自动分析胎儿脑MRI,精准测量11项关键指标,助力病理诊断。
Automated Fetal Brain MRI Biometry in Healthy and Pathological Cases

- 基于H3DE-Net模型定位22个解剖点,自动计算11项临床指标。
- 平均定位误差仅1.36毫米,显著优于对比模型,诊断准确率更高。
- 适合临床研究与胎儿脑发育异常筛查,尤其擅长识别脑室扩大。
胎儿脑MRI的自动化生物测量可实现可重复、无观察者偏差的定量评估,但现有方法通常仅限于少数测量或仅在健康人群中验证。本文构建并评估了一套自动化生物测量流程,在NeSVoR重建的三维图像上定位22个解剖标志点,并推导出11项涵盖幕上、脑室、小脑和中线结构的临床相关指标。在包含122例(健康对照与多种病理)的异质队列中,比较了H3DE-Net与SCN两种地标定位模型。通过线性混合效应模型评估定位精度,使用校准的百分位图对比正常生长轨迹,以决策树判断脑室扩大(VM)严重程度。H3DE-Net在所有标志点上均显著优于SCN(健康组:1.36毫米 vs. 3.58毫米;病理组:1.90毫米 vs. 4.13毫米;p < 0.001),且在11项指标中有7项超越基于胎龄的回归基线。在所有诊断组中,其测量结果的分类AUC均更高,尤其在区分健康与异常组时优势明显。决策树对脑室宽度的阈值设定接近临床常用的10毫米和15毫米标准。
原文摘要 · Abstract (English)
Automated biometric analysis of fetal brain MRI enables reproducible, observer-independent quantitative assessment, yet existing methods are often restricted to few measurements or evaluated only on healthy cases. We assemble and evaluate an automated biometric analysis pipeline that localizes 22 anatomical landmarks on NeSVoR-reconstructed 3D volumes and derives 11 clinically relevant measurements spanning supratentorial, ventricular, cerebellar, and midline structures. We compare two landmark localization models, H3DE-Net and SCN, on a heterogeneous cohort of 122 acquisitions (both healthy controls and range pathologies). Localization accuracy was assessed with a linear mixed-effects model, agreement with normative growth trajectories with calibrated centile charts, and diagnostic utility with a decision tree classifying VM severity. H3DE-Net achieved significantly lower localization error than SCN across all landmarks (mean 1.36 mm vs. 3.58 mm in HC and 1.90 mm vs. 4.13 mm in PC; p < 0.001), and outperformed a GA-based regression baseline in 7 of 11 measurements. H3DE-Net measurements yielded higher classification AUC in every diagnostic group, with the clearest advantage in separating healthy controls from VM. Decision tree thresholds for ventricular width fell near the clinical 10 mm and 15 mm cut-offs used to define and grade VM.
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