TWI773472B - Array measuring method and interpretation device for ultrasonic detection of middle ear effusion - Google Patents
Array measuring method and interpretation device for ultrasonic detection of middle ear effusion Download PDFInfo
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本發明係關於一種超音波偵測中耳積水之陣列式測量與判讀裝置與方法，尤其是一種以單陣元超音波探頭為基礎，結合複數個陣列測量區域的機率密度函數參數的超音波偵測中耳積水之陣列式測量與判讀裝置與方法。The present invention relates to an array type measurement and interpretation device and method for ultrasonic detection of middle ear hydrops, in particular to an ultrasonic detection method based on a single-array element ultrasonic probe and combining the probability density function parameters of a plurality of array measurement areas. Array measurement and interpretation device and method for measuring middle ear hydrops.
中耳炎是一種常見於孩童的疾病，為目前最常使用抗生素的疾病，也是造成孩童需進行手術的主要原因之一，而中耳炎併發中耳積水的機率高且不是察覺，又中耳積水若不進行治療會導致諸多併發症的發生，是造成聽力損失的潛在殺手，因此診斷中耳積水在臨床上有重要的價值。Otitis media is a common disease in children. It is the most common disease for which antibiotics are currently used. It is also one of the main reasons for children to need surgery. Otitis media is complicated by a high probability of middle ear effusion and is not detected. Treatment can lead to many complications and is a potential killer of hearing loss. Therefore, the diagnosis of middle ear effusion has important clinical value.
在臨床上，耳鏡是中耳積水最基礎且直接的檢查方式，主要透過檢視耳膜的外觀或輔以吹氣來觀察耳膜的振動，以判別中耳是否有積液，但診斷需高度依賴醫師的經驗，容易落入主觀判斷。鼓室圖則是另一種常用於評估中耳積水的方法，類似對耳膜吹氣，並在期間測量耳膜對壓力改變之歷程中的運動，但需要患者配合對其耳道封密加壓進行測試，常常因為孩童害怕或哭鬧，且較難溝通，影響耳塞與耳道密合程度，施測時間亦較難掌握。Clinically, otoscopy is the most basic and direct way to check for middle ear hydrops. It mainly checks the appearance of the eardrum or the vibration of the eardrum supplemented by blowing air to determine whether there is fluid in the middle ear. However, the diagnosis is highly dependent on the doctor. experience, it is easy to fall into subjective judgment. Tympanometry is another method commonly used to assess middle ear hydrops. It is similar to blowing air into the eardrum and measures the movement of the eardrum during the process of pressure changes, but requires the patient to cooperate with the pressure test of the ear canal seal. Often because children are afraid or cry, and it is difficult to communicate, it affects the tightness of the earplugs and the ear canal, and it is difficult to grasp the timing of the test.
而電腦斷層掃描(computer tomography)以及核磁共振成像(nuclear magnetic resonance imaging)等醫學影像系統是目前主要偵測中耳積水狀況的標準方法，然而電腦斷層掃描有產生輻射的疑慮，且上述兩種方法所需的測量時間較長，加上測量環境較為密閉，對於中耳炎病者，尤其是小孩來說，容易產生抗拒的反應；此外，電腦斷層掃描以及核磁共振成像還受限於裝置的體績，更有使用時間以及地點的限制。相較於現有的影像系統，超音波則提供一種非侵入式、無輻射、適用於任何地點與任何時間，且可用於評估手術前後中耳積水之判讀。Medical imaging systems such as computer tomography and nuclear magnetic resonance imaging are currently the main standard methods to detect middle ear hydrops. However, computer tomography has concerns about radiation, and the above two methods The measurement time required is relatively long, and the measurement environment is relatively closed. For patients with otitis media, especially children, it is easy to produce resistance reactions; in addition, computed tomography and magnetic resonance imaging are also limited by the physical performance of the device. There are more restrictions on the time and place of use. Compared with the existing imaging system, ultrasound provides a non-invasive, non-radiation, suitable for any place and any time, and can be used to evaluate the interpretation of middle ear hydrops before and after surgery.
目前美國專利公開第US7131946號以及US20100069752號已揭露使用超音波探頭伸入耳道以偵測中耳積水，但該測量方法仍屬於侵入性，尤其不適合用於偵測孩童的中耳積水；而中華民國專利第1549657號揭露使用超音波探頭條貼於使用者耳朵後方對應乳突的位置，以作為音窗來進行非侵入式的量測，並依據超音波回音訊號的統計特性，判斷受檢者的中耳積水狀況，此種技術雖然克服先前超音波探頭必須申入耳道才能評估中耳積水的困境，但是由於乳突區域大，在無法精準掌握測量位置的情況下，會因為測量位置的不確定性，造成偵測結果的失準。At present, US Patent Publication Nos. US7131946 and US20100069752 have disclosed the use of ultrasonic probes to be inserted into the ear canal to detect middle ear effusion, but this measurement method is still invasive and is especially not suitable for detecting middle ear effusion in children; Republic of China Patent No. 1549657 discloses the use of an ultrasonic probe bar attached to the back of the user's ear at the position corresponding to the mastoid, as a sound window for non-invasive measurement, and based on the statistical characteristics of the ultrasonic echo signal to determine the subject Although this technique overcomes the previous dilemma that the ultrasonic probe must be inserted into the ear canal to evaluate the middle ear hydrops, but due to the large mastoid area, if the measurement position cannot be accurately grasped, the measurement position will Deterministic, resulting in inaccurate detection results.
