用胎儿磁共振数据预测早产风险和分娩孕周,准确率达3周以内。
PUUMA (Placental patch and whole-Uterus dual-branch U-Mamba-based Architecture): Functional MRI Prediction of Gestational Age at Birth and Preterm Risk
- 双分支网络同时分析胎盘局部与子宫整体影像特征。
- 预测孕周误差仅3周,早产检测敏感度达67%。
- 为临床提供无需人工测量的自动化早产风险评估方案。
早产是儿童死亡和终身残疾的主要原因,其复杂多因素成因限制了现有临床预测工具的效果。本研究提出一种双分支深度学习架构PUUMA,基于295例妊娠的T2*胎儿磁共振数据,预测分娩孕周(GA)及早产风险。模型融合子宫整体与胎盘局部特征,性能与经验丰富的临床医生通过解剖磁共振测量宫颈长度的线性回归模型相当。在数据集存在明显类别不平衡的情况下,全自动磁共振分析流程与宫颈长度回归均实现平均绝对误差3周,早产分类的敏感度达0.67。结果验证了从功能磁共振自动预测分娩孕周的可行性,凸显全子宫功能成像在识别高危妊娠中的价值。此外,研究还表明目前未常规使用的高分辨率磁共振宫颈长度测量可提供重要预测信息。未来工作将扩大样本量并引入更多器官特异性成像以提升泛化能力与预测性能。
原文摘要 · Abstract (English)
Preterm birth is a major cause of mortality and lifelong morbidity in childhood. Its complex and multifactorial origins limit the effectiveness of current clinical predictors and impede optimal care. In this study, a dual-branch deep learning architecture (PUUMA) was developed to predict gestational age (GA) at birth using T2* fetal MRI data from 295 pregnancies, encompassing a heterogeneous and imbalanced population. The model integrates both global whole-uterus and local placental features. Its performance was benchmarked against linear regression using cervical length measurements obtained by experienced clinicians from anatomical MRI and other Deep Learning architectures. The GA at birth predictions were assessed using mean absolute error. Accuracy, sensitivity, and specificity were used to assess preterm classification. Both the fully automated MRI-based pipeline and the cervical length regression achieved comparable mean absolute errors (3 weeks) and good sensitivity (0.67) for detecting preterm birth, despite pronounced class imbalance in the dataset. These results provide a proof of concept for automated prediction of GA at birth from functional MRI, and underscore the value of whole-uterus functional imaging in identifying at-risk pregnancies. Additionally, we demonstrate that manual, high-definition cervical length measurements derived from MRI, not currently routine in clinical practice, offer valuable predictive information. Future work will focus on expanding the cohort size and incorporating additional organ-specific imaging to improve generalisability and predictive performance.
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