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Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke

Conjugate gaze deviation is associated with acute ischemic stroke (AIS), although previously only measured on a 2D plane. The current study evaluates 3D imaging efficacy to assess conjugate gaze deviation and correlate direction and strength of deviation to neuro-clinical findings. A retrospective a...

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Autores principales: Maresky, Hillel S., Rootman, Joseph M., Klar, Miriam M., Levitt, Max, Kossar, Alexander P., Zucker, David, Glazier, Michael, Kalmanovich-Avnery, Shani, Aviv, Richard, Ertl-Wagner, Birgit, Tal, Sigal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717852/
https://www.ncbi.nlm.nih.gov/pubmed/33285711
http://dx.doi.org/10.1097/MD.0000000000023330
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author Maresky, Hillel S.
Rootman, Joseph M.
Klar, Miriam M.
Levitt, Max
Kossar, Alexander P.
Zucker, David
Glazier, Michael
Kalmanovich-Avnery, Shani
Aviv, Richard
Ertl-Wagner, Birgit
Tal, Sigal
author_facet Maresky, Hillel S.
Rootman, Joseph M.
Klar, Miriam M.
Levitt, Max
Kossar, Alexander P.
Zucker, David
Glazier, Michael
Kalmanovich-Avnery, Shani
Aviv, Richard
Ertl-Wagner, Birgit
Tal, Sigal
author_sort Maresky, Hillel S.
collection PubMed
description Conjugate gaze deviation is associated with acute ischemic stroke (AIS), although previously only measured on a 2D plane. The current study evaluates 3D imaging efficacy to assess conjugate gaze deviation and correlate direction and strength of deviation to neuro-clinical findings. A retrospective analysis of 519 patients who had CT scans for suspected AIS at our institution. Direction and angle of eye deviation were calculated based on 2D axial images. Volumetric reconstruction of CT scans allowed for calculation of 3D conjugate gaze adjusted length (CGAL). Angle, direction, and vector strength of both 2D and 3D scans were calculated by an artificial intelligence algorithm and tested for agreement with hemispheric ischemia location. CGAL measurements were correlated to NIHSS scores. Follow up MRI data was used to evaluate the sensitivity and specificity of CGAL in the identification of AIS. The final analysis included 122 patients. A strong agreement was found between 3D gaze direction and hemispheric ischemia location. CGAL measurements were highly correlated with NIHSS score (r = .72, P = .01). A CGAL >0.25, >0.28, and >0.35 exhibited a sensitivity of 91%, 86%, and 82% and specificity of 66%, 89%, and 89%, respectively, in AIS identification. A CGAL >0.28 has the best sensitivity-specificity balance in the identification of AIS. A CGAL >0.25 has the highest sensitivity. Given CED's correlation with NIHSS score a 1/4 deviation in the ipsilateral direction is a sensitive ancillary radiographic sign to assist radiologists in making a correct diagnosis even when not presented with full clinical data.
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spelling pubmed-77178522020-12-07 Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke Maresky, Hillel S. Rootman, Joseph M. Klar, Miriam M. Levitt, Max Kossar, Alexander P. Zucker, David Glazier, Michael Kalmanovich-Avnery, Shani Aviv, Richard Ertl-Wagner, Birgit Tal, Sigal Medicine (Baltimore) 6800 Conjugate gaze deviation is associated with acute ischemic stroke (AIS), although previously only measured on a 2D plane. The current study evaluates 3D imaging efficacy to assess conjugate gaze deviation and correlate direction and strength of deviation to neuro-clinical findings. A retrospective analysis of 519 patients who had CT scans for suspected AIS at our institution. Direction and angle of eye deviation were calculated based on 2D axial images. Volumetric reconstruction of CT scans allowed for calculation of 3D conjugate gaze adjusted length (CGAL). Angle, direction, and vector strength of both 2D and 3D scans were calculated by an artificial intelligence algorithm and tested for agreement with hemispheric ischemia location. CGAL measurements were correlated to NIHSS scores. Follow up MRI data was used to evaluate the sensitivity and specificity of CGAL in the identification of AIS. The final analysis included 122 patients. A strong agreement was found between 3D gaze direction and hemispheric ischemia location. CGAL measurements were highly correlated with NIHSS score (r = .72, P = .01). A CGAL >0.25, >0.28, and >0.35 exhibited a sensitivity of 91%, 86%, and 82% and specificity of 66%, 89%, and 89%, respectively, in AIS identification. A CGAL >0.28 has the best sensitivity-specificity balance in the identification of AIS. A CGAL >0.25 has the highest sensitivity. Given CED's correlation with NIHSS score a 1/4 deviation in the ipsilateral direction is a sensitive ancillary radiographic sign to assist radiologists in making a correct diagnosis even when not presented with full clinical data. Lippincott Williams & Wilkins 2020-12-04 /pmc/articles/PMC7717852/ /pubmed/33285711 http://dx.doi.org/10.1097/MD.0000000000023330 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 6800
Maresky, Hillel S.
Rootman, Joseph M.
Klar, Miriam M.
Levitt, Max
Kossar, Alexander P.
Zucker, David
Glazier, Michael
Kalmanovich-Avnery, Shani
Aviv, Richard
Ertl-Wagner, Birgit
Tal, Sigal
Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke
title Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke
title_full Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke
title_fullStr Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke
title_full_unstemmed Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke
title_short Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke
title_sort bringing prevost's sign into the third dimension: artificial intelligence estimation of conjugate gaze adjusted length (cgal) and correlation with acute ischemic stroke
topic 6800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717852/
https://www.ncbi.nlm.nih.gov/pubmed/33285711
http://dx.doi.org/10.1097/MD.0000000000023330
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