綜上所述，相較於現有影像系統，研發一種非侵入式、無輻射疑慮、適用於任何地點與任何時間，且可精準地評估中耳積水程度及狀況的方法與判讀裝置，著實有其必要性。To sum up, compared with the existing imaging systems, it is indeed necessary to develop a method and interpretation device that is non-invasive, has no radiation concerns, is applicable to any place and any time, and can accurately assess the degree and condition of middle ear hydrops. necessity.
緣此，本發明之一目的在提供一種超音波偵測中耳積水狀況之陣列式測量與判讀裝置，包含：一超音波探頭，係貼於一使用者之耳朵後方的乳突表面並發送一超音波，其中該乳突表面分隔成複數個陣列式測量區域，並依據該使用者的中耳積水狀況，於各陣列式測量區域分別產生一超音波回音訊號；一超音波發射接收器，係與該超音波探頭連接，並接收各陣列式測量區域的該些超音波回音訊號；一類比數位轉換器，係與該超音波發射接收器連接，並將該些超音波回音訊號分別轉換為一數位訊號；以及一分析單元，係與該類比數位轉換器連接，其中根據該些數位訊號計算出各陣列式測量區域的一機率密度函數(probability density)參數，再使用預訓練模型找出分別對應於各陣列式測量區域之機率密度函數參數的一重要性權重，並將各陣列式測量區域的該機率密度函數參數與所對應的該重要性權重相乘後加總，以產生一經加權的機率密度函數參數，用於量化該使用者之中耳積水程度，據以判讀該使用者之中耳疾病的狀況。Therefore, an object of the present invention is to provide an array measurement and interpretation device for ultrasonic detection of middle ear hydrops, comprising: an ultrasonic probe, which is attached to the mastoid surface behind a user's ear and transmits an ultrasonic probe. Ultrasound, wherein the mastoid surface is divided into a plurality of array measurement areas, and according to the user's middle ear hydrops, an ultrasonic echo signal is respectively generated in each array measurement area; an ultrasonic transmitter receiver is Connect with the ultrasonic probe, and receive the ultrasonic echo signals in each array measurement area; an analog-to-digital converter is connected with the ultrasonic transmitter and receiver, and converts the ultrasonic echo signals into a digital signals; and an analysis unit connected to the analog-to-digital converter, wherein a probability density function (probability density) parameter of each array measurement area is calculated according to the digital signals, and then a pre-training model is used to find out the corresponding an importance weight of the probability density function parameter of each arrayed measurement area, and the probability density function parameter of each arrayed measurement area is multiplied by the corresponding importance weight and summed to generate a weighted probability The density function parameter is used to quantify the degree of middle ear water accumulation of the user, so as to judge the condition of the middle ear disease of the user.
在本發明之一實施例中，該超音波探頭係為一低頻率延遲探頭。In one embodiment of the present invention, the ultrasonic probe is a low frequency delay probe.
在本發明又一實施例中，該分析單元係為一個人電腦。In yet another embodiment of the present invention, the analysis unit is a personal computer.
本發明之又一目的係提供一種超音波偵測中耳積水狀況的陣列式測量與判讀方法，包含以下步驟：將一超音波探頭貼於一使用者之耳朵後方的乳突表面並發送一超音波，其中將該乳突表面分隔成複數個陣列式測量區域，並依據該使用者的中耳積水狀況，於各陣列式測量區域分別產生一超音波回音訊號，並以一超音波發射接收器接收各陣列式測量區域的該些超音波回音訊號；將該些超音波回音訊號，以一類比數為轉換器分別轉換為相應的一數位訊號；以及依據該些數位訊號，以一分析單元計算出各陣列式測量區域的一機率密度函數參數，並使用預訓練模型找出分別對應各陣列式測量區域之機率密度函數參數的一重要性權重，再將各陣列式測量區域的該機率密度函數參數與所對應的該重要性權重相乘後加總，以產生一經加權的機率密度函數參數，用於量化該使用者之中耳積水程度，據以判讀該使用者之中耳疾病的狀況。Another object of the present invention is to provide an array measurement and interpretation method for ultrasonic detection of middle ear hydrops, comprising the following steps: attaching an ultrasonic probe to the mastoid surface behind a user's ear and sending an ultrasonic Sonic wave, wherein the mastoid surface is divided into a plurality of array measurement areas, and according to the user's middle ear effusion condition, an ultrasonic echo signal is generated in each array measurement area, and an ultrasonic transmitter receiver is used Receive the ultrasonic echo signals of each array measurement area; convert the ultrasonic echo signals into corresponding digital signals with an analog digital converter; and calculate with an analysis unit according to the digital signals Obtain a probability density function parameter of each array measurement area, and use the pre-training model to find an importance weight corresponding to the probability density function parameter of each array measurement area, and then calculate the probability density function of each array measurement area. The parameter and the corresponding importance weight are multiplied and added together to generate a weighted probability density function parameter, which is used to quantify the degree of middle ear hydrops of the user, so as to judge the condition of the middle ear disease of the user.
