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评估辅助人工智能对区域麻醉超声扫描的影响。

Evaluation of the impact of assistive artificial intelligence on ultrasound scanning for regional anaesthesia.

机构信息

Oxford Simulation, Teaching and Research Centre, University of Oxford, Oxford, UK; Department of Anaesthesia, Aneurin Bevan University Health Board, Newport, UK.

Department of Anaesthesia, Glasgow Royal Infirmary, Glasgow, UK; School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK.

出版信息

Br J Anaesth. 2023 Feb;130(2):226-233. doi: 10.1016/j.bja.2022.07.049. Epub 2022 Sep 8.

Abstract

BACKGROUND

Ultrasound-guided regional anaesthesia relies on the visualisation of key landmark, target, and safety structures on ultrasound. However, this can be challenging, particularly for inexperienced practitioners. Artificial intelligence (AI) is increasingly being applied to medical image interpretation, including ultrasound. In this exploratory study, we evaluated ultrasound scanning performance by non-experts in ultrasound-guided regional anaesthesia, with and without the use of an assistive AI device.

METHODS

Twenty-one anaesthetists, all non-experts in ultrasound-guided regional anaesthesia, underwent a standardised teaching session in ultrasound scanning for six peripheral nerve blocks. All then performed a scan for each block; half of the scans were performed with AI assistance and half without. Experts assessed acquisition of the correct block view and correct identification of sono-anatomical structures on each view. Participants reported scan confidence, experts provided a global rating score of scan performance, and scans were timed.

RESULTS

Experts assessed 126 ultrasound scans. Participants acquired the correct block view in 56/62 (90.3%) scans with the device compared with 47/62 (75.1%) without (P=0.031, two data points lost). Correct identification of sono-anatomical structures on the view was 188/212 (88.8%) with the device compared with 161/208 (77.4%) without (P=0.002). There was no significant overall difference in participant confidence, expert global performance score, or scan time.

CONCLUSIONS

Use of an assistive AI device was associated with improved ultrasound image acquisition and interpretation. Such technology holds potential to augment performance of ultrasound scanning for regional anaesthesia by non-experts, potentially expanding patient access to these techniques.

CLINICAL TRIAL REGISTRATION

NCT05156099.

摘要

背景

超声引导区域麻醉依赖于超声对关键地标、目标和安全结构的可视化。然而,对于经验不足的从业者来说,这可能具有挑战性。人工智能(AI)越来越多地应用于医学图像解释,包括超声。在这项探索性研究中,我们评估了非超声引导区域麻醉专家使用和不使用辅助 AI 设备进行超声扫描的表现。

方法

21 名麻醉师均为超声引导区域麻醉的非专家,接受了为期 6 周的外周神经阻滞超声扫描标准化教学课程。然后,他们对每个阻滞进行了一次扫描;其中一半扫描使用 AI 辅助,一半不使用。专家评估了正确获取阻滞视图和正确识别每个视图中超声解剖结构的能力。参与者报告了扫描信心,专家提供了扫描性能的总体评分,并且对扫描时间进行了计时。

结果

专家评估了 126 次超声扫描。参与者使用设备获得了 62 次阻滞中的 56 次(90.3%)正确视图,而不使用设备获得了 62 次阻滞中的 47 次(75.1%)(P=0.031,两个数据点丢失)。在视图上正确识别超声解剖结构的次数为 212 次中有 188 次(88.8%),而不使用设备则为 208 次中有 161 次(77.4%)(P=0.002)。参与者信心、专家总体表现评分或扫描时间方面没有显著差异。

结论

使用辅助 AI 设备与改善超声图像采集和解释相关。这种技术有可能通过非专家扩大超声扫描在区域麻醉中的应用,从而潜在地扩大患者对这些技术的接受程度。

临床试验注册

NCT05156099。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51ea/9900732/83968ba8ab5d/gr1.jpg

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