Selective computed tomographic angiography in traumatic subarachnoid hemorrhage: a pilot study

This research was aimed to investigate the accuracy of U-shaped network (UNet)-based computed tomography angiography (CTA) and B-mode ultrasonography (US) in the perforator localization of free anterolateral thigh flap (ALTF). Based on UNet, a fusion of deep supervision mechanism, squeeze-and-excitation module, and attention mechanism was introduced to optimize the algorithm. Then, a CTA segmentation model, DA-UNet, was established. The segmentation performance of DA-UNet and other algorithms was compared under the same conditions. 30 patients who were planned to receive ALTF surgery were selected as the research objects. According to different preoperative localization methods, they were divided into group A (CTA) and group B (B-mode US), 15 cases in each group. Combined with the actual situation during surgery, the diagnostic accordance rate, sensitivity (Sen), specificity, and the distance between the perforator location and the actual location were compared between the two groups. The Dice coefficient, Jaccard index, Sen, the area under curve (AUC), and average Hausdorff distance (AVD) of the DA-UNet segmentation algorithm were 80.70%, 69.97%, 77.56%, 0.887, and 2.48, respectively. These results were significantly better than those of other algorithms ( P < 0.05 ). In group A, the diagnostic accordance rate, Sen, and specificity of patients were 96.55%, 90.52%, and 73.58%, respectively, which were higher than 91.53%, 81.36%, and 15.60% of patients in group B significantly ( P < 0.05 ). There was no statistical difference in the distance between the perforator location and the actual location ( P > 0.05 ). It showed that the accuracy of CTA under the UNet-based DA-UNet segmentation model in the perforator localization of ALTF was better than that of B-mode US. Thus, a reference could be provided for the preparation of free ALTF and its clinical application.

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“…The Jaccard index was a measure of regional overlapping [ 17 ], which is calculated using equation ( 11 ):

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Section: Methodsmentioning

confidence: 99%

Computed Tomography Angiography and B‐Mode Ultrasonography under Artificial Intelligence Plaque Segmentation Algorithm in the Perforator Localization for Preparation of Free Anterolateral Femoral Flap

Shen

Huang

et al. 2022

Contrast Media & Molecular Imaging

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“…A retrospective case series of 186 patients with TSAH who underwent CT angiography (CTA) found that 7% ( n = 13) of patients had an aneurysm on the follow-up CTA. 39 Thirteen patients (6.99%) had an aneurysm on the follow-up CTA. Of those, 61.5% ( n = 8) presented with a ruptured aneurysm.…”

Section: Review Findingsmentioning

confidence: 97%

Traumatic Subarachnoid Hemorrhage: A Scoping Review

Griswold

Fernández

Rubiano

2022

Journal of Neurotrauma

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Sixty-nine million people have a traumatic brain injury (TBI) each year, and TBI is the most common cause of subarachnoid hemorrhage (SAH). Traumatic SAH (TSAH) has been described as an adverse prognostic factor leading to progressive neurological deterioration and increased morbidity and mortality. A limited number of studies, however, evaluate recent trends in the diagnosis and management of SAH in the context of trauma. The objective of this scoping review was to understand the extent and type of evidence concerning the diagnostic criteria and management of TSAH. This scoping review was conducted following the Joanna Briggs Institute methodology for scoping reviews. The review included adults with SAH secondary to trauma, where isolated TSAH (iTSAH) refers to the presence of SAH in the absence of any other traumatic radiographic intracranial pathology, and TSAH refers to the presence of SAH with the possibility or presence of additional traumatic radiographic intracranial pathology. Data extracted from each study included study aim, country, methodology, population characteristics, outcome measures, a summary of findings, and future directives. Thirty studies met inclusion criteria. Studies were grouped into five categories by topic: TSAH associated with mild TBI (mTBI), n = 13), and severe TBI ( n = 3); clinical management and diagnosis ( n = 9); imaging ( n = 3); and aneurysmal TSAH ( n = 1). Of the 30 studies, two came from a low- and middle-income country (LMIC), excluding China, nearly a high-income country. Patients with TSAH associated with mTBI have a very low risk of clinical deterioration and surgical intervention and should be treated conservatively when considering intensive care unit admission. The Helsinki and Stockholm computed tomography scoring systems, in addition to the American Injury Scale, creatinine level, age decision tree, may be valuable tools to use when predicting outcome and death.

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“…A retrospective case series of 186 tSAH patients who underwent CT angiography (CTA) found 7% (n=13) of patients had an aneurysm on the follow-up CTA. 39 Thirteen patients (6.99%) had an aneurysm on the follow-up CTA. Of those, 61.5% (n=8) presented with a ruptured aneurysm.…”

Section: Traumatic Aneurysmmentioning

confidence: 97%

Traumatic subarachnoid hemorrhage: a scoping review

Griswold

Fernández

Rubiano

2021

Preprint

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Sixty-nine million people suffer from traumatic brain injury (TBI) each year, and TBI is the most common cause of subarachnoid hemorrhage (SAH). Traumatic SAH (tSAH) has been described as an adverse prognostic factor leading to progressive neurological deterioration and increased morbidity and mortality. However, a limited number of studies evaluate recent trends in the diagnostic and management of SAH in the context of trauma. The objective of this scoping review was to understand the extent and type of evidence concerning the diagnostic criteria and management of traumatic subarachnoid hemorrhage. This scoping review was conducted following the JBI methodology for scoping reviews. The review included adults who suffered SAH secondary to trauma. Data extracted from each study included study aim, country, methodology, population characteristics, outcome measures, a summary of findings, and future directives. Thirty studies met inclusion criteria. Studies were grouped into five categories by topic: tSAH associated with mild TBI (n=13), and severe TBI (n=3); clinical management and diagnosis (n=9); imaging (n=3); and 5) aneurysmal tSAH (n=1). Of the 30 studies, two came from a low-and middle-income country (LMIC); excluding China, nearly a high-income country. Patients with tSAH associated with mTBI have a very low risk of clinical deterioration and surgical intervention and should be managed conservatively when considering ICU admission. The Helsinki and Stockholm CT scoring systems, in addition to the AIS, Cr, age decision tree, may be valuable tools to use when predicting outcome and mortality.

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Selective computed tomographic angiography in traumatic subarachnoid hemorrhage: a pilot study

Cited by 7 publications

References 23 publications

Computed Tomography Angiography and B‐Mode Ultrasonography under Artificial Intelligence Plaque Segmentation Algorithm in the Perforator Localization for Preparation of Free Anterolateral Femoral Flap

Computed Tomography Angiography and B‐Mode Ultrasonography under Artificial Intelligence Plaque Segmentation Algorithm in the Perforator Localization for Preparation of Free Anterolateral Femoral Flap

Traumatic Subarachnoid Hemorrhage: A Scoping Review

Traumatic subarachnoid hemorrhage: a scoping review

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