临床-超声影像组学联合模型可有效评估冷冻胚胎移植后临床妊娠结局OA

Objective To investigate the value of a combined model integrating ultrasound radiomics and clinical characteristics in evaluating clinical pregnancy after frozen embryo transfer.Methods A total of 137 women who underwent frozen embryo transfer at the First Affiliated Hospital of Anhui Medical University from October 2023 to March 2024 were enrolled in this study.Baseline clinical data were collected,and ultrasound images and data were acquired 1 day before embryo transfer.Independent clinical predictors were selected using logistic regression analysis to construct a clinical model.Radiomics features of the endometrium and junctional zone were extracted from ultrasound images to build a radiomics model and generate a radiomics score(rad-score).A fusion model was subsequently developed by combining the rad-score with the independent clinical predictors.All models were trained and validated using five-fold cross-validation.ROC curves were constructed to compare the predictive performance of the three models for pregnancy outcomes.The Shapley additive explanations(SHAP)method was applied to interpret the contribution of each feature to the predictive results.Results Endometrial blood flow resistivity index(P=0.024)and pulsatility index(P=0.035)were identified as independent clinical predictors.ROC curve analysis demonstrated that the fusion model achieved the optimal predictive performance.The mean area under the curve(AUC)values of the training and validation cohorts were 0.822 and 0.821,respectively.Conclusion The combined model established based on clinical data and ultrasound images can effectively predict pregnancy outcomes.With the SHAP method,clinicians can better understand and interpret the predictive outcomes.