基于CCTA影像组学列线图在鉴别易损斑块中的价值
Value of radiomics nomogram based on CCTA in identifying vulnerable plaques
王林源 1熊鑫 1杨坤 1邓勇志1
作者信息
- 1. 山西医科大学附属心血管病医院 山西省心血管病医院(研究所) 山西省心血管病临床医学研究中心心脏大血管外科 山西 太原 030024
- 折叠
摘要
目的 建立并验证基于CCTA影像组学和临床特征的列线图在鉴别易损斑块的临床应用价值.方法 选取接受CCTA检查的冠状动脉疾病(coronary artery disease,CAD)患者 102 例共 108 个斑块的临床资料,其中易损斑块 35个,稳定斑块 73 个.以 8∶2 比例随机划分为训练集(n=87)及测试集(n=21).在CCTA图像中手动勾画斑块感兴趣区并提取影像组学特征.采用Mann-Whitney U检验、Pearson相关系数及LASSO算法进行特征筛选,构建影像组学模型并计算影像组学评分(Radscore).结合临床特征和Radscore构建列线图模型.最后通过ROC曲线、校准曲线和决策曲线评估模型的效能及临床应用价值.结果 最终筛选得到 8 个最优影像组学特征.结合临床和影像组学特征的列线图模型在训练集及测试集中的曲线下面积值(area under the cure,AUC)分别为 0.999、0.929.校准曲线显示列线图预测结果与实际结果之间具有良好的一致性.决策曲线显示列线图具有更好的临床益处.结论 结合CCTA影像组学特征和临床特征的列线图模型能够客观、准确地鉴别易损斑块,具有较高的诊断效能,为后续临床决策提供建议.
Abstract
Objective To develop and verify a radiomics nomogram of radiomics signature and clinical factors to differentiate vulnerable plaques from stable plaques.Methods The clinical data of patients with coronary artery disease who underwent CCTA examination were retrospectively collected,with a total of 108 plaques in 102 patients,including 35 vulnerable plaques and 73 stable plaques.These plaques were randomly placed in a training or a test cohort at a ratio of 8:2.The plaque regions of interest were manually created from CCTA images and the radiomics features were extracted.The Mann-Whitney U test,Pearson correlation coefficient and least absolute shrinkage and selection operator(LASSO)method were used for screening radiomics features and constructing the radiomics model and calculating the radiomics score(Radscore).A combined diagnostic model and nomogram combining the Radscore and clinical factors were constructed.Finally,the receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis were performed to estimate the performance of each model.Results Eight optimal radiomics features were finally filtered out.The radiomics nomogram,which combined clinical factors with Radscore achieved an area under the curve(AUC)of 0.999 versus 0.929 in the training and test cohorts.Calibration curves indicated that there was good consistency between actual observation and prediction in the identification of vulnerable plaques.Decision curves demonstrated the nomogram had potential in clinical application.Conclusion Nomogram,which combines Radscore and clini-cal factors,has demonstrated superior diagnostic performance in objectively and accurately identifying plaque stability and can provide a reference for future clinical decisions.
关键词
急性冠状动脉综合征/冠状动脉CT血管造影/易损斑块/影像组学/列线图Key words
Acute coronary syndrome/Coronary computed tomography angioplasty/Vulnerable plaques/Radiomics/Nomo-gram引用本文复制引用
基金项目
山西省医学重点科研重大科技攻关计划(2021XM04)
出版年
2024
NETL
NSTL
万方数据