OBJECTIVES: To construct an intelligent analysis model for classifying fetal orientation during intrapartum ultrasound videos based on multi-feature fusion. METHODS: The proposed model consists of the Input, Backbone Network and Classification Head modules. The Input module carries out data augmentation to improve the sample quality and generalization ability of the model. The Backbone Network was responsible for feature extraction based on Yolov8 combined with CBAM, ECA, PSA attention mechanism and AIFI feature interaction module. The Classification Head consists of a convolutional layer and a softmax function to output the final probability value of each class. The images of the key structures (the eyes, face, head, thalamus, and spine) were annotated with frames by physicians for model training to improve the classification accuracy of the anterior occipital, posterior occipital, and transverse occipital orientations. RESULTS: The experimental results showed that the proposed model had excellent performance in the tire orientation classification task with the classification accuracy reaching 0.984, an area under the PR curve (average accuracy) of 0.993, and area under the ROC curve of 0.984, and a kappa consistency test score of 0.974. The prediction results by the deep learning model were highly consistent with the actual classification results. CONCLUSIONS The multi-feature fusion model proposed in this study can efficiently and accurately classify fetal orientation in intrapartum ultrasound videos.
Humans ; Female ; Ultrasonography, Prenatal/methods* ; Pregnancy ; Fetus/diagnostic imaging* ; Neural Networks, Computer ; Video Recording

Objective:This study examines the application of echocardiography in the prenatal diagnosis of copy number variation (CNV) associated with fetal congenital heart disease (CHD).Methods:A retrospective analysis was conducted on 447 singleton pregnancies from Quanzhou Maternal and Child Care Hospital (Quanzhou Children's Hospital) from January 2019 to August 2022. These individuals underwent echocardiographic assessments suggestive of fetal CHD and subsequently received invasive prenatal diagnoses. Comprehensive karyotype analysis and chromosome microarray analysis (CMA) were performed for each case. The discrepancies in the chromosomal abnormality detection were analyzed between the results produced by CMA and karyotype analysis. Furthermore, differences in the detection of pathogenic copy number variation (pCNV) between the two methods in CHD cases with diverse cardiac phenotypes, including the presence or absence of extracardiac structural malformations, the type, and quantity of cardiac structural anomalies, were explored. Statistical analysis was conducted using the Chi-square test. Results:Compared with conventional karyotype analysis, CMA demonstrated a higher detection rate of fetal chromosomal abnormalities [10.5% (47/447) vs. 20.6% (92/447), χ 2=161.56, P<0.001]. In terms of distinct cardiac phenotypes, CHD cases with extracardiac structural anomalies displayed an escalated pCNV detection rate in comparison to isolated CHD cases [11.4% (45/394) vs. 32.1% (17/53), χ 2=16.68, P<0.001]. Within the cardiac structural anomaly subgroups, increased pCNV detection rates were observed in the septal defect subgroup, conotruncal malformation subgroup, and left ventricular malformation subgroup [18.4%(29/158), 25.9%(7/27), and 25.0%(7/28) vs. 7.6%(16/210); χ 2=9.15, 9.68, and 8.55, respectively, all P<0.05]. The CMA-identified pCNV correlated with CHD included 22q11.2 deletions/duplications in eight cases, 4p16.3 deletions in two cases, 11q23.3 microduplications in two cases, 1q21.1 microdeletions/microduplications in two cases, 4q28.3 microduplications in one case, and 10p15.3 microdeletions in one case. Conclusions:CMA technology exhibited an enhanced ability to detect pCNV in fetuses with CHD. Echocardiography can guide targeted CMA screening, thereby facilitating prenatal genetic assessment of CHD.

