Khagi Bijen, Belousova Tatiana, Short Christina M, Taylor Addison A, Bismuth Jean, Shah Dipan J, Brunner Gerd
Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas.
Am J Cardiol. 2024 Jun 1;220:56-66. doi: 10.1016/j.amjcard.2024.03.035. Epub 2024 Apr 3.
Peripheral artery disease (PAD) is associated with impaired blood flow in the lower extremities and histopathologic changes of the skeletal calf muscles, resulting in abnormal microvascular perfusion. We studied the use of convolution neural networks (CNNs) to differentiate patients with PAD from matched controls using perfusion pattern features from contrast-enhanced magnetic resonance imaging (CE-MRI) of the skeletal calf muscles. We acquired CE-MRI based skeletal calf muscle perfusion in 56 patients (36 patients with PAD and 20 matched controls). Microvascular perfusion imaging was performed after reactive hyperemia at the midcalf level, with a temporal resolution of 409 ms. We analyzed perfusion scans up to 2 minutes indexed from the local precontrast arrival time frame. Skeletal calf muscles, including the anterior muscle, lateral muscle, deep posterior muscle group, and the soleus and gastrocnemius muscles, were segmented semiautomatically. Segmented muscles were represented as 3-dimensional Digital Imaging and Communications in Medicine stacks of CE-MRI perfusion scans for deep learning (DL) analysis. We tested several CNN models for the 3-dimensional CE-MRI perfusion stacks to classify patients with PAD from matched controls. A total of 2 of the best performing CNNs (resNet and divNet) were selected to develop the final classification model. A peak accuracy of 75% was obtained for resNet and divNet. Specificity was 80% and 94% for resNet and divNet, respectively. In conclusion, DL using CNNs and CE-MRI skeletal calf muscle perfusion can discriminate patients with PAD from matched controls. DL methods may be of interest for the study of PAD.
外周动脉疾病(PAD)与下肢血流受损以及小腿骨骼肌的组织病理学变化相关,从而导致微血管灌注异常。我们研究了使用卷积神经网络(CNN),利用小腿骨骼肌对比增强磁共振成像(CE-MRI)的灌注模式特征,将PAD患者与匹配的对照组进行区分。我们对56例患者(36例PAD患者和20例匹配的对照组)进行了基于CE-MRI的小腿骨骼肌灌注检查。在小腿中部水平进行反应性充血后进行微血管灌注成像,时间分辨率为409毫秒。我们分析了从局部对比剂前到达时间框架开始的长达2分钟的灌注扫描。小腿骨骼肌,包括前肌、外侧肌、深层后肌群以及比目鱼肌和腓肠肌,进行了半自动分割。分割后的肌肉表示为用于深度学习(DL)分析的CE-MRI灌注扫描的三维医学数字成像和通信堆栈。我们测试了几种用于三维CE-MRI灌注堆栈的CNN模型,以将PAD患者与匹配的对照组进行分类。总共选择了2个性能最佳的CNN(resNet和divNet)来开发最终分类模型。resNet和divNet的峰值准确率分别为75%。resNet和divNet的特异性分别为80%和94%。总之,使用CNN和CE-MRI小腿骨骼肌灌注的DL可以区分PAD患者与匹配的对照组。DL方法可能对PAD的研究有意义。