解剖标志导向穿刺术与三维体表与影像融合定位穿刺术治疗小量丘脑出血的临床效果对比

Comparison of clinical effects between anatomical landmark guided puncture and three-dimensional surface image fusion localization puncture for the treatment of minor thalamic hemorrhage

摘要:

【】? 目的? 通过临床数据对比评价基于体系化医学影像人工智能(Artificial intelligence,AI)诊断系统支持的解剖标志导向穿刺抽吸术在小量丘脑出血手术治疗中的应用价值,以及评价体系化AI影像诊断系统在围手术期安全和手术效果评估中的应用价值。方法 回顾性分析小量丘脑出血且行穿刺抽吸术患者的病例资料218例,其中应用体系化AI系统通过影像诊断识别出血原因、手术安全性和效果,并应用解剖标志导向穿刺术的113例患者的病例资料纳入观察组,应用人工影像诊断识别出血原因、评估手术安全和效果,行机器人辅助三维体表与影像融合定位穿刺术的105例患者的病例资料纳入对照组。对比2组患者手术总时间、导管位置准确率、路径长度符合率、拔管时间、血肿清除率、术后180d美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分、日常生活能力巴氏指数(Barthel Index,BI)等的差异,评价解剖标志导向穿刺抽吸术在丘脑出血手术治疗中的应用价值,对比2组患者CTA诊断时间、复杂影像诊断准确率、CT导管准确诊断时间、CT路径长度诊断时间等差异,评价体系化AI影像诊断系统在围手术期安全和手术效果评估中的应用价值。结果 观察组与对照组手术总时间差异有统计学意义(P<0.05)；观察组与对照组导管位置准确率、路径长度符合率、拔管时间、血肿清除率、术后180dNIHSS评分、BI等的差异比较均无统计学意义( P >0.05)。观察组与对照组患者CTA诊断时间、复杂影像诊断准确率、CT导管准确诊断时间、CT路径长度诊断时间等差异有统计学意义(P<0.05) 结论 解剖标志导向穿刺抽吸术治疗小量丘脑出血,安全可靠,效果良好,简便易行。体系化AI影像诊断系统应用于围手术期安全和手术效果评价中,可明显降低时间成本,提高医学影像诊断准确率。

Abstract:

Objective: Evaluate the application value of anatomical landmark guided puncture aspiration supported by a integrated medical imaging artificial intelligence (AI) diagnostic system in the surgical treatment of minor thalamic hemorrhage through clinical efficacy comparison,and evaluate the application value of integrated AI imaging diagnosis system in perioperative safety and surgical efficacy assessment. Method:A retSRpective analysis was conducted on 218 cases of patients with minor thalamic hemorrhage who underwent puncture aspiration surgery. Among them, a integrated AI system was used to identify the cause of bleeding, surgical safety, and effectiveness through imaging diagnosis. The case data of 113 patients who underwent anatomical landmark guided puncture surgery were included in the observation group, while the case data of 105 patients who underwent robot assisted 3D surface and image fusion positioning puncture surgery were included in the control group. Compare the differences in total surgical time, catheter position accuracy, path length conformity, catheter removal time, hematoma clearance rate, 180 days after surgery of National Institutes of Health Stroke Scale (NIHSS) score and Barthel Index (BI) of daily living ability,between two groups of patients, and evaluate the application value of anatomical landmark guided puncture aspiration in the treatment of thalamic hemorrhage surgery,compare the differences in CTA diagnosis time, complex imaging diagnosis accuracy, CT catheter accurate diagnosis time, CT path length diagnosis time, etc. between two groups of patients, and evaluate the application value of a integrated AI imaging diagnosis system in perioperative safety and surgical efficacy evaluation. Results There was a statistically significant difference in the total surgical time between the observation group and the control group (P<0.05); There was no statistically significant difference (P>0.05) in the accuracy of catheter position, consistency of path length, extubation time, hematoma clearance rate, postoperative 180dNIHSS score, BI, etc. between the observation group and the control group. There were statistically significant differences (P<0.05) between the observation group and the control group in terms of CTA diagnosis time, accuracy of complex imaging diagnosis, accurate diagnosis time of CT catheter, and diagnosis time of CT path length.Conclusion: Anatomical landmark guided puncture aspiration is a safe, reliable, effective, and simple method for treating typical minor thalamic hemorrhage. The application of integrated AI imaging diagnosis system in perioperative safety and surgical efficacy evaluation can significantly reduce time costs and improve the accuracy of medical imaging diagnosis.