基于多任务学习血管分割的拟定量侧支评分在sCTA评估急性缺血性卒中侧支循环中的应用  

Application of self-designed collateral circulation quantitative score based on multi-task learning vascular segmentation in sCTA assessment of collateral circulation in acute ischemic stroke

作　　者：阳运秋 胡庆茂[1] 汪震[1,3] 徐锦萍 刘理伯 杨楠 刘星辰 马国睿 阳晨 YANG Yunqiu;HU Qingmao;WANG Zhen;XU Jinping;LIU Libo;YANG Nan;LIU Xingchen;MA Guorui;YANG Chen(Medical Artificial Intelligence Research Center,Shenzhen Institute of Advanced Technology,Chinese Academy of Sciences,Shenzhen 518055;Department of Neurology-Rehabilitation,Zhongshan Hospital of Traditional Chinese Medicine,Guangzhou University of Chinese Medicine,Zhongshan 528403;Intelligent Equipment Research Center,Zhuhai Zhongke Advanced Technology Research Institute,Zhuhai 519085;Shenzhen Futian District Maternal and Child Health Center,Shenzhen 518016,China)

机构地区：[1]中国科学院深圳先进技术研究院,医学人工智能研究中心,广东深圳518055 [2]广州中医药大学附属中山中医院,神经内科·康复科,广东中山528403 [3]珠海中科先进技术研究院,智能装备研究中心,广东珠海519085 [4]深圳市福田区妇幼保健院,广东深圳518016

出　　处：《西安交通大学学报（医学版）》2024年第3期497-507,共11页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的评估基线CT血管造影(CT angiography,CTA)拟定量评分(self-designed collateral circulation quantitative,SD-CCQ)与Alberta卒中项目早期CT评分(Alberta Stroke Program Early CT Score,ASPECTS)两者间的一致性和准确性,探讨SD-CCQ评估急性缺血性卒中(acute ischemic stroke,AIS)患者侧支循环代偿状态的临床价值。方法回顾性分析2020年1月至2022年12月因急性缺血性卒中在中山市中医院神经康复科收治的84例患者的临床数据和影像学资料,包括CT、CTA、弥散加权成像(DWI)影像数据。采用多任务深度学习方法对CTA源图像进行血管分割标注,并对血管分割后的CTA影像分别进行ASPECTS评分和SD-CCQ评分,从而评估AIS患者的侧支循环代偿情况,通过Kappa检验评价两种方法评估侧支循环的一致性,并通过多因素Logistic回归分析SD-CCQ与AIS患者预后的关系。结果ASPECTS评分与SD-CCQ评分在评估AIS患者侧支循环具有较好的一致性(κ=0.65,P<0.001),SD-CCQ对AIS良性侧支循环的诊断准确率为96.15%。Logistic回归分析显示,SD-CCQ、基线NIHSS、DWI梗死体积是影响AIS患者远期预后的主要因素。结论SD-CCQ可用于CTA影像评估AIS患者侧支循环代偿状态,为临床治疗决策的制定提供循证依据。Objective To evaluate the clinical use of the baseline CT angiography(CTA)quantitative score(self-designed collateral circulation quantitative,SD-CCQ)in determining the collateral circulation compensation status in patients with acute ischemic stroke(AIS),as well as the reliability and accuracy of the SD-CCQ score and the Alberta Stroke Program Early CT Score(ASPECTS).Methods Retrospective analysis was made on the clinical and imaging data,including CT,CTA and DWI image data,of 84 patients who were admitted for acute ischemic stroke to the Department of Neurorehabilitation of Zhongshan Hospital of Traditional Chinese Medicine from January 2020 to December 2022.Their CTA source images were annotated using a multi-task deep learning method for vascular segmentation.The ASPECTS score and SD-CCQ score were then applied to the CTA images following vascular segmentation in order to assess the collateral circulation compensation of AIS patients.The Kappa test was used to assess the consistency of the two methods used to assess collateral circulation,and the multifactorial Logistic regression analysis was used to examine the relationship between the SD-CCQ and the prognosis of the AIS patients.Results ASPECTS score had good consistency with SD-CCQ score in evaluating collateral circulation in AIS patients(κ=0.65,P<0.001),and the diagnostic accuracy of the latter for benign collateral circulation in AIS was 96.15%.Logistic regression analysis showed that the new collateral circulation score,baseline NIHSS,and DWI infarct volume were the main factors affecting the long-term prognosis of AIS patients.Conclusion The new scoring system SD-CCQ can be used to evaluate the compensatory status of collateral circulation in AIS patients,which may help in clinical treatment decision-making and prognosis prediction.

关 键 词：急性缺血性卒中 侧支循环 拟定量侧支评分 ASPECTS评分 

分 类 号：R743.3[医药卫生—神经病学与精神病学]