Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.
Department of Intervention Radiology, Jinshan Hospital, Fudan University, Shanghai, China.
PLoS Negl Trop Dis. 2021 Oct 15;15(10):e0009834. doi: 10.1371/journal.pntd.0009834. eCollection 2021 Oct.
To construct an MR-radiomics nomogram to predict minimal hepatic encephalopathy (MHE) in patients with chronic hepatic schistosomiasis (CHS).
From July 2017 to July 2020, 236 CHS patients with non-HE (n = 140) and MHE (n = 96) were retrospective collected and randomly divided into training group and testing group. Radiomics features were extracted from substantia nigra-striatum system of a brain diffusion weighted images (DWI) and combined with clinical predictors to build a radiomics nomogram for predicting MHE in CHS patients. The ROC curve was used to evaluate the predicting performance in training group and testing group. The clinical decisive curve (CDC) was used to assess the clinical net benefit of using radiomics nomogram in predicting MHE.
Low seralbumin (P < 0.05), low platelet count (P < 0.05) and high plasma ammonia (P < 0.05) was the significant clinical predictors for MHE in CHS patients. The AUC, specificity and sensitivity of the radiomics nomogram were 0.89, 0.90 and 0.86 in the training group, and were 0.83, 0.85 and 0.75 in the training group. The CDC analysis showed clinical net benefits for the radiomics nomogram in predicting MHE.
The radiomics nomogram combining DWI radiomics features and clinical predictors could be useful tool to predict MHE in CHS patients.
构建磁共振放射组学列线图以预测慢性血吸虫病(CHS)患者的轻微肝性脑病(MHE)。
本研究回顾性收集了 2017 年 7 月至 2020 年 7 月期间 236 例 CHS 患者(非 HE 患者 140 例,MHE 患者 96 例),并将其随机分为训练组和测试组。从脑弥散加权图像(DWI)的黑质纹状体系统中提取放射组学特征,并结合临床预测因素,建立预测 CHS 患者 MHE 的放射组学列线图。使用 ROC 曲线评估训练组和测试组的预测性能。使用临床决策曲线(CDC)评估放射组学列线图在预测 MHE 中的临床净获益。
低血清白蛋白(P < 0.05)、低血小板计数(P < 0.05)和高血浆氨(P < 0.05)是 CHS 患者发生 MHE 的显著临床预测因素。放射组学列线图在训练组中的 AUC、特异性和敏感性分别为 0.89、0.90 和 0.86,在测试组中的 AUC、特异性和敏感性分别为 0.83、0.85 和 0.75。CDC 分析表明,放射组学列线图在预测 MHE 方面具有临床净获益。
联合 DWI 放射组学特征和临床预测因素的放射组学列线图可作为预测 CHS 患者 MHE 的有用工具。