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颅内前后循环动脉粥样硬化斑块的影像组学特征:多中心前瞻性研究

何建风 刘磊 吕晋浩 马宁 李志成 马林 娄昕

何建风, 刘磊, 吕晋浩, 马宁, 李志成, 马林, 娄昕. 颅内前后循环动脉粥样硬化斑块的影像组学特征:多中心前瞻性研究[J]. 协和医学杂志, 2019, 10(1): 53-58. doi: 10.3969/j.issn.1674-9081.2019.01.007
引用本文: 何建风, 刘磊, 吕晋浩, 马宁, 李志成, 马林, 娄昕. 颅内前后循环动脉粥样硬化斑块的影像组学特征:多中心前瞻性研究[J]. 协和医学杂志, 2019, 10(1): 53-58. doi: 10.3969/j.issn.1674-9081.2019.01.007
Jian-feng HE, Lei LIU, Jin-hao LYU, Ning MA, Zhi-cheng LI, Lin MA, Xin LOU. Radiomic Features of Atherosclerotic Plaques in the Anterior and Posterior Intracranial Circulation: Multicenter Prospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(1): 53-58. doi: 10.3969/j.issn.1674-9081.2019.01.007
Citation: Jian-feng HE, Lei LIU, Jin-hao LYU, Ning MA, Zhi-cheng LI, Lin MA, Xin LOU. Radiomic Features of Atherosclerotic Plaques in the Anterior and Posterior Intracranial Circulation: Multicenter Prospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(1): 53-58. doi: 10.3969/j.issn.1674-9081.2019.01.007

颅内前后循环动脉粥样硬化斑块的影像组学特征:多中心前瞻性研究

doi: 10.3969/j.issn.1674-9081.2019.01.007
基金项目: 

国家自然科学基金 81671126

国家自然科学基金 81730048

详细信息
    通讯作者:

    娄昕  电话:010-66936620,E-mial:xinlou301@sina.com

  • 中图分类号: R814;R743.1

Radiomic Features of Atherosclerotic Plaques in the Anterior and Posterior Intracranial Circulation: Multicenter Prospective Study

More Information
    Corresponding author: LOU Xin  Tel
  • 摘要:   目的   探讨颅内前后循环动脉粥样硬化的危险因素及其动脉粥样硬化斑块常规高分辨磁共振成像(high resolution magnetic resonance imaging, HRMRI)特征和影像组学特征是否存在差异。   方法   2014年9月至2017年1月在北京天坛医院和中国人民解放军总医院就诊并接受HRMRI检查的疑似症状性颅内动脉狭窄患者连续入组本研究, 比较前、后循环两组患者动脉粥样硬化的危险因素(年龄、高血压、糖尿病、高脂血症、吸烟、肥胖、性别)、斑块常规HRMRI特征(斑块分布、出血、钙化及重构模式)及影像组学特征。所有斑块采用手工勾勒。   结果   共计141例符合纳入和排除标准的患者入选本研究。前循环颅内动脉粥样硬化患者60例, 其中脑梗死及短暂性脑缺血发作(transient ischemic stroke, TIA)患者分别为52例和8例; 后循环颅内动脉粥样硬化患者81例, 其中脑梗死及TIA患者分别为62例和19例; 前后循环的脑缺血类型无统计学差异(χ2=2.282, P=0.131)。危险因素中, 高血压、糖尿病及高脂血症在两组间有统计学差异(χ2=7.047、5.979、11.176, P=0.008、0.014、0.001)。前后循环责任斑块分别判定为63个及105个, 斑块分布具有统计学差异(χ2=34.363, P < 0.001);174个影像组学特征中, 21.3%(37/174)在前后循环组之间存在统计学差异(t值范围2.0052~7.7029, P < 0.05), 其中单因子判别精度最高的5个影像组学特征为基于灰度共生矩阵的集群阴影、最大二维直径柱(形状特征)、最大二维直径行(形状特征)、偏度(一阶特征)、最小轴长(形状特征), 这些特征的受试者工作特征曲线下面积分别为0.807、0.760、0.786、0.791、0.746。   结论   颅内前后循环动脉粥样硬化的危险因素、常规HRMRI特征及影像组学特征存在显著差异, 影像组学的特征差异较常规HRMRI更多见。
    利益冲突  无
  • 图  1  判别颅内前后循环动脉粥样硬化斑块差异精度排名前5的影像组学特征及组合影像组学特征ROC曲线

    AUC:曲线下面积; ROC:受试者特征曲线

    表  1  颅内前后循环动脉粥样硬化危险因素分析[n(%)]

    危险因素 前循环(n=60) 后循环(n=81) χ2 P
    高血压 7.047 0.008
      是 35(58.3) 64(79.0)
      否 25(41.7) 17(21.0)
    糖尿病 5.979 0.014
      是 16(26.7) 38(46.9)
      否 44(73.3) 43(53.1)
    高脂血症 11.176 0.001
      是 10(16.7) 35(43.2)
      否 50(83.3) 46(56.8)
    吸烟 1.361 0.243
      是 42(70.0) 49(60.4)
      否 18(30.0) 32(39.6)
    肥胖 0.300 0.862
      是 8(13.3) 10(12.3)
      否 52(86.7) 71(87.7)
    性别 0.264 0.608
      男 46(76.7) 65(80.2)
      女 14(23.3) 16(19.8)
    下载: 导出CSV

    表  2  颅内前后循环动脉粥样硬化斑块常规HRMRI特征[n(%)]

    斑块HRMRI特征 前循环(n=63) 后循环(n=105) χ2 P
    分布 34.363 <0.001
    局灶 41(65.0) 21(20.0)
    弥漫 22(35.0) 84(80.0)
    出血 3.080 0.079
    8(12.7) 25(23.8)
    55(87.3) 80(76.2)
    钙化 1.839 0.175
    7(11.1) 20(19.0)
    56(88.9) 85(81.0)
    重构模式 3.635 0.162
    阳性重构 26(41.3) 36(34.3)
    阴性重构 33(52.4) 52(49.5)
    无重构 4(6.3) 17(16.2)
    狭窄度 0.450 0.978
    轻度 7(11.1) 12(11.4)
    中度 6(9.5) 9(8.6)
    重度 50(79.4) 84(80.0)
    HRMRI:高分辨磁共振成像
    下载: 导出CSV
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  • 收稿日期:  2018-10-08
  • 刊出日期:  2020-02-01

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