中国中西医结合影像学杂志2025，Vol.23Issue(3)：363-370,8.DOI:10.3969/j.issn.1672-0512.2025.03.018
基于高分辨MRI的颈动脉斑块影像组学模型对症状性颈动脉斑块的鉴别
Discrimination of symptomatic carotid artery plaques based on high-resolution MRI radiomics
摘要
Abstract
Objective:To construct a model based on high-resolution MRI and radiomics features and clinical data of carotid artery plaques for differentiation between symptomatic and asymptomatic carotid artery plaques.Methods:A total of 136 patients with carotid artery stenosis were included.Ninety-three patients from Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University were assigned to the training set,and 43 patients from Luodian Hospital in Baoshan District were assigned to the validation set.Based on whether suspected acute stroke or transient ischemic symptoms occurred on the carotid artery stenosis side within 2 weeks before MRI examination,the training set and validation set were divided into the symptom group and the asymptomatic group.All patients underwent high-resolution MRI examination for the carotid artery,and radiomics features were extracted from T1WI,T2WI,and dynamic contrast-enhanced T1WI(DCE-T1WI)sequences.The radiomics features were selected using least absolute shrinkage and selection operator(LASSO)algorithm,and the radiomics score(Radscore)was calculated.The clinical-imaging model and three radiomics models from T1WI,T2WI and DCE-T1WI were constructed.A combined model predicting symptomatic plaques was constructed based on clinical risk factors,imaging characteristics and Radscore.A nomogram was constructed based on the combined model to visually demonstrate its predictive performance.The discrimination ability of the model was evaluated using the ROC curve,and the decision curve and calibration curve were performed to anlayze the clinical utility and fit of the combined model.Results:Eleven radiomics features were screened out by the LASSO algorithm and stepwise regression.In the training set,univariate and multivariate logistic regression analysis showed that,age,hyperlipidemia,lumen stenosis grade,lipid-enriched necrotic nuclei,and intraplaque hemorrhage were the independent risk factors for symptomatic plaques.The combined model showed good discrimination,with the AUC of 0.910 in the training set and 0.846 in the validation set.The decision curve and calibration curve of the combined model demonstrated good goodness-of-fit and clinical utility.Conclusion:The combined model based on high-resolution MRI and radiomics features and clinical data of carotid artery plaques has a good predictive performance for differentiating between symptomatic and asymptomatic plaques.关键词
磁共振成像/中风/颈动脉粥样硬化斑块/影像组学/列线图Key words
Magnetic resonance imaging/Stroke/Carotid artery atherosclerotic plaques/Radiomics/Nomogram引用本文复制引用
武刚,邓波,高晓龙..基于高分辨MRI的颈动脉斑块影像组学模型对症状性颈动脉斑块的鉴别[J].中国中西医结合影像学杂志,2025,23(3):363-370,8.基金项目
上海市卫生健康委课题(202140322). （202140322）
