Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, China.
Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, China.
Eur J Radiol. 2023 Jun;163:110785. doi: 10.1016/j.ejrad.2023.110785. Epub 2023 Mar 16.
To develop a non-contrast computed tomography(NCCT)based radiomics model for predicting intraparenchymal hemorrhage progression in patients with mild to moderate traumatic brain injury(TBI).
We retrospectively analyzed 166 mild to moderate TBI patients with intraparenchymal hemorrhage from January 2018 to December 2021. The enrolled patients were divided into training cohort and test cohort with a ratio of 6:4. Uni- and multivariable logistic regression analyses were implemented to screen clinical-radiological factors and to establish a clinical-radiological model. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC), the calibration curve, the decision curve analysis, sensitivity, and specificity.
Eleven radiomics features, presence with SDH, and D-dimer > 5 mg/l were selected to construct the combined clinical-radiomic model for the prediction of TICH in mild to moderate TBI patients. The AUC of the combined model was 0.81(95% confidence interval (CI), 0.72 to 0.90) in the training cohort and 0.88 (95% CI 0.79 to 0.96) in the test cohort, which were superior to the clinical model alone (AUC = 0.72, AUC = 0.74). The calibration curve demonstrated that the radiomics nomogram had a good agreement between prediction and observation. Decision curve analysis confirmed clinically useful.
The combined clinical-radiomic model that incorporates the radiomics score and clinical risk factors can serve as a reliable and powerful tool for Predicting intraparenchymal hemorrhage progression for patients with mild to moderate TBI.
开发一种基于非对比计算机断层扫描（NCCT）的放射组学模型，用于预测轻度至中度创伤性脑损伤（TBI）患者的脑实质内出血进展。
我们回顾性分析了 2018 年 1 月至 2021 年 12 月期间 166 例轻度至中度 TBI 合并脑实质内出血的患者。入组患者按 6:4 的比例分为训练队列和测试队列。采用单变量和多变量逻辑回归分析筛选临床-影像学因素，并建立临床-影像学模型。通过受试者工作特征曲线（AUC）下面积、校准曲线、决策曲线分析、敏感性和特异性评估模型性能。
选择了 11 个放射组学特征、存在 SDH 和 D-二聚体>5mg/l，构建了用于预测轻度至中度 TBI 患者 TICH 的联合临床放射组学模型。该模型在训练队列中的 AUC 为 0.81（95%置信区间[CI]，0.72 至 0.90），在测试队列中的 AUC 为 0.88（95% CI，0.79 至 0.96），均优于单独的临床模型（AUC=0.72，AUC=0.74）。校准曲线表明放射组学列线图预测与观察之间具有良好的一致性。决策曲线分析证实该模型具有临床实用性。
联合临床放射组学模型纳入放射组学评分和临床危险因素，可作为预测轻度至中度 TBI 患者脑实质内出血进展的可靠且强大的工具。
