Rondina Jane, Nachev Parashkev
High Dimensional Neurology Group, UCL Queen Square Institute of Neurology, University College London, Russell Square House, Bloomsbury, London, UK.
Curr Opin Neurol. 2025 Feb 1;38(1):40-46. doi: 10.1097/WCO.0000000000001333. Epub 2024 Nov 14.
Though simple in its fundamental mechanism - a critical disruption of local blood supply - stroke is complicated by the intricate nature of the neural substrate, the neurovascular architecture, and their complex interactions in generating its clinical manifestations. This complexity is adequately described by high-resolution imaging with sensitivity not only to parenchymal macrostructure but also microstructure and functional tissue properties, in conjunction with detailed characterization of vascular topology and dynamics. Such descriptive richness mandates models of commensurate complexity only artificial intelligence could plausibly deliver, if we are to achieve the goal of individually precise, personalized care.
Advances in machine vision technology, especially deep learning, are delivering higher fidelity predictive, descriptive, and inferential tools, incorporating increasingly rich imaging information within ever more flexible models. Impact at the clinical front line remains modest, however, owing to the challenges of delivering models robust to the noisy, incomplete, biased, and comparatively small-scale data characteristic of real-world practice.
The potential benefit of introducing AI to stroke, in imaging and elsewhere, is now unquestionable, but the optimal approach - and the path to real-world application - remain unsettled. Deep generative models offer a compelling solution to current obstacles and are predicted powerfully to catalyse innovation in the field.
尽管中风的基本机制很简单——局部血液供应的严重中断——但其临床表现因神经基质、神经血管结构的复杂性及其复杂的相互作用而变得复杂。高分辨率成像不仅对实质宏观结构敏感,而且对微观结构和功能组织特性敏感,同时结合血管拓扑和动力学的详细特征,能够充分描述这种复杂性。如果我们要实现个体化精准、个性化护理的目标,这种丰富的描述需要具有相应复杂性的模型,而只有人工智能才有可能提供这样的模型。
机器视觉技术的进步,尤其是深度学习,正在提供更高保真度的预测、描述和推理工具,在越来越灵活的模型中纳入越来越丰富的成像信息。然而,由于要提供对现实世界实践中嘈杂、不完整、有偏差且规模相对较小的数据具有鲁棒性的模型面临挑战,其在临床一线的影响仍然有限。
将人工智能引入中风领域(在成像及其他方面)的潜在益处现在是毋庸置疑的,但最佳方法以及实际应用的途径仍未确定。深度生成模型为当前的障碍提供了一个引人注目的解决方案,并有望有力地推动该领域的创新。