人工智能辅助诊断系统对主动脉夹层CTA诊断的价值

The CTA Diagnostic Value of Artificial Intelligence-Assisted Diagnosis System for Aortic Dissection

目的:探讨主动脉夹层(AD)CT血管成像(CTA)诊断中人工智能(AI)的辅助诊断效能,明确AI辅助诊断系统对AD诊断的价值。方法:连续收集本院CTA诊断的58例AD患者,以高年资医生的诊断结果为参考标准,AI诊断结果与参考标准进行对比,定量评估AI对AD诊断的价值。结果:线性相关图显示AI与参考标准在整体(EA)、真腔(TL)和假腔(FL)直径测量一致性较好,相关系数均大于0.85(P<0.001)。Bland-Altman图显示AI和参考标准之间的直径偏差EA、TL和FL分别为0.1(-6.2~6.5)mm、-0.1(-7.5~7.2)mm和0.8(-10.6~12.2)mm。诊断结果一致性较好(kappa=1),破裂口数量一致性一般(kappa=0.5),AI诊断时间为(19.34±1.44)min,少于参考标准的(67.97±7.26)min(P<0.001)。高年资医生组间差异:直径测量EA、TL和FL的组内相关系数(ICC)值分别为0.986、0.996、0.998(P<0.001),两者一致性较好,诊断结果两者一致性较好(kappa=1),破裂口数量两者一致性较好(kappa=0.827)。结论:在AD直径测量和相关诊断中,AI与高年资医生具有较好的一致性,并且工作时间少于高年资医生,因此AI可作为AD的有效辅助诊断方法之一。

Purpose:To explore the auxiliary diagnostic efficacy of artificial intelligence(AI)in computed tomography angiography(CTA)diagnosis of aortic dissection(AD),and to clarify the diagnostic value of AI-assisted diagnosis system for AD.Methods:Fifty-eight AD patients diagnosed by CTA of the aorta in our hospital were enrolled.Using senior doctors as a reference standard,the AI diagnosis results were compared with the reference standard to quantitatively evaluate the effects of AI on AD diagnosis.Results:The linear correlation graph shows that AI and the reference standard were in good agreement in entire aorta(EA),true lumen(TL)and false lumen(FL)diameter measurements,and the correlation coefficients were all greater than 0.85(P<0.001).The Bland-Altman diagram shows that the diameter deviations EA,TL and FL between AI and the reference standard were 0.1(-6.2 to6.5)mm,-0.1(-7.5 to 7.2)mm and 0.8(-10.6 to 12.2)mm,respectively.The diagnosis result was with a good consistency(kappa=1),and the number of ruptures agreement(kappa=0.5),and the AI diagnosis time was shorter than the reference standard[(19.34±1.44)min vs(67.97±7.26)min,P<0.001].For groups of senior doctors:the intraclass correlation coefficient(ICC)values of diameter measurement of EA,TL and FL were 0.986,0.996,0.998,P<0.001,the agreement between them was good,the diagnosis results were in good agreement(kappa=1),and the number of ruptures was in good agreement(kappa=0.827).Conclusion:In AD diameter measurement and related diagnosis,AI has good consistency with senior doctors,and the working time is less than that of senior doctors.Therefore,AI can be used as one of the effective auxiliary diagnostic methods for AD.