Automatic Measurement of Fetal Abdominal Biometric Parameters—Feasibility on a Portable Ultrasound Device

An automatic method for measuring the fetal mean abdominal diameter (MAD) or abdominal circumference (AC) with ultrasound is proposed. From a correctly presented abdominal section suitable for MAD or AC measurement, the location of fetal abdomen is detected by image processing. Thereafter, an active contour model is converged along the abdominal boundary for measurement purposes. The validation data set contained 310 images of fetuses with gestational age (GA) from 14 to 41 weeks. The measurement success rate was 88.1%. By manually indicating the location of the abdomen, the success rate was further improved to 95.8% for the failed cases. The correlation between manual and automatic measurements was 0.95 and the intraclass correlation coefficient (ICC) was 0.976 (95% confidence interval (CI);0.969 - 0.981). The average method execution time was 0.3 s. The mean error was lower in young fetuses (0.4%) than in older fetuses (-2.1%). The proposed cross-platform method was implemented on a portable, low-cost ultrasound machine prototype targeted for low- and middle-income countries (LMIC);the results achieved were comparable to those of other state-of-the-art automatic methods.

Automatic Detection and Measurement of Fetal Biparietal Diameter and Femur Length —Feasibility on a Portable Ultrasound Device

An automatic method able to recognize a presented section through the biparietal plane of the fetal head and a section through the fetal femur in ultrasound images is developed. Once the correct anatomical section for measurement is identified by the machine, the placement of the measurement calipers is automatically determined by fitting an active contour model to the structure of interest. The fetal biparietal diameter (BPD) and femur length (FL) are then measured automatically. The validation data set contained 167 and 197 B-mode images for BPD and FL measurements, respectively. The images were acquired using 4 different ultrasound scanners, which resulted in varied image quality and gain settings. The mean gestational age (GA) of the fetuses was 19.4 weeks, range 16 to 41 weeks. A measurement success rate of 90% was achieved for both BPD and FL. The correlation coefficients between the manual and automatic measurements were 0.995 (BPD) and 0.967 (FL), mean errors were 0.5 mm (BPD) and -1.7 mm (FL) and error range with 95% confidence interval (CI) were ﹣3.8 - 4.8 mm (BPD) and ﹣11.4 - 8.1 mm (FL). The automatic measurement results were consistent in both high and low gain settings. The intraclass correlation coefficients between manual and automatic measurements were 0.995 (95% CI;0.981 - 0.999) for BPD in high gain, 1.0 (95% CI;0.998 - 1.0) for BPD in low gain, 0.998 (95% CI;0.991 - 0.999) for FL in high gain and 0.999 (95% CI;0.996 - 1.0) for FL in low gain settings. The method was implemented on a prototype, portable ultrasound machine designed to be used in low- and middle-income countries (LMIC). The overall performance of the method supports our hypothesis that automated methods can be used and are beneficial in a clinical setting.

Application and prospects of AI-based radiomics in ultrasound diagnosis

Artificial intelligence (AI)-based radiomics has attracted considerable research attention in the field of medical imaging, including ultrasound diagnosis. Ultrasound imaging has unique advantages such as high temporal resolution, low cost, and no radiation exposure. This renders it a preferred imaging modality for several clinical scenarios. This review includes a detailed introduction to imaging modalities, including Brightness-mode ultrasound, color Doppler flow imaging, ultrasound elastography, contrast-enhanced ultrasound, and multi-modal fusion analysis. It provides an overview of the current status and prospects of AI-based radiomics in ultrasound diagnosis, highlighting the application of AI-based radiomics to static ultrasound images, dynamic ultrasound videos, and multi-modal ultrasound fusion analysis.

Clinical significance of B-mode ultrasound found bladder trabeculation in BPH patients

Objective To study the role of bladder trabeculation found by B-mode ultrasound in evaluating the degree of bladder outlet obstruction ( BOO ) and the bladder function in benign prostatic hyperplasia ( BPH) patients. Methods Conducted prospective research to determine differences in clinical data and urodynamic