在本發明之一實施例中，對應於各陣列式測量區域之機率密度函數參數的重要性權重係使用線性判別分析 (Linear discriminant analysis, LDA)進行預訓練模型所找出。In an embodiment of the present invention, the importance weights of the probability density function parameters corresponding to each arrayed measurement area are found by using linear discriminant analysis (LDA) to perform a pre-training model.
在本發明之一實施例中，該乳突表面分割成12個陣列式測量區域。In one embodiment of the present invention, the mastoid surface is divided into 12 arrayed measurement areas.
在本發明之一實施例中，該超音波偵測中耳積水之陣列式測量與判讀方法係提升判斷該使用者中耳積水嚴重程度的準確性。In one embodiment of the present invention, the array-based measurement and interpretation method for ultrasonic detection of middle ear hydrops improves the accuracy of judging the severity of the user's middle ear hydrops.
在本發明之一實施例中，該超音波偵測中耳積水之陣列式測量與判讀方法係提升判斷該使用者中耳積水之積液性質的準確性。In one embodiment of the present invention, the array-based measurement and interpretation method for ultrasonic detection of middle ear hydrops improves the accuracy of judging the fluid nature of the user's middle ear hydrops.
在本發明另一實施例中，該中耳疾病包含各式性中耳炎、中耳積水、乳突積水、乳突炎以及耳管植入前後追蹤。In another embodiment of the present invention, the middle ear disease includes various types of otitis media, middle ear hydrops, mastoid hydrops, mastoiditis, and tracking before and after ear tube implantation.
因此，本發明超音波偵測中耳積水之陣列式測量與判讀裝置及方法，藉由單陣元的超音波探頭，以受測者耳朵後方的乳突表面作為音窗並發送超音波訊號，再接收並分析根據該受測者之中耳積水狀況所回傳的超音波回音訊號，以進行非侵入式的測量；其中，由於乳突處的區域大，且未有相關先前技術揭露可以反應最佳測量結果的偵測位置，因此在無法精準掌握測量位置的情況下，會因為測量位置的不確定性，造成結果失準。Therefore, the array type measuring and interpreting device and method for ultrasonic detection of middle ear hydrops of the present invention uses the single-array ultrasonic probe to use the surface of the mastoid behind the subject's ear as a sound window and transmit ultrasonic signals, Then receive and analyze the ultrasonic echo signal returned according to the condition of the subject's middle ear effusion to perform a non-invasive measurement; among which, because the area at the mastoid is large, and there is no relevant prior art disclosure to respond The detection position of the best measurement result, so if the measurement position cannot be accurately grasped, the result will be inaccurate due to the uncertainty of the measurement position.
據此，在本發明中，為了優化整體資訊的運算及分析方式，並整合至原始操作介面中，以達到方便操作且快速分類中耳積水的狀況與性質，來提高以超音波為基礎之非侵入式量測方法及其裝置的精準性及預期性，而進一步將受測者的乳突處表面分隔成複數個陣列式的測量區域，並分別獲取各陣列式測量區域的超音波回音訊號，再分別計算其機率密度函數參數後，於分析單元中搭配資料分析軟體，並使用以機器學習為基礎的線性判別分析進行預訓練，找出各分隔之測量區域於判斷中耳積水狀況的重要性權重，並將各測量區域的機率密度函數參數經加權後，以所得的新參數相較於使用單一參數而言，不僅可以維持良好之判斷患者是否發生中耳積水的能力，更可以用於判斷患者中耳積水的嚴重程度，且還能有效改善判斷患者中耳積水之積液性質(即漿液性或黏液性)的能力。Accordingly, in the present invention, in order to optimize the calculation and analysis method of the overall information, and integrate it into the original operation interface, in order to achieve convenient operation and rapid classification of the condition and nature of middle ear effusion, to improve the ultrasonic-based non-invasive The accuracy and predictability of the invasive measurement method and its device are further divided into a plurality of array-type measurement areas on the surface of the subject's mastoid, and the ultrasonic echo signals of each array-type measurement area are obtained respectively, After calculating the probability density function parameters respectively, the data analysis software is matched in the analysis unit, and the linear discriminant analysis based on machine learning is used for pre-training to find out the importance of each separated measurement area in judging the condition of middle ear effusion. After weighting the probability density function parameters of each measurement area, the new parameters obtained can not only maintain a good ability to judge whether a patient has middle ear hydrops, but also can be used to judge whether a patient has middle ear hydrops. The severity of the patient's middle ear effusion, and it can also effectively improve the ability to judge the nature of the patient's middle ear effusion (ie, serous or mucous).
