非增强型计算机断层扫描放射学有助于检测腹腔大动脉动脉瘤的内血管修复后的内泄
Ge Hu1, Ning Ding2, Zhiwei Wang3
1Medical Research Center, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng Dist, Beijing, 100730, China.
European radiology
|September 2, 2023
概括
非增强型CT扫描可以检测腹腔大动脉动脉瘤 (AAA) 内血管修复 (EVAR) 后的内泄漏,具有高灵敏度. 这些扫描的放射学分析为对比介质不良反应的患者提供了一个有希望的替代方案.
科学领域:
- 放射学 放射学是一门学科.
- 医疗成像医学成像
- 人工智能在医学中的应用
背景情况:
- 内血管修复 (EVAR) 是一种常见的治疗腹腔大动脉动脉瘤 (AAA).
- 在EVAR后检测Endoleak对于成功治疗和患者监测至关重要.
- 增强对比度的CT是检测内泄漏的标准,但对比度介质可能会引起不良反应.
研究的目的:
- 评估使用非增强型CT图像用于检测EVAR后AAA患者内脏泄漏的可行性.
- 探索从未增强的CT中提取的放射性特征的诊断性能,以检测内泄漏.
- 评估机器学习模型在使用未增强的CT数据识别内脏漏洞方面的潜力.
主要方法:
- 对接受EVAR的216名患者的回顾性采集.
- 在未增强的CT图像上从细分动脉瘤囊中提取放射性特征.
- 对直方图特征的统计分析和12个机器学习模型的构建,用于内泄漏检测.
主要成果:
- 在CT衰减和分散的显著差异被观察到在动脉瘤囊在支架外的患者和没有内脏泄漏 (p < 0.001) 之间.
- 使用无增强CT放射学的机器学习模型实现了平均曲线下面积 (AUC) 0.86 ± 0.05,精度为81% ± 4,灵敏度为88% ± 10.
- 当灵敏度设置在90%以上 (92%±2) 时,模型保持了72%±10的特异性.
结论:
- 没有增强的CT特征显示了内脏泄漏和没有内脏泄漏的患者之间的显著差异,使检测成为可能.
- 未增强的CT放射学与机器学习相结合,为内泄探测提供了可行的替代方案,特别是对于对比度过敏患者.
- 这种方法提高了无增强CT在治疗和监测术后AAA患者的临床实用性.
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