影像组学在颅内动脉瘤中的研究进展与挑战
Research Progress and Challenges of Radiomics in Intracranial Aneurysms
DOI: 10.12677/acm.2025.15113074, PDF,   
作者: 徐发宝, 卢瑞斌:赣南医科大学第一临床医学院,江西 赣州;杨少春*:赣南医科大学第一附属医院神经外科,江西 赣州
关键词: 颅内动脉瘤影像组学深度学习综述Intracranial Aneurysm Radiomics Deep Learning Review
摘要: 颅内动脉瘤(Intracranial aneurysm, IA)是一种常见的脑血管疾病,其破裂导致的蛛网膜下腔出血具有较高的致死率和致残率,早期诊断并干预是改善预后的关键。影像组学(Radiomics)作为一种新兴的定量图像分析方法,通过从医学影像中提取高通量特征并可以通过结合机器学习算法,其在颅内动脉瘤的检测诊断、破裂风险评估、治疗决策及预后预测等方面展现出了巨大的潜力。本文旨在综述影像组学在颅内动脉瘤诊疗领域的研究方法与取得的成果,并进一步探讨其在该领域的应用前景及潜在价值。
Abstract: Intracranial aneurysm (IA) is a common cerebrovascular disease. Its rupture leads to subarachnoid hemorrhage (SAH), which carries a high mortality and disability rate. Early diagnosis and intervention are crucial for improving prognosis. Radiomics, an emerging quantitative image analysis method, integrates high-throughput feature extraction from medical images with machine learning algorithms. It shows great potential in intracranial aneurysm detection and diagnosis, rupture risk assessment, treatment decision-making, and prognosis prediction. This paper aims to review the research methodologies and achievements of radiomics in the diagnosis and treatment of intracranial aneurysms, and further explore its application prospects and potential value in this field.
文章引用:徐发宝, 卢瑞斌, 杨少春. 影像组学在颅内动脉瘤中的研究进展与挑战[J]. 临床医学进展, 2025, 15(11): 117-125. https://doi.org/10.12677/acm.2025.15113074

参考文献

[1] Li, M., Chen, S., Li, Y., Chen, Y., Cheng, Y., Hu, D., et al. (2013) Prevalence of Unruptured Cerebral Aneurysms in Chinese Adults Aged 35 to 75 Years: A Cross-Sectional Study. Annals of Internal Medicine, 159, 514-521. [Google Scholar] [CrossRef] [PubMed]
[2] Greving, J.P., Wermer, M.J.H., Brown, R.D., Morita, A., Juvela, S., Yonekura, M., et al. (2014) Development of the PHASES Score for Prediction of Risk of Rupture of Intracranial Aneurysms: A Pooled Analysis of Six Prospective Cohort Studies. The Lancet Neurology, 13, 59-66. [Google Scholar] [CrossRef] [PubMed]
[3] Neifert, S.N., Chapman, E.K., Martini, M.L., Shuman, W.H., Schupper, A.J., Oermann, E.K., et al. (2020) Aneurysmal Subarachnoid Hemorrhage: The Last Decade. Translational Stroke Research, 12, 428-446. [Google Scholar] [CrossRef] [PubMed]
[4] Pontes, F.G.d.B., da Silva, E.M., Baptista-Silva, J.C. and Vasconcelos, V. (2021) Treatments for Unruptured Intracranial Aneurysms. Cochrane Database of Systematic Reviews, 2021, Cd013312. [Google Scholar] [CrossRef] [PubMed]
[5] Kandregula, S., Savardekar, A.R., Terrell, D., Adeeb, N., Whipple, S., Beyl, R., et al. (2023) Microsurgical Clipping and Endovascular Management of Unruptured Anterior Circulation Aneurysms: How Age, Frailty, and Comorbidity Indexes Influence Outcomes. Journal of Neurosurgery, 138, 922-932. [Google Scholar] [CrossRef] [PubMed]
[6] Lambin, P., Rios-Velazquez, E., Leijenaar, R., Carvalho, S., van Stiphout, R.G.P.M., Granton, P., et al. (2012) Radiomics: Extracting More Information from Medical Images Using Advanced Feature Analysis. European Journal of Cancer, 48, 441-446. [Google Scholar] [CrossRef] [PubMed]
[7] Kumar, V., Gu, Y., Basu, S., Berglund, A., Eschrich, S.A., Schabath, M.B., et al. (2012) Radiomics: The Process and the Challenges. Magnetic Resonance Imaging, 30, 1234-1248. [Google Scholar] [CrossRef] [PubMed]
[8] Lambin, P., Leijenaar, R.T.H., Deist, T.M., Peerlings, J., de Jong, E.E.C., van Timmeren, J., et al. (2017) Radiomics: The Bridge between Medical Imaging and Personalized Medicine. Nature Reviews Clinical Oncology, 14, 749-762. [Google Scholar] [CrossRef] [PubMed]
[9] Gillies, R.J., Kinahan, P.E. and Hricak, H. (2016) Radiomics: Images Are More than Pictures, They Are Data. Radiology, 278, 563-577. [Google Scholar] [CrossRef] [PubMed]
[10] Houman, S., Hossein, S.A., et al. (2021) Emerging Applications of Radiomics in Neurological Disorders: A Review. Cureus, 13, e20080-e.
