Clinically, non-contrastive computed tomography (NCCT) is used to quickly diagnose the type and area of stroke, and the Alberta stroke program early computer tomography score (ASPECTS) is used to guide the next treatment. However, in the early stage of acute ischemic stroke (AIS), it's difficult to distinguish the mild cerebral infarction on NCCT with the naked eye, and there is no obvious boundary between brain regions, which makes clinical ASPECTS difficult to conduct. The method based on machine learning and deep learning can help physicians quickly and accurately identify cerebral infarction areas, segment brain areas, and operate ASPECTS quantitative scoring, which is of great significance for improving the inconsistency in clinical ASPECTS. This article describes current challenges in the field of AIS ASPECTS, and then summarizes the application of computer-aided technology in ASPECTS from two aspects including machine learning and deep learning. Finally, this article summarizes and prospects the research direction of AIS-assisted assessment, and proposes that the computer-aided system based on multi-modal images is of great value to improve the comprehensiveness and accuracy of AIS assessment, which has the potential to open up a new research field for AIS-assisted assessment.
临床主要通过非对比计算机断层扫描(NCCT)快速诊断脑卒中的类型和区域,并借助阿尔伯塔卒中项目早期计算机断层扫描评分(ASPECTS)指导下一步的治疗。然而,在急性缺血性脑卒中(AIS)早期,NCCT 上的轻度脑梗肉眼难以分辨,参与 ASPECTS 评分的脑区之间无明显边界,导致临床评分存在一定困难。基于机器学习和深度学习的方法能够快速、准确地从现有影像中识别脑梗区域,并对参与评分的脑区进行分割,辅助医生进行 ASPECTS 定量评分,这对于改善临床评分存在不一致性的问题具有重要意义。本文首先对 AIS 评分领域现阶段面临的挑战进行了阐述,之后从传统机器学习和深度学习两个方面概述了计算机辅助技术在 ASPECTS 评分中的研究现状。最后,对该领域的研究方向进行了总结和展望,并提出基于多模态影像数据的计算机辅助系统对提高 AIS 评估的全面性和准确性具有很高的价值,以期为 AIS 辅助评估领域探索新的研究方向。.
Keywords: Alberta stroke program early computer tomography score; acute ischemic stroke; computer-aided diagnosis; deep learning.