Acute ischemic stroke prognosis evaluation method and system

Abstract

The invention relates to the technical field of data processing, in particular to an acute ischemic stroke prognosis evaluation method and system.The method comprises the steps that the average CT value, obtained based on an ASPECTS scoring system, of an ischemic area and the average CT value, obtained based on the ASPECTS scoring system, of a normal area on the opposite side are obtained; determining a first ASPECTS-NWU value based on the average CT value of the ischemic region and the average CT value of the normal region; the ASPECTS-NWU value represents the injury degree of the ischemic area; a second ASPECTS-NWU value obtained through follow-up visit CT is obtained, and an NWU difference value is determined based on the first ASPECTS-NWU value and the second ASPECTS-NWU value; the NWU difference represents the progress of lesion edema; constructing a regression model based on the NWU difference value, and performing acute ischemic stroke prognosis evaluation based on the regression model; according to the invention, the efficiency of prognosis evaluation of acute ischemic stroke can be improved.

Description

Technical Field

[0001] The present invention relates to the technical field of data processing, and in particular to an acute ischemic stroke prognosis assessment method and system. Background Art

[0002] NWU (net water uptake) is an analytical method used to quantify the degree of brain tissue damage. Currently, the calculation of NWU is mostly based on multimodal CT imaging examinations. The infarct area is determined according to the cerebral blood volume (CBV) map of CT brain perfusion imaging, and the infarct area and the contralateral mirror brain area are manually outlined and segmented. However, this method is time-consuming and labor-intensive, and requires multimodal CT technology. Manual segmentation of images is also susceptible to subjective factors of the observer. Moreover, it is difficult to achieve in primary stroke centers and grassroots hospitals that have not yet developed multimodal CT technology, which also limits its widespread clinical application. Summary of the invention

[0003] To solve the above problems, the present invention provides a method and system for prognosis assessment of acute ischemic stroke, aiming to improve the efficiency of prognosis assessment of acute ischemic stroke.

[0004] In order to achieve the above object, the present invention provides the following technical solutions:

[0005] In one aspect, an embodiment of the present invention provides a method for evaluating the prognosis of acute ischemic stroke, the method comprising the following steps:

[0006] Obtaining the average CT value of the ischemic area and the average CT value of the contralateral normal area based on the ASPECTS scoring system; wherein the ischemic area is located on the lesion side of the middle cerebral artery supply area;

[0007] Determining a first ASPECTS-NWU value based on the average CT value of the ischemic area and the average CT value of the normal area; wherein the ASPECTS-NWU value represents the degree of damage to the ischemic area;

[0008] Obtaining a second ASPECTS-NWU value obtained through a follow-up CT scan, and determining a NWU difference based on the first ASPECTS-NWU value and the second ASPECTS-NWU value; wherein the NWU difference represents the progression of lesion edema;

[0009] A regression model is constructed based on the NWU difference, and the prognosis of acute ischemic stroke is evaluated based on the regression model.

[0010] Optionally, the calculation formula of the first ASPECTS-NWU value is:

[0011] NWUFCT =[1-(HU1 ischemic / HU1 normal )]x100;

[0012] Among them, NWU FCT Indicates the first ASPECTS-NWU value, HU1 ischemic HU1 represents the average CT value of the ischemic area obtained by admission CT. normal It represents the average CT value of the normal area obtained by admission CT.

[0013] Optionally, the calculation formula of the second ASPECTS-NWU value is:

[0014] NWUadmisson=[1-(HU2 ischemic / HU2 normal )]x100;

[0015] Among them, NWUadmisson represents the first ASPECTS-NWU value, HU2 ischemic represents the average CT value of the ischemic area obtained by follow-up CT, HU2 normal It represents the average CT value of the normal area obtained by follow-up CT.

[0016] Optionally, the calculation formula of the NWU difference is:

[0017] ΔNWU=NWU FCT -NWUadmisson;

[0018] Here, ΔNWU represents the NWU difference.

