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人工智能在腹主动脉瘤中的应用。

Artificial intelligence in abdominal aortic aneurysm.

机构信息

Clinical Chemistry Laboratory, University Hospital of Nice, Nice, France; Université Côte d'Azur, CHU, Inserm U1065, C3M, Nice, France.

Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Université Paris-Saclay, Paris, France.

出版信息

J Vasc Surg. 2020 Jul;72(1):321-333.e1. doi: 10.1016/j.jvs.2019.12.026. Epub 2020 Feb 21.

Abstract

OBJECTIVE

Abdominal aortic aneurysm (AAA) is a life-threatening disease, and the only curative treatment relies on open or endovascular repair. The decision to treat relies on the evaluation of the risk of AAA growth and rupture, which can be difficult to assess in practice. Artificial intelligence (AI) has revealed new insights into the management of cardiovascular diseases, but its application in AAA has so far been poorly described. The aim of this review was to summarize the current knowledge on the potential applications of AI in patients with AAA.

METHODS

A comprehensive literature review was performed. The MEDLINE database was searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy used a combination of keywords and included studies using AI in patients with AAA published between May 2019 and January 2000. Two authors independently screened titles and abstracts and performed data extraction. The search of published literature identified 34 studies with distinct methodologies, aims, and study designs.

RESULTS

AI was used in patients with AAA to improve image segmentation and for quantitative analysis and characterization of AAA morphology, geometry, and fluid dynamics. AI allowed computation of large data sets to identify patterns that may be predictive of AAA growth and rupture. Several predictive and prognostic programs were also developed to assess patients' postoperative outcomes, including mortality and complications after endovascular aneurysm repair.

CONCLUSIONS

AI represents a useful tool in the interpretation and analysis of AAA imaging by enabling automatic quantitative measurements and morphologic characterization. It could be used to help surgeons in preoperative planning. AI-driven data management may lead to the development of computational programs for the prediction of AAA evolution and risk of rupture as well as postoperative outcomes. AI could also be used to better evaluate the indications and types of surgical treatment and to plan the postoperative follow-up. AI represents an attractive tool for decision-making and may facilitate development of personalized therapeutic approaches for patients with AAA.

摘要

目的

腹主动脉瘤(AAA)是一种危及生命的疾病,唯一的根治方法依赖于开放或血管内修复。治疗的决策依赖于 AAA 生长和破裂风险的评估,而在实践中这很难评估。人工智能(AI)为心血管疾病的管理提供了新的见解,但迄今为止,其在 AAA 中的应用描述甚少。本综述的目的是总结 AI 在 AAA 患者中的潜在应用的现有知识。

方法

进行了全面的文献综述。根据系统评价和荟萃分析的首选报告项目指南,在 MEDLINE 数据库中进行搜索。搜索策略使用了关键词的组合,并包括自 2000 年 5 月至 2019 年 5 月期间发表的使用 AI 治疗 AAA 患者的研究。两位作者独立筛选标题和摘要并进行数据提取。对已发表文献的搜索确定了 34 项具有不同方法、目的和研究设计的研究。

结果

AI 用于 AAA 患者以改善图像分割以及用于 AAA 形态、几何形状和流体动力学的定量分析和特征描述。AI 允许计算大型数据集以识别可能预测 AAA 生长和破裂的模式。还开发了几个预测和预后程序来评估患者的术后结局,包括血管内动脉瘤修复后的死亡率和并发症。

结论

AI 通过实现自动定量测量和形态特征描述,代表了 AAA 成像解释和分析的有用工具。它可以帮助外科医生进行术前规划。基于 AI 的数据管理可能会导致开发用于预测 AAA 演变和破裂风险以及术后结局的计算程序。AI 还可以用于更好地评估手术治疗的适应证和类型,并规划术后随访。AI 代表了一种有吸引力的决策工具,并可能有助于为 AAA 患者开发个性化的治疗方法。

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