计算机辅助定量分析多发性大动脉炎颈动脉病变的超声造影图像

发布时间：2018-05-25 23:27

本文选题：多发性大动脉炎 + 超声造影　；参考：《生物医学工程学杂志》2017年05期

【摘要】：多发性大动脉炎(TA)是一种常发生在主动脉及其主要分支的慢性非特异性炎症疾病。患者往往起病隐匿,导致误诊率高,待确诊时已发生受累动脉狭窄或闭塞,并引发动脉管腔缺血、缺氧症状,重症者将危及生命。超声造影(CEUS)是分析TA的新兴方法,分析手段主要依赖医生的经验进行人工定性分析,因此诊断结果常有失精准。基于此,本文提出一种TA颈动脉病变CEUS的计算机辅助定量分析方法:首先在颈动脉壁上勾勒TA病灶的轮廓,在颈动脉管腔中选取匀质的矩形和多边形各一个作为参考区域;然后分别求出病灶区域与参考区域的时域特征和空域特征,并计算病灶与参考区域间特征的差值和比值,作为新的特征;最后分析所有特征与炎症指标血沉(ESR)和C反应蛋白(CRP)间的相关性。本文选取中山医院就诊的34例TA患者的共37个接受CEUS检查的颈动脉受累病灶,其中2例患者各有治疗前后两个病灶,1例患者有左右双侧病灶;这些患者中有13例为未经治疗的初发患者,共14个病灶,其中1例有左右双侧病灶。结果表明,全体患者的病灶内部1/3区域中新生血管面积比(ARi_(1/3))与CRP的相关系数r值达0.56(P=0.001),初发患者的病灶内部1/2区域中新生血管面积比(ARi_(1/2))与CRP的r值达0.76(P=0.001)。本文研究说明,所提出的计算机辅助方法能从CEUS图像中客观、半自动地提取TA病变的定量特征,减轻医生主观经验对诊断的影响,今后有望用于临床上TA颈动脉病变的诊断判别与严重程度评估。
[Abstract]:Takayasu arteritis (TAA) is a chronic nonspecific inflammatory disease that often occurs in the aorta and its main branches. Patients often start to hide, leading to a high rate of misdiagnosis, to be diagnosed has occurred when the involved artery stenosis or occlusion, and lead to arterial ischemia, anoxic symptoms, serious will endanger life. Contrast-enhanced echocardiography (CEUSS) is a new method of TA analysis, which mainly relies on the experience of doctors for artificial qualitative analysis, so the diagnostic results are often inaccurate. In this paper, a computer-aided quantitative analysis method for TA carotid lesions is proposed. Firstly, the outline of TA lesions is drawn on the carotid artery wall, and one uniform rectangle and one polygon are selected as the reference regions in the carotid artery lumen. Then, the temporal and spatial characteristics of the focus region and the reference region are calculated respectively, and the difference and ratio between the focus and reference region are calculated as new features. Finally, the correlation between ESR and CRP was analyzed. A total of 37 carotid artery lesions were examined by CEUS in 34 TA patients in Zhongshan Hospital, 2 of whom had two lesions before and after treatment, and one patient had bilateral lesions. Of these patients, 13 cases were untreated primary patients with 14 lesions, including 1 case with bilateral lesions. The results showed that the correlation coefficient between the area of neovascularization and CRP in 1 / 3 region of all patients was 0.56 ~ 0. 001g / CRP, and the ratio of neovascularization area in 1 / 2 / 2 region of primary lesion was 0. 76P0. 001 ~ (-1 / 2) and 0. 76P0. 001 ~ (1 / 2) respectively. The results show that the proposed computer-aided method can extract the quantitative features of TA lesions objectively and semi-automatically from CEUS images, and reduce the influence of the subjective experience of doctors on the diagnosis. It is expected to be used to diagnose and evaluate the severity of TA carotid artery disease.
【作者单位】：上海大学通信与信息工程学院;复旦大学附属中山医院超声科;
【基金】：国家自然科学基金面上项目(61671281);国家自然科学基金青年科学基金项目(61401267)
【分类号】：R445.1;R543.5;TP391.41

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