协和医学杂志

2019, v.10(01) 53-58

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

何建风;刘磊;吕晋浩;马宁;李志成;马林;娄昕;
HE Jian-feng;LIU Lei;LYU Jin-hao;MA Ning;LI Zhi-cheng;MA Lin;LOU Xin;Department of Radiology,Chinese People's Liberation Army General Hospital;Institute of Biomedical and Health Engineering,Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences;Department of Interventional Neurology,Beijing Tian Tan Hospital,Capital Medical University;

摘要(Abstract):

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(X~2=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(X~2=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(X~2=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。
Objective The study aimed to explore the risk factors of atherosclerosis in the intracranial anterior circulation( AC) and posterior circulation( PC),and to explore their features of conventional high-resolutionmagnetic resonance imaging( HRMRI) and radiomics approach. Methods Consecutive patients with suspected symptomatic intracranial arterial stenosis were enrolled from Beijing Tian Tan Hospital and Chinese People's Liberation Army General Hospital between September 2014 and January 2017. All patients underwent HRMRI. Related risk factors( age,hypertension,diabetes mellitus,hyperlipidemia,smoking,obesity,sex),conventional HRMRI features( plaque distribution,calcification,hemorrhage,remodeling pattern),and radiomic features were compared between the AC and PC groups. All plaques were segmented manually. Results A total of 141 patients were enrolled in this study. There were 60 patients in the AC group( including 52 with infarction and 8 with transient ischemic stroke) and 81 patients in the PC group( including 62 with infarction and 19 with transient ischemic stroke); ischemic type showed no statistical significance between the two groups( X~2= 2. 282,P =0. 131). Among the risk factors,hypertension,diabetes mellitus,and hyperlipidemia showed the statistically different between the AC and PC groups( X~2= 7. 047,5. 979,11. 176,and P = 0. 008,0. 014,0. 001,respectively). Sixty-three culprit plaques of AC and 105 of PC were identified and the plaque distribution between AC and PC groups showed a significant difference( X~2= 34. 363,P < 0. 001). Among 178 radiomic features,21. 3%( 37/174) showed significantly different between AC and PC plaques( t = 2. 0052-7. 7029,P<0. 05). The five selected features with the highest discriminant accuracy were GLCM Cluster Shade,Shape maximum 2 D Diameter Colum,Shape maximum 2 D Diameter Row,Firstoder Skewness,and Shape Least Axis,and their area under the receiver operating curve were 0. 807,0. 760,0. 786,0. 791,and 0. 746,respectively. Conclusions There are significant differences in risk factors,conventional HRMRI features,and radiomic features between intracranial AC and PC atherosclerosis. More differences can be detected by radiomic features rather than the conventional HRMRI.

关键词(KeyWords): 影像组学;粥样硬化斑块;高分辨磁共振成像
radiomics;atherosclerotic plaque;high-resolution magnetic resonance imaging

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基金项目(Foundation): 国家自然科学基金(81671126、81730048)

作者(Author): 何建风;刘磊;吕晋浩;马宁;李志成;马林;娄昕;
HE Jian-feng;LIU Lei;LYU Jin-hao;MA Ning;LI Zhi-cheng;MA Lin;LOU Xin;Department of Radiology,Chinese People's Liberation Army General Hospital;Institute of Biomedical and Health Engineering,Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences;Department of Interventional Neurology,Beijing Tian Tan Hospital,Capital Medical University;

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