颈动脉斑块超声影像组学对高危短暂性脑缺血发作进展为缺血性卒中的预测价值研究  

Predictive value of ultrasound imagingomics of carotid artery plaque on ischemic stroke of the progression of transient ischemic attack with high risk

作　　者：王梦琪 胡剑 吴倩 周丽 Wang Mengqi;Hu Jian;Wu Qian;Zhou Li(Department of Medical Ultrasound,The Central Hospital of Enshi Tujia And Miao Autonomous Prefecture,Enshi 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院超声科,恩施445000

出　　处：《中国医学装备》2024年第12期88-92,共5页China Medical Equipment

基　　金：湖北省卫生健康委科研项目(WJ2021F094)。

摘　　要：目的:探讨颈动脉斑块超声影像组学对高危短暂性脑缺血发作(TIA)进展为缺血性卒中的预测价值。方法:选取2022年10月至2024年5月恩施土家族苗族自治州中心医院收治的120例高危TIA患者,依据是否发生缺血性卒中将其分为发作组(42例)和非发作组(78例)。比较两组患者的颈动脉斑块最大长度、面积、狭窄处的最大流速以及阻力指数等超声影像特征的差异。将所有患者影像学特征感兴趣区域按照7∶3的比例进行分析,将其分为训练集和验证集,并对验证集和训练集的诊断灵敏度进行分析。结果:发作组患者的斑块最大长度(21.86±1.31)mm、斑块最大高度(6.92±1.27)mm、斑块最大面积(72.58±1.37)mm^(2)、狭窄处最大流速(4.14±1.17)cm/s以及阻力指数(0.77±0.32),显著高于非发作组的(15.04±1.32)mm、(2.81±0.29)mm、(65.78±1.4)mm^(2)、(2.81±0.15)cm/s和(0.34±0.42),两组比较差异有统计学意义(t=27.129、20.685、25.735、7.335、6.272,P<0.05);较高的斑块最大长度、斑块最大高度、斑块最大面积、狭窄处最大流速以及阻力指数均是造成患者缺血性脑卒中的危险因素(OR=3.323、2.846、2.963、2.915、2.974,P<0.05)。训练集和验证集的影像组学综合诊断模型的受试者工作特征(ROC)曲线下面积(AUC)均>0.700。结论:颈动脉斑块超声影像组学分析方法能够更全面地评估患者颈动脉斑块的情况,为临床医生提供重要的辅助信息,有助于缺血性脑卒中的医疗诊断和治疗方案制定。Objective:To investigate predictive value of ultrasound imageomics of carotid artery plaque on the progression of transient ischemic attack(TIA)with high risk.Methods:We enrolled 120 patients with high-risk TIA who admitted to The Central Hospital of Enshi Tujia And Miao Autonomous Prefecture from October 1,2022 to May 1,2024,and they were divided into seizure group(42 cases)and non-seizure group(78 cases)according to whether occurred ischemic stroke.The differences of the characteristics of ultrasonic images,which included the maximum length,the area,the maximum flow velocity and resistance index of the stenosis of plaque,were compared between two groups.The region of interest(ROI)of imaging characteristics of all patients were analyzed as ratio of 7:3,and they were divided into train set and verification set,and the diagnostic sensitivities of verification set and train set were further analyzed.Results:The maximum length(21.86±1.31)mm,the maximum height(6.92±1.27)mm,the area(72.58±1.37)mm^(2),the maximum flow velocity(4.14±1.17)cm/s and resistance index(0.77±0.32)of the narrow area of plaque in seizure group were significantly higher than those[(15.04±1.32)mm,(2.81±0.29)mm,(65.78±1.4)mm^(2),(2.81±0.15)cm/s and(0.34±0.42)]in non-seizure group,and the differences of them between two groups were significant(t=27.129,20.685,25.735,7.335,6.272,P<0.05),respectively.Higher values of the maximum length,the maximum height and the area of plaque,and the maximum flow velocity at stenosis,and the resistance index were risk factors of causing ischemic stroke in patients(OR=3.323,2.846,2.963,2.915,2.974,P<0.05),respectively.The area under curve(AUC)values of receiver operating characteristic(ROC)curve of the comprehensive diagnostic model of the imageomics in both train set and verification set were above 0.700.Correlation:The analysis method of ultrasound imageomics for plaque can more comprehensively assess the situation of carotid artery plaque of patients,which can provide importantly auxiliary information for

关 键 词：颈动脉斑块超声 影像组学 短暂性脑缺血发作(TIA) 缺血性脑卒中 

分 类 号：R445.1[医药卫生—影像医学与核医学]