Department of Pediatrics, National Taiwan University Hospital, and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pediatric Neurology, National Taiwan University Children's Hospital, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
Ultrasonics. 2019 Apr;94:235-241. doi: 10.1016/j.ultras.2018.09.004. Epub 2018 Sep 20.
Duchenne muscular dystrophy (DMD) results in loss of ambulation for the patients. Ultrasound attenuation correlates with fat content in muscles, resulting in changes in signal frequency. The Hilbert-Huang transform (HHT) allows time-frequency analysis with high time-frequency resolution. This study explored the feasibility of using the instantaneous frequency (IF) obtained from the HHT to diagnose the walking function of patients with DMD. Eighty-five participants (12 control and 73 patients with DMD) underwent a standard-care ultrasound examination of the gastrocnemius to acquire raw image data for ultrasound B-mode and IF calculations, which were compared with the DMD stage using Pearson correlation and receiver operating characteristic (ROC) curve analyses. With increasing DMD stage, the median IF decreased from 7.25 to 7.01 MHz (the correlation coefficient r = -0.73; the probability value p < 0.0001). The area under the ROC curve was 0.97 when using ultrasound IF to discriminate between ambulatory and nonambulatory patients (accuracy: 91.76%; sensitivity: 93.75%; and specificity: 90.57%). The study reveals that ultrasound IF has great potential in DMD evaluation and management.
杜氏肌营养不良症（DMD）会导致患者丧失行走能力。超声衰减与肌肉中的脂肪含量相关，导致信号频率发生变化。希尔伯特-黄变换（HHT）允许进行具有高时间-频率分辨率的时频分析。本研究探索了使用 HHT 获得的瞬时频率（IF）来诊断 DMD 患者行走功能的可行性。85 名参与者（12 名对照和 73 名 DMD 患者）接受了腓肠肌的标准护理超声检查，以获取用于超声 B 模式和 IF 计算的原始图像数据，并使用 Pearson 相关和接收者操作特征（ROC）曲线分析将其与 DMD 阶段进行比较。随着 DMD 阶段的增加，IF 的中位数从 7.25MHz 降至 7.01MHz（相关系数 r = -0.73；概率值 p < 0.0001）。使用超声 IF 区分可走动和不可走动患者的 ROC 曲线下面积为 0.97（准确度：91.76%；敏感度：93.75%；特异性：90.57%）。该研究表明，超声 IF 在 DMD 评估和管理中有很大的潜力。
