Accuracy of electromyometrial imaging of uterine contractions in clinical environment
Accuracy of electromyometrial imaging of uterine contractions in clinical environment
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DOI：
10.1016/j.compbiomed.2019.103543
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发表时间：
2020-01-01
影响因子：
7.7
通讯作者：
Wang, Yong
中科院分区：
文献类型：
--
作者：
Wang, Hui;Wu, Wenjie;Wang, Yong
在临床上，子宫收缩是通过产力计或宫腔内压导管监测的。在研究环境中，肌电(EMG)从腹部的几个电极检测子宫的电活动是可行的，可以提供比这些其他方法更准确的数据，并可能有助于预测早产。然而，肌电图缺乏足够的空间分辨率和覆盖率来揭示子宫收缩的起源、如何传播，以及早产和不早产的妇女之间是否存在差异。为了解决这些局限性，最近开发并验证了子宫肌电成像(EMMI)，以非侵入性地评估怀孕绵羊整个子宫表面的三维(3D)电激活模式。EMMI使用磁共振成像来获得特定于受试者的身体-子宫几何形状，并从人体表面多达256个电极收集子宫肌电数据。然后，EMMI软件解决了不适定的逆计算，将两个数据集结合在一起，生成了整个3D子宫表面上的电活动地图。在这里，我们通过在临床环境中不可避免的几何变化和电子噪声污染下评估EMMI的准确性来评估临床翻译EMMI的可行性。我们开发了一个混合实验-模拟平台来模拟胎儿踢腿、宫缩、胎儿/母亲的运动以及由母亲呼吸和环境电活动引起的噪声污染的影响。我们的数据表明，在存在几何变形和电噪声的情况下，EMMI可以准确地成像子宫电活动，这表明EMMI可以可靠地转换为孕妇3D子宫电激活的非侵入性成像。
Clinically, uterine contractions are monitored with tocodynamometers or intrauterine pressure catheters. In the research setting, electromyography (EMG), which detects electrical activity of the uterus from a few electrodes on the abdomen, is feasible, can provide more accurate data than these other methods, and may be useful for predicting preterm birth. However, EMG lacks sufficient spatial resolution and coverage to reveal where uterine contractions originate, how they propagate, and whether preterm contractions differ between women who do and do not progress to preterm delivery. To address those limitations, electromyometrial imaging (EMMI) was recently developed and validated to non-invasively assess three-dimensional (3D) electrical activation patterns on the entire uterine surface in pregnant sheep. EMMI uses magnetic resonance imaging to obtain subject-specific body-uterus geometry and collects uterine EMG data from up to 256 electrodes on the body surface. EMMI software then solves an ill-posed inverse computation to combine the two datasets and generate maps of electrical activity on the entire 3D uterine surface. Here, we assessed the feasibility to clinically translate EMMI by evaluating EMMI's accuracy under the unavoidable geometrical alterations and electrical noise contamination in a clinical environment. We developed a hybrid experimental-simulation platform to model the effects of fetal kicks, contractions, fetal/maternal movements, and noise contamination caused by maternal respiration and environmental electrical activity. Our data indicate that EMMI can accurately image uterine electrical activity in the presence of geometrical deformations and electrical noise, suggesting that EMMI can be reliably translated to non-invasively image 3D uterine electrical activation in pregnant women.