Tunthanathip Thara, Trakulpanitkit Avika
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Acute Crit Care. 2025 Aug;40(3):473-481. doi: 10.4266/acc.001425. Epub 2025 Aug 29.
Intracranial pressure (ICP) waveform analysis provides critical insights into brain compliance and can aid in the early detection of neurological deterioration. Deep learning (DL) has recently emerged as an effective approach for analyzing complex medical signals and imaging data. The aim of the present research was to develop a DL-based model for detecting ICP waveforms indicative of poor brain compliance.
A retrospective cohort study was conducted using ICP wave images collected from postoperative hydrocephalus (HCP) patients who underwent ventriculostomy. The images were categorized into normal and poor compliance waveforms. Precision, recall, mean average precision at the 0.5 intersection over union (mAP_0.5), and the area under the receiver operating characteristic curve (AUC) were used to test.
The dataset consisted of 2,744 ICP wave images from 21 HCP patients. The best-performing model achieved a precision of 0.97, a recall of 0.96, and a mAP_0.5 of 0.989. The confusion matrix for poor brain compliance waveform detection using the test dataset also demonstrated a high classification accuracy, with true positive and true negative rates of 48.5% and 47.8%, respectively. Additionally, the model demonstrated high accuracy, achieving a mAP_0.5 of 0.994, sensitivity of 0.956, specificity of 0.970, and an AUC of 0.96 in the detection of poor compliance waveforms.
The DL-based model successfully detected pathological ICP waveforms, thereby enhancing clinical decision-making. As DL advances, its significance in neurocritical care will help to pave the way for more individualized and data-driven approaches to brain monitoring and management.
颅内压(ICP)波形分析为脑顺应性提供了关键见解,并有助于早期发现神经功能恶化。深度学习(DL)最近已成为分析复杂医学信号和成像数据的有效方法。本研究的目的是开发一种基于深度学习的模型,用于检测提示脑顺应性差的ICP波形。
采用回顾性队列研究,使用从接受脑室造瘘术的术后脑积水(HCP)患者收集的ICP波图像。将图像分为正常和顺应性差的波形。使用精确率、召回率、交并比为0.5时的平均平均精度(mAP_0.5)以及受试者工作特征曲线下面积(AUC)进行测试。
数据集包括来自21例HCP患者的2744张ICP波图像。性能最佳的模型精确率为0.97,召回率为0.96,mAP_0.5为0.989。使用测试数据集进行脑顺应性差波形检测的混淆矩阵也显示出较高的分类准确率,真阳性率和真阴性率分别为48.5%和47.8%。此外,该模型在检测顺应性差的波形时显示出高准确率,mAP_0.5为0.994,灵敏度为0.956,特异性为0.