綜上所述，本發明超音波偵測中耳積水之陣列式測量與判讀裝置及方法能夠改善先前技術既有的缺點，具有非侵入性、無輻射、適用於任何地點與時間等優點，尤其適合用於測量孩童的中耳積水狀況，且若使用本發明重覆於手術前後測量使用者之中耳積水狀況，則可用於評估手術前後之中耳積水是否有清除，最重要的是，本發明數據分析的方式還能夠減少因主觀判定導致的不確定性，使中耳積水的診斷更加快速、操作更方便，且檢測結果更加地準確。To sum up, the array type measuring and interpreting device and method for ultrasonic detection of middle ear hydrops of the present invention can improve the existing shortcomings of the prior art, and has the advantages of non-invasiveness, no radiation, suitable for any place and time, etc., especially It is suitable for measuring the condition of middle ear effusion in children, and if the present invention is used to measure the user's middle ear effusion before and after surgery repeatedly, it can be used to evaluate whether the middle ear effusion has been cleared before and after surgery. The inventive method of data analysis can also reduce the uncertainty caused by subjective judgment, so that the diagnosis of middle ear hydrops is faster, the operation is more convenient, and the detection results are more accurate.
以下將進一步說明本發明的實施方式，下述所列舉的實施例係用以闡明本發明，並非用以限定本發明之範圍，任何熟習此技藝者，在不脫離本發明之精神和範圍內，當可做些許更動與潤飾，因此本發明之保護範圍當視後附之申請專利範圍所界定者為準。The embodiments of the present invention will be further described below. The following examples are used to illustrate the present invention, but not to limit the scope of the present invention. Anyone who is familiar with this technique, without departing from the spirit and scope of the present invention, Some changes and modifications can be made, so the protection scope of the present invention should be determined by the scope of the appended patent application.
依據本發明有關超音波探測與接收的操作程序與參數條件等，包含超音波探頭及超音波發射接收器，是落在熟習此項技術之人士的專業素養與例行技術範疇內。The operating procedures and parameter conditions related to ultrasonic detection and reception according to the present invention, including ultrasonic probes and ultrasonic transmitter receivers, fall within the professional quality and routine technical scope of those who are familiar with this technology.
依據本發明有關類比數位轉換器的操作程序與參數條件等是落在熟習此項技術之人士的專業素養與例行技術範疇內。The operating procedures and parameter conditions of the analog-to-digital converter according to the present invention fall within the professional quality and routine technical scope of those who are familiar with the technology.
請參見圖1A，係為本發明超音波偵測中耳積水之陣列式測量與判讀裝置1的組成元件示意圖；本發明超音波偵測中耳積水之陣列式測量與判讀裝置1包含：一超音波探頭11、一超音波發射接收器12、一類比數位轉換器13、以及一分析單元14；其中，該超音波探頭11與該超音波發射接收器12連接，而該超音波發射接收器12與該類比數位轉換器13連接，且該該類比數位轉換器13與該分析單元14連接。Please refer to FIG. 1A , which is a schematic diagram of the components of the array-type measuring and interpreting
本發明超音波偵測中耳積水之陣列式測量與判讀裝置1的使用方法如下：首先，將該超音波探頭11貼於一使用者之耳朵後方乳突處的表面，以向作為音窗的乳突表面發送一超音波，並根據該使用者的中耳積水狀況，產生相對應的超音波回音訊號以進行非侵入式的測量，而由於乳突區域較大，容易因測量位置不固定而導致結果失真，因此為了提高訊號測量與判讀的準確性，在本發明超音波偵測中耳積水之陣列式測量與判讀裝置1中，會先將該使用者的乳突表面定義成複數個陣列式測量區域，綜合考量該超音波探頭11的大小與該使用者乳突的大小，本領域熟悉技藝者可以調整陣列式測量區域的數量，而如圖1B所示，最佳為定義成12個陣列式測量區域，並針對各陣列式測量區域分別產生一超音波回音訊號；接著，再使用該超音波發射接收器12接收所有的超音波回音訊號，並透過該類比數位轉換器13將該些超音波回音訊號分別轉換成相對應的一數位訊號，再將各陣列式測量區域的該些數位訊號傳送至該分析單元14，以進一步的分析與計算該些數位訊號。The method of using the array type measuring and interpreting
在本發明超音波偵測中耳積水之陣列式測量與判讀裝置1的分析單元14中，會根據該些數位訊號計算出各陣列式測量區域的一機率密度函數(probability density)參數(或稱不同階數的統計動差值)，且該分析單元14會依據各陣列式測量區域的數位訊號及其機率密度函數，使用以機器學習為基礎的線性判別分析 (Linear discriminant analysis, LDA) (或稱費雪線性判別，Fisher Linear Discriminant)進行預訓練，以找出各陣列式測量區域之機率密度函數參數(不同階數的統計動差值)分別所對應的重要性權重，接著將各陣列式測量區域的機率密度函數參數分別與所對應的重要性權重相乘後再全部加總起來，即可獲得一經加權的機率密度函數參數，而各陣列式測量區域之機率密度函數參數係透過Nakagami參數進行量化，因此當機率密度函數參數的數值越高時，就表示該使用者的情況越接近所欲偵測的中耳積水狀況 (包含：中耳是否積水、中耳積水的嚴重程度、以及中耳積水的積液性質，將於後續進行詳細的描述)，而在組合重要性權重後，該經加權的機率密度函數參數也同樣依循此判斷標準，故藉由該經加權的機率密度函數參數可精準地量化該使用者的中耳積水狀況，而可據以判讀該使用者之中耳疾病的狀況。In the
