arXiv:2410.17124physics.med-phcs.AI2024-10综述被引 2

系统梳理脑血管病影像自动分析工具,发现尚无系统能同时检测所有关键病变。

Automated neuroradiological support systems for multiple cerebrovascular disease markers -- A systematic review and meta-analysis

  • 分类梳理29款商业软件与13篇研究,聚焦脑卒中与微小血管病变的自动化识别
  • 现有系统多仅针对单一或少数病灶(如白质高信号、梗死灶),缺乏全面整合
  • 研究侧重随访与神经退行性疾病支持,临床急症场景仍依赖人工判断

脑血管病(CVD)可导致中风和痴呆,其中中风为全球第二大死因,痴呆发病率逐年上升。脑部影像可见多种CVD标志物,包括白质高信号(WMH)、急性和慢性缺血性梗死灶(ISL)、腔隙、扩大的血管周围间隙(PVS)、急性及慢性出血性病变和脑微出血(CMB),以及脑萎缩。这些标志物对患者管理至关重要,提示未来中风和痴呆风险。本研究系统回顾了用于支持放射科医生报告这些CVD影像特征的自动化系统,涵盖商用软件与研究论文,要求至少识别两种CVD标志物。共纳入29款商用产品与13项研究。商业系统分为两类:一类基于CT识别急性卒中病灶(出血性与缺血性),用于患者分诊;另一类则用于区域性和纵向测量WMH与脑萎缩。研究中,最常联合分析的是WMH与ISL,来自MRI扫描;腔隙与PVS各被研究两次,微出血仅一次。商用系统主要服务于急诊场景,而研究系统更关注随访与常规扫描。针对脑萎缩与WMH的量化系统多用于神经退行性疾病支持。目前尚无公开验证的系统可对全部七种标志物(WMH、ISL、腔隙、PVS、出血性病变、微出血、脑萎缩)进行综合分析。

原文摘要 · Abstract (English)

Cerebrovascular diseases (CVD) can lead to stroke and dementia. Stroke is the second leading cause of death world wide and dementia incidence is increasing by the year. There are several markers of CVD that are visible on brain imaging, including: white matter hyperintensities (WMH), acute and chronic ischaemic stroke lesions (ISL), lacunes, enlarged perivascular spaces (PVS), acute and chronic haemorrhagic lesions, and cerebral microbleeds (CMB). Brain atrophy also occurs in CVD. These markers are important for patient management and intervention, since they indicate elevated risk of future stroke and dementia. We systematically reviewed automated systems designed to support radiologists reporting on these CVD imaging findings. We considered commercially available software and research publications which identify at least two CVD markers. In total, we included 29 commercial products and 13 research publications. Two distinct types of commercial support system were available: those which identify acute stroke lesions (haemorrhagic and ischaemic) from computed tomography (CT) scans, mainly for the purpose of patient triage; and those which measure WMH and atrophy regionally and longitudinally. In research, WMH and ISL were the markers most frequently analysed together, from magnetic resonance imaging (MRI) scans; lacunes and PVS were each targeted only twice and CMB only once. For stroke, commercially available systems largely support the emergency setting, whilst research systems consider also follow-up and routine scans. The systems to quantify WMH and atrophy are focused on neurodegenerative disease support, where these CVD markers are also of significance. There are currently no openly validated systems, commercially, or in research, performing a comprehensive joint analysis of all CVD markers (WMH, ISL, lacunes, PVS, haemorrhagic lesions, CMB, and atrophy).

脑血管病影像分析自动化诊断卒中

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