首页|期刊导航|中国骨伤|基于多模态深度学习的颈椎失稳症辅助诊断模型的初步构建与验证研究

基于多模态深度学习的颈椎失稳症辅助诊断模型的初步构建与验证研究OA

Preliminary construction and validation of an auxiliary diagnosis model for cervical instability based on multimodal deep learning

中文摘要英文摘要

目的:初步构建并验证基于多模态深度学习的颈椎失稳症(cervical spine instability,CSI)诊断模型,开发面向临床使用场景的开放共享网络化原型平台.方法:纳入122例受试者的临床数据,整合三体位X线影像及9项结构化临床变量.以ResNetXt50构建影像分支、以全连接神经网络(fully connected neural network,FCNN)构建临床分支,并在特征层完成跨模态融合(ResNetXt50-FCNN);设置"仅影像(ResNetXt50)"与"仅临床(FCNN)"两种对照开展模态消融试验.评价指标包括受试者工作特征曲线下面积(area under curve,AUC)、PR曲线下方的面积平均精度(average precision,AP)、准确率、精确率、召回率、F1分数与特异度.采用Grad-CAM对影像分支进行注意力可视化,采用SHAP解析临床分支的全局与个体特征贡献.最终通过Streamlit框架部署最优模型,构建临床可用的交互式平台.结果:多模态模型在验证集上取得优于对照的综合性能(AUC=0.964,AP=0.973,准确率=0.919,精确率=0.875,F1=0.933,特异度=0.813).消融试验显示,融合策略显著弥补"仅影像"敏感性不足与"仅临床"特异度偏低的局限.Grad-CAM显示模型跨三体位稳定聚焦于疑似异常结构,能够有效抑制背景干扰;SHAP结果提示,年龄、屈伸受限、压痛、性别与头痛为主要贡献变量.基于此开发的AI平台(https://cervical-instability-classifier.streamlit.app/)可实时输出辨证概率及特征贡献可视化结果.结论:本研究成功构建并初步验证了基于多模态深度学习的CSI判别模型,该模型表现出较好的诊断性能、可解释性与临床应用潜力.鉴于本研究样本量有限,该模型的泛化能力与最终临床效用仍需进一步的外部验证.

Objective To preliminarily construct and validate a diagnostic model for Cervical Spine Instability(CSI)based on multimodal deep learning,and to develop an open-access,web-based prototype platform tailored for clinical scenarios.Methods Clinical data from 122 subjects were included,integrating three-position X-ray images and nine structured clinical variables.The model architecture featured an imaging branch built on ResNeXt50 and a clinical branch based on a Fully Con-nected Neural Network(FCNN),with cross-modal fusion performed at the feature level(ResNeXt50-FCNN).Modality ablation studies were conducted using two control groups:"Imaging-only"(ResNeXt50)and"Clinical-only"(FCNN).Evaluation met-rics included Area Under the Receiver Operating Characteristic Curve(AUC),Average Precision(AP),Accuracy,Precision,Recall,F1-score,and Specificity.Grad-CAM was employed for attention visualization of the imaging branch,while SHAP(SHapley Additive exPlanations)was used to interpretglobal and individual feature contributions of the clinical branch.Final-ly,the optimal model was deployed via the Streamlit framework to create an interactive,clinically usable platform.Results The multimodal model achieved superior comprehensive performance on the validation set compared to the control groups,yielding an AUC of 0.964,AP of 0.973,Accuracy of 0.919,Precision of 0.875,F1-score of 0.933,and Specificity of 0.813.Ablation studies demonstrated that the fusion strategy significantly compensated for the insufficient sensitivity of the"Imaging-only"model and the low specificity of the"Clinical-only"model.Grad-CAM visualizations revealed that the model consistently fo-cused on suspected abnormal structures across all three positions,effectively suppressing background interference.SHAP anal-ysis identified age,limitation of flexion-extension,tenderness,gender,and headache as the primary contributing variables.The developed AI platform(https://cervical-instability-classifier.streamlit.app/)provides real-time outputs of diagnostic probabili-ties and visualizations of feature contributions.Conclusion This study successfully constructed and preliminarily validated a CSI discrimination model based on multimodal deep learning,demonstrating promising diagnostic performance,interpretabili-ty,and potential for clinical application.However,given the limited sample size of this study,further external validation is re-quired to confirm the model's generalizability and ultimate clinical utility.

杨光奕;韩昶晓;冯敏山;温海宝;李静;彭博辰;朱立国

中国中医科学院望京医院脊柱二科,北京 100102||北京中医药大学,北京 102488中国中医科学院望京医院脊柱二科,北京 100102||数智中医防治骨与关节退行性疾病实验室,北京 100102中国中医科学院望京医院脊柱二科,北京 100102||数智中医防治骨与关节退行性疾病实验室,北京 100102中国中医科学院望京医院脊柱二科,北京 100102中国中医科学院望京医院脊柱二科,北京 100102中国中医科学院望京医院脊柱二科,北京 100102||北京中医药大学,北京 102488中国中医科学院望京医院脊柱二科,北京 100102||数智中医防治骨与关节退行性疾病实验室,北京 100102||朱立国全国名老中医药专家传承工作室,北京 100102

医药卫生

颈椎失稳深度学习多模态学习诊断,计算机辅助神经网络,计算机放射摄影术回顾性研究

Cervical spine instabilityDeep learningMultimodal learningDiagnosis,computer-assistedNeu-ral networks,computerRadiographyRetrospective studies

《中国骨伤》 2026 (8)

806-814,9

北京市科技计划AI+健康协同创新培育项目(编号:Z221100003522009)中国中医科学院望京医院高水平中医医院建设项目(编号:WJCC-202302)国家中医药传承创新团队项目(编号:ZYYCXTD-C-202003)Beijing Science and Technology Plan AI+Health Collaborative Innovation Cultivation Project(Z221100003522009)

10.12200/j.issn.1003-0034.20251185

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