[11] Cao, X., Zeng, Y., Wang, J., Cao, Y., Wu, Y. and Xia, W. (2022) Differentiation of Cerebral Dissecting Aneurysm from Hemorrhagic Saccular Aneurysm by Machine-Learning Based on Vessel Wall MRI: A Multicenter Study. Journal of Clinical Medicine, 11, Article No. 3623. [Google Scholar] [CrossRef] [PubMed]
[12] Kong, D., Li, J., Lv, Y., Wang, M., Li, S., Qian, B., et al. (2023) Radiomics Nomogram Model Based on TOF-MRA Images: A New Effective Method for Predicting Microaneurysms. International Journal of General Medicine, 16, 1091-1100. [Google Scholar] [CrossRef] [PubMed]
[13] Podgorsak, A.R., Rava, R.A., Shiraz Bhurwani, M.M., Chandra, A.R., Davies, J.M., Siddiqui, A.H., et al. (2019) Automatic Radiomic Feature Extraction Using Deep Learning for Angiographic Parametric Imaging of Intracranial Aneurysms. Journal of NeuroInterventional Surgery, 12, 417-421. [Google Scholar] [CrossRef] [PubMed]
[14] Wu, K., Gu, D., Qi, P., Cao, X., Wu, D., Chen, L., et al. (2022) Evaluation of an Automated Intracranial Aneurysm Detection and Rupture Analysis Approach Using Cascade Detection and Classification Networks. Computerized Medical Imaging and Graphics, 102, Article ID: 102126. [Google Scholar] [CrossRef] [PubMed]
[15] Feng, J., Zeng, R., Geng, Y., Chen, Q., Zheng, Q., Yu, F., et al. (2023) Automatic Differentiation of Ruptured and Unruptured Intracranial Aneurysms on Computed Tomography Angiography Based on Deep Learning and Radiomics. Insights into Imaging, 14, Article No. 76. [Google Scholar] [CrossRef] [PubMed]
[16] Neulen, A., Pantel, T., König, J., Brockmann, M.A., Ringel, F. and Kantelhardt, S.R. (2021) Comparison of Unruptured Intracranial Aneurysm Treatment Score and PHASES Score in Subarachnoid Hemorrhage Patients with Multiple Intracranial Aneurysms. Frontiers in Neurology, 12, Article ID: 616497. [Google Scholar] [CrossRef] [PubMed]
[17] Liu, Q., Jiang, P., Jiang, Y., Li, S., Ge, H., Jin, H., et al. (2019) Bifurcation Configuration Is an Independent Risk Factor for Aneurysm Rupture Irrespective of Location. Frontiers in Neurology, 10, Article No. 844. [Google Scholar] [CrossRef] [PubMed]
[18] Liu, Q., Jiang, P., Jiang, Y., Ge, H., Li, S., Jin, H., et al. (2019) Prediction of Aneurysm Stability Using a Machine Learning Model Based on Pyradiomics-Derived Morphological Features. Stroke, 50, 2314-2321. [Google Scholar] [CrossRef] [PubMed]
[19] Tong, X., Feng, X., Peng, F., Niu, H., Zhang, B., Yuan, F., et al. (2021) Morphology-Based Radiomics Signature: A Novel Determinant to Identify Multiple Intracranial Aneurysms Rupture. Aging, 13, 13195-13210. [Google Scholar] [CrossRef] [PubMed]
[20] Jia, X., Chen, Y., Zheng, K., Zhu, D., Chen, C., Liu, J., et al. (2024) Clinical-Radiomics Nomogram Model Based on CT Angiography for Prediction of Intracranial Aneurysm Rupture: A Multicenter Study. Journal of Multidisciplinary Healthcare, 17, 5917-5926. [Google Scholar] [CrossRef] [PubMed]
[21] Korja, M., Kivisaari, R., Rezai Jahromi, B. and Lehto, H. (2017) Size and Location of Ruptured Intracranial Aneurysms: Consecutive Series of 1993 Hospital-Admitted Patients. Journal of Neurosurgery, 127, 748-753. [Google Scholar] [CrossRef] [PubMed]
[22] 陈鹏飞, 范文辉, 梁奕, 等. 基于CTA影像组学特征的前交通动脉瘤破裂的预测模型的构建及验证[J]. 中国临床神经外科杂志, 2024, 29(7): 385-390.
