The Application Value of Artificial Intelligence in Predicting the Prognosis of Patients with Intracranial Aneurysm Rupture and Bleeding Using CTA Combined with Graeb Score

WANG Haixia; TAI Zhaoqin; XU Yachun

doi:10.3639/j.issn.2095-3097.2024.09.020

Abstract：Objective To explore the application value of artificial intelligence(AI)in CT angiography(CTA)combined with Graeb score in predicting the prognosis of patients with intracranial aneurysm rupture and bleeding.Methods A total of 142 patients with intracranial aneurysm rupture and bleeding who underwent head and neck CTA and Graeb scoring at Haian People's Hospital from January 2021 to January 2024 were retrospectively selected as the study subjects.Patient information and CTA findings were collected and processed using an AI diagnostic system.After three months of follow-up,patients were divided into a poor prognosis group and a good prognosis group based on aneurysm rerupture and death.x2 test and t-test were used for data analysis.ROC curve analysis was applied to assess the predictive value of CTA combined with Graeb score under AI assistance.Logistic regression analysis was used to explore factors affecting prognosis.Results Thir-ty-nine patients were included in the poor prognosis group with aneurysm rerupture or death,while the re-maining 103 patients were included in the good prog-nosis group.There were no significant differences in age,male-to-female ratio,history of diabetes,history of hypertension,or the number and location of aneurysms between the two groups(P＞0.05).However,the poor prognosis group had higher proportions of smoking and drinking histories,WFNS grade Ⅳ-Ⅴ,and Hunt-Hess grade Ⅳ-Ⅴ compared to the good prognosis group(P＜0.05).The AR value,SR value,incident angle,and Graeb score were significantly higher in the poor prognosis group(P＜0.05).ROC curve analysis showed that AR value,SR value,incident angle,and Graeb score had predictive value for prognosis,with their combination achieving the best overall performance(AUC=0.925,sensitivity=87.2％,specificity=92.2％).Logistic regression analysis identified smoking history,drinking history,WFNS grade Ⅳ-Ⅴ,Hunt-Hess grade Ⅳ-Ⅴ,and higher AR value,SR value,incident angle,and Graeb score as risk factors for poor prognosis.Conclusion AI-assisted CTA combined with Graeb score can effectively pre-dict prognosis in patients with intracranial aneurysm rupture and bleeding.Among the predictors,AR value,SR value,incident angle,and Graeb score are significant predictors,with their combined use showing the best performance.