PICC (Peripherally Inserted Central Catheter) positioning examination method based on X-ray chest radiography and related device

Abstract

The invention discloses a PICC (Peripherally Inserted Central Catheter) positioning examination method based on an X-ray chest radiograph and a related device. The method comprises the following steps: acquiring an X-ray chest radiograph image of a target patient; establishing an X-ray chest radiography PICC positioning model to identify an anatomical structure and a PICC catheter path in the X-ray chest radiography image; the X-ray chest radiography PICC positioning model comprises an anatomical structure identification unit, a catheter path identification unit and a position evaluation unit; the anatomical structure identification unit is used for identifying an anatomical structure in the X-ray chest radiography image; the catheter path identification unit is used for identifying a PICC catheter path in the X-ray chest radiography image, and the PICC catheter path comprises a starting point, a walking path and a tail end position of a catheter; the position evaluation unit is used for evaluating the position of the tail end of the catheter according to the anatomical structure and the PICC path and generating a position evaluation result; and examining the positioning of the PICC according to the position information text of the tip of the PICC and the position evaluation result. The accuracy and efficiency of PICC positioning examination are improved through the X-ray chest radiography PICC positioning model.

Description

Technical Field

[0001] The present invention relates to the technical field of medical image processing, and in particular to a PICC positioning review method and device based on an X-ray chest film, and a computing device. Background Art

[0002] Peripherally inserted central catheters (PICCs) are widely used in clinical practice. However, after PICC placement, the position of the catheter tip must be confirmed before it can be used. Currently, the gold standard for PICC tip positioning is chest X-ray positioning. Clinically, hospitalized patients basically use chest X-rays to locate the PICC tip. Chest X-ray examinations are convenient and quick, but clinical medical staff have difficulty identifying and judging the results. They often need to consult with PICC specialists or full-time personnel to identify whether the PICC tip has reached the ideal position. The entire process takes a long time and the process is relatively complicated.

[0003] To solve the above problems, the present invention proposes a PICC positioning review method and device based on chest X-ray, and a computing device to improve the accuracy and efficiency of PICC positioning review. Summary of the invention

[0004] In view of the above problems, the present invention provides a PICC positioning review method and device based on chest X-ray, and a computing device.

[0005] According to one aspect of the present invention, a PICC positioning review method based on chest X-ray is provided, comprising:

[0006] Obtain chest X-ray images of target patients through the hospital information system;

[0007] Establish an X-ray chest film PICC positioning model to identify the anatomical structure and PICC catheter path in the X-ray chest film image; wherein the X-ray chest film PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest film image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest film image, and the PICC catheter path includes the starting point, running path and terminal position of the catheter; the position evaluation unit is used to evaluate the terminal position of the catheter according to the anatomical structure and the PICC catheter path, and generate a position evaluation result;

[0008] Generate PICC catheter tip position information text that integrates visual features and text coding features according to the anatomical structure and PICC catheter path; and review PICC catheter positioning according to the PICC catheter tip position information text and position assessment results.

[0009] In an optional manner, the anatomical structure recognition unit uses a skip connection to fuse features of corresponding levels in the encoder, and outputs a pixel-level segmentation mask for each anatomical structure; wherein the pixel values ​​of the segmentation mask are all 0 or 1, 0 represents the background, and 1 represents the anatomical structure;

[0010] The precision and recall of the segmentation mask of each anatomical structure are calculated, and the F1 score is used as the evaluation indicator for each anatomical structure.

[0011] In an optional manner, the catheter path identification unit uses a multi-scale edge response algorithm to identify the catheter edge;

[0012] The straight line segments in the edge of the catheter are detected by Hough transform algorithm, and the straight line segments are optimized by dynamic program method;

[0013] Each straight line segment is processed through a bidirectional LSTM network to obtain the coordinates of the starting point, middle node, and end position of the PICC catheter;

[0014] According to the coordinates of the starting point, middle node and terminal position of the PICC catheter, the PICC catheter path is connected and generated, and the PICC catheter path is smoothed by B-spline curve.

[0015] In an optional manner, the assessing of the catheter tip position according to the anatomical structure and the PICC catheter path further comprises:

[0016] Calculate the distance between the PICC catheter tip and the entrance of the superior vena cava;

[0017] If the distance is less than a preset threshold, the end position is located in the superior vena cava; wherein the entrance point of the superior vena cava is determined by the relative positions of the trachea mask and the clavicle mask;

[0018] If the catheter tip is located in the right atrium, the tip is located in the right atrium; if the catheter tip is located in the right ventricle, the tip is located in the right ventricle; wherein the ranges of the right atrium and the right ventricle are determined by the heart contour mask.

