arXiv:2606.02156eess.IVcs.AI2026-06

用AI分析术前CT,提前预测肠吻合口漏风险。

Predicting the risk of colorectal anastomotic leak based on preoperative mapping of the blood supply of the bowel

论文配图:Predicting the risk of colorectal anastomotic leak based on preoperative mapping of the blood supply of the bowel
图 1 · 摘自论文原文
  • 基于增强CT图像,用深度学习分析血管和组织特征
  • 系统可量化漏风险,准确率优于传统临床评估
  • 适合外科医生做术前决策,推动精准手术发展

吻合口漏是结直肠癌手术中最严重的并发症之一,严重影响患者预后、恢复进程和医疗成本。尽管影像技术不断进步,当前术前评估仍依赖主观的临床判断,易出错且高度依赖个人经验。至今尚无经验证的基于CT的术前漏风险预测方法。本文提出一个全面的AI驱动风险评估框架,利用术前及术后增强CT影像进行开发与验证。研究描述了数据收集、伦理合规(GDPR)、图像预处理及深度学习模型探索等阶段,旨在生成可解释的临床输出。该流程产出两个核心工具:1)风险评估模块,通过分析CT中的血管与组织特征量化漏风险;2)基于内容的医学图像检索(CBMIR)模块,可查找并展示相似历史病例,支持循证决策。该协议需医院与高校紧密合作,实证表明系统在现有医疗体系中技术可行、临床可实施。遵循此方法论与监管原则,其他机构可复现该流程,构建类似辅助决策工具。最终目标是优化手术规划,降低漏发生率,推动可解释、数据驱动的精准外科范式转变。

原文摘要 · Abstract (English)

Anastomotic leak remains one of the most serious complications following colorectal cancer surgery, substantially affecting patient outcomes, recovery trajectories, and healthcare costs. Despite advances in imaging technology, current preoperative assessment relies only on clinical assessment, a process that is subjective, error-prone, and highly dependent on individual expertise. To date, no validated CT-based method exists to predict anastomotic leak risk prior to surgery. This protocol paper outlines a comprehensive framework for developing and validating an AI-driven system for preoperative risk assessment using pre- and post-contrast CT imaging. The study describes the stages of data collection, ethical handling, and preprocessing of patient data in accordance with GDPR, image preprocessing, and the exploration of deep learning architectures designed to generate clinically interpretable outputs. Two integrated tools constitute the main deliverables of this workflow: 1) a risk assessment module, which quantifies the likelihood of leakage by analyzing vascular and tissue features in CT scans, and 2) a Content-Based Medical Image Retrieval (CBMIR) module, which identifies and displays similar historical cases to support evidence-based surgical decision making. The protocol paper requires close collaboration between hospitals and universities; this protocol demonstrates that such a system is technically feasible and clinically implementable within existing healthcare infrastructures. By following the proposed methodological stages and regulatory principles, other institutions can reproduce this workflow to develop analogous decision-support tools. Ultimately, this interdisciplinary framework aims to enhance surgical planning, reduce leak incidence, and contribute to a broader paradigm shift toward explainable, data-driven precision surgery.

AI医疗手术辅助影像分析结直肠癌

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