中华中医药杂志2025，Vol.40Issue(2)：505-511,7.
MRI影像组学在颈椎失稳诊断及手法干预机制研究中的价值
Value of MRI radiomics in diagnosis of cervical instability and mechanism study of manipulation intervention
摘要
Abstract
Objective:To study the value of MRI radiomics in diagnosis of cervical instability and mechanism study of manipulation.Methods:A total of 155 young and middle-aged adults with cervical instability and 88 non-unstable subjects who met the criteria were included for cervical MRI image collection.Five specific regions of interest(ROI),including the intervertebral disc region,the facet region,the prevertebral muscle region,the deep region of the posterior cervical muscle,and the superficial region of the posterior cervical muscle,were manually divided on the cross-sectional layer where the disc was located.To extract and screen the radiomics features,construct the cervical instability diagnostic classification model,and use the area under the curve(AUC)to evaluate the effectiveness of the model.At the same time,40 of the subjects with cervical instability were treated with cervical rotation-traction manipulation for two weeks.The established radiomics model was used to identify the recall rate of instability,combined with visual analogue scale(VAS)and neck disability index(NDI)to evaluate and analyze the intervention effect and mechanism of cervical rotation-traction manipulation.Results:After model training,5 groups of cervical instability diagnosis classification models with 5 ROIs were established.Among them,the models of deep region of the posterior cervical muscle,and the superficial region of the posterior cervical muscle had the best classification effect,and the average AUC value of ten fold cross-validation of each model was above 0.8.The results of the facet region model classification are accurate,and the average AUC value of ten fold cross-validation of 50％models was above 0.8.The classification effect of the intervertebral disc region and the prevertebral muscle region was general,and the average AUC value of the ten-fold cross-validation of each model did not reach 0.8.VAS score and NDI index of the patients were significantly lower than before treatment(P＜0.01).The recall rates of the models in the facet region and intervertebral disc region after treatment were significantly lower than those before treatment(P＜0.01).Conclusion:The diagnostic classification model of cervical instability constructed by MRI radiomics can effectively classify the instability and non-instability.At the same time,this technique can initially explain the intervention mechanism of cervical instability by cervical rotation-traction manipulation.关键词
颈椎失稳/MRI影像组学/诊断分类模型/颈椎旋提手法Key words
Cervical instability/MRI radiomics/Diagnostic classification model/Cervical rotation-traction manipulation引用本文复制引用
路广琦,于杰,李靖,庄明辉,袁娜,崔莹,俞张镜泽,孙馨悦,马明明,朱立国..MRI影像组学在颈椎失稳诊断及手法干预机制研究中的价值[J].中华中医药杂志,2025,40(2):505-511,7.基金项目
中国中医科学院科技创新工程创新团队项目(No.CI2021B010),中国中医科学院科技创新工程重大攻关项目(No.CI2021A02002),国家自然科学基金面上项目(No.82074455),北京市科技计划首都临床诊疗技术研究及转化应用项目(No.Z211100002921023),中国中医科学院望京医院高水平中医医院建设项目中医药临床循证研究专项(No.WJYY-XZKT-2023-01) （No.CI2021B010）