彩超云技术实时远程教学系统在超声医师住培中的应用

目的 探讨超声医师在住院医师规范化培训时应用基于智能便携彩超云技术实时远程教学系统的实际效果。方法 选取滨州医学院附属医院超声医学科2020年1月—2023年1月进行规范化培训的46名超声医师为研究对象,按随机数字法分为观察组和对照组,每组23名。对照组采用传统教学进行授课,观察组采用基于智能便携彩超云技术的实时远程教学进行授课,均培训6个月。培训前后2组学员均接受超声技能考核,考核完成后采用自编问卷对试验组学员进行调查。结果 观察组理论考试成绩及上机操作考试成绩为(82.96±5.44)分、(81.72±4.69)分,对照组为(73.82±4.51)分、(71.64±5.07)分,观察组各评分均高于对照组,差异有统计学意义(P <0.001)。观察组教学方式满意度、提高学习效率、有利于培养临床思维、提高自主学习能力认可率分别为91.30%、91.30%、95.65%、86.96%,高于对照组的43.48%、34.78%、39.13%、34.78%,差异有统计学意义(P <0.001)。结论 针对超声医学住培学员进行基于智能便携彩超云技术的远程教学培训可以提升超声医学住培学员的临床操作技能,获得了学员的认可。

便携式多模态医学影像系统在应急医学救援中的应用

随着精密制造技术的迅速发展,轻便、环境适应性强且性能高的便携式医学影像设备已经取得重要突破,为灾难、灾害现场高质量医学救援提供客观的医学影像依据,在救援领域得到了广泛应用。便携式医学影像设备为救援工作提供了更高效、更准确的诊断和救治参考,尤其是在应急救援领域和战伤救援中效果显著。根据应急救援和战伤救援的特点,结合便携式医学影像设备在应急救援中应用的相关文献,讨论便携式多模态医学影像系统在应急救援中的应用价值。

Contrast-enhanced ultrasound imaging for intestinal lymphoma

BACKGROUND Intestinal lymphoma is a rare tumor.Contrast-enhanced ultrasound(CEUS)findings of intestinal lymphoma have not been reported previously,and the relationship between CEUS and clinicopathological features and prognostic factors is still unknown.AIM To describe the B-mode US and CEUS features of intestinal lymphoma and investigate the correlation of CEUS and histopathological features.METHODS This was a single-center retrospective study.Eighteen patients with histologically confirmed intestinal lymphoma underwent B-mode US and CEUS examinations between October 2016 and November 2019.We summarized the features of Bmode US and CUES imaging of intestinal lymphoma and compared the frequency of tumor necrosis in intestinal lymphomas with reference to different pathological subtypes(aggressive or indolent)and clinical stage(early or advanced).The time–intensity curve parameters of CEUS were also compared between patients with normal and elevated serum lactate dehydrogenase.RESULTS In B-mode imaging,four patterns were observed in intestinal lymphoma:Mass type(12/18,66.7%),infiltration type(1/18,5.6%),mesentery type(4/18,22.2%)and mixed type(1/18,5.6%).All cases were hypoechoic and no cystic areas were detected.On CEUS,most cases(17/18,94.4%)showed arterial hyperechoic enhancement.All cases showed arterial enhancement followed by venous wash out.A relatively high rate of tumor necrosis(11/18,61.1%)was observed in this study.Tumor necrosis on CEUS was more frequent in aggressive subtypes(10/13,76.9%)than in indolent subtypes(1/5,20.0%)(P=0.047).There were no correlations between tumor necrosis and lesion size and Ann Arbor stage.There was no significant difference in time–intensity curve parameters between normal and elevated lactate dehydrogenase groups.CONCLUSION B-mode US and CEUS findings of intestinal lymphoma are characteristic.We observed a high rate of tumor necrosis,which appeared more frequently in aggressive pathological subtypes of intestinal lymphoma.

A Study on the Temperature Correlation of B-mode Ultrasonic Image Gray for Noninvasive Temperature Monitoring in Hyperthermia

This paper deals with the temperature correlation of gray scale of B-mode ultrasound image from heated tissue. In this study, many in-vitro fresh pig livers are heated in a temperature range from 28 ℃ to 45℃, from which a series of B-mode ultrasonic images of livers were obtained. The gray-value is evaluated from the ultrasound images respectively. A correlation of the mean gray value of the selected regions (12×12 pixels) in B-mode ultrasonic images of liver and its temperature was pointed out. And the experiment results agreed the evaluation well. And it is possible to monitor the tissue temperature changing in hyperthermia using this correlation.

