AI and ROSS-assisted ultra-early thalamic hematoma drainage in elderly patients with minor thalamus and internal capsule hematoma and severe hypoperfusion in the internal capsule area
10.3760/cma.j.cn115354-20241014-00626
- VernacularTitle:AI及ROSS辅助超早期丘脑血肿引流术治疗老年少量丘脑内囊型出血伴内囊区严重低灌注患者的临床价值
- Author:
Ruishan ZHANG
1
;
Weimin ZHANG
1
;
Xianghui ZHANG
1
;
Sibo XUE
1
;
Jian SONG
1
;
Kai WANG
1
;
Tingting SHEN
1
;
Yan ZHOU
1
;
Hongbin KU
1
Author Information
1. 邢台市中心医院神经外科，邢台 054000
- Publication Type:Journal Article
- Keywords:
Artificial intelligence;
Multi-modal image fusion;
Thalamus and internal capsule hematoma;
Region cerebral blood flow;
Surgical indication
- From:
Chinese Journal of Neuromedicine
2025;24(5):488-495
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the application value of artificial intelligence (AI) and robot of stereotactic surgery (ROSS)-assisted ultra-early thalamic hematoma drainage in elderly patients with minor thalamus and internal capsule hematoma (TICH) and severe hypoperfusion in the internal capsule area.Methods:A retrospective cross-sectional study was performed; 278 patients with TICH and severe hypoperfusion in the internal capsule area identified by AI medical imaging diagnostic system were enrolled from Department of Neurosurgery, Xingtai Central Hospital from January 2023 to August 2024. Among them, 134 patients (study group) received AI and ROSS-assisted ultra-early thalamic hematoma drainage, and 144 patients (control group) received drug treatment. Differences in baseline data and therapy efficiency between the two groups of patients were compared. Multivariate Logistic regression analysis was used to screen the independent influencing factors for prognosis in the study group 180 days after onset (good prognosis: modified Rankin scale scores of 0-3).Results:Compared with the control group, the study group had significantly higher Glasgow coma scale (GCS) score and regional cerebral blood flow (rCBF) in the internal capsule area 14 days after onset, and statistically higher therapy efficiency and good prognosis rate 180 days after onset ( P<0.05). In the study group, 84 patients had a good prognosis and 50 had a poor prognosis 180 days after onset; compared with the good prognosis group, the poor prognosis group had significantly higher proportion of patients with hyper-homocysteinemia history, lower GCS score on admission, larger volume of thalamic hematoma, higher proportions of patients with combined intraventricular hemorrhage and shunt-dependent hydrocephalus, and lower rCBF in the internal capsule area on admission ( P<0.05). Multivariate Logistic regression analysis showed that thalamic hematoma volume ( OR=2.527, 95% CI: 1.504-4.247, P<0.001), combined intraventricular hemorrhage ( OR=2.325, 95% CI: 1.460-3.703, P<0.001), shunt dependent hydrocephalus ( OR=2.371, 95% CI: 1.267-4.078, P=0.006), and rCBF in the internal capsule area on admission ( OR=0.672, 95% CI: 0.314-1.025, P<0.001) were independent risk factors for prognosis of patients in the study group. Conclusion:AI and ROSS-assisted ultra-early thalamic hematoma drainage is effective for elderly patients with minor TICH and severe hypoperfusion in the internal capsule area; patients with large thalamic hematoma volume, combined intraventricular hemorrhage, shunt-dependent hydrocephalus, and low rCBF in the internal capsule area on admission are prone to have a poor prognosis.
