在超声心动图检查过程中利用深度学习进行实时引导,以减少左心室前缩短和测量变异性。

European heart journal. Imaging methods and practice Pub Date : 2023-08-01 eCollection Date: 2023-05-01 DOI:10.1093/ehjimp/qyad012
Sigbjorn Sabo, Hakon Neergaard Pettersen, Erik Smistad, David Pasdeloup, Stian Bergseng Stølen, Bjørnar Leangen Grenne, Lasse Lovstakken, Espen Holte, Havard Dalen
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引用次数: 0

摘要

目的:心尖前缩短会导致低估左心室(LV)容积,高估左心室射血分数和整体纵向应变。在超声心动图检查过程中使用深度学习(DL)进行实时引导以减少前缩短,可以提高标准化程度并减少变异性。我们旨在研究超声心动图检查过程中实时 DL 引导对左心室前缩短测量值和观察者间变异性的影响:纳入窦性心律的超声心动图检查患者(n = 88),无造影适应症。所有患者均接受了三次超声心动图检查。前两次检查由超声技师进行,第三次检查由心脏病专家进行。在第一阶段,超声技师被要求提供高质量的超声心动图。在第二阶段,由第二名超声技师使用 DL 导航。一位盲法专家测量所有记录中的左心室长度。心脏病专家的三平面记录作为参考。计算舒张末期心尖前缩短。两组超声技师在第一期都明显缩短了左心室(平均缩短:超声技师 1:4 毫米;超声技师 2:2 毫米):超声技师 1:4 毫米;超声技师 2:3 毫米,与参考值相比,P 均 < 0.001),而在第 2 期,前缩短减少(分别为 2 毫米和 0 毫米,第 1 期与第 2 期相比,P < 0.05)。使用 DL 导引的超声技师的前缩短程度并不比心脏病专家高(P ≥ 0.409)。实时引导并未改善类内相关性(ICC)[左心室舒张末期容积 ICC,(95% 置信区间):DL引导0.87 (0.77-0.93) vs. 无引导0.92 (0.88-0.95)]:结论:实时引导减少了有经验操作者的前臂缩短,并有可能提高图像标准化。尽管实时引导对经验丰富的操作者之间的变异性影响很小,但对经验不足的操作者来说,实时引导可能会改善测试-重复变异性:临床试验注册:ClinicalTrials.gov, Identifier:临床试验注册:ClinicalTrials.gov,标识符:NCT04580095。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Real-time guiding by deep learning during echocardiography to reduce left ventricular foreshortening and measurement variability.

Aims: Apical foreshortening leads to an underestimation of left ventricular (LV) volumes and an overestimation of LV ejection fraction and global longitudinal strain. Real-time guiding using deep learning (DL) during echocardiography to reduce foreshortening could improve standardization and reduce variability. We aimed to study the effect of real-time DL guiding during echocardiography on measures of LV foreshortening and inter-observer variability.

Methods and results: Patients (n = 88) in sinus rhythm referred for echocardiography without indication for contrast were included. All participants underwent three echocardiograms. The first two examinations were performed by sonographers, and the third by cardiologists. In Period 1, the sonographers were instructed to provide high-quality echocardiograms. In Period 2, the DL guiding was used by the second sonographer. One blinded expert measured LV length in all recordings. Tri-plane recordings by cardiologists were used as reference. Apical foreshortening was calculated at the end-diastole. Both sonographer groups significantly foreshortened the LV in Period 1 (mean foreshortening: Sonographer 1: 4 mm; Sonographer 2: 3 mm, both P < 0.001 vs. reference) and reduced foreshortening in Period 2 (2 and 0 mm, respectively. Period 1 vs. Period 2, P < 0.05). Sonographers using DL guiding did not foreshorten more than cardiologists (P ≥ 0.409). Real-time guiding did not improve intra-class correlation (ICC) [LV end-diastolic volume ICC, (95% confidence interval): DL guiding 0.87 (0.77-0.93) vs. no guiding 0.92 (0.88-0.95)].

Conclusion: Real-time guiding reduced foreshortening among experienced operators and has the potential to improve image standardization. Even though the effect on inter-operator variability was minimal among experienced users, real-time guiding may improve test-retest variability among less experienced users.

Clinical trial registration: ClinicalTrials.gov, Identifier: NCT04580095.

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