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基于三维卷积神经网络的人工智能辅助诊断模型对超声心动图视频异常变化的识别

[Recognition of abnormal changes in echocardiographic videos by an artificial intelligence assisted diagnosis model based on 3D CNN].

作者信息

Shen K K, Zhang X J, Shao R J, Zhao M C, Chen J J, Yuan J J, Zhao J G, Zhu H H

机构信息

Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou 450003, China.

CHISON Medical Technologies Co., LTD. Wuxi 214142, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2023 Jul 24;51(7):750-758. doi: 10.3760/cma.j.cn112148-20230202-00058.

Abstract

To investigate the diagnostic efficiency and clinical application value of an artificial intelligence-assisted diagnosis model based on a three-dimensional convolutional neural network (3D CNN) on echocardiographic videos of patients with hypertensive heart disease, chronic renal failure (CRF) and hypothyroidism with cardiac involvement. This study is a retrospective study. The patients with hypertensive heart disease, CRF and hypothyroidism with cardiac involvement, who admitted in Henan Provincial People's Hospital from April 2019 to October 2021, were enrolled. Patients were divided into hypertension group, CRF group, and hypothyroidism group. Additionally, a simple random sampling method was used to select control healthy individuals, who underwent physical examination at the same period. The echocardiographic video data of enrolled participants were analyzed. The video data in each group was divided into a training set and an independent testing set in a ratio of 5 to 1. The temporal and spatial characteristics of videos were extracted using an inflated 3D convolutional network (I3D). The artificial intelligence assisted diagnosis model was trained and tested. There was no case overlapped between the training and validation sets. A model was established according to cases or videos based on video data from 3 different views (single apical four chamber (A4C) view, single parasternal left ventricular long-axis (PLAX) view and all views). The statistical analysis of diagnostic performance was completed to calculate sensitivity, specificity and area under the ROC curve (). The time required for the artificial intelligence and ultrasound physicians to process cases was compared. A total of 730 subjects aged (41.9±12.7) years were enrolled, including 362 males (49.6%), and 17 703 videos were collected. There were 212 cases in the hypertensive group, 210 cases in the CRF group, 105 cases in the hypothyroidism group, and 203 cases in the normal control group. The diagnostic performance of the model predicted by cases based on single PLAX view and all views data was excellent: (1) in the hypertensive group, the sensitivity, specificity and of models based on all views data were 97%, 89% and 0.93, respectively, while those of models based on a single PLAX view were 94%, 95%, and 0.94, respectively; (2) in the CRF group, the sensitivity, specificity and of models based on all views data were 97%, 95% and 0.96, respectively, while those of models based on a single PLAX view were 97%, 89%, and 0.93, respectively; (3) in the hypothyroidism group, the sensitivity, specificity and of models based on all views data were 64%, 100% and 0.82, respectively, while those of models based on a single PLAX view were 82%, 89%, and 0.86, respectively. The time required for the 3D CNN model to measure and analyze the echocardiographic videos of each subject was significantly shorter than that for the ultrasound physicians ((23.96±6.65)s vs. (958.25±266.17)s, <0.001). The artificial intelligence assisted diagnosis model based on 3D CNN can extract the dynamic temporal and spatial characteristics of echocardiographic videos jointly, and quickly and efficiently identify hypertensive heart disease and cardiac changes caused by CRF and hypothyroidism.

摘要

为探讨基于三维卷积神经网络(3D CNN)的人工智能辅助诊断模型对高血压性心脏病、慢性肾衰竭(CRF)及合并心脏受累的甲状腺功能减退症患者超声心动图视频的诊断效能及临床应用价值。本研究为回顾性研究。纳入2019年4月至2021年10月在河南省人民医院就诊的高血压性心脏病、CRF及合并心脏受累的甲状腺功能减退症患者。患者分为高血压组、CRF组和甲状腺功能减退组。另外,采用简单随机抽样方法选取同期进行体检的健康对照个体。对纳入参与者的超声心动图视频数据进行分析。每组视频数据按5∶1的比例分为训练集和独立测试集。使用膨胀三维卷积网络(I3D)提取视频的时空特征。对人工智能辅助诊断模型进行训练和测试。训练集和验证集之间无病例重叠。根据来自3个不同视图(单心底四腔(A4C)视图、单胸骨旁左心室长轴(PLAX)视图和所有视图的视频数据,按病例或视频建立模型。完成诊断性能的统计分析以计算敏感性、特异性和ROC曲线下面积()。比较人工智能和超声医师处理病例所需的时间。共纳入730例年龄为(41.9±12.7)岁的受试者,其中男性362例(49.6%),收集到17 703个视频。高血压组212例,CRF组210例,甲状腺功能减退组105例,正常对照组203例。基于单PLAX视图和所有视图数据按病例预测的模型诊断性能优异:(1)在高血压组,基于所有视图数据的模型敏感性、特异性和分别为97%、89%和0.93,而基于单PLAX视图的模型分别为94%、95%和0.94;(2)在CRF组,基于所有视图数据的模型敏感性、特异性和分别为97%、95%和0.96,而基于单PLAX视图的模型分别为97%、89%和0.93;(3)在甲状腺功能减退组,基于所有视图数据的模型敏感性、特异性和分别为64%、100%和0.82,而基于单PLAX视图的模型分别为82%、89%和0.86。3D CNN模型测量和分析每个受试者超声心动图视频所需的时间明显短于超声医师((23.96±6.65)秒对(958.25±266.17)秒,<0.001)。基于3D CNN的人工智能辅助诊断模型可联合提取超声心动图视频的动态时空特征,快速高效地识别高血压性心脏病以及CRF和甲状腺功能减退症所致心脏改变。

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