肺间质综合征的自动化超声信号指示器的研发。
Development of an Automated Ultrasound Signal Indicator of Lung Interstitial Syndrome.
机构信息
Department of Medicine, University of Washington, Seattle, Washington, USA.
Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA.
出版信息
J Ultrasound Med. 2024 Mar;43(3):513-523. doi: 10.1002/jum.16383. Epub 2023 Dec 5.
OBJECTIVES
The number and distribution of lung ultrasound (LUS) imaging artifacts termed B-lines correlate with the presence of acute lung disease such as infection, acute respiratory distress syndrome (ARDS), and pulmonary edema. Detection and interpretation of B-lines require dedicated training and is machine and operator-dependent. The goal of this study was to identify radio frequency (RF) signal features associated with B-lines in a cohort of patients with cardiogenic pulmonary edema. A quantitative signal indicator could then be used in a single-element, non-imaging, wearable, automated lung ultrasound sensor (LUSS) for continuous hands-free monitoring of lung fluid.
METHODS
In this prospective study a 10-zone LUS exam was performed in 16 participants, including 12 patients admitted with acute cardiogenic pulmonary edema (mean age 60 ± 12 years) and 4 healthy controls (mean age 44 ± 21). Overall,160 individual LUS video clips were recorded. The LUS exams were performed with a phased array probe driven by an open-platform ultrasound system with simultaneous RF signal collection. RF data were analyzed offline for candidate B-line indicators based on signal amplitude, temporal variability, and frequency spectrum; blinded independent review of LUS images for the presence or absence of B-lines served as ground truth. Predictive performance of the signal indicators was determined with receiving operator characteristic (ROC) analysis with k-fold cross-validation.
RESULTS
Two RF signal features-temporal variability of signal amplitude at large depths and at the pleural line-were strongly associated with B-line presence. The sensitivity and specificity of a combinatorial indicator were 93.2 and 58.5%, respectively, with cross-validated area under the ROC curve (AUC) of 0.91 (95% CI = 0.80-0.94).
CONCLUSION
A combinatorial signal indicator for use with single-element non-imaging LUSS was developed to facilitate continuous monitoring of lung fluid in patients with respiratory illness.
目的
被称为 B 线的肺部超声（LUS）成像伪影的数量和分布与急性肺部疾病（如感染、急性呼吸窘迫综合征（ARDS）和肺水肿）的存在相关。B 线的检测和解释需要专门的培训，并且依赖于机器和操作人员。本研究的目的是确定与心源性肺水肿患者队列中 B 线相关的射频（RF）信号特征。然后，可以在单个元件、非成像、可穿戴、自动肺部超声传感器（LUSS）中使用定量信号指标，用于连续、无需手持、监测肺部液体。
方法
在这项前瞻性研究中，对 16 名参与者进行了 10 区 LUS 检查，包括 12 名因急性心源性肺水肿入院的患者（平均年龄 60±12 岁）和 4 名健康对照者（平均年龄 44±21 岁）。总共记录了 160 个 LUS 视频片段。LUS 检查使用相控阵探头进行，探头由具有同时 RF 信号采集的开放式超声系统驱动。对 RF 数据进行离线分析，以确定基于信号幅度、时间变异性和频谱的候选 B 线指标；LUS 图像的盲独立审查用于确定 B 线的存在或不存在作为地面真实。通过 K 折交叉验证的接收者操作特征（ROC）分析确定信号指标的预测性能。
结果
两个 RF 信号特征-大深度和胸壁处信号幅度的时间变异性-与 B 线存在密切相关。组合指标的灵敏度和特异性分别为 93.2%和 58.5%，经 K 折交叉验证的 ROC 曲线下面积（AUC）为 0.91（95%CI=0.80-0.94）。
结论
开发了一种用于单个元件非成像 LUSS 的组合信号指标，以促进呼吸疾病患者肺部液体的连续监测。
Zotero 插件