[23] 杨净松, 赵卫, 黄建强. 基底动脉尖区动脉瘤合并基底动脉尖综合征介入术相关性分析及治疗进展[J]. 介入放射学杂志, 2018, 27(8): 801-805.
[24] 刘松, 田超, 任涛, 等. CT血管造影影像组学评估基底动脉尖动脉瘤破裂风险[J]. 中国医学影像技术, 2025, 41(1): 20-24.
[25] Maupu, C., Lebas, H. and Boulaftali, Y. (2022) Imaging Modalities for Intracranial Aneurysm: More than Meets the Eye. Frontiers in Cardiovascular Medicine, 9, Article ID: 793072. [Google Scholar] [CrossRef] [PubMed]
[26] Larsen, N., von der Brelie, C., Trick, D., Riedel, C.H., Lindner, T., Madjidyar, J., et al. (2018) Vessel Wall Enhancement in Unruptured Intracranial Aneurysms: An Indicator for Higher Risk of Rupture? High-Resolution MR Imaging and Correlated Histologic Findings. American Journal of Neuroradiology, 39, 1617-1621. [Google Scholar] [CrossRef] [PubMed]
[27] Gaidzik, F., Pravdivtseva, M., Larsen, N., Jansen, O., Hövener, J. and Berg, P. (2021) Luminal Enhancement in Intracranial Aneurysms: Fact or Feature?—A Quantitative Multimodal Flow Analysis. International Journal of Computer Assisted Radiology and Surgery, 16, 1999-2008. [Google Scholar] [CrossRef] [PubMed]
[28] Veeturi, S.S., Saleem, A., Ojeda, D.J., Sagues, E., Sanchez, S., Gudino, A., et al. (2024) Radiomics-Based Predictive Nomogram for Assessing the Risk of Intracranial Aneurysms. Translational Stroke Research, 16, 79-87. [Google Scholar] [CrossRef] [PubMed]
[29] Wermer, M.J.H., van der Schaaf, I.C., Algra, A. and Rinkel, G.J.E. (2007) Risk of Rupture of Unruptured Intracranial Aneurysms in Relation to Patient and Aneurysm Characteristics: An Updated Meta-Analysis. Stroke, 38, 1404-1410. [Google Scholar] [CrossRef] [PubMed]
[30] Yuan, W., Jiang, S., Wang, Z., Yan, C., Jiang, Y., Guo, D., et al. (2025) High-Resolution Vessel Wall Imaging-Driven Radiomic Analysis for the Precision Prediction of Intracranial Aneurysm Rupture Risk: A Promising Approach. Frontiers in Neuroscience, 19, Article ID: 1581373. [Google Scholar] [CrossRef] [PubMed]
[31] Xie, Y., Liu, S., Lin, H., Wu, M., Shi, F., Pan, F., et al. (2023) Automatic Risk Prediction of Intracranial Aneurysm on CTA Image with Convolutional Neural Networks and Radiomics Analysis. Frontiers in Neurology, 14, Article ID: 1126949. [Google Scholar] [CrossRef] [PubMed]
[32] Turhon, M., Li, M., Kang, H., Huang, J., Zhang, F., Zhang, Y., et al. (2023) Development and Validation of a Deep Learning Model for Prediction of Intracranial Aneurysm Rupture Risk Based on Multi-Omics Factor. European Radiology, 33, 6759-6770. [Google Scholar] [CrossRef] [PubMed]
[33] Huang, T., Li, W., Zhou, Y., Zhong, W. and Zhou, Z. (2024) Can the Radiomics Features of Intracranial Aneurysms Predict the Prognosis of Aneurysmal Subarachnoid Hemorrhage? Frontiers in Neuroscience, 18, Article ID: 1446784. [Google Scholar] [CrossRef] [PubMed]
[34] Shan, D., Wang, J., Qi, P., Lu, J. and Wang, D. (2023) Non-Contrasted CT Radiomics for SAH Prognosis Prediction. Bioengineering, 10, Article No. 967. [Google Scholar] [CrossRef] [PubMed]
[35] Peng, Y., Wang, Y., Wen, Z., Xiang, H., Guo, L., Su, L., et al. (2024) Deep Learning and Machine Learning Predictive Models for Neurological Function after Interventional Embolization of Intracranial Aneurysms. Frontiers in Neurology, 15, Article ID: 1321923. [Google Scholar] [CrossRef] [PubMed]