[0019] In an optional manner, the step of generating the PICC catheter tip position information text integrating the visual features and the text coding features further comprises:

[0020] Extract the local image of the PICC catheter end position in the X-ray chest image, and use the ResNet network to extract the visual features of the local image to obtain the visual feature vector;

[0021] Generate a location description text based on the location evaluation result, and encode the location description text through the BERT model to obtain a text encoding vector;

[0022] The visual feature vector and the text encoding vector are concatenated to generate a fusion vector and obtain the PICC catheter tip position information text.

[0023] In an optional manner, the reviewing of the PICC catheter positioning according to the PICC catheter tip position information text and the position assessment result further includes:

[0024] Assign different confidence scores to the classification of each evaluation result to obtain the confidence score of the evaluation result;

[0025] The PICC catheter tip position information text and position evaluation results are input into the multi-layer perceptron network, and the position category of the PICC catheter tip and the corresponding confidence score are output;

[0026] The confidence score of the assessment result and the confidence score of the position category of the PICC catheter tip were weighted and summed to obtain the review confidence score.

[0027] In an optional manner, the extracting visual features of the local image using the ResNet network to obtain the visual feature vector further includes:

[0028] Use the ResNet network as the basic feature extractor and remove the fully connected layer of the ResNet network;

[0029] An attention mechanism module is introduced to weight the extracted feature map, wherein the attention mechanism module includes at least one convolution layer and a sigmoid activation layer;

[0030] The weighted feature map is subjected to global average pooling to obtain a visual feature vector.

[0031] In an optional manner, a Transformer encoder layer is introduced before the input layer of the multi-layer perceptron to capture the context dependency between the PICC catheter tip position information text and the position evaluation result;

[0032] A cross-modal fusion module is introduced between the output of the Transformer encoder layer and the input layer of the multi-layer perceptron network to concatenate the fused feature vector of the text output by the Transformer encoder and the evaluation result with the global visual feature vector.

[0033] Wherein, the Transformer encoder layer includes:

[0034] The embedding layer maps the word vector of the PICC catheter tip location information text and the category one-hot encoding vector of the location assessment result to a high-dimensional space;

[0035] Position encoding layer, which adds position information to the embedded vector to preserve the sequence order;

[0036] A plurality of interlaced and stacked multi-head self-attention sublayers and feedforward neural network sublayers, wherein the multi-head self-attention sublayer uses a self-attention mechanism to calculate the correlation between input vectors, and the feedforward neural network sublayer performs nonlinear transformation.

[0037] According to another aspect of the present invention, a PICC positioning review device based on chest X-ray is provided, comprising:

[0038] A data acquisition module is used to obtain the chest X-ray images of the target patient through the hospital information system;

[0039] A model building module is used to establish an X-ray chest film PICC positioning model to identify the anatomical structure and PICC catheter path in the X-ray chest film image; wherein the X-ray chest film PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest film image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest film image, and the PICC catheter path includes the starting point, running path and terminal position of the catheter; the position evaluation unit is used to evaluate the terminal position of the catheter according to the anatomical structure and the PICC catheter path, and generate a position evaluation result;

[0040] The positioning review module is used to generate a PICC catheter tip position information text that integrates visual features and text coding features according to the anatomical structure and the PICC catheter path; and to review the PICC catheter positioning according to the PICC catheter tip position information text and the position evaluation result.

[0041] According to another aspect of the present invention, there is provided a computing device, comprising: a processor, a memory, a communication interface and a communication bus, wherein the processor, the memory and the communication interface communicate with each other via the communication bus;

[0042] The memory is used to store at least one executable instruction, and the executable instruction enables the processor to execute operations corresponding to the above-mentioned PICC positioning review method based on chest X-ray.