掌上无线超声引导桡动脉穿刺置管的护理配合

目的总结掌上无线超声引导桡动脉穿刺置管的护理配合要点。方法对51例患者采用掌上超声定位桡动脉穿刺置管,护理配合包括患者准备、仪器及耗材等准备,Allen试验评估,穿刺中配合医生摆放穿刺体位、进行桡动脉穿刺配合,穿刺后护理及常见并发症处理等。结果51例均完成置管,其中一次穿刺成功44例(86.28%),1例5次穿刺成功患者出现穿刺处血肿,其余患者未发生感染、血管痉挛、动脉血栓、神经损伤等并发症。结论高效、规范的护理配合可提高掌上无线超声引导桡动脉穿刺置管成功率,减少并发症。

5G便携式远程超声的应用进展

随着网络信息技术的发展和超声仪器性能的改进,便携化、智能化的超声设备在临床诸多领域发挥了重要作用,远程技术的实现使超声诊疗工作摆脱了空间位置的束缚,应用场景的外延得以拓展。本文通过总结便携式远程超声在临床疾病诊断、急危重症抢救、围手术期辅助、军事卫勤保障、学员带教等方面的应用现状,充分体现其“小身材、大功能”的独特优势,并结合目前5G技术高速率、低延迟的特点,对其应用拓展进行展望。

“互联网+创伤急救”区域性可视化院前急救模式的研究

目的 探讨创伤超声重点评估(focused assessment with sonography for trauma, FAST)在区域性院前创伤患者中应用,利用“互联网+创伤急救”建立一个集统筹调度、绿色通道等功能的院前可视化急救模式。方法 自2020年6月起,广州市番禺区在全区范围内采用FAST对院前创伤患者进行创伤评估,开展区域性院前可视化急救,2021年12月完成培训工作。收集2020年6月至2023年6月期间全区创伤急救患者的数据,将2020年6月至2021年12月的患者分为对照组,2022年1月至2023年6月的患者分为实验组。利用“急救绿道”APP、紫云系统以及各医院信息系统收集急诊准备时间、FAST完成时间、术前准备时间、门术时间,以及漏诊、误诊、死亡人数等信息,采用大数据回顾性分析院前可视化急救实施效果。结果 回顾性分析符合标准的804例急诊创伤患者显示,与对照组相比,实验组明显缩短急诊准备时间[(2.23±1.30)min vs.(11.54±4.61)min]、FAST完成时间[(9.08±3.45)min vs.(29.23±5.36)min]、超声检查准备时间[(2.43±0.79)min vs.(11.14±3.29)min]、紧急手术术前准备时间[(21.45±6.73)min vs.(46.15±17.10)min]、门术时间[(40.44±25.20)min vs.(71.40±47.65)min],差异有统计学意义(P<0.05);实验组在信息预警比例(82.9%vs. 63.8%)、直达手术室比率(4.98%vs. 0.01%)高于对照组,差异有统计学意义(P<0.05);实验组在漏诊率(3.9%vs. 13.2%)、误诊率(1.3%vs. 4.9%)、病死率(0.2%vs. 2.6%)、严重创伤患者病死率(0.7%vs. 5.9%)明显低于对照组,差异有统计学意义(P<0.05)。结论 “互联网+创伤急救”区域性院前可视化急救模式缩短FAST完成时间、急诊准备时间和创伤救治时间,降低漏诊率和严重创伤患者病死率,实现创伤性疾病的快速、可视化、高效的诊疗,这种模式显著提高区域性创伤急救水平。