[0019] Optionally, constructing a regression model based on the NWU difference, and performing acute ischemic stroke prognosis assessment based on the regression model, includes:

[0020] Clinical data are obtained, a Logistic regression model is constructed based on the clinical data and the corresponding NWU difference, and the prognosis of acute ischemic stroke is evaluated based on the Logistic regression model.

[0021] On the other hand, an embodiment of the present invention provides an acute ischemic stroke prognosis assessment system, comprising:

[0022] at least one processor;

[0023] at least one memory for storing at least one program;

[0024] When the at least one program is executed by the at least one processor, the at least one processor implements the above method.

[0025] On the other hand, an embodiment of the present invention provides a computer-readable storage medium, in which a program executable by a processor is stored. When the program executable by the processor is executed by the processor, it is used to perform the above method.

[0026] The beneficial effects of the present invention are as follows: the present invention discloses an acute ischemic stroke prognosis assessment method and system, through semi-automatic quantitative calculation of the first ASPECTS-NWU value before and after reperfusion therapy, the degree of ischemic area damage is obtained; the NWU difference is determined by the first ASPECTS-NWU value of the admission CT and the second ASPECTS-NWU value obtained by the follow-up CT; thus, the progression of lesion edema can be identified by a simple CT scan, a regression model is constructed based on the NWU difference, and the acute ischemic stroke prognosis assessment is performed based on the regression model, so that the patient's condition can be quickly assessed. The present invention improves the efficiency of acute ischemic stroke prognosis assessment. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required for use in the embodiments will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative labor.

[0028] Figure 1 It is a flow chart of a method for prognosis assessment of acute ischemic stroke according to an embodiment of the present invention;

[0029] Figure 2 is a schematic diagram of an automated software ASPECTS scoring system according to an embodiment of the present invention;

[0030] Figure 3 It is a structural schematic diagram of an acute ischemic stroke prognosis assessment system according to an embodiment of the present invention. DETAILED DESCRIPTION

[0031] The following will be combined with the embodiments and drawings to clearly and completely describe the concept, specific structure and technical effects disclosed in the present invention, so as to fully understand the purpose, scheme and effect disclosed in the present invention. It should be noted that the embodiments and features in the embodiments in this application can be combined with each other without conflict.

[0032] In 2017, BROOCKS et al. proposed the concept of net water uptake (NWU). Through in vivo and in vitro experiments, they confirmed the relationship between the net water uptake per unit volume of ischemic lesions and CT attenuation. The water uptake of infarct lesions can be quantitatively calculated by relative CT density measurement. After cerebral infarction, the gray value of CT decreases due to water uptake. NWU is a quantitative index that reflects the net water uptake per unit volume of brain tissue through the change of gray value, thereby judging the severity of post-stroke cerebral edema. At present, net water uptake has been confirmed to be an important biological marker of cerebral edema in AIS patients and an individual indicator of the "tissue clock". NWU in the lesion area of ​​acute ischemic stroke has been widely used in its diagnosis and treatment. NWU can be used as a predictor of the onset time window of AIS to screen patients who are suitable for endovascular treatment and whose onset time is unknown. It can indirectly reflect the state of collateral circulation, predict the occurrence of malignant cerebral edema (MCE) after stroke, and has important clinical significance in quantifying treatment effects and evaluating prognosis.

[0033] Based on this, the present invention provides a method and system for evaluating the prognosis of acute ischemic stroke, which does not require multimodal CT imaging examination, and does not require manual image segmentation to avoid the influence of subjective factors of the observer. The prognosis of acute ischemic stroke can be evaluated by simply performing a CT scan, so as to improve the efficiency of prognosis evaluation.

[0034] refer to Figure 1 ,like Figure 1 An acute ischemic stroke prognosis assessment method provided by an embodiment of the present invention is shown, and the method comprises the following steps:

[0035] S100, obtaining an average CT value of the ischemic area and an average CT value of the contralateral normal area based on the ASPECTS scoring system; wherein the ischemic area is located on the lesion side of the middle cerebral artery supply area;

[0036] S200, determining a first ASPECTS-NWU value based on the average CT value of the ischemic area and the average CT value of the normal area; wherein the ASPECTS-NWU value represents the degree of damage of the ischemic area;

[0037] S300, obtaining a second ASPECTS-NWU value obtained by follow-up CT, and determining a NWU difference based on the first ASPECTS-NWU value and the second ASPECTS-NWU value; wherein the NWU difference represents the progression of lesion edema;

[0038] S400, constructing a regression model based on the NWU difference, and performing acute ischemic stroke prognosis assessment based on the regression model.

