基于影像组学的神经血管压迫与原发性三叉神经痛关系探讨  

Analysis of the relationship between neurovascular compression and primary trigeminal neuralgia based on radiomics

作　　者：倪洋 张昉 张勇[1] 林劲芝[1] NI Yang;ZHANG Fang;ZHANG Yong;LIN Jin-zhi(Department of Neurosurgery,Guangdong Second Provincial General Hospital,Guangzhou 510317,Guangdong,China)

机构地区：[1]广东省第二人民医院神经外科,广州510317

出　　处：《中国现代神经疾病杂志》2024年第8期668-673,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：广东省医学科学技术研究基金资助项目(项目编号:A2022236);广东省医学科学技术研究基金项目(项目编号:B2023037);广东省第二人民医院博士工作站项目(项目编号:2021BSGZ006)。

摘　　要：目的 基于影像组学筛查原发性三叉神经痛相关危险因素。方法 选择2017年1月至2020年12月广东省第二人民医院诊断与治疗的48例原发性三叉神经痛患者,测量平均动脉压,行头部MRI检查构建神经血管压迫模型。单因素和多因素Logistic回归分析筛查原发性三叉神经痛相关危险因素,根据危险因素绘制受试者工作特征(ROC)曲线,评价其预测效能。结果 共48例患者平均动脉压为56.89~120.44 mm Hg,平均为(94.32±11.34)mm Hg;42例(87.50%)病灶位于单侧、6例(12.50%)病灶位于双侧,计54例次神经血管压迫模型。根据是否引发三叉神经痛分为患侧组(40例次)和健侧组(14例次),患侧组神经血管压迫面积(Z=-2.823,P=0.005)和神经血管压力(Z=-0.365,P=0.006)均大于健侧组。Logistic回归分析显示,神经血管压力大是原发性三叉神经痛的危险因素(OR=1.001,95%CI:1.0003~1.0022;P=0.011)。ROC曲线显示,神经血管压迫面积预测原发性三叉神经痛的曲线下面积为0.747(95%CI:0.605~0.890,P=0.006),灵敏度为42.50%、特异度为100%,截断值为25.34 mm^(2);神经血管压力的曲线下面积为0.755(95%CI:0.616~0.895,P=0.005),灵敏度为67.50%、特异度为78.60%,截断值为1672.99 mm Hg·mm^(2);且二者预测效能相当(Z=-0.250,P=0.805)。结论 神经血管压迫面积和神经血管压力对原发性三叉神经痛具有重要诊断价值。Objective To screen the risk factors related to primary trigeminal neuralgia(PTN)based on radiomics.Methods A total of 48 patients with PTN admitted to Guangdong Second Provincial General Hospital from January 2017 to December 2020 were selected.The mean arterial pressure(MAP)of the patients was measured,and the neurovascular compression model was constructed by head MRI examination.Univariate and multivariate Logistic regression analyses were used to screen for risk factors associated with PTN,and the predictive efficacy was evaluated by receiver operating characteristic(ROC)curve according to the risk factors.Results Among 48 patients,42 patients(87.50%)had unilateral lesions and 6 patients(12.50%)had bilateral lesions.The MAP was 56.89-120.44 mm Hg,with an average of(94.32±11.34)mm Hg.The neurovascular compression model of 54 cases was divided into the affected side(n=40)and the healthy side(n=14)according to whether the disease occurred.The neurovascular compression area(Z=-2.823,P=0.005)and neurovascular pressure(Z=-0.365,P=0.006)on the affected side were greater than those onthe healthy side.Logistic regression analyses showed that high neurovascular pressure(0R=1.001,95%CI:1.0003-1.0022;P=0.011)was a risk factor for PTN.R0C showed the area under the curve(AUC)of neurovascular compression area for predicting PTN was 0.747(95%CI:0.605-0.890,P=0.006),the sensitivity was 42.50%,the specificity was 100%,and the cut-off value was 25.34 mm^(2).The AUC of neurovascular pressure was 0.755(95%CI:0.616-0.895,P=0.005),the sensitivity was 67.50%,the specificity was 78.60%,and the cut-off value was 1672.99 mm Hg·mm^(2).Conclusions The neurovascular compression area and neurovascular pressure are important in the diagnosis of PTN.

关 键 词：三叉神经痛 磁共振成像 影像组学(非MeSH词) 危险因素 LOGISTIC模型 ROC曲线 

分 类 号：R745.11[医药卫生—神经病学与精神病学]