开发和验证一个名图,用于预测在内内透视达克里奥西斯托里诺斯托米期间同时进行内透视分泌术的需要
Kerui Wang1, Xinyue Yu1, Rongxin Chen1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Quantitative imaging in medicine and surgery
|September 16, 2024
概括
一个新的基于CT的模型预测了在初级获得的鼻管阻塞 (PANDO) 时需要进行内镜分管整形术 (En-DCR). 这种工具有助于外科医生优化鼻隔膜偏差 (NSD) 患者的治疗.
科学领域:
- 眼科和耳鼻喉科的眼科和耳鼻喉科.
- 医疗成像医学成像
- 手术规划 手术规划
背景情况:
- 肠膜内镜达克里奥西斯托利诺斯托米 (En-DCR) 通常需要同时进行内镜分管整形,以获得初级获得的鼻管阻塞 (PANDO) 的最佳外科结果.
- 目前依赖于鼻镜和内镜检查的方法缺乏对隔膜偏差严重性的定量评估,这阻碍了同时进行隔膜整形的准确决策.
- 需要客观评估,以确定在患有PANDO和鼻隔膜偏差 (NSD) 的患者在En-DCR期间进行内镜分层整形的必要性.
研究的目的:
- 开发和验证使用计算机断层扫描 (CT) 的放射学预测模型,以预测在En-DCR期间需要同时进行内镜分管整形的需要.
- 为外科医生提供一个定量工具,用于在PANDO患者中进行手术规划.
主要方法:
- 对225名患有PANDO和NSD的患者进行了回顾性分析,这些患者接受了单方面En-DCR.
- 最小绝对收缩和选择运算子 (LASSO) 回归用于预测器选择.
- 用于模型开发的多变量逻辑回归,内部验证;创建了名图和在线计算器.
主要成果:
- 确定为独立预测因素的CT成像特征:NSD角度 (OR 1.54),NSD位置 (OR 4.49),NSD方向 (OR 5.38),以及手术侧的中鼻通道宽度 (MNPW) (OR 0.61).
- 基于CT的诺图表显示出高预测性能,曲线下的面积 (AUC) 为0.913 (训练) 和0.909 (验证).
- 该模型有效地预测了En-DCR.期间内镜分管整形的必要性.
结论:
- 一个基于CT的新型放射学预测模型已经开发和验证.
- 该模型有助于外科医生确定在En-DCR期间对患有NSD的PANDO患者同时进行内镜分管整形的必要性.
- 该工具旨在优化手术规划,并可能提高En-DCR的成功率.
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