Artificial intelligence aneurysm measurement tool finds growth in all aneurysms that ruptured during conservative management
Artificial intelligence aneurysm measurement tool finds growth in all aneurysms that ruptured during conservative management
复制标题
人工智能动脉瘤测量工具发现所有在保守治疗期间破裂的动脉瘤都有增长
DOI：
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发表时间：
2022
影响因子：
4.8
通讯作者：
C. Kulwin
中科院分区：
文献类型：
--
作者：
D. Sahlein;D. Gibson;J. Scott;A. Denardo;K. Amuluru;T. Payner;David Rosenbaum;C. Kulwin
背景脑动脉瘤破裂具有较高的发病率和死亡率。在管理决策中，检测破裂风险高的动脉瘤是至关重要的。传统上，破裂风险与尺寸有关--以最大尺寸衡量。然而，动脉瘤在形态上是动态的，这一特征被大型前瞻性动脉瘤风险研究忽视了。手工测量具有挑战性，而且误差很大。我们使用人工智能(AI)测量工具来研究在保守治疗过程中破裂的动脉瘤，以检测手动线性测量无法识别的大小变化。方法对一个包含5000个动脉瘤的单一实践数据库进行检索。保守随访的未破裂动脉瘤患者使用适当的诊断代码进行识别。使用程序代码对该队列进行后续破裂筛查。只有在破裂前有两次血管成像检查的患者才包括在内。结果5例患者符合标准。所有患者都有动脉瘤增大，其中两例在大容量多学科神经血管会议期间，通过手动线性测量(包括判定和分析)未被发现。从第一次扫描到最后一次，最大直径增加了至少1.8%(范围1.8-63.3%)，动脉瘤体积增加了至少5.9%(5.9-385.5%)，强调了体积测量的重要性。结论在保守治疗期间破裂的所有动脉瘤中，人工智能启用的体积测量对大小的改变和检测到的增大更敏感。这一发现对临床实践和用于保守随访患者的动脉瘤间期测量方法具有重要意义。
Background Cerebral aneurysm rupture is associated with high rates of morbidity and mortality. Detecting aneurysms at high risk of rupture is critical in management decision making. Rupture risk has traditionally been associated with size—measured as a maximum dimension. However, aneurysms are morphologically dynamic, a characteristic ignored by large prospective aneurysm risk studies. Manual measurement is challenging and fraught with error. We used an artificial intelligence (AI) measurement tool to study aneurysms that ruptured during conservative management to detect changes in size not appreciated by manual linear measurement. Methods A single practice database with >5000 aneurysms was queried. Patients followed conservatively for an unruptured aneurysm were identified using appropriate diagnosis codes. This cohort was screened for subsequent rupture using procedure codes. Only patients with two vascular imaging studies before rupture were included. Results Five patients met the criteria. All patients had aneurysm enlargement, two of which were not detected from manual linear measurements, including adjudication and analysis, during a multidisciplinary neurovascular conference in a high volume practice. Maximum dimension increased at a minimum of 1.8% (range 1.8–63.3%) from the first scan to the last, and aneurysm volume increased at a minimum of 5.9% (5.9–385.5%), highlighting the importance of volumetric measurement. Conclusions AI-enabled volumetric measurements are more sensitive to changes in size and detected enlargement in all aneurysms that ruptured during conservative management. This finding has major implications for clinical practice and methods used for interval aneurysm measurement in patients being conservatively followed.
影响因子：
4.8
作者：
Mehan, William A., Jr.;Romero, Javier M.;Schaefer, Pamela W.
通讯作者：
Schaefer, Pamela W.