[0039] refer to Figure 2 Specifically, the HU values ​​of the lesion side and the contralateral side of the middle cerebral artery blood supply area are obtained based on the automated software ASPECTS scoring system. ASPECTS (Alberta Stroke Program Early CT Score) is a 10-point scoring system that uses CT scan images to evaluate the ischemia of 10 different areas in the brain. The net water uptake rate before and after reperfusion therapy is calculated semi-automatically to obtain the degree of damage to the ischemic area. The embodiment provided by the present invention does not require multimodal CT imaging examinations, and does not require manual image segmentation to avoid the influence of subjective factors of the observer. A simple CT scan can identify the progression of lesion edema. It is conducive to the widespread application of primary stroke centers and grassroots hospitals that have not been able to carry out multimodal CT technology.

[0040] The present invention realizes semi-automatic quantitative evaluation of net water uptake rate based on the automated ASPECTS scoring system software; by constructing a prediction model based on the progression of lesion edema, a new method is provided for evaluating whether recanalization is effective after reperfusion therapy and clinical prognosis, and it has good predictive value for poor prognosis 90 days after reperfusion therapy for acute anterior circulation large vessel occlusive stroke patients. It can quickly evaluate the patient's condition and provide important decision support for clinicians.

[0041] In some embodiments, the calculation formula of the first ASPECTS-NWU value is:

[0042] NWU FCT =[1-(HU1 ischemic / HU1 normal )]x100;

[0043] Among them, NWU FCT Indicates the first ASPECTS-NWU value, HU1 ischemic HU1 represents the average CT value of the ischemic area obtained by admission CT. normal It represents the average CT value of the normal area obtained by admission CT.

[0044] In this embodiment, the average Hounsfield unit (HU) value of each area is calculated by the automated ASPECT scoring system software. The relative difference of the HU value of each part of the ischemic side and the contralateral normal side is calculated and expressed as a percentage of the HU difference. The degree of damage in the ischemic area is calculated by comparing the CT value of the ischemic area and the normal area. If the CT value of the ischemic area is lower, it means that the damage is more serious, and the value of NWU% is also larger.

[0045] In some embodiments, the calculation formula of the second ASPECTS-NWU value is:

[0046] NWUadmisson=[1-(HU2 ischemic / HU2 normal )]x100;

[0047] Among them, NWUadmisson represents the first ASPECTS-NWU value, HU2 ischemic represents the average CT value of the ischemic area obtained by follow-up CT, HU2 normal It represents the average CT value of the normal area obtained by follow-up CT.

[0048] In this embodiment, the calculation formula of the second ASPECTS-NWU value of the follow-up CT is the same as the calculation formula of the first ASPECTS-NWU value of the admission CT, and both are calculated based on the net water uptake rate.

[0049] In some embodiments, the NWU difference is calculated as:

[0050] ΔNWU=NWU FCT -NWUadmisson;

[0051] Among them, ΔNWU represents the NWU difference, NWU FCT represents the first ASPECTS-NWU value, and NWUadmisson represents the second ASPECTS-NWU value.

[0052] In this embodiment, the progression of lesion edema is characterized by the NWU difference, which is defined as the difference between the first ASPECTS-NWU value of the follow-up CT scan and the second ASPECTS-NWU value of the admission CT scan.

[0053] In some embodiments, constructing a regression model based on the NWU difference, and performing acute ischemic stroke prognosis assessment based on the regression model, comprises:

[0054] Clinical data are obtained, a Logistic regression model is constructed based on the clinical data and the corresponding NWU difference, and the prognosis of acute ischemic stroke is evaluated based on the Logistic regression model.

