目的:我们旨在开发基于MRI的影像组学模型(RM),以提高放射科医师对克罗恩病(CD)患者肠纤维化的诊断准确性。
方法:这项回顾性研究包括2013年11月至2021年9月在手术前接受MR检查的难治性CD患者。切除的肠段在组织学上分为无轻度或中度重度纤维化。基于不同MR序列组合的RM(RM1:T2WI和增强T1WI;RM2:T2WI,增强型T1WI,弥散加权成像[DWI],和表观扩散系数[ADC]);RM3:T2WI,增强型T1WI,DWI,ADC,和磁化转移MRI[MTI]),在一个独立的测试队列中开发和验证。使用相同的序列和临床模型将RM的诊断性能与视觉解释的性能进行了比较。
结果:最终人群包括123名患者(81名男性,42名妇女;平均年龄:30.26±7.98岁;培训队列,n=93;测试队列,n=30)。RM1,RM2和RM3的受试者工作特征曲线(AUC)下面积为0.86(p=0.001),0.88(p=0.001),和0.93(p=0.02),分别。决策曲线分析证实了添加更多特异性序列的三个RM的诊断性能的逐步改善。所有RM性能都超过了基于相同MR序列的视觉解释(视觉模型1,AUC=0.65,p=0.56;视觉模型2,AUC=0.63,p=0.04;视觉模型3,AUC=0.77,p=0.002),以及C反应蛋白和血沉组成的临床模型(AUC=0.60,p=0.13)。
结论:RM,利用传统的各种组合,DWI和MTI序列,显着增强放射科医师准确表征CD患者肠纤维化的能力。
■基于MRI的RM的利用显着提高了放射科医师在表征肠纤维化方面的诊断准确性。
结论:基于MRI的RM可以使用常规,扩散,和MTI序列。RM的AUC为0.86-0.93,用于评估纤维化等级。MRI影像组学在CD肠纤维化分级方面优于视觉解释。
OBJECTIVE: We aimed to develop MRI-based radiomic models (RMs) to improve the diagnostic accuracy of radiologists in characterizing intestinal
fibrosis in patients with Crohn\'s disease (CD).
METHODS: This retrospective study included patients with refractory CD who underwent MR before surgery from November 2013 to September 2021. Resected bowel segments were histologically classified as none-mild or moderate-severe
fibrosis. RMs based on different MR sequence combinations (RM1: T2WI and enhanced-T1WI; RM2: T2WI, enhanced-T1WI, diffusion-weighted imaging [DWI], and apparent diffusion coefficient [ADC]); RM3: T2WI, enhanced-T1WI, DWI, ADC, and magnetization transfer MRI [MTI]), were developed and validated in an independent test cohort. The RMs\' diagnostic performance was compared to that of visual interpretation using identical sequences and a clinical model.
RESULTS: The final population included 123 patients (81 men, 42 women; mean age: 30.26 ± 7.98 years; training cohort, n = 93; test cohort, n = 30). The area under the receiver operating characteristic curve (AUC) of RM1, RM2, and RM3 was 0.86 (p = 0.001), 0.88 (p = 0.001), and 0.93 (p = 0.02), respectively. The decision curve analysis confirmed a progressive improvement in the diagnostic performance of three RMs with the addition of more specific sequences. All RMs performance surpassed the visual interpretation based on the same MR sequences (visual model 1, AUC = 0.65, p = 0.56; visual model 2, AUC = 0.63, p = 0.04; visual model 3, AUC = 0.77, p = 0.002), as well as the clinical model composed of C-reactive protein and erythrocyte sedimentation rate (AUC = 0.60, p = 0.13).
CONCLUSIONS: The RMs, utilizing various combinations of conventional, DWI and MTI sequences, significantly enhance radiologists\' ability to accurately characterize intestinal fibrosis in patients with CD.
UNASSIGNED: The utilization of MRI-based RMs significantly enhances the diagnostic accuracy of radiologists in characterizing intestinal fibrosis.
CONCLUSIONS: MRI-based RMs can characterize CD intestinal
fibrosis using conventional, diffusion, and MTI sequences. The RMs achieved AUCs of 0.86-0.93 for assessing
fibrosis grade. MRI-radiomics outperformed visual interpretation for grading CD intestinal
fibrosis.