Objective:To explore the application value of renal artery resistance index in the diagnosist of intra-abdominal hypertension (IAH) in critically ill patients.Methods:89 patients with risk factors of IAH in the intensive care unit of Zhangzhou Hospital Affiliated to Fujian Medical University from February 2022 to June 2022 were retrospective analyzed. The intra-abdominal pressure (IAP) were measured by bladder, and patients divided into IAH group (IAP≥12 mmHg) and non-IAH group (IAP <12 mmHg). The resistance index (RI) of the right renal aorta, segment artery and interlobar artery were measured by color Doppler ultrasound. The difference between the measurement indicators of patients in the IAH and non-IAH groups and the correlation with IAP were analyzed. As for different indicators to predict the diagnostic efficacy of IAH, ROC curve analysis was used to evaluate the effect. And further multivariate logistic regression analysis was to find independent risk predictor.Results:A total of 89 patients were included in the study, including 44 patients with normal IAP and 45 patients diagnosed IAH. There were significant differences in the right renal aorta, segmental artery and interlobar artery RI (all P<0.01). The interlobar artery RI≥0.698 was the highest diagnostic cut-off,area under the curve was 0.914, sensitivity was 82.2%, specificity was 97.7%, and Jordon index was 0.799. The Spearman correlation analysis of IAP and the ultrasonographic measurements revealed a strong correlation between right renal interlobar artery RI and IAP ( r=0.741, P<0.01). The multivariate logistic regression analysis showed that the right renal interlobar artery RI ( OR= 24.472, 95% CI:5.122~116.919, P<0.01) was an independent risk predictor of IAH ( P<0.01). Conclusion:Right renal interlobar artery RI had better diagnostic efficacy of IAH,renal ultrasound could be used as an alternative, non-invasive technique for the diagnosis and follow-up of IAH.

Objective To observe the value of three-dimensional ultrasound virtual organ computer-aided analysis(VOCAL)technique for measuring choroid plexus volume(CPV)and lateral ventricle volume(LVV)in normal fetus of 11-13+6 gestational weeks.Methods Three-dimensional ultrasonic data of 428 normal singletons at 11-13+6 gestational weeks were retrospectively analyzed.The fetuses were divided into 11-11+6 weeks group(n=77),12-12+6 weeks group(n=225)and 13-13+6 weeks group(n=126).Fetal CPV,LVV and CPV/LVV ratio were measured and calculated using VOCAL technique and compared between groups.Pearson correlation analysis was performed to observe the correlations of CPV,LVV,CPV/LVV ratio with crown-rump length(CRL).Results Significant differences of CPV,LVV and CPV/LVV ratio were found among groups(all P＜0.05).Among 11-11+6 weeks group,12-12+6 weeks group and 13-13+6 weeks group,CPV and LVV increased progressively,while CPV/LVV ratio decreased progressively(all adjusted P＜0.05).During 11-13+6 gestational weeks,CPV and LVV were both highly positively correlated with CRL(r=0.904,0.929,both P＜0.05),while CPV/LVV ratio was highly negatively correlated with CRL(r=-0.893,P＜0.05).Conclusion Three-dimensional ultrasound VOCAL technique was feasible for measuring CPV and LVV in normal fetus of 11-13+6 gestational weeks.

