自动化容积成像自动获取中孕期正常胎儿心脏标准切面的评估

Automated retrieval of standard of normal fetal cardiac ultrasound planes in the second trimester pregnancy:volume computer aided diagnosis

目的:探讨利用自动化容积成像(volume computer aided diagnosis,VCAD)自动获取胎儿心脏筛查切面,并与二维超声(2D)比较,进一步提高中孕期胎儿心脏的筛查效率。方法:以100例中晚孕期经常规超声筛查,心脏未见异常的正常胎儿为研究对象。在2D模式下采集胎儿心脏筛查所需要的标准切面,包括四腔心(four-chamber view,4CV),五腔心(five-chamber view,5CV)、左右室流出道(left ventricular outflow track LVOT、right ventricular outflow track RV-OT),大动脉短轴(Artery short-axis SAV),主动脉弓(aortic arch LAV-AoA),动脉导管弓(ductal arch LAV-DA)、上下腔静脉长轴(superior-inferior vena cava,SVC-IVC)切面,记录采集时间。采用(Spatio-Temporal Image Correlation)STIC技术扫描获得胎儿心脏整体容积数据,存盘后进行脱机分析。利用4DVIEW 7.0软件VCAD技术,通过模式自带的SetStarting Plane的Start Plane、cardiac 1、cardiac 2、cardiac 3、cardiac 4、cardiac 5,分别自动获取上述各切面图像,并记录采集时间。比较VCAD技术自动获取的图像和2D图像吻合率及图像质量。采用超声断层显像(Tomographic UltrasoundImaging TUI)模式,通过调节层距和中心层位置,分别显示上述各切面,并记录采集时间。比较STIC-TUI检查时间和VCAD检查时间。结果:①VCAD检查时间:(138±10)s至(198±12)s明显小于2D检查时间(288±13)s和STIC-TUI检查时间(408±18)s,差异均有统计学意义;②VCAD自动获取切面和2D切面图像合格率的比较:扫描起始切面为心轴位于右上象限的心尖四腔心切面的容积数据样本,二维超声显示的筛查切面与VCAD重现的上述各切面合格率差异均无显著性(P>0.05)。扫描起始切面为心轴不位于右上象限的心尖四腔心切面的样本,容积数据利用VCAD自动获得的图像,配对卡方检验显示,LAV-AoA、LAV-DA、SAV切面,VCAD重建切面合格率低于2D,两者相比差异有统计学意义(P=0.045,P=0.045,P=0.001,<0.05);③VCAD和2D获取各个切面图像质量的比较:扫描起始切面为为心轴位于右上象限的心尖四腔心切面的样本,VCAD自动获取各切面图像质量和2D达到了极好的一致性或好的一致性。扫描起始切面为心轴不位于右上象限的心尖四腔心切面的样本,VCAD自动获取切面在4CV、5CV切面图像质量和2D达到了极好的一致性,在LVOT、RVOT和SVC+IVC切面图像质量和2D一致性好,在LAV-AoA、LAV-DA和SAV切面图像质量和2D的一致性差。结论:VCAD快速自动且较全面的获得胎儿心脏筛查各标准化切面高品质的图像信息,简化了三维容积数据的后处理方法,提高了超声诊断的准确性。

Objective:To investigate the application of volume computer aided diagnosis(VCAD)techniques in acquisition of the fetal heart section images automatically comapring with 2-D supersonic images,and to improve the screening efficiency of fetal heart disorder in the second trimester pregnancy.Methods:The 100 normal fetus of the second trimester pregnancy,which were confirmed with tranditional ultrasonic dianosis,were used as investigation samples.The standard section images of the fetal heart were collected under 2-D pattern,including four-chamber view(4CV),five-chamber view(5CV),left/right ventricular outflow tract(LVOT,RVOT) view,Aortic short axis view(SAV),Aortic arch(AOA) view(LAV-DA),(SVC-IVC),the collecting time span was record.Spatio-Temporal Image Correlation(STIC)scan technology was used to collect the fetal heart volume.The data was saved and analyzed.VCAD(4D VIEW 7.0 soft——ware) technology was used.Through the start plane,cardiac 1,cardiac 2,cardiac 3,cardiac 4,cardiac 5 program in set starting plane,the section images indicated above were collected automatically.The collecting time span was recorded.The images from VCAD and 2-D Ultrosound respectively were compared for consistency and image quality.Tomographic Ultrasound Imaging(TUI) pattern was used.The section images were showed through adjusting the layer distance and central layer position.The collecting time span was recorded.The STIC-TUI detecting time span was compared with that of VCAD. Results:① VCAD detecting time span(138±10) s to(198±12) s was apparently shorter than that of 2D detecting(288±13) s and STIC-TUI detecting(408±18) s.The difference is of statistic significance;② The comparing of the qualification rate of VCAD and 2D ultrasonic section images:if the scan section axle start from heart tip four chamber heart section in right upper quardrant,the qualification rate of the 2-D ultrasonic section images was consistant with that of VCAD reaproduced sections,without statistic significance(P>0.05).If the scan section axle start from the other part except heart tip four chamber heart section in right upper quardrant.The qualification rate of VCAD reporduced LAV-AoA,LAV-DA,SAV section images was lower than that of 2-D ultrasonic images.The difference was of statistic significance(P=0.045,P=0.045,P=0.001,respectively,<0.05);③ Comparing of the image quality of VCAD and 2D ultrasonic sections:if the scan section axle start from heart tip four chamber heart section in right upper quardrant,the image qulity of the 2-D ultrasonic section images were highly or well consistant with that of VCAD reaproduced sections.If the scan section axle start from the other part except heart tip four chamber heart section in right upper quardrant,the image qulity of VCAD reporduced 4CV,5CV section images were highly consistant with that of 2-D ultrasonic images,and LVOT,RVOT and SVC+IVC section images were well consistant with that of 2-D ultrasonic images,but LAV-AoA,LAV-DA,SAV section images were badly consistant with that of 2-D ultrasonic images. Conclusion:VCAD can adquire the high quality of fetal heart section image fast,automatically and relatively entirely.The post-treatment of 3-Dimentional volume data was simplified.The working efficiency was improved apparently.