Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, China; Computer Science and Engineering, Northeastern University, Shenyang, China; National Frontiers Science Center for Industrial Intelligence and Systems Optimization, China.
Department of Cardiovascular Ultrasound The First Hospital of China Medical University, China.
Comput Methods Programs Biomed. 2024 Jan;243:107882. doi: 10.1016/j.cmpb.2023.107882. Epub 2023 Oct 27.
BACKGROUND AND OBJECTIVE: Aortic valve calcification (AVC) is a strong predictor of adverse cardiovascular events and is correlated with the degree of coronary artery stenosis. Generally, AVC is identified by echocardiography using visual "eyeballing", which results in huge differences between observers and requires a long time to learn. Therefore, accurately identifying AVC from echocardiographic images is a challenging task due to the interference of various factors. METHOD: In this paper, we built a dynamical local feature fusion net capable of processing echocardiography to recognize AVC automatically. We proposed high-echo area which were segmented by a U-Net. Meanwhile, we fine-tuned the segmentation results by adding brightness in the mask tuning module in order to dynamically adjust the selection of local features. To better fuse multi-level and multi-scale information, we designed a pyramid-based two-branch feature fusion module in classification, which enables the network to better integrate global and local semantic representations. In addition, for the echocardiographic data collected by different devices and doctors, inconsistent aortic valve position with a small occupied area, a unified preprocessing algorithm was designed. RESULTS: To highlight the effectiveness of the proposed approach, we compared several state-of-the-art methods on the same ultrasound dataset. The 231 patients with short-axis views of the aortic valve images were collected and labeled (masked) by experienced ultrasound doctors from The First Hospital of China Medical University. The accuracy, precision, sensitivity, specificity, and F1 score, micro-AUC, and macro-AUC of the model for the test dataset were, 82.40%, 82.50%, 82.50%, 91.23%, 82.47%, 92.39%, and 92.25%, respectively. CONCLUSIONS: The results showed the possibility of using echocardiography to examine AVC automatically and verified by visualization methods that the Region of Interest of the model is consistent with the observed region of the experts.
背景与目的:主动脉瓣钙化(AVC)是不良心血管事件的强有力预测因子,与冠状动脉狭窄程度相关。通常,通过超声心动图使用视觉“目测”来识别 AVC,这导致观察者之间存在巨大差异,并且需要很长时间才能学习。因此,由于各种因素的干扰,从超声心动图图像中准确识别 AVC 是一项具有挑战性的任务。
方法:在本文中,我们构建了一个能够处理超声心动图的动态局部特征融合网络,以自动识别 AVC。我们提出了高回声区域,该区域通过 U-Net 进行分割。同时,我们通过在掩模调整模块中添加亮度来调整分割结果,以动态调整局部特征的选择。为了更好地融合多层次和多尺度信息,我们在分类中设计了基于金字塔的两分支特征融合模块,使网络能够更好地整合全局和局部语义表示。此外,对于不同设备和医生采集的超声心动图数据,由于主动脉瓣位置不一致且占用面积较小,我们设计了统一的预处理算法。
结果:为了突出所提出方法的有效性,我们在相同的超声数据集上比较了几种最先进的方法。从中国医科大学第一附属医院采集并由有经验的超声医生标记(掩蔽)了 231 名主动脉瓣短轴视图的患者。模型对测试数据集的准确性、精度、敏感性、特异性、F1 评分、微 AUC 和宏 AUC 分别为 82.40%、82.50%、82.50%、91.23%、82.47%、92.39%和 92.25%。
结论:结果表明,使用超声心动图自动检查 AVC 的可能性,并通过可视化方法验证,模型的感兴趣区域与专家观察到的区域一致。
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