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• Clinical Article •
Construction of a nomogram model for hemorrhagic transformation risk after mechanical thrombectomy in patients with acute stroke
LIU Zhen  HUANG Xiaobin  PENG Mingyang  WANG Tongxing  XIE Guanghui  REN Jun  Yin Xindao 

Cite this article as: Liu Z, Huang XB, Peng MY, et al. Construction of a nomogram model for hemorrhagic transformation risk after mechanical thrombectomy in patients with acute stroke[J]. Chin J Magn Reson Imaging, 2022, 13(4): 15-19. DOI:10.12015/issn.1674-8034.2022.04.003.


[Abstract] Objective To construct a nomogram model for hemorrhage transformation after mechanical thrombectomy in acute stroke based on multimodal MRI radiomics and clinical risk factors.Materials and Methods A total of 174 patient cases with acute ischemic stroke in Nanjing First Hospital from January 2017 to December 2020 were analyzed retrospectively. The patients were randomly divided into the training set (n=122) and test set (n=52). Then the patients were divided into hemorrhage transformation group and no hemorrhage transformation group according to the MRI images after treatment. A.K. software was used to extract diffusion weighted imaging and perfusion weighted imaging lesions features and construct radiomics tags. Multivariate Logistic regression was used to select the best predictors and construct a nomogram model. The receiver operating characteristic (ROC) curve was utilized to evaluate the predictive performance of the model.Results A total of 1584 radiomics features were extracted from each patient. After dimensionality reduction, 15 features that were highly associated with hemorrhage transformation were screened out. ROC showed that the AUC of nomograph model in the training set was 0.979 (sensitivity and specificity: 0.950, 0.989), which included radiomics labels, atrial fibrillation history, age, and NIHSS score on admission. The AUC in the test set was 0.885 (sensitivity and specificity: 0.836, 0.908). Both of them were better than models built based on pure radiomics lables (AUC=0.763) or clinical features (AUC=0.707).Conclusions Radiomics and machine learning based on multimodal MRI and clinical features are reliable to predict hemorrhage transformation after mechanical thrombectomy in acute ischemic stroke.
[Keywords] stroke；machine learning；radiomics；nomogram model；diffusion weighted imaging；perfusion weighted imaging；hemorrhage transformation

LIU Zhen1, 2   HUANG Xiaobin1   PENG Mingyang1   WANG Tongxing1   XIE Guanghui1   REN Jun1   Yin Xindao1*  

1 Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

2 Department of CT and MRI, the Affiliated Chuzhou Hospital of Anhui Medical University (the First People's Hospital of Chuzhou), Chuzhou 239000, China

Yin XD, E-mail: y.163yy@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Jiangsu Provincial Special Program of Medical Science (No. BE2021604); Natural Science Foundation of Jiangsu Province (No. BK20201118).
Received  2021-12-23
Accepted  2022-03-25
DOI: 10.12015/issn.1674-8034.2022.04.003
Cite this article as: Liu Z, Huang XB, Peng MY, et al. Construction of a nomogram model for hemorrhagic transformation risk after mechanical thrombectomy in patients with acute stroke[J]. Chin J Magn Reson Imaging, 2022, 13(4): 15-19. DOI:10.12015/issn.1674-8034.2022.04.003.

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