The Journal of Practical Medicine ›› 2026, Vol. 42 ›› Issue (15): 2786-2797.doi: 10.3969/j.issn.1006-5725.2026.15.015
• Treatise:Mechanism and Practice • Previous Articles
Xin ZHU1,2,Yangbiao LIANG2,Xiong XIAO1,2,Jialin XIE1,2,Junyan ZHU1,2,Yan CHEN2(
)
Received:2026-04-15
Revised:2026-06-04
Accepted:2026-06-08
Online:2026-08-10
Published:2026-08-13
Contact:
Yan CHEN
E-mail:smu_chen@163.com
CLC Number:
Xin ZHU,Yangbiao LIANG,Xiong XIAO,Jialin XIE,Junyan ZHU,Yan CHEN. Development of a disease activity assessment model for rheumatoid arthritis using ultrasound radiomics and deep learning[J]. The Journal of Practical Medicine, 2026, 42(15): 2786-2797.
Tab.1
The ultrasound scoring criteria for rheumatoid arthritis"
| 评分 | 滑膜增厚程度 | 增生滑膜的彩色多普勒信号等级 | 关节积液情况 |
|---|---|---|---|
| 0 | 滑膜无增厚 | 没有彩色多普勒信号 | 无积液 |
| 1 | 增生的滑膜不超过骨嵴连线,且其上表面呈凹陷状 | 在增生的滑膜内检测到3个点状血流信号,或2个点状血流信号加1个融合血流信号,或2个融合血流信号 | 轻度——仅在关节一侧出现积液 |
| 2 | 增生的骨膜超出骨嵴连线,且上表面的增生滑膜呈凹陷状 | 血流信号大于评分1,但血流信号面积小于增生滑膜面积的50% | 中度——关节周围可见积液,但未完全充满关节腔 |
| 3 | 增生的滑膜超出骨嵴连线,且其上表面呈凸面形态 | 血流信号等级超过评分2,且血流信号面积超过增生滑膜面积的50% | 重度——关节积液充满整个关节腔 |
Tab.3
Scoring characteristics of ultrasound sonograms for rheumatoid arthritis-affected joints"
| 变量 | RA活动度分级 | Z值 | P值 | 单因素分析 | ||
|---|---|---|---|---|---|---|
| 高活动度(n = 88) | 中低活动度(n = 96) | P值 | OR(95%CI) | |||
| 滑膜增厚程度 | -7.785 | < 0.001 | < 0.001 | 3.633(0.005 ~ 0.133) | ||
| 0分 | 0(0.0) | 2(2.0) | ||||
| 1分 | 1(1.1) | 36(37.5) | ||||
| 2分 | 2(69.5) | 57(59.3) | ||||
| 3分 | 29(32.9) | 1(1.0) | ||||
| 关节积液情况 | -6.319 | 0.04 | 0.062 | 0.489(0.367 ~ 1.025) | ||
| 0分 | 35(39.7) | 38(39.5) | ||||
| 1分 | 19(21.5) | 46(47.9) | ||||
| 2分 | 28(31.8) | 12(12.5) | ||||
| 3分 | 6(6.8) | 0(0.0) | ||||
| 增生滑膜血流情况 | -2.052 | < 0.001 | < 0.001 | 2.283(0.36 ~ 0.288) | ||
| 0分 | 0(0.0) | 27(28.1) | ||||
| 1分 | 60(68.1) | 63(65.6) | ||||
| 2分 | 25(28.4) | 6(6.2) | ||||
| 3分 | 3(3.4) | 0(0.0) | ||||
| 增生滑膜回声等级 | -3.887 | < 0.001 | 0.528 | 0.638(0.116 ~ 2.398) | ||
| 0分 | 0(0.0) | 2(2.0) | ||||
| 1分 | 70(79.5) | 91(94.7) | ||||
| 2分 | 18(20.4) | 3(3.1) | ||||
| 3分 | 0(0.0) | 0(0.0) | ||||
Tab.4
Predictive performance of three rheumatoid arthritis disease activity assessment models"
| 模型 | 数据集 | AUC(95%CI) | 敏感度 | 特异度 | 精确度 | F1指数 | 准确度 |
|---|---|---|---|---|---|---|---|
| 超声评分模型 | 训练集 | 0.909(0.864 ~ 0.954) | 0.96 | 0.677 | 0.783 | 0.862 | 0.832 |
| 测试集 | 0.832(0.709 ~ 0.954) | 0.667 | 0.885 | 0.824 | 0.737 | 0.787 | |
| 影像组学模型 | 训练集 | 0.788(0.711 ~ 0.864) | 0.773 | 0.677 | 0.744 | 0.758 | 0.730 |
| 测试集 | 0.824(0.701 ~ 0.947) | 0.810 | 0.808 | 0.773 | 0.791 | 0.809 | |
| 深度学习模型 | 训练集 | 0.944(0.908 ~ 0.98) | 0.853 | 0.903 | 0.914 | 0.883 | 0.876 |
| 测试集 | 0.788(0.642 ~ 0.933) | 0.619 | 0.962 | 0.929 | 0.743 | 0.809 | |
| 超声-影像组学模型 | 训练集 | 0.968(0.954 ~ 0.992) | 0.867 | 0.968 | 0.970 | 0.915 | 0.912 |
| 测试集 | 0.852(0.743 ~ 0.96) | 0.714 | 0.846 | 0.789 | 0.750 | 0.787 | |
| 超声-影像组学-深度学习联合模型 | 训练集 | 0.995(0.985 ~ 1.000) | 0.987 | 0.984 | 0.810 | 0.987 | 0.985 |
| 测试集 | 0.901(0.815 ~ 0.988) | 0.810 | 0.846 | 0.810 | 0.810 | 0.830 |
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