| 杨阳,黄增发,陈俊,丁义,张树桐,王翔.基于冠状动脉CT血管成像左心室心肌影像组学模型预测冠状动脉疾病患者主要不良心血管事件及死亡[J].中国医学影像技术,2025,41(12):1995~1999 |
| 基于冠状动脉CT血管成像左心室心肌影像组学模型预测冠状动脉疾病患者主要不良心血管事件及死亡 |
| Left ventricular myocardial radiomics model based on coronary CT angiography for predicting major adverse cardiovascular events and mortality in patients with coronary artery disease |
| 投稿时间：2025-04-09 修订日期：2025-11-17 |
| DOI：10.13929/j.issn.1003-3289.2025.12.012 |
| 中文关键词: 冠状动脉疾病 CT血管造影 心室 心肌 影像组学 |
| 英文关键词:coronary artery disease computed tomography angiography heart ventricles myocardium radiomics |
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| 中文摘要: |
| 目的 观察基于冠状动脉CT血管成像(CCTA)构建左心室心肌影像组学模型预测冠状动脉疾病(CAD)患者主要不良心血管事件(MACE)及死亡的价值。方法 回顾性收集895例有CAD症状且接受CCTA检查患者,按7∶3比例随机分为训练集626例和验证集269例;以影像组学得分(Radscore)中位数为截断值划分高、低风险组;分别基于左心室心肌 Radscore、临床参数和临床+Radscore构建影像组学、临床及联合模型,以受试者工作特征(ROC)曲线评估模型预测效能。结果 高风险组447例(训练集313例、验证集134例)、低风险组448例(训练集313例、验证集135例);高风险组MACE及全因死亡发生风险均高于低风险组(P均＜0.05)。3种模型对第5、7、9年的预测结果显示,影像组学模型预测效能较好,联合模型预测效能最高。结论 基于CCTA左心室心肌影像组学模型预测CAD患者长期预后效能较好;而联合模型预测效能更佳。 |
| 英文摘要: |
| Objective To observe the value of left ventricular myocardial radiomics model based on coronary CT angiography (CCTA) for predicting major adverse cardiovascular events (MACE) and mortality in patients with coronary artery disease (CAD). Methods Totally 895 patients with CAD symptoms who underwent CCTA were retrospectively collected and randomly divided into training set (626 cases) and validation set (269 cases) at the ratio of 7 ∶ 3. Taken the median radiomics score (Radscore) as the cutoff value, the patients were stratified into high- and low-risk groups. Then a radiomics model, clinical model and combined model were constructed based on left ventricular myocardial Radscore, clinical and clinical+Radscore, and the predictive efficacy of the models were evaluated using receiver operating characteristic (ROC) curve. Results There were 447 cases (313 in training set and 134 in validation set) in high-risk group, and 448 cases (313 in training set and 135 in validation set) in low-risk group. The incidence of MACE and all-cause mortality in high-risk group were both significantly higher than those in low-risk group (all P＜0.05). Predictive performance at 5, 7 and 9 years of the models indicated that the radiomics model demonstrated good predictive efficacy, and the combined model exhibited the best predictive performance. Conclusion CCTA based left ventricular myocardial radiomics model had better predictive efficacy for long-term prognosis of CAD patients, while combined model had the bset predictive efficacy. |
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