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基于神经网络从超声数据估计动脉直径

Neural network-based arterial diameter estimation from ultrasound data.

作者信息

Yu Zhuangzhuang, Sifalakis Manolis, Hunyadi Borbála, Beutel Fabian

机构信息

Department of Signal Processing & Modelling, imec The Netherlands / Holst Centre, Eindhoven, The Netherlands.

Department of Microelectronics / Signal Processing Systems, Delft University of Technology, Delft, The Netherlands.

出版信息

PLOS Digit Health. 2024 Dec 2;3(12):e0000659. doi: 10.1371/journal.pdig.0000659. eCollection 2024 Dec.

Abstract

Cardiovascular diseases are the leading cause of mortality and early assessment of carotid artery abnormalities with ultrasound is key for effective prevention. Obtaining the carotid diameter waveform is essential for hemodynamic parameter extraction. However, since it is not a trivial task to automate, compact computational models are needed to operate reliably in view of physiological variability. Modern machine learning (ML) techniques hold promise for fully automated carotid diameter extraction from ultrasonic data without requiring annotation by trained clinicians. Using a conventional digital signal processing (DSP) based approach as reference, our goal is to (a) build data-driven ML models to identify and track the carotid diameter, and (b) keep the computational complexity minimal for deployment in embedded systems. A ML pipeline is developed to estimate the carotid artery diameter from Hilbert-transformed ultrasound signals acquired at 500Hz sampling frequency. The proposed ML pipeline consists of 3 processing stages: two neural-network (NN) models and a smoothing filter. The first NN, a compact 3-layer convolutional NN (CNN), is a region-of-interest (ROI) detector confining the tracking to a reduced portion of the ultrasound signal. The second NN, an 8-layer (5 convolutional, 3 fully-connected) CNN, tracks the arterial diameter. It is followed by a smoothing filter for removing any superimposed artifacts. Data was acquired from 6 subjects (4 male, 2 female, 37 ± 7 years, baseline mean arterial pressure 86.3 ± 7.6 mmHg) at rest and with diameter variation induced by paced breathing and a hand grip intervention. The label reference is extracted from a fine-tuned DSP-based approach. After training, diameter waveforms are extracted and compared to the DSP reference. The predicted diameter waveform from the proposed NN-based pipeline has near perfect temporal alignment with the reference signal and does not suffer from drift. Specifically, we obtain a Pearson correlation coefficient of r = 0.87 between prediction and reference waveforms. The mean absolute deviation of the arterial diameter prediction was quantified as 0.077 mm, corresponding to a 1% error given an average carotid artery diameter of 7.5 mm in the study population. This work proposed and evaluated an ML neural network-based pipeline to track the carotid artery diameter from an ultrasound stream of A-mode frames. By contrast to current clinical practice, the proposed solution does not rely on specialist intervention (e.g. imaging markers) to track the arterial diameter. In contrast to conventional DSP-based counterpart solutions, the ML-based approach does not require handcrafted heuristics and manual fine-tuning to produce reliable estimates. Being trainable from small cohort data and reasonably fast, it is useful for quick deployment and easy to adjust accounting for demographic variability. Finally, its reliance on A-mode ultrasound frames renders the solution promising for miniaturization and deployment in on-line clinical and ambulatory monitoring.

摘要

心血管疾病是导致死亡的主要原因,通过超声对颈动脉异常进行早期评估是有效预防的关键。获取颈动脉直径波形对于血流动力学参数提取至关重要。然而,由于自动化并非易事,鉴于生理变异性,需要紧凑的计算模型才能可靠运行。现代机器学习(ML)技术有望从超声数据中完全自动提取颈动脉直径,而无需训练有素的临床医生进行标注。以传统的基于数字信号处理(DSP)的方法为参考,我们的目标是:(a)构建数据驱动的ML模型来识别和跟踪颈动脉直径;(b)将计算复杂度降至最低,以便在嵌入式系统中部署。开发了一个ML管道,用于从以500Hz采样频率采集的经希尔伯特变换的超声信号中估计颈动脉直径。所提出的ML管道由3个处理阶段组成:两个神经网络(NN)模型和一个平滑滤波器。第一个NN是一个紧凑的3层卷积神经网络(CNN),是一个感兴趣区域(ROI)检测器,将跟踪限制在超声信号的缩减部分。第二个NN是一个8层(5个卷积层、3个全连接层)的CNN,用于跟踪动脉直径。随后是一个平滑滤波器,用于去除任何叠加的伪影。数据来自6名受试者(4名男性,2名女性,37±7岁,静息时平均动脉压86.3±7.6mmHg),包括静息状态以及通过有节奏呼吸和握力干预引起直径变化的状态。标签参考是从基于DSP的微调方法中提取的。训练后,提取直径波形并与DSP参考进行比较。所提出的基于NN的管道预测的直径波形与参考信号具有近乎完美的时间对齐,且不会出现漂移。具体而言,我们在预测波形与参考波形之间获得了皮尔逊相关系数r = 0.87。动脉直径预测的平均绝对偏差量化为0.077mm,鉴于研究人群中颈动脉平均直径为7.5mm,这对应于1%的误差。这项工作提出并评估了一种基于ML神经网络的管道,用于从A模式帧的超声流中跟踪颈动脉直径。与当前临床实践相比,所提出的解决方案不依赖专家干预(如成像标记)来跟踪动脉直径。与传统的基于DSP的对应解决方案相比,基于ML的方法不需要手工启发式方法和手动微调来产生可靠的估计。它可从小队列数据中训练且速度合理,有助于快速部署,并且易于根据人口统计学变异性进行调整。最后,其对A模式超声帧的依赖使得该解决方案有望实现小型化并应用于在线临床和门诊监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b94/11611178/93ba7bbbe129/pdig.0000659.g001.jpg

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