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机器学习在狭窄和动脉瘤检测中的应用:在一个生理逼真的虚拟患者数据库中的应用。

Machine learning for detection of stenoses and aneurysms: application in a physiologically realistic virtual patient database.

机构信息

Faculty of Science and Engineering, Swansea University, Swansea, UK.

McLaren Technology Centre, Woking, UK.

出版信息

Biomech Model Mechanobiol. 2021 Dec;20(6):2097-2146. doi: 10.1007/s10237-021-01497-7. Epub 2021 Jul 31.

DOI:10.1007/s10237-021-01497-7
PMID:34333696
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8595223/
Abstract

This study presents an application of machine learning (ML) methods for detecting the presence of stenoses and aneurysms in the human arterial system. Four major forms of arterial disease-carotid artery stenosis (CAS), subclavian artery stenosis (SAS), peripheral arterial disease (PAD), and abdominal aortic aneurysms (AAA)-are considered. The ML methods are trained and tested on a physiologically realistic virtual patient database (VPD) containing 28,868 healthy subjects, adapted from the authors previous work and augmented to include disease. It is found that the tree-based methods of Random Forest and Gradient Boosting outperform other approaches. The performance of ML methods is quantified through the [Formula: see text] score and computation of sensitivities and specificities. When using six haemodynamic measurements (pressure in the common carotid, brachial, and radial arteries; and flow-rate in the common carotid, brachial, and femoral arteries), it is found that maximum [Formula: see text] scores larger than 0.9 are achieved for CAS and PAD, larger than 0.85 for SAS, and larger than 0.98 for both low- and high-severity AAAs. Corresponding sensitivities and specificities are larger than 90% for CAS and PAD, larger than 85% for SAS, and larger than 98% for both low- and high-severity AAAs. When reducing the number of measurements, performance is degraded by less than 5% when three measurements are used, and less than 10% when only two measurements are used for classification. For AAA, it is shown that [Formula: see text] scores larger than 0.85 and corresponding sensitivities and specificities larger than 85% are achievable when using only a single measurement. The results are encouraging to pursue AAA monitoring and screening through wearable devices which can reliably measure pressure or flow-rates.

摘要

本研究应用机器学习 (ML) 方法来检测人体动脉系统中狭窄和动脉瘤的存在。考虑了四种主要形式的动脉疾病:颈动脉狭窄 (CAS)、锁骨下动脉狭窄 (SAS)、外周动脉疾病 (PAD) 和腹主动脉瘤 (AAA)。ML 方法在一个包含 28868 名健康受试者的生理逼真虚拟患者数据库 (VPD) 上进行训练和测试,该数据库改编自作者之前的工作,并扩展到包括疾病。研究发现,基于树的方法随机森林和梯度提升优于其他方法。通过[公式:见文本]评分和计算敏感性和特异性来量化 ML 方法的性能。当使用六个血流动力学测量值(颈总动脉、肱动脉和桡动脉的压力;颈总动脉、肱动脉和股动脉的血流率)时,发现 CAS 和 PAD 的最大[公式:见文本]评分大于 0.9,SAS 大于 0.85,低严重度和高严重度 AAA 均大于 0.98。相应的敏感性和特异性对于 CAS 和 PAD 大于 90%,对于 SAS 大于 85%,对于低严重度和高严重度 AAA 均大于 98%。当减少测量次数时,当使用三个测量值时,性能下降小于 5%,当仅使用两个测量值进行分类时,性能下降小于 10%。对于 AAA,当仅使用单个测量值时,证明可以实现大于 0.85 的[公式:见文本]评分以及大于 85%的相应敏感性和特异性。这些结果令人鼓舞,可以通过可可靠测量压力或流量的可穿戴设备来监测和筛查 AAA。

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