在本發明之一較佳實施例中，該分析單元14係為個人電腦。且根據本發明，該分析單元14可以搭配一般市面流通的資料分析軟體，例如：MATLAB，並提供機率密度函數與重要性權重等數值的計算之功能。In a preferred embodiment of the present invention, the
在本發明之一較佳實施例中，該超音波探頭11係為低頻率延遲探頭，因此可分離量測訊號以及脈衝激勵訊號(excitation pulse)，而增加量測訊號與機率密度函數分析的準確度。In a preferred embodiment of the present invention, the
接著，為測試本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置，確實能夠有效提升測量與判讀中耳積水狀況的精準度，分別進行以下三個實驗組測試：(1) 中耳是否積水：分別於正常人 (即未有中耳積水者)、中耳積水患者、以及經耳管手術後三個月患者 (亦為中耳積水患者)，使用本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置；(2) 中耳積水的嚴重程度：分別於輕中度中耳積水患者、以及重度中耳積水患者，使用本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置；以及(3) 中耳積水的積液性質：分別於漿液性中耳積水患者、以及黏液性中耳積水患者，使用本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置；其中，本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置，會針對中耳是否積水、中耳積水的嚴重程度、以及中耳積水的積液性質三種不同偵測目的，而將該三者所分別對應之各陣列式測量區域的數位訊號及其機率密度函數，各自以機器學習為基礎的線性判別分析進行預訓練，以找出此三種不同偵測目的中，各自所對應之各陣列式測量區域之機率密度函數參數分別所對應的重要性權重，再計算其各自之經加權的機率密度函數參數。Next, in order to test the method and device of the array type measurement and interpretation of ultrasonic detection of middle ear effusion of the present invention, which can effectively improve the accuracy of measuring and interpreting the condition of middle ear effusion, the following three experimental group tests were carried out respectively: (1 ) Whether the middle ear is stagnant: in normal people (that is, those who do not have middle ear effusion), patients with middle ear effusion, and patients three months after ear tube surgery (also middle ear effusion patients), use ultrasonic detection of the present invention. Array type measurement and interpretation method and device for measuring middle ear effusion; (2) Severity of middle ear effusion: in patients with mild to moderate middle ear effusion and patients with severe middle ear effusion, the ultrasonic detection method of the present invention is used. Method and device for array measurement and interpretation of hydrocephalus; and (3) the nature of the hydrops in the middle ear: respectively in patients with serous middle ear and mucous middle ear, using the ultrasonic detection method of the present invention Method and device for array type measurement and interpretation of hydrocephalus; wherein, the method and device for array type measurement and interpretation of middle ear hydrocephalus by ultrasonic detection of the present invention will be directed to whether or not the middle ear is hydrops, the severity of middle ear hydrops, and There are three different detection purposes for the effusion properties of middle ear hydrops, and the digital signals and their probability density functions of each array measurement area corresponding to the three are pre-trained by machine learning-based linear discriminant analysis. In order to find out the importance weights corresponding to the probability density function parameters of the respective array measurement areas corresponding to the three different detection purposes, and then calculate their respective weighted probability density function parameters.
此外，在該三個實驗組中，對照組皆為未將乳突處的表面分隔成複數個陣列式測量區域，對相同族群進行測試，即僅使用單一機率密度函數參數進行中耳積水狀況的測量與判讀。In addition, in the three experimental groups, the control group did not divide the surface of the mastoid into a plurality of array measurement areas, and the same population was tested, that is, only a single probability density function parameter was used to measure the condition of middle ear hydrops. Measurement and interpretation.