手持式便携超声仪在肥胖产妇硬膜外麻醉中的应用效果

目的探究手持式便携超声仪对肥胖产妇硬膜外麻醉的效果及应激反应因子的影响。方法选择2021年7—10月择期行硬膜外麻醉剖宫产术的肥胖产妇60例。依据随机数字表法分为手持式便携超声仪组(超声组)和触诊组,每组30例。观察手持式便携超声仪测量皮肤至硬膜外腔距离与实际进针深度的相关性;比较2组穿刺情况及患者满意度、麻醉相关评分及产时发热率、应激反应因子水平;记录不同时间点新生儿Apgar评分、麻醉相关并发症及腰椎软组织损伤发生情况。结果触诊组因更换麻醉方式失访1例,最终纳入59例产妇。超声测量皮肤至硬膜外腔距离与实际进针深度具有相关性(r=0.926,P<0.001)。超声组首针穿刺成功率高于触诊组,插针次数及穿刺次数少于触诊组,定位时间长于触诊组,穿刺时间短于触诊组,患者满意度高于触诊组(P<0.05,P<0.01)。超声组硬膜外麻醉效果评分高于触诊组,视觉模拟评分法评分低于触诊组(P<0.05,P<0.01)。分娩后6 h,2组促肾上腺皮质激素、皮质醇、去甲肾上腺素、C反应蛋白均高于麻醉前,但超声组低于触诊组(P<0.05)。2组不同时间点新生儿Apgar评分比较差异无统计学意义(P>0.05)。2组均未发生严重并发症。结论手持式便携超声仪可有效减少肥胖产妇硬膜外麻醉失误、提高硬膜外穿刺准确性和产妇满意度,减少对腰椎软组织的损伤,降低麻醉相关应激反应因子水平。

Pre-Trained Deep Neural Network-Based Computer-Aided Breast Tumor Diagnosis Using ROI Structures

Deep neural network(DNN)based computer-aided breast tumor diagnosis(CABTD)method plays a vital role in the early detection and diagnosis of breast tumors.However,a Brightness mode(B-mode)ultrasound image derives training feature samples that make closer isolation toward the infection part.Hence,it is expensive due to a metaheuristic search of features occupying the global region of interest(ROI)structures of input images.Thus,it may lead to the high computational complexity of the pre-trained DNN-based CABTD method.This paper proposes a novel ensemble pretrained DNN-based CABTD method using global-and local-ROI-structures of B-mode ultrasound images.It conveys the additional consideration of a local-ROI-structures for further enhan-cing the pretrained DNN-based CABTD method’s breast tumor diagnostic performance without degrading its visual quality.The features are extracted at various depths(18,50,and 101)from the global and local ROI structures and feed to support vector machine for better classification.From the experimental results,it has been observed that the combined local and global ROI structure of small depth residual network ResNet18(0.8 in%)has produced significant improve-ment in pixel ratio as compared to ResNet50(0.5 in%)and ResNet101(0.3 in%),respectively.Subsequently,the pretrained DNN-based CABTD methods have been tested by influencing local and global ROI structures to diagnose two specific breast tumors(Benign and Malignant)and improve the diagnostic accuracy(86%)compared to Dense Net,Alex Net,VGG Net,and Google Net.Moreover,it reduces the computational complexity due to the small depth residual network ResNet18,respectively.

Impact of intestinal ultrasound with a portable system in the management of Crohn’s disease

Background:Intestinal ultrasound(IUS)is a valid cross-sectional imaging technique for the evaluation of Crohn’s disease(CD).With advancements in technology,portable ultrasound systems are becoming widely available,and the inevitable change to their use by non-radiologist clinicians would be a valuable contribution to improving patient care.This study aimed to investigate the diagnostic yield of IUS examination performed by a gastroenterologist with a portable system as an adjunct imaging modality in the routine care of CD patients.Methods:A total of 117 CD patients were assessed by IUS imaging.Pre-and post-IUS clinical-management decisions were recorded.The primary outcome was to evaluate the change in the patients’clinical-management decision following the IUS examination.The diagnostic accuracy was compared against the reference decision reached via a multidisiplinary meeting after the evaluation of all patient-related data.The endoscopic disease activity was determined using the simple endoscopic score for Crohn’s disease(SES-CD).Results:The initial clinical-management decision was changed in 47 patients(40.2%)after the IUS examination(P=0.001).The accuracy of patient-management decisions improved from 63.2%to 90.6%in comparison to reference decisions(P<0.001).After IUS examination,a further 13 cases(11.1%)were identified for urgent surgical/interventional procedures.The accuracy of colonoscopic(SES-CD≥3)assessment was shown to be comparable to that of IUS(94%vs 91%).The sensitivity for disease presence was 95%with colonoscopy and 94%with the IUS assessment.Conclusion:IUS examination with the use of a portable ultrasonography system significantly improves clinicalmanagement decisions.With further supporting data,this practice would possibly become a requirement for CD management.

