Background:We aimed to determine whether quantitative computed tomography radiomic features can aid in differentiating between the causes of prosthetic valve obstruction (PVO) in patients who had undergone prosthetic valve replacement.Methods:This retrospective study included 39 periprosthetic masses in 34 patients who underwent cardiac computed tomography scan from January 2014 to August 2017 and were clinically suspected as PVO. The cause of PVO was assessed by redo-surgery and follow-up imaging as standard reference, and classified as pannus, thrombus, or vegetation. Visual analysis was performed to assess the possible cause of PVO on axial and valve-dedicated views. Computed tomography radiomic analysis of periprosthetic masses was performed and radiomic features were extracted. The advantage of radiomic score compared with visual analysis for differentiation of pannus from other abnormalities was assessed.Results:Of 39 masses, there were 20 cases of pannus, 11 of thrombus, and 8 of vegetation on final diagnosis. The radiomic score was significantly higher in the pannus group compared with nonpannus group (mean, −0.156±0.422 versus −0.883±0.474; P<0.001). The area under the curve of radiomic score for diagnosis of pannus was 0.876 (95% CI, 0.731–0.960). Combination of radiomic score and visual analysis showed a better performance for the differentiation of pannus than visual analysis alone.Conclusions:Compared with visual analysis, computed tomography radiomic features may have added value for differentiating pannus from thrombus or vegetation in patients with suspected PVO.

中文翻译：

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计算机断层摄影放射学特征对疑似人工瓣膜阻塞的患者假体周围质量的鉴别价值。

背景：我们旨在确定定量计算机体层摄影术的放射学特征是否能帮助区分接受人工瓣膜置换术的患者的人工瓣膜阻塞（PVO）的原因。方法：这项回顾性研究包括34例接受心脏瓣膜置换术的患者中的39例假体周围包块。 2014年1月至2017年8月进行计算机X线断层扫描，临床上被怀疑为PVO。通过重做手术和随访影像学评估PVO的原因，并将其分类为pan，血栓或植被。进行了视觉分析，以评估轴向和瓣膜专用视图上PVO的可能原因。进行了假体周围肿块的计算机断层摄影放射线分析，并提取了放射线特征。结果：39例肿块中，有20例血管11、11例血栓和8例植被被确诊。non骨组的放射学评分显着高于非pan骨组（平均值为-0.156±0.422对-0.883±0.474；P <0.001）。诊断pan的放射学评分曲线下面积为0.876（95％CI，0.731–0.960）。放射学评分与视觉分析相结合显示出比单独的视觉分析更好的pan细胞分化结论。结论：与可视化分析相比，计算机断层摄影的放射学特征可能在鉴别疑似PVO的患者中将pan与血栓或植物区分开。