Scavasine Valéria Cristina, Ferreti Lucas Andrade, da Costa Rebeca Teixeira, Leitao Cleverson Alex, Teixeira Bernardo Correa, Zétola Viviane de Hiroki Flumignan, Lange Marcos Christiano
Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
Radiology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
J Neuroimaging. 2023 Jan;33(1):134-137. doi: 10.1111/jon.13066. Epub 2022 Oct 28.
Precise evaluation of brain computerized tomography (CT) is a crucial step in acute ischemic stroke evaluation. Electronic Alberta Stroke Program Early CT Score (E-ASPECTS) helps in the selection of patients who may be eligible for thrombolysis. This paper seeks to assess the performance of emergency physicians (EPs) in the evaluation of ASPECTS scores with and without the use of E-ASPECTS and to compare their results with neuroradiologists.
A total of 116 patients were selected. Initially, two EPs and two neuroradiologists evaluated the admission nonenhanced CT without E-ASPECTS. Then, after 30 days, they re-evaluated the images using E-ASPECTS. Sensitivity, specificity, Matthew's correlation coefficients (MCC), and receiver operating characteristic curves were generated for analysis before and after the software use.
Eps' performances improved when they used E-ASPECTS, with their results closer to those obtained by neuroradiologists. In the initial evaluation, MCC values for the two EPs were -0.01 and 0.04, respectively. After the software assistance, they obtained 0.38 and 0.43, respectively, which was closer to the scores obtained by the neuroradiologists (0.53 and 0.39, respectively).
This is the first study that has specifically compared neuroradiologists' and EPs' performances before and after using E-ASPECTS. E-ASPECTS assisted and improved the evaluation of the images of patients with acute ischemic stroke.
Artificial intelligence in the emergency room may increase the number of patients treated with tissue-type plasminogen activators.
脑部计算机断层扫描（CT）的精确评估是急性缺血性中风评估的关键步骤。艾伯塔卒中项目早期CT电子评分（E-ASPECTS）有助于筛选可能适合溶栓治疗的患者。本文旨在评估急诊医生（EP）在使用和不使用E-ASPECTS的情况下对ASPECTS评分的评估表现，并将其结果与神经放射科医生的结果进行比较。
共选取116例患者。最初，两名急诊医生和两名神经放射科医生在不使用E-ASPECTS的情况下评估入院时的非增强CT。然后，在30天后，他们使用E-ASPECTS重新评估图像。生成软件使用前后的敏感性、特异性、马修斯相关系数（MCC）和受试者操作特征曲线进行分析。
急诊医生使用E-ASPECTS后表现有所改善，其结果更接近神经放射科医生的结果。在初始评估中，两名急诊医生的MCC值分别为-0.01和0.04。在软件辅助后，他们分别获得了0.38和0.43，更接近神经放射科医生获得的分数（分别为0.53和0.39）。
这是第一项专门比较神经放射科医生和急诊医生在使用E-ASPECTS前后表现的研究。E-ASPECTS辅助并改善了急性缺血性中风患者图像的评估。
急诊室中的人工智能可能会增加接受组织型纤溶酶原激活剂治疗的患者数量。
