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基于深度学习算法的 CT 图像在哮喘儿童小气道阻塞糖皮质激素治疗中的应用。

Deep Learning Algorithms-Based CT Images in Glucocorticoid Therapy in Asthma Children with Small Airway Obstruction.

机构信息

Department of Pediatrics, Xingtai People's Hospital, Xingtai 054001, Hebei, China.

Department of Endocrinology, Xingtai People's Hospital, Xingtai 054001, Hebei, China.

出版信息

J Healthc Eng. 2021 Oct 21;2021:5317403. doi: 10.1155/2021/5317403. eCollection 2021.

Abstract

CT image information data under deep learning algorithms was adopted to evaluate small airway function and analyze the clinical efficacy of different glucocorticoid administration ways in asthmatic children with small airway obstruction. The Res-NET in the deep learning algorithm was used to perform feature extraction, summary classification, and other reconstruction of CT images. A deep learning network model Mask-R-CNN was constructed to enhance the ability of image reconstruction. A total of 118 children hospitalized with acute exacerbation of asthma in the hospital were recruited. After acute exacerbation treatment, 96 children with asthma were screened out for small airway obstruction, which were divided into glucocorticoid aerosol inhalation group (group A, 32 cases), glucocorticoid combined with bronchodilator aerosol inhalation group (group B, 32 cases), and oral hormone therapy group (group C, 32 cases). Asthmatic children with small airway obstruction were screened after acute exacerbation treatment and were rolled into glucocorticoid aerosol inhalation group (group A), glucocorticoid combined with bronchodilators aerosol inhalation group (group B), and oral hormone therapy group (group C). Lung function indicators (maximal mid-expiratory flow (MMEF75 and 25), 50% forced expiratory flow (FEF50), and 75% forced expiratory flow (FEF75)), FeNO level, and airway inflammation indicators (IL-6, IL-35, and eosinophilic (EOS)) were compared before and one month after treatment. The ratio of airway wall thickness to outer diameter (T/D) and the percentage of airway wall area to total airway area (WA%) were measured by e-Health high-resolution CT (HRCT). The constructed network model was used to measure the patient's coronary artery plaque and blood vessel volume, and the image was reconstructed on the Res-Net network. It was found that the MSE value of the Res-Net network was the lowest, and the efficiency was very high during the training process. T/D and WA (%) of asthmatic children with small airway obstruction after treatment were significantly lower than those before treatment ( < 0.01). After treatment, MMEF75/25 and FEF75 were significantly higher than those before treatment ( < 0.05). Lung function-related indicator FEF50 was significantly higher than that before treatment ( < 0.01). FeNO level after treatment was remarkably lower than that before treatment ( < 0.01). In addition, lung function-related indicators, airway inflammation indicators, and FeNO level improved the most in group C, followed by group B, and those improvements in group A were the least obvious, with great differences among groups ( < 0.05). In summary, the Res-Net model proposed was of certain feasibility and effectiveness for CT image segmentation and can effectively improve the clinical evaluation of patient CT image information. Glucocorticoids could improve small airway function and airway inflammation in asthmatic children with small airway obstruction, and oral corticosteroids were more effective than aerosol inhalation therapy.

摘要

采用深度学习算法下的 CT 图像信息数据,评估小气道功能,并分析不同糖皮质激素给药方式在小儿哮喘小气道阻塞中的临床疗效。深度学习算法中的 Res-NET 用于进行 CT 图像的特征提取、汇总分类等重建。构建了一个深度学习网络模型 Mask-R-CNN,以增强图像重建能力。共纳入我院急性发作期哮喘住院患儿 118 例,急性发作期治疗后筛选出哮喘合并小气道阻塞患儿 96 例,分为糖皮质激素气雾剂吸入组(A 组,32 例)、糖皮质激素联合支气管扩张剂气雾剂吸入组(B 组,32 例)和口服激素治疗组(C 组,32 例)。筛选出哮喘合并小气道阻塞患儿后,进行急性发作期治疗,分别纳入糖皮质激素气雾剂吸入组(A 组)、糖皮质激素联合支气管扩张剂气雾剂吸入组(B 组)和口服激素治疗组(C 组)。肺功能指标(最大中期呼气流量(MMEF75 和 25)、50%用力呼气流量(FEF50)和 75%用力呼气流量(FEF75))、FeNO 水平和气道炎症指标(IL-6、IL-35 和嗜酸性粒细胞(EOS))在治疗前和治疗后 1 个月进行比较。采用 e-Health 高分辨率 CT(HRCT)测量气道壁厚度与外径比(T/D)和气道壁面积与总气道面积比(WA%)。在 Res-Net 网络上构建的网络模型用于测量患者的冠状动脉斑块和血管容积,并对 Res-Net 网络进行图像重建。结果发现,Res-Net 网络的 MSE 值最低,在训练过程中效率非常高。哮喘合并小气道阻塞患儿治疗后 T/D 和 WA(%)明显低于治疗前(<0.01)。治疗后 MMEF75/25 和 FEF75 明显高于治疗前(<0.05)。肺功能相关指标 FEF50 明显高于治疗前(<0.01)。治疗后 FeNO 水平明显低于治疗前(<0.01)。此外,肺功能相关指标、气道炎症指标和 FeNO 水平在 C 组改善最明显,其次是 B 组,而 A 组改善最不明显,组间差异有统计学意义(<0.05)。综上所述,提出的 Res-Net 模型对于 CT 图像分割具有一定的可行性和有效性,可以有效提高患者 CT 图像信息的临床评估。糖皮质激素可以改善哮喘合并小气道阻塞患儿的小气道功能和气道炎症,口服皮质激素治疗比气雾剂吸入治疗更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3fc/8553479/9357214da959/JHE2021-5317403.001.jpg

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