Correlation Between CT Texture Spatial Clustering And Clinical Indicators Of Essential Hypertension Adrenal Gland

Background: Adrenal gland changes in patients with essential hypertension are hidden.Rountine imaging examination can only judge its morphology,but it is difficult to find the microscopic changes of adrenal gland.In recent years,radiomics have been widely applied to the diagnosis and differential diagnosis of adrenal space-occupying lesions that cause hypertension,while the correlation between adrenal radiomics changes and commonly used clinical parameters in essential hypertension has not been reported.Objective: The purpose of this paper is to obtain the texture characteristic parameters of adrenal unenhanced CT and enhanced CT scan,including cortical,medullary and excretory phase that distinguish the patients with essential hypertension from the normal control group by using the standardized radiomics,and then use these characteristic parameters for spatial labeling,and use the spatial clustering method to obtain the RTF-score values of different anatomical areas of the adrenal gland in patients with essential hypertension,so as to determine the correlation between the heterogeneity of different regions of the adrenal gland and clinical indicators,in order to obtain new adrenalbiomarkers.Methods: In this retrospective study,which was approved by the Ethics Committee of the Affiliated Hospital of Yunnan University,plain and enhanced CT images of the upper and middle abdomen of 3082 inpatients in the hospital from October 2019 to March 2022 were collected,and 62 patients with essential hypertension and 59 non-hypertensive subjects were selected as the study subjects.Extract the characteristic parameters of bilateral adrenal texture of all subjects in plain scan and enhanced scan,including cortical phase,medullary phase and excretory phase.121 subjects were randomly divided into training set(n=84,50.15 ± 15.33 years old,48males,36 females)and test set(n=37,54.22 ± 16.68 years old,19 males,18females)at 7:3.Through data balance,normalization,dimensionality reduction and feature selection,unenhanced CT scan and enhanced adrenal non-zero texture feature parameters were screened,six machine learning methods including support vector machine,linear discriminant analysis,random forest,logistic regression,LASSO logistic regression and decision tree were used to build models separately.ROC curve analysis was used to evaluate the performance of the model,the area under the ROC curve(AUC)was calculated to select the optimal model,and the selected optimal radiomics parameters were used to perform spatial clustering of adrenal image texture features and calculate RTF-score.The clustering score of the essential hypertension group is divided into two groups with high and low scores.Multiple logistic regression was used to analyze the correlation between RTF-score and clinical indicators in different regions of the adrenal gland as a whole,cortex and medulla in patients with essential hypertension.Results: According to the screening of classic radiomics process,the medullary phase has the highest AUC value in CT plain scan and enhancement examination,including cortical phase,medullary phase and excretory phase.The AUC values in training set and test set are 0.784 and0.798 respectively.After spatial clustering of adrenal image texture characteristics and calculation of RTF-score score for medullary phase parameters,in the logistic regression univariate and multivariate analysis of RTF-score high and low scores and clinical indicators in the hyperten sion group,it was found that the OR value of the overall high heterogeneity of the adrenal gland and sex in essential hypertension was 0.01(0.00-0.17,p=0.011),and OR of height was 0.83(0.68-0.96,p=0.027),OR of left ventricular hypertrophy was 0.04(0.00-0.57,p=0.027),OR of fatty liver was 0.11(0.01-0.81,p=0.044).The OR value with serum uric acid was 1.01(1.00-1.03,p=0.012),and with fasting blood glucose was 0.29(0.07-0.94,p=0.040);The OR value of adrenal cortex high heterogeneity and body w eight was 1.10(1.01-1.22,p=0.049),0.07(0.00-0.68,p=0.043)with smoking history,0.17(0.03-0.56,p=0.013)with total cholesterol,and 6.53(1.56-49.8,p=0.025)with low density lipoprotein cholesterol;The OR value of adrenal medulla high heterogeneit y and high-density lipoprotein was 0.03(0.00-0.28,p=0.004).Conclusion: Adrenal texture parameters obtained by un-enhanced and enhanced CT scan at different stages have a certain differential effect between essential hypertension and normal control group,and the differential effect of medullary stage.Spatial clustering score of CT radiomics features of adrenal gland in patients with essential hypertension showed that clinical features were the influencing factors of heterogeneity of adrenal gland in different anatomical regions of patients with essential hypertension.