[0043] According to the scheme provided by the present invention, an X-ray chest image of a target patient is obtained through a hospital information system; an X-ray chest PICC positioning model is established to identify the anatomical structure and the PICC catheter path in the X-ray chest image; wherein the X-ray chest PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit, and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour, and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest image, and the PICC catheter path includes the starting point, running path, and terminal position of the catheter; the position evaluation unit is used to evaluate the catheter terminal position according to the anatomical structure and the PICC catheter path, and generate a position evaluation result; according to the anatomical structure and the PICC catheter path, a PICC catheter tip position information text that integrates visual features and text coding features is generated; and the PICC catheter positioning is reviewed according to the PICC catheter tip position information text and the position evaluation result. The present invention improves the accuracy and efficiency of PICC positioning review through the X-ray chest PICC positioning model. Specifically, by identifying key anatomical structures such as the trachea, clavicle, ribs, spine, heart contours, and mediastinal anatomical landmarks, a reliable reference is provided for the positioning of the PICC catheter. By identifying the starting point, running path, and end position of the catheter, it helps to determine whether the catheter has abnormal running. An objective position assessment result is generated based on the anatomical structure and catheter path, reducing the bias of subjective judgment. Based on the generated PICC catheter tip position information text that integrates visual features and text coding features, it is convenient for doctors to quickly understand the catheter position information.

[0044] The above description is only an overview of the technical solution of the present invention. In order to more clearly understand the technical means of the present invention, it can be implemented according to the contents of the specification. In order to make the above and other purposes, features and advantages of the present invention more obvious and easy to understand, the specific implementation methods of the present invention are listed below. BRIEF DESCRIPTION OF THE DRAWINGS

[0045] Various other advantages and benefits will become apparent to those of ordinary skill in the art by reading the detailed description of the preferred embodiments below. The accompanying drawings are only for the purpose of illustrating the preferred embodiments and are not to be considered as limiting the present invention. Moreover, the same reference symbols are used throughout the accompanying drawings to represent the same components. In the accompanying drawings:

[0046] Figure 1 A schematic diagram showing a flow chart of a PICC positioning review method based on chest X-ray according to an embodiment of the present invention;

[0047] Figure 2The schematic diagram of the process of the PICC positioning review method based on the X-ray chest film of the embodiment of the present invention is shown. Figure 2 ;

[0048] Figure 3 A schematic diagram of the framework of a PICC positioning and review device based on chest X-ray film according to an embodiment of the present invention is shown;

[0049] Figure 4 A schematic diagram of the structure of a computing device according to an embodiment of the present invention is shown. DETAILED DESCRIPTION

[0050] The exemplary embodiments of the present invention will be described in more detail below with reference to the accompanying drawings. Although the exemplary embodiments of the present invention are shown in the accompanying drawings, it should be understood that the present invention can be implemented in various forms and should not be limited by the embodiments set forth herein. On the contrary, these embodiments are provided in order to enable a more thorough understanding of the present invention and to enable the scope of the present invention to be fully communicated to those skilled in the art.

[0051] Figure 1 FIG. 2 is a flow chart showing a method for PICC positioning and review based on chest X-ray according to an embodiment of the present invention. Specifically, Figure 1 As shown, the following steps are included:

[0052] Step S101, obtaining a chest X-ray image of a target patient through a hospital information system.

[0053] For example, a chest X-ray image list of a target patient is obtained in a PACS system.

[0054] Step S102, establishing an X-ray chest film PICC positioning model to identify the anatomical structure and PICC catheter path in the X-ray chest film image; wherein the X-ray chest film PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest film image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest film image, and the PICC catheter path includes the starting point, running path and terminal position of the catheter; the position evaluation unit is used to evaluate the terminal position of the catheter according to the anatomical structure and the PICC catheter path, and generate a position evaluation result.

[0055] In this embodiment, the X-ray chest film PICC positioning model includes three units: an anatomical structure recognition unit, a catheter path recognition unit, and a position evaluation unit. The X-ray chest film image is input, and the anatomical structure recognition unit processes the image and outputs the contour or position information of the anatomical structure. The catheter path recognition unit processes the image and outputs the starting point, path, and terminal position information of the catheter. The position evaluation unit integrates the anatomical structure and catheter path information to generate a catheter terminal position evaluation result, and outputs the position evaluation result and a visual marking image.

[0056] Among them, the anatomical structure recognition unit is responsible for identifying key anatomical structures in the X-ray chest film. For example, the trachea helps determine the midline of the chest and serves as a reference for the entrance of the superior vena cava. The clavicle provides a skeletal framework for the upper chest to assist in determining the location of the subclavian vein. The ribs provide a framework for the thorax, which facilitates the determination of the boundaries of the thoracic cavity and the positioning of the catheter in the thoracic cavity. The spine serves as a midline reference to assist in determining whether the catheter deviates from the midline. The heart contour is used to determine whether the catheter enters the heart or pericardium. Mediastinal anatomical landmarks (such as the aortic arch and pulmonary artery) are used to determine whether the catheter is located in a blood vessel. A large number of X-ray chest images are required for training data, and each image needs to be manually annotated with the contours of the above anatomical structures.