地震后危重多发伤患者野外条件下的救治体会

目的:探讨突发灾难后危重多发伤患者在野外条件下的救治方案。方法和结果:患者女性,53岁,因"地震中骨盆砸伤、大量血尿"入院,呼吸困难,全腹压痛,褥疮。便携式B超示腹腔积液,左胸腔积液,膀胱破裂。便携式血气分析仪提示"严重贫血+低氧血症+低钾+酸中毒"。术前行左胸腔穿刺,膀胱穿刺引流。剖腹探查见直肠破裂(穿孔),遂行Harttman手术加膀胱造瘘术和抗感染治疗。术后第18日基本恢复。结论:术者具有精湛的技术和丰富的经验、充分发挥便携式设备的作用、依靠具有地理优势的当地医院、积极抗感染是艰苦环境下救治危重多发伤患者的成功因素。

便携式高频超声在军事训练急性软组织损伤中的应用研究

目的 :评价便携式高频超声诊断仪在军事训练急性软组织损伤的检出以及伤情判断方面的价值。方法 :选择军事急训期间有临床症状的新兵123例作为研究对象,采用便携式高频超声检查软组织损伤情况,与大型仪器(大型高频超声和MRI)检查结果进行对比,进行检查的一致性分析。结果:便携式超声检查与大型仪器检查相关系数为0.759(P<0.001),一致性检验Kappa值为0.731(P<0.001),二者诊断符合率为91.1%。结论 :便携式高频超声携带方便、操作简单,对于较大范围病变及严重病例具有较好的检出率,可以作为军事训练急性软组织损伤的重要检查工具,在基层部队广泛应用。

床旁彩超在深静脉穿刺置管术中的应用价值

目的评价床旁彩超在深静脉穿刺置管术中的应用价值。方法记录盲穿不成功的33例患者穿刺所用时间及改为床旁彩超引导下穿刺置管所用的时间,记录直接在床旁彩超引导下43例患者穿刺置管所用的时间,分别计算盲穿及彩超引导穿刺成功率、并发症发生率。结果盲穿组中33例患者盲穿耗时长,经过反复多次穿刺均不成功,而改在床旁彩超引导下穿刺置管均一次性成功,彩超引导组43例患者均一次性成功,两组76例患者在床旁彩超引导下穿刺置管耗时短;盲穿组一次性穿刺成功率74.34%,总成功率90.27%,并发症发生率1.47%,彩超引导组一次性穿刺成功率100%,并发症发生率0。结论床旁彩超在深静脉穿刺置管术中用时少,成功率高,并发症少,且搬运方便,应在临床广泛开展应用。

四种穿刺方法建立经皮肾通道行经皮肾镜取石术治疗上尿路结石116例报告

目的 :评价不同穿刺方法建立经皮肾通道的优缺点。方法 :对 116例上尿路结石患者采用不同穿刺方法建立经皮肾通道 ,其中采用C臂X线机定位穿刺 6 5例 ,B超定位穿刺 35例 ,盲穿刺 16例 ,小切口手指引导穿刺 4例。结果 :成功建立通道 112例 ,改行开放手术 4例。结石残留率为 15 .2 %。术后平均住院天数为 6 .5d。结论 :各种定位穿刺方法各有优缺点 ,可根据患者具体情况进行选择。

便携式B超在部队演习保障中的临床应用价值

目的:探讨便携式B超检查在部队演习保障中的应用价值。方法:回顾分析2001年1月至2010年12月部队演习保障中61例患者的超声检查结果、临床手术及保守治疗资料。结果:在61例患者中,经手术治疗19例,与手术相符合18例,符合率为94.74%,保守治疗41例,与临床诊断治疗及随访符合39例,符合率为95.12%,漏诊2例,占3.27%,总符合率为96.73%。结论:便携式B超检查能准确判断病变部位、性质及严重程度能给临床拟定手术方案或保守治疗提供正确合理的诊断依据。因此,便携式B超在部队演习保障中具有重要临床价值。

便携式彩超在贫困地区基层医疗机构配置与利用分析

目的:了解便携式彩超在贫困地区基层医疗机构的配置利用情况,为促进适宜设备在贫困地区的推广使用提供参考。方法:通过问卷调查和深度访谈,对10个贫困县242家基层医疗机构便携式彩超的配置利用情况进行调查分析。结果:调查地区基层医疗机构便携式彩超配置率较低,国产品牌占71.7%,同时在性价比、维保服务、操作便捷性等方面具有优势。结论:便携式彩超在贫困地区基层医疗机构有较大的市场空间。