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关于人工智能在床旁超声检查中整合应用的范围综述:当前临床应用

A scoping review on the integration of artificial intelligence in point-of-care ultrasound: Current clinical applications.

作者信息

Kim Junu, Maranna Sandhya, Watson Caterina, Parange Nayana

机构信息

University of South Australia, Adelaide, South Australia, Australia.

Edith Cowan University, 270 Joondalup Dr, Joondalup, Western Australia, Australia.

出版信息

Am J Emerg Med. 2025 Jun;92:172-181. doi: 10.1016/j.ajem.2025.03.029. Epub 2025 Mar 17.

Abstract

BACKGROUND

Artificial intelligence (AI) is used increasingly in point-of-care ultrasound (POCUS). However, the true role, utility, advantages, and limitations of AI tools in POCUS have been poorly understood.

AIM

to conduct a scoping review on the current literature of AI in POCUS to identify (1) how AI is being applied in POCUS, and (2) how AI in POCUS could be utilized in clinical settings.

METHODS

The review followed the JBI scoping review methodology. A search strategy was conducted in Medline, Embase, Emcare, Scopus, Web of Science, Google Scholar, and AI POCUS manufacturer websites. Selection criteria, evidence screening, and selection were performed in Covidence. Data extraction and analysis were performed on Microsoft Excel by the primary investigator and confirmed by the secondary investigators.

RESULTS

Thirty-three papers were included. AI POCUS on the cardiopulmonary region was the most prominent in the literature. AI was most frequently used to automatically measure biometry using POCUS images. AI POCUS was most used in acute settings. However, novel applications in non-acute and low-resource settings were also explored. AI had the potential to increase POCUS accessibility and usability, expedited care and management, and had a reasonably high diagnostic accuracy in limited applications such as measurement of Left Ventricular Ejection Fraction, Inferior Vena Cava Collapsibility Index, Left-Ventricular Outflow Tract Velocity Time Integral and identifying B-lines of the lung. However, AI could not interpret poor images, underperformed compared to standard-of-care diagnostic methods, and was less effective in patients with specific disease states, such as severe illnesses that limit POCUS image acquisition.

CONCLUSION

This review uncovered the applications of AI in POCUS and the advantages and limitations of AI POCUS in different clinical settings. Future research in the field must first establish the diagnostic accuracy of AI POCUS tools and explore their clinical utility through clinical trials.

摘要

背景

人工智能(AI)在床旁超声(POCUS)中的应用日益增多。然而,人们对人工智能工具在POCUS中的真正作用、效用、优势和局限性了解甚少。

目的

对POCUS中人工智能的当前文献进行范围综述,以确定(1)人工智能在POCUS中的应用方式,以及(2)POCUS中的人工智能如何在临床环境中得到利用。

方法

该综述遵循JBI范围综述方法。在Medline、Embase、Emcare、Scopus、Web of Science、谷歌学术和AI POCUS制造商网站上进行了检索策略。在Covidence中进行选择标准、证据筛选和选择。由第一作者在Microsoft Excel上进行数据提取和分析,并由第二作者进行确认。

结果

纳入了33篇论文。文献中关于心肺区域的人工智能POCUS最为突出。人工智能最常被用于使用POCUS图像自动测量生物特征。人工智能POCUS在急性环境中使用最多。然而,也探索了在非急性和资源匮乏环境中的新应用。人工智能有可能提高POCUS的可及性和可用性,加快护理和管理,并且在有限的应用中具有相当高的诊断准确性,如测量左心室射血分数、下腔静脉塌陷指数、左心室流出道速度时间积分以及识别肺部B线。然而,人工智能无法解读质量差的图像,与标准护理诊断方法相比表现不佳,并且在患有特定疾病状态的患者中效果较差,例如限制POCUS图像采集的严重疾病患者。

结论

本综述揭示了人工智能在POCUS中的应用以及人工智能POCUS在不同临床环境中的优势和局限性。该领域未来的研究必须首先确定人工智能POCUS工具的诊断准确性,并通过临床试验探索其临床效用。

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