Department of Neurosurgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; Department of Cardio-thoracic surgery, Zhoushan hospital, Zhoushan 316000, China.
Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Seizure. 2021 Dec;93:120-126. doi: 10.1016/j.seizure.2021.10.012. Epub 2021 Oct 17.
This study aim to identify the clinical risk factors of and to develop a radiomics-based predictive model for early postoperative seizure.
We retrospectively assessed 322 operative patients with meningioma who met the inclusion criteria from January 2014 to December 2016 at The First Affiliated Hospital of Wenzhou Medical University. Univariate and multivariate analyses were performed to determine the predictive value of clinical variables. Magnetic resonance imaging (MRI) was performed to obtain the radiomic score (Rscore) for early postoperative seizure. Radiological features were evaluated using the AK software. The minimal redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) methods were used to assess for radiomic features, and the Rscore was obtained based on radiomic characteristics using a specific formula.
In total, 260 patients who met the inclusion criteria were finally enrolled in this study. Among them, 20 experienced early postoperative seizure. Logistic regression analysis showed that Rscore was associated with a significantly high risk of seizure (p<0.000). Receiver operating characteristic (ROC) curve analysis revealed that the area under the ROC curve of the Rscore was 0.92 (95% confidence interval: 0.853-0.987). The model had a high accuracy for predicting early postoperative seizure.
The Rscore was found to be associated with a high risk of early postoperative seizures. Thus, a higher Rscore (>-1.644) can identify high-risk patients requiring intensive care.
本研究旨在确定术后早期癫痫的临床危险因素,并建立基于放射组学的预测模型。
我们回顾性评估了 2014 年 1 月至 2016 年 12 月在温州医科大学第一附属医院符合纳入标准的 322 例脑膜瘤手术患者。采用单因素和多因素分析确定临床变量的预测价值。磁共振成像(MRI)用于获取术后早期癫痫的放射组学评分(Rscore)。使用 AK 软件评估放射学特征。采用最小冗余(mRMR)和最小绝对收缩和选择算子(LASSO)方法评估放射组学特征,并根据放射组学特征使用特定公式获得 Rscore。
共纳入 260 例符合纳入标准的患者,其中 20 例发生术后早期癫痫。Logistic 回归分析显示,Rscore 与癫痫发作的风险显著相关(p<0.000)。受试者工作特征(ROC)曲线分析显示,Rscore 的 ROC 曲线下面积为 0.92(95%置信区间:0.853-0.987)。该模型对预测术后早期癫痫具有较高的准确性。
Rscore 与术后早期癫痫发作的高风险相关。因此,较高的 Rscore(>-1.644)可以识别需要加强护理的高危患者。