[36] Vergouwen, M.D.I., Vermeulen, M., van Gijn, J., Rinkel, G.J.E., Wijdicks, E.F., Muizelaar, J.P., et al. (2010) Definition of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage as an Outcome Event in Clinical Trials and Observational Studies: Proposal of a Multidisciplinary Research Group. Stroke, 41, 2391-2395. [Google Scholar] [CrossRef] [PubMed]
[37] Galea, J.P., Dulhanty, L. and Patel, H.C. (2017) Predictors of Outcome in Aneurysmal Subarachnoid Hemorrhage Patients: Observations from a Multicenter Data Set. Stroke, 48, 2958-2963. [Google Scholar] [CrossRef] [PubMed]
[38] Chen, L., Wang, X., Wang, S., Zhao, X., Yan, Y., Yuan, M., et al. (2025) Development of a Non-Contrast CT-Based Radiomics Nomogram for Early Prediction of Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage. BMC Medical Imaging, 25, Article No. 182. [Google Scholar] [CrossRef] [PubMed]
[39] Aravind, G., Mayank, G., Alexis, W.T., et al. (2022) Association of Iatrogenic Infarcts with Clinical and Cognitive Out-comes in the Evaluating Neuroprotection in Aneurysm Coiling Therapy Trial. Neurology, 98, e1446-e1458.
[40] Park, J.C., Lee, D.H., Kim, J.K., Ahn, J.S., Kwun, B.D., Kim, D.Y., et al. (2016) Microembolism after Endovascular Coiling of Unruptured Cerebral Aneurysms: Incidence and Risk Factors. Journal of Neurosurgery, 124, 777-783. [Google Scholar] [CrossRef] [PubMed]
[41] Lee, E., Kang, D. and Warach, S. (2016) Silent New Brain Lesions: Innocent Bystander or Guilty Party? Journal of Stroke, 18, 38-49. [Google Scholar] [CrossRef] [PubMed]
[42] Sangha, R.S., Caprio, F.Z., Askew, R., Corado, C., Bernstein, R., Curran, Y., et al. (2015) Quality of Life in Patients with TIA and Minor Ischemic Stroke. Neurology, 85, 1957-1963. [Google Scholar] [CrossRef] [PubMed]
[43] Chen, R., Lu, Y., Tian, Z., Chen, J., Li, W., Wang, C., et al. (2025) Dwi-Based Deep Learning Radiomics Nomogram for Predicting the Impaired Quality of Life in Patients with Unruptured Intracranial Aneurysm Developing New Iatrogenic Cerebral Infarcts Following Stent Placement: A Multicenter Cohort Study. Neurosurgical Review, 48, Article No. 508. [Google Scholar] [CrossRef] [PubMed]
[44] Kang, H., Zhou, Y., Luo, B., Lv, N., Zhang, H., Li, T., et al. (2021) Pipeline Embolization Device for Intracranial Aneurysms in a Large Chinese Cohort: Complication Risk Factor Analysis. Neurotherapeutics, 18, 1198-1206. [Google Scholar] [CrossRef] [PubMed]
[45] Ma, C., Liang, S., Liang, F., Lu, L., Zhu, H., Lv, X., et al. (2024) Predicting Postinterventional Rupture of Intracranial Aneurysms Using Arteriography-Derived Radiomic Features after Pipeline Embolization. Frontiers in Neurology, 15, Article ID: 1327127. [Google Scholar] [CrossRef] [PubMed]
[46] Wang, H., Xu, H., Fan, J., Liu, J., Li, L., Kong, Z., et al. (2024) Predictive Value of Radiomics for Intracranial Aneurysm Rupture: A Systematic Review and Meta-Analysis. Frontiers in Neuroscience, 18, Article ID: 1474780. [Google Scholar] [CrossRef] [PubMed]