Gorek M, Stief C G, Hartung C, Jonas U
Department of Urology, Medizinische Hochschule Hannover, Germany.
World J Urol. 1997;15(1):65-70. doi: 10.1007/BF01275159.
An electromyogram of the corpora cavernosa (CC-EMG) imparts information on the autonomic cavernous innervation and/or the cavernous smooth muscles. The CC-EMG is interpreted mainly by evaluation of signal patterns of higher activity. The time required for interpretation is reduced by the implementation of a computer-assisted diagnosis program with a Microsoft Windows user interface. The program offers four levels of diagnosis: on the first level, recordings can be edited; on the second and third levels, signal patterns can be searched or evaluated; and on the last level the final diagnosis is provided. The computer-assisted interpretation is based on digital measurement data. These data have been obtained through a 170.6-Hz sampling frequency and a quantization of 10 V/12 Bit of the amplified signal. The first task of this diagnosis program is to discover and extract signal patterns of higher activity from data stored on the hard disk of a personal computer (PC). For a mathematic description of these patterns the following features were defined: relative time position, relative reproducibility, part of normal phases, and part of whip phases. Syntactic pattern recognition was introduced to identify the characteristic signal forms. An evaluation of the patterns could be derived from these features using fuzzy logic. For a summary of the evaluated patterns the variable global normality was established. The global normality forms an important evaluation basis along with the global synchronism, which represents an investigator's first impression of a recording. The final diagnosis is completed using fuzzy logic. The program was tested by comparison of expert and computer diagnoses. A total of 30 records were independently evaluated by an expert team and the computer program. With reference to the four classified levels of diagnosis a correspondence of 70% could be found. Furthermore, the rate in each of the classified levels was higher than 50%. The discrimination between normal and abnormal evaluation was 80% for clinical routine. Our results show that a computer-assisted interpretation of the CC-EMG can be achieved using mathematically based software. Within the last 7 months this computer-assisted CC-EMG program proved to be of great help in routine diagnosis. Furthermore, it demonstrated results comparable with a blinded-expert interpretation. This approach should bring about dramatic improvements in the diagnosis of erectile dysfunction.
阴茎海绵体肌电图（CC-EMG）可提供有关自主神经海绵体神经支配和/或海绵体平滑肌的信息。CC-EMG主要通过评估较高活动的信号模式来进行解读。通过实施具有Microsoft Windows用户界面的计算机辅助诊断程序，可减少解读所需的时间。该程序提供四个诊断级别：在第一级别，可以编辑记录；在第二和第三级别，可以搜索或评估信号模式；在最后一级别提供最终诊断。计算机辅助解读基于数字测量数据。这些数据是通过170.6赫兹的采样频率和对放大信号进行10伏/12位的量化获得的。该诊断程序的首要任务是从个人计算机（PC）硬盘上存储的数据中发现并提取较高活动的信号模式。为了对这些模式进行数学描述，定义了以下特征：相对时间位置、相对再现性、正常相位部分和波动相位部分。引入句法模式识别来识别特征信号形式。使用模糊逻辑可以从这些特征中得出对模式的评估。为了总结评估的模式，建立了可变全局正常性。全局正常性与全局同步性一起构成了重要的评估基础，全局同步性代表了研究者对记录的第一印象。最终诊断使用模糊逻辑完成。通过比较专家诊断和计算机诊断对该程序进行了测试。一个专家团队和计算机程序对总共30份记录进行了独立评估。参照四个分类诊断级别，发现符合率为70%。此外，每个分类级别中的比率都高于50%。在临床常规中，正常与异常评估之间的辨别率为80%。我们的结果表明，使用基于数学的软件可以实现CC-EMG的计算机辅助解读。在过去7个月中，这个计算机辅助CC-EMG程序在常规诊断中被证明有很大帮助。此外，它展示的结果与盲法专家解读相当。这种方法应该会给勃起功能障碍的诊断带来显著改善。