[0055] In some embodiments, the clinical data include the age and NHISS score of the elderly patient. The present invention integrates clinical data to construct a Logistic regression model based on elderly, NHISS score and NWU difference, thereby improving the predictive value of acute ischemic stroke prognosis assessment.

[0056] refer to Figure 3 The embodiment of the present invention further provides an acute ischemic stroke prognosis assessment system, comprising:

[0057] at least one processor;

[0058] at least one memory for storing at least one program;

[0059] When the at least one program is executed by the at least one processor, the at least one processor implements the above method.

[0060] The contents of the above method embodiments are all applicable to this embodiment. The functions specifically implemented by this embodiment are the same as those of the above method embodiments, and the beneficial effects achieved are also the same as those achieved by the above method embodiments, which will not be repeated here.

[0061] Although the description of the present disclosure has been quite detailed and specifically describes several described embodiments, it is not intended to be limited to any of these details or embodiments or any particular embodiment, but should be regarded as providing a broad possible interpretation of these claims by reference to the appended claims, taking into account the prior art, so as to effectively cover the intended scope of the present disclosure. In addition, the above description of the present disclosure is based on the embodiments foreseeable by the inventor, and its purpose is to provide a useful description, and those non-substantial changes to the present disclosure that have not yet been foreseen may still represent equivalent changes to the present disclosure.

Claims

1. A method for evaluating the prognosis of acute ischemic stroke, characterized in that: The method comprises the following steps: Obtaining the average CT value of the ischemic area and the average CT value of the contralateral normal area based on the ASPECTS scoring system; wherein the ischemic area is located on the lesion side of the middle cerebral artery supply area; Determining a first ASPECTS-NWU value based on the average CT value of the ischemic area and the average CT value of the normal area; wherein the ASPECTS-NWU value represents the degree of damage to the ischemic area; Obtaining a second ASPECTS-NWU value obtained through a follow-up CT scan, and determining a NWU difference based on the first ASPECTS-NWU value and the second ASPECTS-NWU value; wherein the NWU difference represents the progression of lesion edema; A regression model is constructed based on the NWU difference, and the prognosis of acute ischemic stroke is evaluated based on the regression model.

2. The method for evaluating the prognosis of acute ischemic stroke according to claim 1, characterized in that: The calculation formula of the first ASPECTS-NWU value is: NWU FCT =[1-(HU1 ischemic / HU1 normal )]x100; Among them, NWU FCT Indicates the first ASPECTS-NWU value, HU1 ischemic HU1 represents the average CT value of the ischemic area obtained by admission CT. normal It represents the average CT value of the normal area obtained by admission CT.

3. The method for evaluating the prognosis of acute ischemic stroke according to claim 2, characterized in that: The calculation formula of the second ASPECTS-NWU value is: NWUadmisson=[1-(HU2 ischemic / HU2 normal )]x100; Among them, NWUadmisson represents the first ASPECTS-NWU value, HU2 ischemic represents the average CT value of the ischemic area obtained by follow-up CT, HU2 normal It represents the average CT value of the normal area obtained by follow-up CT.

4. The method for evaluating the prognosis of acute ischemic stroke according to claim 3, characterized in that: The NWU difference is calculated as follows: ΔNWU=NWU FCT -NWUadmisson; Here, ΔNWU represents the NWU difference.

5. The method for prognosis assessment of acute ischemic stroke according to claim 1, characterized in that: The step of constructing a regression model based on the NWU difference and performing acute ischemic stroke prognosis assessment based on the regression model includes: Clinical data are obtained, a Logistic regression model is constructed based on the clinical data and the corresponding NWU difference, and the prognosis of acute ischemic stroke is evaluated based on the Logistic regression model.

6. An acute ischemic stroke prognosis assessment system, characterized in that: include: at least one processor; at least one memory for storing at least one program; When the at least one program is executed by the at least one processor, the at least one processor implements the method according to any one of claims 1 to 5.

7. A computer-readable storage medium storing a program executable by a processor, characterized in that: The processor-executable program is used to perform the method according to any one of claims 1 to 5 when executed by the processor.

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