Hippocampal T1WI radiomics- and clinical feature-based models for predicting early mild cognitive impairment in secondary hydrocephalus.

Introduction: Mild cognitive impairment (MCI) represents the initial stage of dementia, and early diagnosis is crucial in clinical practice. This study aimed to investigate the predictive performance of three models based on clinical features, radiomics features of hippocampal T1-weighted imaging, and a combination of these features for identifying MCI in patients with secondary hydrocephalus. Methods: Of the 378 patients with secondary hydrocephalus, 124 were ultimately included in the study and divided into two cohorts: those with Mild Cognitive Impairment (MCI, Results: In the clinical model, the disease course, serum uric acid, serum cystatin C, and the lateral ventricular temporal horn ratio emerged as independent risk factors for MCI following hydrocephalus. In the radiomics model, four optimal hippocampal features were identified. The AUC values for the clinical, radiomics, and combined models in the training/validation sets were 0.827 (0.736 ~ 0.919)/0.812 (0.666 ~ 0.957), 0.864 (0.790 ~ 0.937)/0.849 (0.724 ~ 0.974), and 0.937 (0.889 ~ 0.985)/0.907 (0.804 ~ 1.000), respectively. The combined model exhibited higher AUC values than the MoCA scale in both datasets. There was a significant difference in the training set, and while the validation set showed a consistent trend, it did not achieve statistical significance. Conclusion: The combined model achieved optimal performance and demonstrated superior predictive capabilities for MCI in the patients with secondary hydrocephalus outperforming other models.