Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China.
College of Computer Science and Technology, Zhejiang University, Hangzhou, China.
Stroke Vasc Neurol. 2021 Dec;6(4):610-614. doi: 10.1136/svn-2020-000647. Epub 2021 Feb 1.
Early haematoma expansion is determinative in predicting outcome of intracerebral haemorrhage (ICH) patients. The aims of this study are to develop a novel prediction model for haematoma expansion by applying deep learning model and validate its prediction accuracy.
Data of this study were obtained from a prospectively enrolled cohort of patients with primary supratentorial ICH from our centre. We developed a deep learning model to predict haematoma expansion and compared its performance with conventional non-contrast CT (NCCT) markers. To evaluate the predictability of this model, it was also compared with a logistic regression model based on haematoma volume or the BAT score.
A total of 266 patients were finally included for analysis, and 74 (27.8%) of them experienced early haematoma expansion. The deep learning model exhibited highest C statistic as 0.80, compared with 0.64, 0.65, 0.51, 0.58 and 0.55 for hypodensities, black hole sign, blend sign, fluid level and irregular shape, respectively. While the C statistics for swirl sign (0.70; p=0.211) and heterogenous density (0.70; p=0.141) were not significantly higher than that of the deep learning model. Moreover, the predictive value for the deep learning model was significantly superior to that of the logistic model of haematoma volume (0.62; p=0.042) and the BAT score (0.65; p=0.042).
Compared with the conventional NCCT markers and BAT predictive model, the deep learning algorithm showed superiority for predicting early haematoma expansion in ICH patients.
血肿扩大是预测颅内出血(ICH)患者结局的决定性因素。本研究旨在通过应用深度学习模型开发一种新的血肿扩大预测模型,并验证其预测准确性。
本研究的数据来自于我们中心前瞻性纳入的原发性幕上ICH 患者队列。我们开发了一种深度学习模型来预测血肿扩大,并将其性能与常规非增强 CT(NCCT)标志物进行比较。为了评估该模型的可预测性,还将其与基于血肿体积或 BAT 评分的逻辑回归模型进行了比较。
共纳入 266 例患者进行分析,其中 74 例(27.8%)发生早期血肿扩大。深度学习模型的 C 统计量最高,为 0.80,而低信号区、黑洞征、混合征、液平及形态不规则的 C 统计量分别为 0.64、0.65、0.51、0.58 和 0.55。而漩涡征(0.70;p=0.211)和不均匀密度(0.70;p=0.141)的 C 统计量并不显著高于深度学习模型。此外,深度学习模型的预测值明显优于血肿体积(0.62;p=0.042)和 BAT 评分(0.65;p=0.042)的逻辑模型。
与传统的 NCCT 标志物和 BAT 预测模型相比,深度学习算法在预测 ICH 患者早期血肿扩大方面具有优势。