Telediagnosis system for congenital heart disease in a Japanese prefecture.
Telediagnosis system for congenital heart disease in a Japanese prefecture.
复制标题
日本某县先天性心脏病远程诊断系统。
DOI：
10.1007/s10396-020-01020-y
复制
发表时间：
2020
期刊：
影响因子：
1.8
通讯作者：
Kitawaki J. Telediagnosis system for congenital heart disease in a Japanese prefecture.
中科院分区：
文献类型：
--
作者：
Mabuchi A;Waratani M;Tanaka Y;Mori T;Kitawaki J. Telediagnosis system for congenital heart disease in a Japanese prefecture.
目的本研究旨在评估日本某县三级转诊单位9年期间使用基于时空图像相关的远程诊断系统进行产前诊断的准确性，并调查分娩医院选择的有效性。方法本研究回顾性分析了6家地理位置偏远的医院2009年至2018年的远程诊断病例。我们建立了一个远程诊断系统，称为京都胎儿超声远程诊断系统（K-FUTS）。这些转诊医院的三维超声图像通过光纤网络系统转发到京都府立医科大学（KPUM）医院进行分析。主要终点是产前诊断的准确性。使用 K-FUTS 识别出需要立即进行产后治疗的严重先天性心脏病 (CHD) 病例。然后对这些病例进行检查，以确定它们是否在适当的医院分娩。结果在研究期间，182 例病例的数据集被转移到 KPUM 医院。由于数据不可用或图像质量差，二十一个数据集被排除。 14.9% 的病例检出先心病 (24/161)；产前诊断准确率为95.0%（153/161）。 K-FUTS 发现了 7 例患有先心病的严重病例，需要立即进行产后手术或药物治疗。这些病例是在 KPUM 医院分娩的，有一名儿科医生在场。其余17例适合在转诊医院分娩的病例均在转诊医院分娩，出生后无需立即干预。结论我们的远程诊断系统有助于对距离三级医院较远的患者进行先心病产前诊断和妊娠管理。
PurposeThis study aimed to evaluate the accuracy of prenatal diagnosis using a spatio-temporal image correlation-based telediagnosis system at a tertiary referral unit in a Japanese prefecture over a 9-year period, and to investigate the validity of delivery hospital selection.MethodsThis study retrospectively analyzed telediagnosis cases from 2009 to 2018 in six geographically remote hospitals. We built a telediagnosis system called the Kyoto Fetal Ultrasonographic Telediagnosis System (K-FUTS). Three-dimensional ultrasonographic images from these referral hospitals were forwarded to the Kyoto Prefectural University of Medicine (KPUM) Hospital through an optical fiber network system for analysis. The primary endpoint was accuracy of prenatal diagnosis. Cases with severe congenital heart disease (CHD) that required immediate postnatal treatment were identified using the K-FUTS. These cases were then examined to determine whether they were delivered at appropriate hospitals.ResultsDuring the study period, datasets from 182 cases were transferred to KPUM Hospital. Twenty-one datasets were excluded because of data unavailability or poor image quality. CHD was detected in 14.9% of cases (24/161); the accuracy of prenatal diagnosis was 95.0% (153/161). The K-FUTS identified seven severe cases with CHD requiring immediate postnatal surgical or medical treatment. These cases were delivered at KPUM Hospital with a pediatrician present. The remaining 17 cases considered suitable for delivery at the referral hospitals were delivered there, and they did not require intervention immediately after birth.ConclusionOur telediagnosis system contributed to the prenatal diagnosis of CHD and management of pregnancies in patients who were geographically remote from a tertiary hospital.