[0057] The catheter path recognition unit is responsible for identifying the PICC catheter path in the chest X-ray. The catheter starting point is the location where the catheter is inserted into the skin, the path is the path of the catheter in the blood vessel, and the end position is the location of the tip of the catheter. Each image of the training data needs to be manually annotated with the starting point, path, and end position of the catheter.

[0058] The position assessment unit assesses the position of the catheter tip based on the anatomical structure and catheter path information and generates an assessment result. For example, the ideal position is when the catheter tip is located at the junction of the superior vena cava and the right atrium. The abnormal position is when the catheter tip enters the heart, pericardium, internal jugular vein, or subclavian vein. Possible risks are risks that may be caused by the catheter tip being too deep or too shallow.

[0059] In an optional manner, the anatomical structure recognition unit uses a skip connection to fuse features of corresponding levels in the encoder, and outputs a pixel-level segmentation mask for each anatomical structure; wherein the pixel values ​​of the segmentation mask are all 0 or 1, 0 represents the background, and 1 represents the anatomical structure;

[0060] The precision and recall of the segmentation mask of each anatomical structure are calculated, and the F1 score is used as the evaluation indicator for each anatomical structure.

[0061] In this embodiment, skip connections are used to fuse features of different levels in the encoder with features of the corresponding levels in the decoder, which can preserve image detail information and improve segmentation accuracy, which is especially important for the recognition of small objects in medical images. A pixel-level segmentation mask is output for each anatomical structure, where the value of each pixel is 0 or 1, which more accurately divides the boundary of each anatomical structure.

[0062] Specifically, the encoder uses a convolutional neural network to extract the features of the input image, gradually reducing the size of the feature map and increasing the number of channels. The decoder uses deconvolution or upsampling operations to gradually increase the size of the feature map, reduce the number of channels, and gradually restore the low-resolution abstract features to high-resolution pixel-level features. The jump connection directly transfers the feature map corresponding to each downsampling layer in the encoder to the corresponding upsampling layer in the decoder through the jump connection, connecting the feature maps in the channel dimension.

[0063] In an optional manner, the catheter path identification unit uses a multi-scale edge response algorithm to identify the catheter edge;

[0064] The straight line segments in the edge of the catheter are detected by Hough transform algorithm, and the straight line segments are optimized by dynamic program method;

[0065] Each straight line segment is processed through a bidirectional LSTM network to obtain the coordinates of the starting point, middle node, and end position of the PICC catheter;

[0066] According to the coordinates of the starting point, middle node and terminal position of the PICC catheter, the PICC catheter path is connected and generated, and the PICC catheter path is smoothed by B-spline curve.

[0067] In this embodiment, the sequence of straight line segments is input into a bidirectional long short-term memory network (Bi-LSTM) to capture the context in the sequence data, thereby predicting the coordinates of the starting point, intermediate nodes, and terminal positions of the catheter. The path of the PICC catheter is constructed based on the coordinate points obtained from the Bi-LSTM network. In order to make the path smoother and more natural, a B-spline curve is used to smooth the path to reduce jitter or uneven parts on the path.

[0068] In an optional manner, the assessing of the catheter tip position according to the anatomical structure and the PICC catheter path further comprises:

[0069] Calculate the distance between the PICC catheter tip and the entrance of the superior vena cava;

[0070] If the distance is less than a preset threshold, the end position is located in the superior vena cava; wherein the entrance point of the superior vena cava is determined by the relative positions of the trachea mask and the clavicle mask;

[0071] If the catheter tip is located in the right atrium, the tip is located in the right atrium; if the catheter tip is located in the right ventricle, the tip is located in the right ventricle; wherein the ranges of the right atrium and the right ventricle are determined by the heart contour mask.

[0072] In this embodiment, a preset threshold is used to determine whether the end of the catheter is located in the superior vena cava. If the distance between the end of the catheter and the entrance of the superior vena cava is less than this threshold, the end of the catheter is considered to be located in the superior vena cava. The determination of the entrance point of the superior vena cava can be achieved by analyzing the relative positions of the trachea and clavicle, because these anatomical structures usually have a fixed spatial relationship with the superior vena cava in the image. If the position of the end of the catheter is not in the superior vena cava, it is further determined whether it is located in the heart. The range of the right atrium is determined by the heart contour mask, and if the end of the catheter is within this range, it is determined to be located in the right atrium. By using the relative position of the anatomical structure and the mask to determine the position of the catheter, it is possible to accurately evaluate whether the end position of the catheter meets medical requirements and ensure the safe placement of the catheter.

