Ahn Honggi, Kim Sun Ju, Kang Seungyoung, Han Junghun, Hwang Sung Oh, Cha Kyoung-Chul, Yang Sejung
Department of Biomedical Engineering, Yonsei University, 26493 Wonju, Republic of Korea.
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do 26426 Republic of Korea.
Biomed Eng Lett. 2023 Jun 30;13(4):715-728. doi: 10.1007/s13534-023-00293-9. eCollection 2023 Nov.
High-quality cardiopulmonary resuscitation (CPR) is the most important factor in promoting resuscitation outcomes; therefore, monitoring the quality of CPR is strongly recommended in current CPR guidelines. Recently, transesophageal echocardiography (TEE) has been proposed as a potential real-time feedback modality because physicians can obtain clear echocardiographic images without interfering with CPR. The quality of CPR would be optimized if the myocardial ejection fraction (EF) could be calculated in real-time during CPR. We conducted a study to derive a protocol to detect systole and diastole automatically and calculate EF using TEE images acquired from patients with cardiac arrest. The data were supplemented using thin-plate spline transformation to solve the problem of insufficient data. The deep learning model was constructed based on ResUNet + + , and a monogenic filtering method was applied to clarify the ventricular boundary. The performance of the model to which the monogenic filter was added and the existing model was compared. The left ventricle was segmented in the ME LAX view, and the left and right ventricles were segmented in the ME four-chamber view. In most of the results, the performance of the model to which the monogenic filter was added was high, and the difference was very small in some cases; but the performance of the existing model was high. Through this learned model, the effect of CPR can be quantitatively analyzed by segmenting the ventricle and quantitatively analyzing the degree of contraction of the ventricle during systole and diastole.
The online version contains supplementary material available at 10.1007/s13534-023-00293-9.
高质量心肺复苏(CPR)是促进复苏结果的最重要因素;因此,当前心肺复苏指南强烈建议监测心肺复苏质量。最近,经食管超声心动图(TEE)已被提议作为一种潜在的实时反馈方式,因为医生可以在不干扰心肺复苏的情况下获得清晰的超声心动图图像。如果能在心肺复苏期间实时计算心肌射血分数(EF),心肺复苏质量将得到优化。我们进行了一项研究,以推导一种协议,用于自动检测收缩期和舒张期,并使用从心脏骤停患者获取的TEE图像计算EF。使用薄板样条变换补充数据,以解决数据不足的问题。基于ResUNet++构建深度学习模型,并应用单基因滤波方法来明确心室边界。比较了添加单基因滤波器的模型与现有模型的性能。在ME LAX视图中分割左心室,在ME四腔视图中分割左、右心室。在大多数结果中,添加单基因滤波器的模型性能较高,在某些情况下差异非常小;但现有模型的性能也较高。通过这个学习模型,可以通过分割心室并定量分析心室在收缩期和舒张期的收缩程度来定量分析心肺复苏的效果。
在线版本包含可在10.1007/s13534-023-00293-9获取的补充材料。