Clinical Analysis of Deep Learning Technology in Assisting Diagnosis of Colorectal Polyps / 胃肠病学

Background: Computer-aided diagnosis based on deep learning technology is a research hotspot in the field of gastroenterology, and computer-aided diagnosis of colorectal polyps has received more and more attention. Aims: To validate a model based on deep learning for the automatic identification of colorectal polyps, and to analyze its auxiliary learning function for helping novice endoscopists. Methods: A total of 1 200 colonoscopy images (600 colorectal polyp images and 600 normal images) in the endoscopy center database of Qingdao Municipal Hospital (East) from January 2019 to January 2020 were retrospectively collected. Deep learning model was used to identify the 1 200 images. The sensitivity, specificity, accuracy and diagnosis time of deep learning model and 5 novice endoscopists for diagnosis of colorectal polyps were compared. Results: The deep learning model showed a sensitivity of 93.2%, specificity of 98.7%, accuracy of 95.9% for detecting colorectal polyps, and the diagnosis time of each image was (0.20±0.03) second. The sensitivity, accuracy, and diagnosis time of the model were superior to 5 novice endoscopists, and the specificity was superior to some novice endoscopists. The accuracies of model for polyps with size ≤5 mm and 6~9 mm were 88.1% and 96.8%, respectively, and were superior to 5 novice endoscopists; the accuracy of model for polyps with size ≥10 mm was 100%, and was similar to 5 novice endoscopists. The accuracy of model for polyps with protrude type was 94.8%, and was superior to some novice endoscopists; the accuracy of model for polyps with flat type was 91.7%, and was superior to 5 novice endoscopists. Missing the polyps with flat type (38.8%), polyps at mucosal folds (32.7%), and mistaking the mucosal folds as polyps (12.2%) were the main causes of false negative or false positive results of the model. Conclusions: The deep learning model has a high accuracy, sensitivity, specificity and shorter diagnosis time for diagnosis of colorectal polyps, and can be used to assist novice endoscopists in diagnosing small polyps and flat polyps.

Percutaneous transhepatic variceal obliteration in patients with severe hepatic cirrhosis / 介入放射学杂志

Objective To evaluate the effects of percutaneous transhepatic variceal obliteration in the treatment of acute bleeding from gastroesophageal varices in patients with severe cirrhosis.Methods 19 patients with Child C cirrhosis suffered from active bleeding from gastroesphageal varices. Emergency procechures of percutaneous transhepatic variceal obliteration were performed in all 19 patients. Results Successful catheterization and obliteration of the varices in all of the 19 cases. Active bleeding were controlled in 18 cases with only one failure and TIPSS was performed. During a follow up peroiod ranging from one to 12 months, 14 cases bled recurrently during 3 to 12 months. 15 cases died within the follow up period. 4 cases were alive. Severe complication of intraperitoneal bleeding occurred in 1 case, and laparotomy was performed. Conclusions Percutaneous transhepatic variceal obliteration is effective in controlling acute bleeding from gastroesophageal varices in patients with Child C cirrhosis. It could be used as the first choice treatment method for emergency when TIPSS is contraindicated.