CT images texture analysis versus clinical scores in predicting hemorrhagic transformation of acute ischemic stroke
10.3969/j.issn.1008-794X.2024.03.002
- VernacularTitle:比较基于CT图像的纹理分析与临床评分在预测急性缺血性脑卒中出血性转化中的价值
- Author:
Xinyu SONG
1
;
Zheng SUN
;
Yuehua LI
Author Information
1. 200233 上海 上海交通大学医学院附属第六人民医院放射介入科
- Keywords:
ischemic stroke;
hemorrhagic transformation;
texture analysis;
clinical score;
prediction
- From:
Journal of Interventional Radiology
2024;33(3):230-235
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the value of CT image texture features in predicting the occurrence of hemorrhagic transformation(HT)in ischemic stroke,and to compare it with the traditional clinical prediction scores.Methods A total of 73 patients with acute anterior circulation ischemic stroke were enrolled in this study.All patients received reperfusion treatment.The region of interesting(ROI)of the infarction area was outlined according to the diffusion restricted area displayed on the follow-up ADC images,which were matched to the corresponding ischemic region on computed tomographic angiography(CTA)and on plain CT scan(non-contrast CT,NCCT).Five patients with HT and 5 patients with non-HT were randomly selected and used as the test set,and the remaining patients were assigned to the train set.The 6 texture features that had the most predictive value were separately selected from the CTA sets and NCCT train set,then the training of classifiers was earried out by using the 5-fold cross-validation method.Finally,the test set was evaluated according to the trained classifier.Besides,the determination of four clinical scores(HAT,SEDAN,HIAT2,THRIVE-c)was performed for all patients in the train set.Results The trained classifiers model performed well in not only CTA but also NCCT.In the CTA prediction model,linear SVM was chosen as the final classifier with 0.816 validation accuracy and 0.890 AUC value;and with 0.800 test accuracy,0.600 sensitivity,and 1.000 specificity in external test set Logistic regression(LR)was the best-performing classifier in NCCT.The predicted performance of HT was slightly worse than that of CTA,which had 0.697 validation accuracy and 0.763 AUC value.The test set of NCCT achieved 0.700 accuracy with 0.600 sensitivity and 0.800 specificity.Compared to the texture analysis models,all the four clinical scores showed a modest prediction efficiency in HT and AUC values,which were no more than 0.700.Conclusion Texture analysis of cerebral ischemic area based on CT images(CTA and NCCT)has the ability to predict HT after reperfusion treatment in AIS patients,and it is superior to traditional clinical scoring methods.(J Intervent Radiol,2024,33:230-235)