在得到測試結果後，將各實驗組別分別以統計軟體(例如：sigmaplot)繪製接收者操作特徵曲線 (receiver operating characteristic curve, ROC，以下稱為ROC曲線)以進行分析，並比較各實驗組與對照組的ROC曲線下方面積 (Area under the Curve of ROC, AUROC)，以評估本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置的準確度；其中，ROC曲線常用於分析一檢測方法的準確度，其為一種二元分析模型，即輸出結果只有二種類別的模型，例如在實驗組(1)為有中耳積水或無中耳積水，在實驗組(2)為輕中度或重度的中耳積水，以及在實驗組(3)為漿液性或黏液性中耳積水，並設定一閾值以分別該二種結果類別，再將各實驗組之經加權的機率密度函數參數、或是將各對照組之單一機率密度函數參數各自帶入，以判斷其各自的真第一類別性、偽第一類別性、真第二類別性、及偽第二類別性，並繪製出ROC曲線，而ROC曲線下方面積 (Area under the Curve of ROC, AUROC)越接近1則表示帶入ROC曲線進行分析的檢測方法準確性越高；其中，在本發明實施例中，針對中耳是否積水、中耳積水的嚴重程度、以及中耳積水的積液性質三種不同偵測目的，分別設定以下閾值：＞7.58判定有中耳積水；＜0.60判定為重度的中耳積水；以及＜-0.84判定為黏液性中耳積水。After obtaining the test results, the receiver operating characteristic curve (ROC, hereinafter referred to as the ROC curve) was drawn for each experimental group using statistical software (for example: sigmaplot) for analysis. The area under the curve of ROC (AUROC) of the control group is used to evaluate the accuracy of the method and device for the array measurement and interpretation of the ultrasonic detection of middle ear hydrops of the present invention; wherein, the ROC curve is often used for analysis The accuracy of a detection method is a binary analysis model, that is, the output results are only two types of models, for example, in the experimental group (1) with or without middle ear hydrops, in the experimental group (2) as Mild to moderate or severe middle ear hydrops, and in the experimental group (3), serous or mucous middle ear hydrops, and a threshold was set to separate the two outcome categories, and then the weighted probability density of each experimental group was calculated. function parameters, or the single probability density function parameters of each control group are respectively brought in to determine their respective true first class, pseudo first class, true second class, and pseudo second class, and The ROC curve is drawn, and the area under the ROC curve (Area under the Curve of ROC, AUROC) is closer to 1, indicating that the detection method brought into the ROC curve for analysis is more accurate; The following thresholds were set for three different detection purposes: whether or not there was hydrops, the severity of middle ear hydrops, and the nature of middle ear hydrops: >7.58 for middle ear hydrops; <0.60 for severe middle ear hydrops; and < -0.84 was judged as mucoid middle ear hydrops.
該三個實驗組及其對照組的ROC分析曲線分別如圖2至圖4所示；其中，圖2A與圖2B為第(1)組之中耳積水與否的測試結果，圖2A為本發明之一實施例，使用經加權的機率密度函數參數對正常人與中耳積水患者進行狀況判讀後，以ROC曲線進行分析所得的AUROC為0.85，而圖2B則為對照組，僅使用單一機率密度函數參數對正常人與中耳積水患者進行狀況判讀，以ROC曲線進行分析所得的AUROC為0.87，二者相似。此結果顯示，使用本發明測量與判讀的方法及裝置可以良好判斷患者是否發生中耳積水。The ROC analysis curves of the three experimental groups and their control groups are shown in Fig. 2 to Fig. 4 respectively; wherein, Fig. 2A and Fig. 2B are the test results of middle ear hydrops in group (1), and Fig. 2A is this In one embodiment of the invention, after using the weighted probability density function parameters to interpret the condition of normal people and patients with middle ear hydrops, the AUROC obtained by the ROC curve analysis is 0.85, while FIG. 2B is the control group, and only a single probability is used. The density function parameters were used to interpret the condition of normal people and patients with middle ear hydrops. The AUROC obtained by the ROC curve analysis was 0.87, which were similar. This result shows that, using the method and device for measuring and interpreting the present invention can well determine whether the patient has middle ear hydrops.
圖3A與圖3B為第(2)組之中耳積水嚴重程度的測試結果，圖3A為本發明之一實施例，以本發明測量與判讀的方法及裝置，使用經加權的機率密度函數參數對中度中耳積水患者與重度中耳積水患者進行狀況判讀後，以ROC進行分析所得的AUROC高達0.87，而圖3B則為對照組，僅使用單一機率密度函數參數對輕中度中耳積水患者與重度中耳積水患者進行狀況判讀後，以ROC進行分析所得的AUROC僅有0.53，顯示該測量與判讀方法並無預測中耳積水嚴重程度的能力。 此結果顯示，使用本發明測量與判讀的方法及裝置可以用於判斷患者中耳積水的嚴重程度。3A and 3B are test results of the severity of middle ear effusion in group (2), and FIG. 3A is an embodiment of the present invention, using the method and device for measurement and interpretation of the present invention, using weighted probability density function parameters After interpreting the condition of patients with moderate middle ear hydrops and severe middle ear hydrops, the AUROC obtained by ROC analysis was as high as 0.87, while Figure 3B is the control group, only using a single probability density function parameter for mild to moderate middle ear hydrops. The AUROC obtained by the ROC analysis was only 0.53 after the condition interpretation of the patients and the patients with severe middle ear effusion, indicating that the measurement and interpretation method did not have the ability to predict the severity of middle ear effusion. This result shows that the measurement and interpretation method and device of the present invention can be used to judge the severity of middle ear hydrops in patients.