[0073] Step S103, generating a PICC catheter tip position information text that integrates visual features and text coding features according to the anatomical structure and the PICC catheter path; and reviewing the PICC catheter positioning according to the PICC catheter tip position information text and the position evaluation result.

[0074] In this embodiment, the brightness, contrast, surrounding vascular structure and other features of the catheter can also be extracted. For text encoding features, a series of text labels are pre-defined and relevant anatomical terms are extracted, such as "inside the superior vena cava", "inside the right atrium", "inside the right ventricle", etc. The position description text is automatically generated according to the catheter path and anatomical structure, such as "the end of the catheter is located 2 cm above the entrance of the superior vena cava", "the catheter passes through the subclavian vein and enters the superior vena cava", etc. The extracted visual features (coordinates, mask information) and text encoding features (position labels, anatomical terms) are fused to generate structured catheter tip position information text. For example:

[0075]

[0076] The generated PICC catheter tip position information text, catheter path visualization results, and position assessment results (distance, whether it is located in the cavity) are presented to the doctor or other reviewers. Based on the above information, a manual review is conducted to determine whether the catheter tip position meets the requirements. Pass: If the catheter tip position is correct, it is marked as passed. If the catheter tip position is incorrect, it is marked as unqualified and the catheter position needs to be adjusted or further checked. If there is uncertainty or doubt in the information, it is marked as requiring review.

[0077] The review points include: whether the end of the catheter is located at the expected target location (usually the superior vena cava or its connection with the right atrium); whether the catheter path is smooth, whether there are obvious bends or folds; and whether the catheter position will cause potential risks to the patient (for example, whether it enters the right ventricle).

[0078] Then, according to the preset rules (for example, the distance threshold of the superior vena cava entrance), automated review assistance is implemented to automatically mark the situations that do not meet the rules so that they can be manually reviewed and the workload of manual review is reduced.

[0079] In an optional manner, the step of generating the PICC catheter tip position information text integrating the visual features and the text coding features further comprises:

[0080] Extract the local image of the PICC catheter end position in the X-ray chest image, and use the ResNet network to extract the visual features of the local image to obtain the visual feature vector;

[0081] Generate location description text based on the location evaluation result, and encode the location description text through the BERT model to obtain a text encoding vector;

[0082] The visual feature vector and the text encoding vector are concatenated to generate a fusion vector and obtain the PICC catheter tip position information text.

[0083] In this embodiment, the local image includes the catheter tip and the surrounding anatomical structures so as to provide sufficient context information.

[0084] In an optional manner, the reviewing of the PICC catheter positioning according to the PICC catheter tip position information text and the position assessment result further includes:

[0085] Assign different confidence scores to the classification of each evaluation result to obtain the confidence score of the evaluation result;

[0086] The PICC catheter tip position information text and position evaluation results are input into the multi-layer perceptron network, and the position category of the PICC catheter tip and the corresponding confidence score are output;

[0087] The confidence score of the assessment result and the confidence score of the position category of the PICC catheter tip were weighted and summed to obtain the review confidence score.

[0088] In this embodiment, the position assessment results are classified, for example, within the superior vena cava (SVC): the catheter tip is located in the ideal position of the superior vena cava. Within the right atrium (RA): the catheter tip enters the right atrium, which may not be ideal. Within the right ventricle (RV): the catheter tip enters the right ventricle, which is usually not ideal and needs to be repositioned. Other locations: other situations where the position of the catheter tip is not within the expected range. A different confidence score is assigned to each classification result, and the confidence score reflects the reliability of the position assessment result. For example, within the superior vena cava (SVC): 0.95 (indicating high confidence, the catheter position is good); within the right atrium (RA): 0.75 (indicating moderate confidence, further evaluation is required); within the right ventricle (RV): 0.2 (indicating low confidence).

[0089] The generated PICC catheter tip position information text (vector representation of fusion visual features and text encoding features) and position evaluation results (numerical or categorical values) are input into the multi-layer perceptron network (MLP), which outputs the position category of the PICC catheter tip (SVC, RA, RV or other) and the corresponding confidence score. The confidence score of the evaluation result and the confidence score output by the MLP are weighted and summed to obtain the final review confidence score.

