Rupture-Related Features of Cerebral Arteriovenous Malformations and Their Utility in Predicting Hemorrhage

作者：Yupeng Zhang, Haoyu Zhu, Tingliang Cao, Longhui Zhang, Yuzhou Chang, Shikai Liang, Chao Ma, Fei Liang, Yuqi Song, Jiarui Zhang, Changxuan Li, Chuhan Jiang · 发表于：Stroke · 年份：2024 · DOI：10.1161/strokeaha.123.045456 · 被引用次数：21 · 研究领域：Vascular Malformations Diagnosis and Treatment、Intracranial Aneurysms: Treatment and Complications、Intracerebral and Subarachnoid Hemorrhage Research

BACKGROUND: Evaluating rupture risk in cerebral arteriovenous malformations currently lacks quantitative hemodynamic and angioarchitectural features necessary for predicting subsequent hemorrhage. We aimed to derive rupture-related hemodynamic and angioarchitectural features of arteriovenous malformations and construct an ensemble model for predicting subsequent hemorrhage. METHODS: This retrospective study included 3 data sets, as follows: training and test data sets comprising consecutive patients with untreated cerebral arteriovenous malformations who were admitted from January 2015 to June 2022 and a validation data set comprising patients with unruptured arteriovenous malformations who received conservative treatment between January 2009 and December 2014. We extracted rupture-related features and developed logistic regression (clinical features), decision tree (hemodynamic features), and support vector machine (angioarchitectural features) models. These 3 models were combined into an ensemble model using a weighted soft-voting strategy. The performance of the models in discriminating ruptured arteriovenous malformations and predicting subsequent hemorrhage was evaluated with confusion matrix-related metrics in the test and validation data sets. RESULTS: A total of 896 patients (mean±SD age, 28±14 years; 404 women) were evaluated, with 632, 158, and 106 patients in the training, test, and validation data sets, respectively. From the training set, 9 clinical, 10 hemodynam...