圖4A與圖4B為第(3)組之中耳積水之積液性質的測試結果，圖4A為本發明之一實施例，以本發明測量與判讀的方法及裝置，使用經加權的機率密度函數參數對漿液性中耳積水患者與黏液性中耳積水患者進行狀況判讀後，以ROC進行分析所得的AUROC有效提升至0.69，而圖4B則為對照組，僅使用單一機率密度函數參數對漿液性中耳積水患者與黏液性中耳積水患者進行狀況判讀後，以ROC進行分析所得的AUROC僅有0.55，顯示該測量與判讀方法幾乎無法預測中耳積水的積液特性。此結果顯示，使用本發明測量與判讀的方法及裝置可以有效地提升判斷患者中耳積水之積液性質(即漿液性或黏液性)的能力。4A and 4B are the test results of the effusion properties of the middle ear effusion in group (3), and FIG. 4A is an embodiment of the present invention, using the method and device for measuring and interpreting the present invention, using the weighted probability density After the function parameters were used to interpret the condition of patients with serous hydrocephalus and mucous middle ear hydrops, the AUROC obtained by ROC analysis was effectively improved to 0.69, while Figure 4B is the control group, only a single probability density function parameter was used to analyze the serous middle ear. The AUROC obtained by the ROC analysis was only 0.55 after the status of the patients with hydrocephalus and mucous middle ear hydrops were analyzed, indicating that this measurement and interpretation method could hardly predict the fluid characteristics of middle ear hydrops. This result shows that using the method and device for measuring and interpreting the present invention can effectively improve the ability to judge the fluid nature (ie, serous or mucous) of the patient's middle ear hydrops.
因此，本發明超音波偵測中耳積水之陣列式測量與判讀裝置及方法，藉由單陣元的超音波探頭，以受測者耳朵後方的乳突表面作為音窗並發送超音波訊號，再接收並分析根據該受測者之中耳積水狀況所回傳的超音波回音訊號，以進行非侵入式的測量；其中，由於乳突處的區域大，且未有相關先前技術揭露可以反應最佳測量結果的偵測位置，因此在無法精準掌握測量位置的情況下，會因為測量位置的不確定性，造成結果失準。Therefore, the array type measuring and interpreting device and method for ultrasonic detection of middle ear hydrops of the present invention uses the single-array ultrasonic probe to use the surface of the mastoid behind the subject's ear as a sound window and transmit ultrasonic signals, Then receive and analyze the ultrasonic echo signal returned according to the condition of the subject's middle ear effusion to perform a non-invasive measurement; among which, because the area at the mastoid is large, and there is no relevant prior art disclosure to respond The detection position of the best measurement result, so if the measurement position cannot be accurately grasped, the result will be inaccurate due to the uncertainty of the measurement position.
據此，在本發明中，為了優化整體資訊的運算及分析方式，並整合至原始操作介面中，以達到方便操作且快速分類中耳積水的狀況與性質，來提高以超音波為基礎之非侵入式量測方法及其裝置的精準性及預期性，而進一步將受測者的乳突處表面分隔成複數個陣列式的測量區域，並分別獲取各陣列式測量區域的超音波回音訊號，再分別計算其機率密度函數參數後，於分析單元中搭配資訊分析軟體，並使用以機器學習為基礎的線性判別分析進行預訓練，找出各分隔之測量區域於判斷中耳積水狀況的重要性權重，並將各測量區域的機率密度函數參數經加權後，以所得的新參數相較於使用單一參數而言，不僅可以維持良好之判斷患者是否發生中耳積水的能力，更可以用於判斷患者中耳積水的嚴重程度，且還能有效改善判斷患者中耳積水之積液性質(即漿液性或黏液性)的能力。Accordingly, in the present invention, in order to optimize the calculation and analysis method of the overall information, and integrate it into the original operation interface, in order to achieve convenient operation and rapid classification of the condition and nature of middle ear effusion, to improve the ultrasonic-based non-invasive The accuracy and predictability of the invasive measurement method and its device are further divided into a plurality of array-type measurement areas on the surface of the subject's mastoid, and the ultrasonic echo signals of each array-type measurement area are obtained respectively, After calculating the probability density function parameters respectively, the analysis unit is equipped with information analysis software, and the machine learning-based linear discriminant analysis is used for pre-training to find out the importance of each separated measurement area in judging the condition of middle ear hydrops. After weighting the probability density function parameters of each measurement area, the new parameters obtained can not only maintain a good ability to judge whether a patient has middle ear hydrops, but also can be used to judge whether a patient has middle ear hydrops. The severity of the patient's middle ear effusion, and it can also effectively improve the ability to judge the nature of the patient's middle ear effusion (ie, serous or mucous).
