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Khirurgii

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Year 2013 Vol. 21 No 4

INFORMATION TECHNOLOGIES IN SURGERY

L.K. KULIKOV1, N.M. BYKOVA2, U.A. PRIVALOV1, V.F. SOBOTOVICH1, A.A. SMIRNOV1

DIFFERENTIAL DIAGNOSTICS OF SYMPTOMATIC ARTERIAL HYPERTENSION AT ADRENAL TUMORS

SBEE APE “Irkutsk State Medical Academy of Post-Graduate Education” 1,
MAME “City Clinical Hospital ¹10”, Irkutsk2,
The Russian Federation

Objectives. To study efficiency of differential diagnostics of the secondary arterial hypertension in patients with the revealed adrenal tumors by means of the mathematical device of artificial neural networks (ANN).
Methods. 174 patients’ cards (56 males and 118 females, the age of 16-74 yrs.) with adrenal incidentalomas combined with arterial hypertension have been investigated. 57 patients out of 174 were operated on. In 26 patients (45,6%) the primary aldosteronism was diagnosed, in 14 (24,6%) – corticosteromas, in 13 (22,8%) – catecholamine-secreting tumors, and only in 4 (7%) – hormonally inactive tumors. Out of 117 patients who were subjected to the dynamic observation within a period of 1 to 15 years, 14 – were operated on after an additional examinations of clinical, laboratory signs of hormonal activity as well as the worked out method of the differential diagnostics of the symptomatic arterial hypertension.
Results. To diagnose the symptomatic arterial hypertension in patients with accidentally revealed adrenal tumors (incidentalomas) 35 signs have been singled out and divided into 2 groups. The first group included the signs characterized by the quantitative parameters. The second group included the information about a patient expressed in medical terms and concepts coded in figures. The established diagnoses in patients with symptomatic arterial hypertension of adrenal genesis were coded as the figures too. For forecasting the artificial neural networks (ANN) was created for each patient with the symptomatic arterial hypertension. For current forecasting the card of a definite patient was filled in with the coded information. The result of the forecast was seen on the monitor as a figure which was compared with the presumable results. The difference of obtained results less than 0,5 indicated that diagnosis of the symptomatic arterial hypertension in patients with incidentalomas is considered to be probable.
Conclusions. The accuracy of the worked out method is 92,9%, sensitivity – 79,1%, specificity – 96,2%. The received result of the decision of an “artificial intellect” can be considered to be as additional criteria to determine the treatment tactics of this category of patients.

Keywords: adrenal tumors, incidentaloma, symptomatic arterial hypertension, diagnostics, artificial neural networks
p. 99 – 106 of the original issue
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Address for correspondence:
664079, Rossiiskaia Federatsiia, g. Irkutsk, m-n. Iubileinyi, d.100, GBOU DPO «Irkutskaia gosudarstvennaia meditsinskaia akademiia poslediplomnogo obrazovaniia», kafedra khirurgii,
e-mail: giuv.surgery@ya.ru,
Kulikov Leonid Konstantinovich
Information about the authors:
Kulikov L.K. MD, professor, a head of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-graduate Education”.
Bykova N.M. PhD, a head of the endocrinology department of MAME “City Clinical Hospital ¹ 10”, Irkutsk.
Privalov U.A. PhD, an associate professor of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-graduate Education”.
Sobotovich V.F. PhD, an associate professor of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-graduate Education”.
Smirnov A.A. PhD, an assistant of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-graduate Education”.  
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