断OP的诊断效能。应用DeLong检验比较2个模型的诊断效能。结果选择出8个影像组学特征建立Radscore。验证组中的Radscore和影像组学列线图区分骨量正常与骨量减少及OP、骨量减少与OP、OP与骨量减少及骨量正常的AUC分别为0.891和0.976,0.866和0.976,0.897和0.982。根据DeLong检验,影像组学列线图的AUC明显高于Radscore(P<0.05)。结论基于腰椎CT影像组学列线图模型可作为个体化评估OP的一种新方法,能为临床医师的决策提供辅助作用。Objective To investigate the diagnostic value of lumbar spine CT radiomics nomogram for osteoporosis(OP).Methods A total of 414 patients who underwent abdominal CT and quantitative computed tomography(QCT)examinations were retrospectively selected.The patients were randomly divided into a training group(n=290)and a validation group(n=124)at a ratio of 7︰3.Radiomics features were extracted from lumbar spine CT images.The least absolute shrinkage and selection operator(LASSO)algorithm was used for dimension reduction and feature selection.Multivariable logisitic regression was used to build the radiomics signature and the radiomics nomogram.The area under the curve(AUC)of receiver operating characteristic(ROC)curve was used to analyze the diagnostic performance of the Radiomics score(Radscore)and radiomics nomogram in diagnosing OP.The DeLong test was used to compare the diagnostic performance between the two models.Results Eight radiomics features were selected to establish the Radscore.The AUC of the Radscore and radiomics nomograms in the validation group for distinguishing normal bone mass from reduced bone mass and OP,reduced bone mass from OP,and OP from reduced bone mass and normal bone mass were 0.891 and 0.976,0.866 and 0.976,0.897 and 0.982,respectively.According to the DeLong test,the AUC of the radiomics nomograms was significantly higher than that of the Radscore(P<0.05).Conclusion The radiomics nomogram model based on lumbar spine CT can serve as a novel method for individualized assessment of OP and provide assistance to clinical decision-making.

关 键 词：骨质疏松 骨密度 腰椎 计算机体层成像 影像组学 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学] R445[医药卫生—临床医学]