綜上所述，本發明超音波偵測中耳積水之陣列式測量與判讀裝置及方法能夠改善先前技術既有的缺點，具有非侵入性、無輻射、適用於任何地點與時間等優點，尤其適合用於測量孩童的中耳積水狀況，且若使用本發明重覆於手術前後測量使用者之中耳積水狀況，則可用於評估手術前後之中耳積水是否有清除，最重要的是，本發明數據分析的方式還能夠減少因主觀判定導致的不確定性，使中耳積水的診斷更加快速、操作更方便，且檢測結果更加準確。To sum up, the array type measuring and interpreting device and method for ultrasonic detection of middle ear hydrops of the present invention can improve the existing shortcomings of the prior art, and has the advantages of non-invasiveness, no radiation, suitable for any place and time, etc., especially It is suitable for measuring the condition of middle ear effusion in children, and if the present invention is used to measure the user's middle ear effusion before and after surgery repeatedly, it can be used to evaluate whether the middle ear effusion has been cleared before and after surgery. The inventive data analysis method can also reduce the uncertainty caused by subjective judgment, so that the diagnosis of middle ear hydrops can be diagnosed more quickly, the operation is more convenient, and the detection results are more accurate.
1:超音波偵測中耳積水之陣列式測量與判讀裝置 11:超音波探頭 12:超音波發射接收器 13:類比數位轉換器 14:分析單元1: Array measurement and interpretation device for ultrasonic detection of middle ear hydrops 11: Ultrasonic probe 12: Ultrasonic transmitter receiver 13: Analog-to-digital converters 14: Analysis Unit
圖1A係為本發明超音波偵測中耳積水的陣列式測量與判讀裝置的組成元件示意圖。 圖1B係為將使用者的乳突表面定義成複數個陣列式測量區域的示意圖。 圖2A係為使用本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置，測量與判讀正常人與中耳積水患者之中耳積水狀況的接收者操作特徵曲線。 圖2B係為僅使用單一機率密度函數參數，測量與判讀正常人與中耳積水患者之中耳積水狀況的接收者操作特徵曲線。 圖3A係為使用本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置，測量與判讀輕中度中耳積水患者與重度中耳積水患者之中耳積水狀況的接收者操作特徵曲線。 圖3B係為僅使用單一機率密度函數參數，測量與判讀輕中度中耳積水患者與重度中耳積水患者之中耳積水狀況的接收者操作特徵曲線。 圖4A係為使用本發明超音波偵測中耳積水之陣列式測量與判讀的方法及裝置，測量與判讀漿液性中耳積水患者與黏液性中耳積水患者之中耳積水狀況的接收者操作特徵曲線。 圖4B係為僅使用單一機率密度函數參數，測量與判讀漿液性中耳積水患者與黏液性中耳積水患者之中耳積水狀況的接收者操作特徵曲線。 FIG. 1A is a schematic diagram of the components of an array type measuring and interpreting device for ultrasonic detection of middle ear hydrops according to the present invention. FIG. 1B is a schematic diagram of defining a user's mastoid surface into a plurality of arrayed measurement areas. 2A is a receiver operating characteristic curve for measuring and interpreting middle ear hydrops in normal people and patients with middle ear hydrops by using the method and apparatus for array measurement and interpretation of middle ear hydrops detected by ultrasonic waves of the present invention. 2B is a receiver operating characteristic curve for measuring and interpreting the condition of middle ear hydrops in normal subjects and patients with middle ear hydrops using only a single probability density function parameter. 3A shows the receiver operation of measuring and interpreting the condition of middle ear hydrops in patients with mild to moderate middle ear hydrops and patients with severe middle ear hydrops by using the method and device for measuring and interpreting the array type of hydrocephalus detected by ultrasonic waves of the present invention characteristic curve. FIG. 3B is a receiver operating characteristic curve for measuring and interpreting the condition of middle ear hydrops in patients with mild to moderate hydrocephalus and patients with severe hydrocephalus using only a single probability density function parameter. 4A shows the receiver operation of measuring and interpreting the condition of middle ear effusion in patients with serous middle ear effusion and patients with mucinous middle ear effusion using the method and device for array measurement and interpretation of ultrasonic detection of middle ear effusion of the present invention characteristic curve. FIG. 4B is a receiver operating characteristic curve for measuring and interpreting middle ear hydrops in patients with serous hydromiddle ear effusion and patients with mucous middle ear effusion using only a single probability density function parameter.
無。none.
1:超音波偵測中耳積水之陣列式測量與判讀裝置 1: Array measurement and interpretation device for ultrasonic detection of middle ear hydrops
11:超音波探頭 11: Ultrasonic probe
12:超音波發射接收器 12: Ultrasonic transmitter receiver
13:類比數位轉換器 13: Analog-to-digital converters
14:分析單元 14: Analysis Unit
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| TW200621203A (en) * | 2004-12-29 | 2006-07-01 | Ind Tech Res Inst | Intravascular ultrasound probing device |
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| TW200621203A (en) * | 2004-12-29 | 2006-07-01 | Ind Tech Res Inst | Intravascular ultrasound probing device |
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