摘要
目的探讨基于高分辨磁共振血管壁成像(HR-VWI)特征构建的列线图在鉴别烟雾病(MMD)与动脉粥样硬化性烟雾综合征(A-MMS)中的应用价值。方法回顾性收集自2020年6月至2023年11月于济宁医学院附属医院医学影像科接受HR-VWI检查且经DSA确诊的84例MMD患者(MMD组)与73例A-MMS患者(A-MMS组)的影像学资料,采用单因素分析比较2组患者间影像学特征的差异,进一步采用多因素Logistic回归分析筛选出鉴别MMD与A-MMS的独立影响因素并依此构建列线图,通过受试者工作特征(ROC)曲线及校准曲线评价列线图的鉴别效能及校准度。结果单因素分析显示MMD组与A-MMS组患者在年龄、管壁增厚方式、管壁最大厚度、管壁强化程度、血管外径、同侧大脑前动脉受累及点征等方面的差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示年龄(OR=6.990,95%CI:2.340~20.360,P<0.001)、管壁增厚方式(OR=0.066,95%CI:0.014~0.307,P<0.001)、血管外径(OR=5.224,95%CI:1.672~16.324,P=0.005)、同侧大脑前动脉是否受累(OR=0.160,95%CI:0.038~0.679,P=0.013)和有无点征(OR=0.081,95%CI:0.018~0.364,P=0.001)是鉴别MMD和A-MMS的独立影响因素。列线图的ROC曲线下面积为0.884(95%CI:0.821~0.947,P<0.001),校准曲线示预测概率与实际概率间一致性较高。结论基于HR-VWI特征构建的列线图能有效鉴别MMD与A-MMS。
ObjectiveTo assess the clinical value of nomogram based on high resolution magnetic resonance vessel wall imaging(HR-VWI)features in differentiating moyamoya disease(MMD)from atherosclerotic moyamoya syndrome(A-MMS).MethodsEighty-four patients with digital subtraction angiography(DSA)-confirmed MMD and 73 patients with DSA-confirmed A-MMS were enrolled from Department of Medical Imaging,Affiliated Hospital of Jining Medical University from June 2020 to November 2023.All patients underwent HR-VWI.A retrospective analysis was performed on their imaging data.Univariate analysis was used to compare the differences in imaging characteristics between the two groups.Multivariate Logistic regression analysis was used to screen independent influencing factors for differentiating MMD from A-MMS and a nomogram was constructed accordingly.Receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the validity and calibration of the nomogram.ResultsUnivariate analysis showed that age,pattern of vessel wall thickening,maximum vessel wall thickness,enhancement degree of vessel wall,vessel external diameter,ipsilateral anterior cerebral artery involvement and dot sign were statistically different between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age(OR=6.990,95%CI:2.340-20.360,P<0.001),pattern of vessel wall thickening(OR=0.066,95%CI:0.014-0.307,P<0.001),vessel external diameter(OR=5.224,95%CI:1.672-16.324,P=0.005),ipsilateral anterior cerebral artery involvement(OR=0.160,95%CI:0.038-0.679,P=0.013)and dot sign(OR=0.081,95%CI:0.018-0.364,P=0.001)were independent influencing factors for differentiating MMD from A-MMS.ROC curve showed that area under the curve(AUC)of this nomogram was 0.884(95%CI:0.821-0.947,P<0.001),and the calibration curve showed a good fit between the predicted probability and actual probability.ConclusionNomogram based on HR-VWI features can effectively differentiate MMD from A-MMS.
作者
种振
侯丽花
靳晴晴
刘德国
于昊
张树军
陈月芹
Chong Zhen;Hou Lihua;Jin Qingqing;Liu Deguo;Yu Hao;Zhang Shujun;Chen Yueqin(Department of Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Radiology,Jining First People's Hospital,Jining 272002,China;MR Room,Weishan County People's Hospital,Jining 277600,China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2024年第11期1100-1106,共7页
Chinese Journal of Neuromedicine
基金
国家自然科学基金(82001805)
山东省自然科学基金(ZR2021MH109)
济宁市重点研发计划(2023YXNS032)。