Objective:To analyze the correlation between the muscle thickness (MT) and echo intensity (EI) of the medial head of gastrocnemius and muscle mass, strength and functional parameters, and to evaluate the diagnostic efficacy of MT and EI for decreased muscle mass.Methods:Fifty-two subjects who visited the Department of Ultrasound Medicine of the Second Affiliated Hospital of Fujian Medical University from March to December 2021 were collected.MT of the medial head of gastrocnemius was measured by two-dimensional ultrasound, and EI values in the region of interest were analyzed using Image J software. Twenty of the subjects were selected to assess the intra-observer and inter-observer agreements in measuring MT and EI values using the intraclass correlation coefficient (ICC) and Altman-Bland analysis was performed. The subjects were divided into healthy control group (30 cases) and decreased muscle mass group (22 cases) according to 2019 Asian Sarcopenia Working Group (AWGS) diagnostic criteria, the differences in MT and EI values between the two groups were compared, and the correlation between MT, EI values and muscle mass, strength, function were analyzed using Pearson correlation analysis. The diagnostic cutoff values of MT and EI values for decreased muscle mass were obtained using ROC curves, and the diagnostic efficacy was compared.Results:①The ICC of MT and EI in medial head of gastrocnemius detected by the same physician and different physicians were greater than 0.97, and the retest reliability was good. ②Compared with the healthy control group, the MT value in medial head of gastrocnemius decreased and the EI value increased in the decreased muscle mass group ( t=4.759, -3.789; all P<0.001). ③The MT value in medial head of gastrocnemius was positively correlated with appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), lower limb skeletal muscle mass (LLSM), grip strength, and gait speed ( r=0.579, 0.568, 0.585, 0.495, 0.415; all P<0.001), of which, the correlation with LLSM was the best; ④EI in medial head of gastrocnemius was negatively correlated with ASM and ASMI, LLSM, grip strength, and gait speed, ( r=-0.583, -0.591, -0.590, -0.537, -0.455; all P<0.001), and among which the correlation with ASMI was the best. ⑤The medial head of gastrocnemius MT and EI were 14.33 mm and 58.85 for predicting decreased muscle mass, respectively, and there was no significant difference in the diagnostic performance of the two for decreased muscle mass ( Z=0.734 3, P>0.05). Conclusions:The MT and EI values of the medial head of gastrocnemius can accurately assess muscle mass and can be used in the evaluation of patients with decreased muscle mass.

Artificial Intelligence ; Forecasting ; Humans ; Rare Diseases ; Urinary Bladder Neoplasms/diagnosis*

Objective:To evaluate the value of improved pulmonary ultrasonography in the follow-up assessment of lung damage in patients who recovered from corona virus disease 2019(COVID-19).Methods:Twenty-two patients who were cured of COVID-19 in Quanzhou First Hospital from January to May 2020 were randomly selected and divided into 7 mild cases, 12 moderate cases and 3 severe cases according to the first high-resolution CT (HRCT) at admission. Six months after recovery, modified lung ultrasonography and HRCT were used prospectively to assess the lung damage and evaluate the correlation and consistency between the two techniques.Results:①There were significant differences in lung damage between the mild group and the moderate group, severe group (all P<0.05), while there was no significant difference between the moderate group and severe group ( P>0.05). ②There was good consistency between the improved lung ultrasound examination and HRCT (Kappa=0.776, P<0.001). ③There was a positive correlation between the score of improved pulmonary ultrasound examination and HRCT Warrick score ( r=0.755, P<0.001). Conclusions:Improved pulmonary ultrasonography can be used as a priority in the evaluation of pulmonary damage follow-up in patients with COVID-19 recovery, reducing the use of CT, and providing favorable evidence for further clinical management.

Objective:To explore ultrasonographic diagnostic characteristics of ovarian epithelial tumors and establish prediction models.Methods:The ultrasonographic images of 427 cases from multicenter with ovarian epithelial tumors confirmed by pathology from January 2015 to July 2019 were retrospectively analyzed according to the International Ovarian Tumor Analysis (IOTA). Ultrasonographic signs with distinguishing significance were obtained through univariate analysis and included into multivariate Logistic regression analysis to obtain important ultrasonagraphic indicators for distinguishing borderline, benign and malignant ovarian tumors, and to establish prediction models.Results:The microcystic pattern of papillary projections and solid components was the diagnostic characteristic between borderline and benign, malignant ovarian epithelial tumors( OR value 10.97 and 19.22, respectively). Irregular morphology, septa thickness, solid lesions, rich blood supply and ascites were diagnostic characteristics between benign and malignant tumors, with the irregular morphology having the highest value. Irregular morphology, large papillary, septa thickness and rich blood supply could be used to identify borderline and malignant tumors. At the same time, irregular morphology was the valuable sign to distinguish borderline and benign tumors. In this study, the total coincidence rate of the proposed model was 72.4%, among which the predicted coincidence rate of the borderline model was 57.2%, 78.6% for benign, and 80.7% for malignant. Conclusions:The microcystic pattern of papillary projections and solid components are the specific sonographic characteristics of borderline ovarian tumors. Irregularity, solid lesions, rich blood supply and ascites have important value in differentiating ovarian epithelial tumors. The prediction models of benign, malignant and borderline ovarian tumors in this study have higher diagnostic efficacy.

