Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, 11217, Taipei City, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou District, Taipei City, 112, Taiwan.
Eur Radiol. 2024 Jan;34(1):588-599. doi: 10.1007/s00330-023-09982-6. Epub 2023 Aug 9.
Angioarchitectural analysis of brain arteriovenous malformations (BAVMs) is qualitative and subject to interpretation. This study quantified the morphology of and signal changes in the nidal and perinidal areas by using MR radiomics and compared the performance of MR radiomics and angioarchitectural analysis in detecting epileptic BAVMs.
From 2010 to 2020, a total of 111 patients with supratentorial BAVMs were retrospectively included and grouped in accordance with the initial presentation of seizure. Patients' angiograms and MR imaging results were analyzed to determine the corresponding angioarchitecture. The BAVM nidus was contoured on time-of-flight MR angiography images. The perinidal brain parenchyma was contoured on T2-weighted images, followed by radiomic analysis. Logistic regression analysis was performed to determine the independent risk factors for seizure. ROC curve analysis, decision curve analysis (DCA), and calibration curve were performed to compare the performance of angioarchitecture-based and radiomics-based models in diagnosing epileptic BAVMs.
In multivariate analyses, low sphericity (OR: 2012.07, p = .04) and angiogenesis (OR: 5.30, p = .01) were independently associated with a high risk of seizure after adjustment for age, sex, temporal location, and nidal volume. The AUC for the angioarchitecture-based, MR radiomics-based, and combined models was 0.672, 0.817, and 0.794, respectively. DCA confirmed the clinical utility of the MR radiomics-based and combined models.
Low nidal sphericity and angiogenesis were associated with high seizure risk in patients with BAVMs. MR radiomics-derived tools may be used for noninvasive and objective measurement for evaluating the risk of seizure due to BAVM.
Low nidal sphericity was associated with high seizure risk in patients with brain arteriovenous malformation and MR radiomics may be used as a noninvasive and objective measurement method for evaluating seizure risk in patients with brain arteriovenous malformation.
• Low nidal sphericity was associated with high seizure risk in patients with brain arteriovenous malformation. • The performance of MR radiomics in detecting epileptic brain arteriovenous malformations was more satisfactory than that of angioarchitectural analysis. • MR radiomics may be used as a noninvasive and objective measurement method for evaluating seizure risk in patients with brain arteriovenous malformation.
脑动静脉畸形（BAVM）的血管构筑分析是定性的，并需要解释。本研究通过磁共振放射组学定量分析病灶和周边区域的形态学和信号变化，并比较磁共振放射组学和血管构筑分析在检测癫痫性 BAVM 中的性能。
回顾性纳入 2010 年至 2020 年间共 111 例幕上 BAVM 患者，根据初始癫痫发作表现进行分组。分析患者的血管造影和磁共振成像结果以确定相应的血管构筑。在时飞磁共振血管造影图像上勾勒 BAVM 病灶，在 T2 加权图像上勾勒周边脑实质，然后进行放射组学分析。采用 logistic 回归分析确定癫痫发作的独立危险因素。进行 ROC 曲线分析、决策曲线分析（DCA）和校准曲线分析，以比较基于血管构筑和基于放射组学模型在诊断癫痫性 BAVM 中的性能。
多因素分析中，在调整年龄、性别、时间位置和病灶体积后，低球形度（OR：2012.07，p=0.04）和血管生成（OR：5.30，p=0.01）与癫痫发作风险增加独立相关。基于血管构筑的、基于磁共振放射组学的和联合模型的 AUC 分别为 0.672、0.817 和 0.794。DCA 证实了基于磁共振放射组学和联合模型的临床实用性。
BAVM 患者病灶低球形度和血管生成与高癫痫发作风险相关。MR 放射组学衍生工具可用于无创和客观评估 BAVM 引起的癫痫发作风险。
低球形度与 BAVM 患者的高癫痫发作风险相关，MR 放射组学可作为评估 BAVM 患者癫痫发作风险的一种非侵入性和客观的测量方法。
低球形度与 BAVM 患者的高癫痫发作风险相关。
在检测癫痫性 BAVM 方面，磁共振放射组学的性能优于血管构筑分析。
MR 放射组学可作为一种非侵入性和客观的方法，用于评估 BAVM 患者的癫痫发作风险。
