Computer analysis of the early diastolic notch in Doppler sonograms of the uterine arteries.
This article describes a set of processing and analysis techniques for automated identification and quantification of the early diastolic notch (EDN), a feature of Doppler sonograms from the uterine arteries which has been associated with adverse pregnancy outcomes such as preeclampsia and intrauterine growth retardation. Examples covering different sonogram types are provided to illustrate the effectiveness and reproducibility of the processing/analysis tools. Also, a receiver-operating characteristic-based evaluation of the EDN quantification and pulsatility indexes is presented, which examines the ability to predict hypertension and/or intrauterine growth retardation, using a set of uterine Doppler sonograms from 92 patients acquired at 18 weeks of gestation. In summary, the ROC results confirm the link between the EDN and abnormal pregnancy outcomes, and suggest that EDN quantification has a higher diagnostic accuracy than the pulsatility index, which characterises the flow waveform in a global manner and therefore does not take explicitly into account the localised nature of the EDN. Quantification of the EDN at 18 weeks of gestation appears to best predict the most severely abnormal pregnancy outcomes.
Loupas
T
T
Ultrasonics Laboratory, CSIRO Division of Radiophysics, Sydney, Australia.
Ellwood
D A
DA
Gill
R W
RW
Bruce
S
S
Fay
R A
RA
D001158:Arteries; D003971:Diastole; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology; D005544:Forecasting; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology; D007091:Image Processing, Computer-Assisted; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D011256:Pregnancy Outcome; D011673:Pulsatile Flow; D012372:ROC Curve; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging