摘要
目的基于儿童肠套叠超声表现构建模型,以预测持续型肠套叠风险。方法回顾性分析1274例肠套叠患儿的临床及超声数据,按照7∶3比例划分训练集(n=891,持续型457例、一过型434例)与验证集(n=383,持续型206例、一过型177例)。利用最小绝对收缩和选择算子(LASSO)回归于训练集不同类别肠套叠间差异有统计学意义的变量中筛选与持续型肠套叠相关者,以多因素logistic回归构建风险预测模型并以列线图可视化。绘制受试者工作特征曲线,计算曲线下面积(AUC),以校准曲线及决策曲线分析(DCA)评估模型效能。结果最终基于4个变量构建模型,包括套筒直径、长度、部位及套筒内淋巴结状态。该模型预测训练集和验证集持续型肠套叠的AUC分别为0.987和0.979,校准曲线Brier值分别为0.028和0.033;DCA图显示模型能带来较高临床净收益。结论基于肠套叠直径、长度、部位、套筒内淋巴结状态构建的模型可用于预测儿童持续型肠套叠风险。
Objective To construct model based on ultrasonic findings for predicting risk of persistent intussusception in children.Methods Clinical and ultrasonic data of 1274 cases of pediatric intussusception were retrospectively analyzed and divided into training set(n=891,including 457 cases of persistent and 434 cases of transient intussusception)and validation set(n=383,including 206 cases of persistent and 177 cases of transient intussusception)at a ratio of 7:3.The least absolute shrinkage and selection operator(LASSO)regression was used to screen factors associated with persistent intussusception among variables being significantly different compared between two types of intussusception in training set.Then a risk prediction model was constructed using multivariable logistic regression and visualized with a nomogram,and the performance of this model was evaluated via receiver operating characteristic curve and the area under the curve(AUC),calibration plots and decision curve analysis(DCA).Results The final predictive model included 4 variables,i.e.diameter and length of the intussusception,anatomical location and condition of lymph nodes within the intussusception.The AUC of this model for predicting persistent intussusception was 0.987 and 0.979 in training set and validation set,respectively,and the Brier score of the calibration curve was 0.028 and 0.033,respectively.DCA revealed that the model could provide high net clinical benefit.Conclusion The model based on the diameter and length of intussusception,anatomical location and condition of lymph node could be used to predict the risk of persistent intussusception in children.
作者
吴文菁
袁莉
付曼丽
谭娇艳
景珅
舒欣
WU Wenjing;YUAN Li;FU Manli;TAN Jiaoyan;JING Shen;SHU Xin(Department of Ultrasound Medicine,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430015,China)
出处
《中国医学影像技术》
北大核心
2025年第11期1800-1804,共5页
Chinese Journal of Medical Imaging Technology
关键词
肠套叠
儿童
超声检查
intussusception
child
ultrasonography