Objective:To evaluate the diagnostic value of refined transthoracic lung ultrasound(TLUS) scoring method in interstitial lung diseases(ILD).Methods:The TLUS was performed in 39 ILD patients in respiratory department and immunology department of the Second Affiliated Hospital of Fujian Medical University from March 2019 to February 2020. The ultrasonic recordings were evaluated by Buda ultrasound scoring method and refined ultrasound scoring method. The diagnostic efficacies of the refined ultrasound scoring method, Buda ultrasound scoring method and high resolution computed tomography(HRCT) scoring method for ILD were analyzed. The correlations between refined ultrasound score and Buda ultrasound score/HRCT score were evaluated. The difference of diagnostic efficacy between refined ultrasound scoring method and Buda ultrasound scoring method were analyzed in different severity of ILD. Then, the HRCT Warrick scoring method was used as the criterion to judge the severity of ILD, and the receiver operator characteristic (ROC) curve was plotted to predict the cutoff values of the fefined ultrasound score for different degrees of ILD.Results:①The sensitivity of the refined ultrasound scoring method in diagnosing ILD was 92.3%, specificity was 92.3%, area under ROC curve(AUC)=0.978, 95% CI=0.941-1.000. The sensitivity of Buda ultrasound scoring method in diagnosing ILD was 87.2%, specificity was 87.2%, AUC=0.950, 95% CI=0.892-1.000. The sensitivity of HRCT scoring method in diagnosing ILD was 97.4%, specificity was 97.4%, AUC=0.999, 95% CI=0.994-1.000. ②The correlations between the refined ultrasound score, the HRCT Warrick score and the Buda ultrasound score were high ( r=0.929, 0.920, 0.862 respectively, P<0.001). ③The values of refined ultrasound scoring method and Buda ultrasound scoring method consistently and significantly increased with the increasing severity of ILD. With regards to the former one, there were significant differences among mild group, moderate group and severe group ( P<0.05). ④The ROC curve confirmed that refined ultrasound score cut-off points for predicting mild and severe interstitial lung diseases, were 34 [sensitivity of 100%, specificity of 87.5% respectively, AUC=0.891, 95% CI=0.686-1.000] and 64.5 [sensitivity of 91.3%, specificity of 87.5% respectively, AUC=0.954, 95% CI=0.877-1.000]. Conclusions:The severity of the interstitial lung diseases could be evaluated by the refined ultrasound scoring method, which is useful in the semi-quantitative evaluation of ILD.

Objective:To explore the safety and clinical value of ultrasound-guided percutaneous core needle biopsy in the diagnosis of cardiac intermural tumors and pericardial tumors.Methods:Seven patients who underwent ultrasound-guided percutaneous cardiac tumors needle biopsy in Fujian Provincial Hospital from January 2012 to December 2019 were selected for this study. The locations and sizes of the lesions were recorded preoperatively by echocardiography and the operation time was recorded by conventional ultrasonography. The postoperative complications was followed up, and the satisfaction of pathological materials was used as the evaluation standard to comprehensively analyze the safety and clinical application value of ultrasound-guided percutaneous biopsy in the diagnosis of cardiac tumors.Results:Ultrasound-guided percutaneous biopsy was performed successfully in all the 7 cases, 3 of them were intermural tumors and 4 of them were pericardial tumors. Except for 2 patients with diffuse pericardial space, the maximum diameter of the remaining 5 patients was (58.6±23.5)mm. Six cases were punctured from the apex of the heart, and 1 case from the left parasternal through third intercostal space toward the bottom of the heart as the needle pathway. The satisfaction of pathological material was 100%, and the time of procedure was (15.1±3.3)min. There were no postoperative complications such as bleeding, infection or arrhythmia.Conclusions:Ultrasound-guided percutaneous transthoracic needle biopsy is safe and feasible, which provides a simple and easy method for the biopsy of cardiac intramural tumors and pericardial tumors.