基于冠状动脉造影的影像组学列线图在预测择期冠脉介入无复流中的应用研究

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[中图分类号]R541.4 [文献标志码]A [文章编号] 1674-7887（2025）04-0332-06

Application studyofcoronaryangiography-based radiomicsnomogramin predicting no-reflow phenomenon during elective PCI*

XUPeishu，2*#，，YAOLihong*，LIU Hu，CAO Xinnan2，CHENYufeng2，ZHUO Jian’，FANMengkang¹，，SHENGHongzhuan*** （DepartmentofCardiology，Afiliated Hospitalof Nantong University，Jiangsu 226OO1; Medical Schoolof Nantong University）

[Abstract]Objective：Developmentofacoronaryangiography-basedradiomics nomogramforpredicting intraproceduralnoreflowriskduring electivepercutaneouscoronaryintervention（PCI）.Methods：Thisretrospectivestudyenrolled88patients undergoingelectivePCIandomlyalocatedintoatrainingset（62cases）andvalidationset26cases）.Radiomicsfeatures etracted frompreproceduralangiographicimageswereanalyzed throughunivariatescreeningandLASSOregresiontoidentifykey predictors.Theseselectedfeatureswereintegratedwiththeindependentclinicalrisk factortoconstructthenomogrammodel. Model performancewassystematicallyevaluatedusing ROC curveanalysis，F1-score，and decisioncurve analysis（DCA）. Results：Theradiomicsnomogram demonstratedsuperior predictiveperformance，with AUCof O.897（O.816-0.978）in the trainingsetand0.810（0.64-0.979）inthevalidationset，ouperforingboththeclinical-onlymodel（0.77.696andadioics only model（0.792-0744）.ItalsoachievedahigherF1-score（0696）comparedwiththeclinical-onlymodel0.692）andradiic onlymodel（0.545）.DCAfurthervalidateditsclinicalutility.Conclusions：Theradiomics-basednomogramderivedfrom coronaryangiographydemonstratessuperiorpredictiveperformance comparedwithclinical-onlyandradiomics-onlymodels， enabling more effective risk stratification of no-reflow during elective PCI.

[Key words] acute coronary syndrome; no-reflow;percutaneous coronary intervention; radiomics

经皮冠状动脉介人治疗（percutaneouscoronaryintervention，PCI）已经成为处理冠状动脉粥样硬化性心脏病（以下简称冠心病）的重要治疗手段之一。（剩余7721字）