Department of Interventional Radiology, Second Affiliated Hospital of Nantong University, No.666 Shengli Road, Nantong, Jiangsu, 226014, Jiangsu, China.
Department of Department of Imaging Medicine, Second Affiliated Hospital of Nantong University, Nantong, 226014, Jiangsu, China.
BMC Med Imaging. 2024 Oct 7;24(1):267. doi: 10.1186/s12880-024-01438-7.
To evaluate value of Nomogram prediction model based on CTA imaging features for selecting treatment methods for isolated superior mesenteric artery dissection (ISMAD).
Symptomatic ISMAD patients were randomly divided into a training set and a validation set in a 7:3 ratio. In the training set, relevant risk factors for conservative treatment failure in ISMAD patients were analyzed, and a Nomogram prediction model for treatment outcome of ISMAD was constructed with risk factors. The predictive value of the model was evaluated.
Low true lumen residual ratio (TLRR), long dissection length, and large arterial angle (superior mesenteric artery [SMA]/abdominal aorta [AA]) were identified as independent high-risk factors for conservative treatment failure (P < 0.05). The receiver operating characteristic curve (ROC) results showed that the area under curve (AUC) of Nomogram prediction model was 0.826 (95% CI: 0.740-0.912), indicating good discrimination. The Hosmer-Lemeshow goodness-of-fit test showed good consistency between the predicted curve and the ideal curve of the Nomogram prediction model. The decision curve analysis (DCA) analysis results showed that when probability threshold for the occurrence of conservative treatment failure predicted was 0.05-0.98, patients could obtain more net benefits. Similar results were obtained for the predictive value in the validation set.
Low TLRR, long dissection length, and large arterial angle (SMA/AA) are independent high-risk factors for conservative treatment failure in ISMAD. The Nomogram model constructed with independent high-risk factors has good clinical effectiveness in predicting the failure.
评估基于 CTA 成像特征的列线图预测模型在选择孤立性肠系膜上动脉夹层（ISMAD）治疗方法中的价值。
将症状性 ISMAD 患者按 7：3 的比例随机分为训练集和验证集。在训练集中，分析 ISMAD 患者保守治疗失败的相关风险因素，并构建基于风险因素的 ISMAD 治疗结果列线图预测模型。评估模型的预测价值。
低真腔残余比（TLRR）、长夹层长度和大的动脉角度（肠系膜上动脉[SMA]/腹主动脉[AA]）被确定为保守治疗失败的独立高危因素（P<0.05）。受试者工作特征曲线（ROC）结果显示，列线图预测模型的曲线下面积（AUC）为 0.826（95%CI：0.740-0.912），表明具有良好的区分能力。Hosmer-Lemeshow 拟合优度检验表明列线图预测模型的预测曲线与理想曲线具有良好的一致性。决策曲线分析（DCA）分析结果表明，当预测保守治疗失败发生概率的阈值在 0.05-0.98 之间时，患者可以获得更多的净收益。验证集中也得到了类似的预测价值结果。
TLRR 低、夹层长度长、动脉角度（SMA/AA）大是 ISMAD 保守治疗失败的独立高危因素。基于独立高危因素构建的列线图模型在预测失败方面具有良好的临床效果。
