Ultrasound clutter and noise improvements applied to echocardiographic left atrial appendage visualization

超声波杂波和噪声改进应用于超声心动图左心耳可视化

• 批准号: 10299361
• 负责人: Brett C Byram
• 金额: $ 64.92万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10299361
• 关键词: Acoustics; Address; Age; Algorithms; American; Atrial Fibrillation; Chronic; Clinical; Code; Consumption; Data; Development; Devices; Diagnosis; Diagnostic; Echocardiography; Electric Countershock; Ensure; Failure; Goals; Gold; Healthcare Systems; Heart; Heart Atrium; Heart Diseases; Image; Incidence; Left; Left atrial structure; Length; Link; Magnetic Resonance Imaging; Measures; Methods; Modality; Modeling; Monitor; Nature; Noise; Patients; Penetration; Performance; Physicians; Play; Procedures; Role; Safety; Scheme; Sensitivity and Specificity; Signal Transduction; Sinus; Source; Speed; Testing; Thrombus; Time; Training; Transesophageal Echocardiography; Ultrasonics; Ultrasonography; United States; Variant; Visualization; Work; appendage; auricular appendage; clinical translation; clinically relevant; cost; deep neural network; flexibility; imaging modality; imaging study; implantable device; improved; in silico; in vivo; innovation; insight; monitoring device; reconstruction; screening; second harmonic; skills; sound; standard of care; success; tool

Summary Ultrasonic imaging is the most widely used advanced imaging modality in the United States, and excluding planar radiography, it represents 44% of all imaging studies. Unfortunately, ultrasound images are often subopti- mal, and some echocardiography studies show degradation in up to 98% of patients. This rate of degradation and the freehand nature of clinical ultrasound means that image quality is more dependent on operator skill than other advanced modalities, but even with the most skilled practitioners, ultrasound completely fails in 11-64% of clinical tasks. Our overall goal for this application is to fundamentally decrease ultrasound failure rates. Low-quality ultrasound is particularly problematic in echocardiography because of its role as a first-line tool for diagnosing and monitoring cardiac disease. When transthoracic echo is inadequate more costly and time-consuming exams like transesophageal echo or MRI are required. To (1) facilitate the high volumes of transthoracic echo, (2) im- prove patient comfort and safety (i.e. reduce transesophageal echo), (3) reduce cost and procedure time, and (4) maximize physician efficiency, it is crucial to have consistently high quality transthoracic echo. To provide this, we introduce new acquisition and reconstruction solutions for ultrasound imaging. Echocardiographic imaging of the left atrial appendage is growing in importance in lockstep with the rising incidence of atrial fibrillation, which currently effects as many as 2-6 million Americans and is expected to grow to 6-12 million by 2050. In patients with atrial fibrillation, thrombus may appear in as many as 12-26% of left atria with most appearing in the appendage. Therefore, in patients with current atrial fibrillation the left atrial appendage must be screened with echocardiography for thrombus before cardioversion can be performed to return the heart to sinus rhythm. Further, patients receiving a left atrial appendage closure device due to chronic atrial fibrillation require annual transesophageal echo follow ups to monitor the device. For both cases, the gold- standard and standard-of-care is transesophageal echocardiography, and while the left atrial appendage can be visualized transthoracically, is is rarely used because the image quality is considered too unreliable. Ultrasound image quality is degraded by both clutter and thermal noise, so to make clinically transforma- tional improvements to ultrasound–and echocardiography specifically–it is necessary to address both the clutter problem and the noise problem. Addressing both of these issues is becoming increasingly important because recent developments in beamforming have focused on non-linear algorithms (including deep networks), and the performance of these methods are more strongly linked to the noise level compared to conventional beamforming methods. To this end, we introduce both a solution enhancing signal-to-noise ratio using coded excitation and a comprehensive solution for clutter reduction using deep network beamforming.

摘要 超声成像是美国使用最广泛的先进成像方式，不包括 平面放射成像，它占所有成像研究的44%。不幸的是，超声图像通常是次优的- MAL和一些超声心动图研究显示，高达98%的患者病情恶化。这个退化的速度和 临床超声的徒手性质意味着图像质量比其他技术更依赖于操作员的技能 先进的方法，但即使有最熟练的医生，超声完全失败的11-%的临床 任务。我们这项应用的总体目标是从根本上降低超声失败率。低质量 超声在超声心动图中尤其成问题，因为它是fi诊断的第一线工具。 以及监测心脏病。当经胸回波不充分时，更昂贵和耗时的检查 如经食道超声或核磁共振检查。为了(1)促进高容量的经胸回声，(2)注射。 证明患者舒适和安全(即减少经食道回声)，(3)减少成本和手术时间，以及(4) 最大限度地提高医生的fi效率，拥有始终如一的高质量经胸回声是至关重要的。为了提供这一点，我们 介绍新的超声成像采集和重建解决方案。 左心耳的超声心动图成像的重要性与日俱增。 房性fi颤动的发生率，目前影响多达200-600万美国人，预计还会增加 到2050年达到600-1200万。在房性fi颤动的患者中，血栓可能出现在多达12%-26%的左侧 Atria，大多数出现在附属物中。因此，在当前心房fi颤动的患者中，左心房 在进行心脏复律之前，必须先用超声心动图筛查附件是否有血栓。 使心脏恢复到窦性心律。此外，由于慢性心绞痛而接受左心耳关闭装置的患者 房性fi颤动需要每年经食道回波随访以监测该设备。在这两种情况下，黄金- 标准和标准护理是经食道超声心动图，而左心耳可以 经胸腔可视化，IS很少使用，因为图像质量被认为太不可靠。 超声图像质量受到杂波和热噪声的双重影响，因此在临床上需要对超声图像进行变换。 对超声的传统改进，特别是超声心动图，有必要解决这两个杂乱的问题 问题和噪音问题。解决这两个问题正变得越来越重要，因为 波束形成的最新发展集中在非线性算法(包括深度网络)上，并且 与传统的波束形成相比，这些方法的性能与噪声水平有更强的联系 方法：研究方法。为此，我们介绍了一种使用编码激励来提高信噪比的解决方案和一种 采用深度网络波束形成的杂波抑制综合解决方案。