Misser Shalendra K, Mchunu Nobuhle, Lotz Jan W, Kjonigsen Lisa, Ulug Aziz, Archary Moherndran
Department of Radiology, Lake Smit and Partners Inc., Durban, South Africa.
Department of Radiology, Faculty of Health Sciences, University of KwaZulu-Natal, Duban, South Africa.
SA J Radiol. 2023 Dec 26;27(1):2728. doi: 10.4102/sajr.v27i1.2728. eCollection 2023.
Injury patterns in hypoxic-ischaemic brain injury (HIBI) are well recognised but there are few studies evaluating cerebral injury using neuroquantification models.
Quantification of brain volumes in a group of patients with clinically determined cerebral palsy.
In this retrospective study, 297 children with cerebral palsy were imaged for suspected HIBI with analysis of various cerebral substrates. Of these, 96 children over the age of 3 years with a clinical diagnosis of cerebral palsy and abnormal MRI findings underwent volumetric analyses using the NeuroQuant software solution. The spectrum of volumetric changes and the differences between the various subtypes (and individual subgroups) of HIBI were compared.
Compared with the available normative NeuroQuant database, the average intracranial volume was reduced to the 1st percentile in all patient groups ( < 0.001). Statistically significant differences were observed among the types and subgroups of HIBI. Further substrate volume reductions were identified and described involving the thalami, brainstem, hippocampi, putamina and amygdala. The combined volumes of five regions of interest (frontal pole, putamen, hippocampus, brainstem and paracentral lobule) were consistently reduced in the Rolandic basal ganglia-thalamus (RBGT) subtype.
This study determined a quantifiable reduction of intracranial volume in all subtypes of HIBI and predictable selective cerebral substrate volume reduction in subtypes and subgroups. In the RBGT subtype, a key combination of five substrate injuries was consistently noted, and thalamic, occipital lobe and brainstem volume reduction was also significant when compared to the watershed subtype.
This study demonstrates the value of integrating an artificial intelligence programme into the radiologists' armamentarium serving to quantify brain injuries more accurately in HIBI. Going forward this will be an inevitable evolution of daily radiology practice in many fields of medicine, and it would be beneficial for radiologists to embrace these technological innovations.
缺氧缺血性脑损伤（HIBI）的损伤模式已得到充分认识，但使用神经量化模型评估脑损伤的研究较少。
对一组临床诊断为脑瘫的患者的脑容量进行量化。
在这项回顾性研究中，对297例疑似HIBI的脑瘫患儿进行成像，并对各种脑基质进行分析。其中，96例年龄超过3岁、临床诊断为脑瘫且MRI检查结果异常的患儿使用NeuroQuant软件解决方案进行了体积分析。比较了HIBI不同亚型（及各个亚组）之间的体积变化范围和差异。
与可用的NeuroQuant标准数据库相比，所有患者组的平均颅内体积均降至第1百分位数（<0.001）。在HIBI的类型和亚组之间观察到了具有统计学意义的差异。进一步确定并描述了包括丘脑、脑干、海马体、壳核和杏仁核在内的脑基质体积减少情况。在罗兰基底神经节-丘脑（RBGT）亚型中，五个感兴趣区域（额极、壳核、海马体、脑干和中央旁小叶）的联合体积持续减少。
本研究确定了所有HIBI亚型中颅内体积的可量化减少，以及各亚型和亚组中可预测的选择性脑基质体积减少。在RBGT亚型中，始终观察到五种基质损伤的关键组合，与分水岭亚型相比，丘脑、枕叶和脑干体积减少也很显著。
本研究证明了将人工智能程序纳入放射科医生的工具库的价值，有助于更准确地量化HIBI中的脑损伤。展望未来，这将是许多医学领域日常放射学实践的必然发展，放射科医生接受这些技术创新将是有益的。
