AI在头颈CTA诊断颅内微小动脉瘤中的应用价值探讨

Application value of AI in the diagnosis of intracranial microaneurysm with head and neck CTA

目的:探讨AI在头颈CT血管造影(CTA)诊断颅内微小动脉瘤中的应用价值。方法:回顾性选取2023年2月—2024年2月于贵州省人民医院行头颈CTA及数字减影血管造影(DSA)检查的100例疑诊颅内动脉瘤患者为研究对象,以DSA检查结果为金标准,分析AI检测颅内动脉瘤的灵敏度、特异度及准确率,对比AI与DSA检测颅内动脉瘤的瘤颈长、瘤体长径及短径。结果:DSA检查结果显示,100例疑诊颅内动脉瘤患者确诊为颅内动脉瘤90例,共检出动脉瘤113个。以DSA检查结果为金标准,AI检测颅内动脉瘤阳性的灵敏度、准确率分别为95.6%、91.0%,对<3 mm、3~5 mm和>5 mm动脉瘤的判断灵敏度分别为50.0%、69.4%、70.5%,准确率分别为86.7%、72.2%、76.7%,阳性结果及判断动脉瘤大小结果与DSA检查结果一致性较好(Kappa=0.756、0.556)。AI与DSA检测颅内动脉瘤颈长、长径、短径对比,差异均无统计学意义(P>0.05)。结论:AI在头颈CTA诊断颅内微小动脉瘤中具有较高的应用价值,AI检测的动脉瘤瘤体颈长、长径及短颈可作为瘤体大小测量参考,尤其对<3 mm动脉瘤诊断准确率及特异度较高,可作为临床辅助诊断手段。

Objective To investigate the application value of AI in head and neck CT angiography(CTA)in the diagnosis of intracranial microaneurysm.Methods A total of 100 patients with suspected intracranial aneurysms who underwent head and neck CTA and digital subtraction angiography(DSA)in Guizhou Provincial People's Hospital from February 2023 to February 2024 were retrospectively selected as the study objects.The sensitivity,specificity and accuracy of AI in detecting intracranial aneurysms were analyzed using DSA results as the gold standard.AI and DSA were compared to detect the neck length,long diameter and short diameter of intracranial aneurysm.Results DSA data showed that 90 of 100 suspected intracranial aneurysms were confirmed as intracranial aneurysms,and 113 aneurysms were detected.Using DSA as the gold standard,the sensitivity and accuracy of AI in detecting positive intracranial aneurysms were 95.6%and 91.0%,respectively.The sensitivity and accuracy of AI in detecting aneurysms<3 mm,3-5 mm and>5 mm were 50.0%,69.4%and 70.5%,respectively,and the accuracy were 86.7%,72.2%and 76.7%,respectively.The positive results and the size of aneurysm were in good agreement with the DSA(Kappa=0.756,0.556).There was no significant difference between AI and DSA in detecting intracranial aneurysm neck length,long diameter and short diameter(P>0.05).Conclusion AI has high application value in head and neck CTA in the diagnosis of intracranial microaneurysms.The neck length,long diameter and short neck of aneurysm detected by AI can be used as a reference for the measurement of tumor size,especially for aneurysms<3 mm with high diagnostic accuracy and specificity,and can be promoted as a clinical auxiliary diagnostic means.