[0090] In an optional manner, the extracting visual features of the local image using the ResNet network to obtain the visual feature vector further includes:

[0091] Use the ResNet network as the basic feature extractor and remove the fully connected layer of the ResNet network;

[0092] An attention mechanism module is introduced to weight the extracted feature map, wherein the attention mechanism module includes at least one convolution layer and a sigmoid activation layer;

[0093] The weighted feature map is subjected to global average pooling to obtain a visual feature vector.

[0094] In this embodiment, the goal is to extract general visual features rather than to perform specific classification or regression tasks. Retaining the fully connected layer makes the features learned by the network biased towards specific classification or regression targets, thereby reducing the generalization ability of the features. Removing the fully connected layer can retain the more original and general features extracted by the convolutional layer.

[0095] In an optional manner, a Transformer encoder layer is introduced before the input layer of the multi-layer perceptron to capture the context dependency between the PICC catheter tip position information text and the position evaluation result;

[0096] A cross-modal fusion module is introduced between the output of the Transformer encoder layer and the input layer of the multi-layer perceptron network to concatenate the fused feature vector of the text output by the Transformer encoder and the evaluation result with the global visual feature vector.

[0097] Wherein, the Transformer encoder layer includes:

[0098] The embedding layer maps the word vector of the PICC catheter tip location information text and the category one-hot encoding vector of the location assessment result to a high-dimensional space;

[0099] Position encoding layer, which adds position information to the embedded vector to preserve the sequence order;

[0100] A plurality of interlaced and stacked multi-head self-attention sublayers and feedforward neural network sublayers, wherein the multi-head self-attention sublayer uses a self-attention mechanism to calculate the correlation between input vectors, and the feedforward neural network sublayer performs nonlinear transformation.

[0101] In this embodiment, the PICC catheter tip position information text refers to the text description of the catheter tip position, such as "located in the superior vena cava", "close to the atrium", etc. The position evaluation result refers to the preliminary evaluation result of the catheter tip position, such as "correct", "too deep", "too shallow". The goal of the Transformer encoder is to understand the relationship between the text description and the position evaluation result, for example, the two pieces of information "close to the atrium" and "too deep" are contextually related.

[0102] According to the scheme provided by the present invention, an X-ray chest image of a target patient is obtained through a hospital information system; an X-ray chest PICC positioning model is established to identify the anatomical structure and the PICC catheter path in the X-ray chest image; wherein the X-ray chest PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit, and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour, and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest image, and the PICC catheter path includes the starting point, running path, and terminal position of the catheter; the position evaluation unit is used to evaluate the catheter terminal position according to the anatomical structure and the PICC catheter path, and generate a position evaluation result; according to the anatomical structure and the PICC catheter path, a PICC catheter tip position information text that integrates visual features and text coding features is generated; and the PICC catheter positioning is reviewed according to the PICC catheter tip position information text and the position evaluation result. The present invention improves the accuracy and efficiency of PICC positioning review through the X-ray chest PICC positioning model. Specifically, by identifying key anatomical structures such as the trachea, clavicle, ribs, spine, heart contours, and mediastinal anatomical landmarks, a reliable reference is provided for the positioning of the PICC catheter. By identifying the starting point, running path, and end position of the catheter, it helps to determine whether the catheter has abnormal running. An objective position assessment result is generated based on the anatomical structure and catheter path, reducing the bias of subjective judgment. Based on the generated PICC catheter tip position information text that integrates visual features and text coding features, it is convenient for doctors to quickly understand the catheter position information.

[0103] Figure 3 The schematic diagram of the framework of the PICC positioning and reviewing device based on the chest X-ray film of the embodiment of the present invention is shown. The PICC positioning and reviewing device based on the chest X-ray film comprises:

[0104] A data acquisition module is used to obtain the chest X-ray images of the target patient through the hospital information system;

[0105] A model building module is used to establish an X-ray chest film PICC positioning model to identify the anatomical structure and PICC catheter path in the X-ray chest film image; wherein the X-ray chest film PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest film image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest film image, and the PICC catheter path includes the starting point, running path and terminal position of the catheter; the position evaluation unit is used to evaluate the terminal position of the catheter according to the anatomical structure and the PICC catheter path, and generate a position evaluation result;

[0106] The positioning review module is used to generate a PICC catheter tip position information text that integrates visual features and text coding features according to the anatomical structure and the PICC catheter path; and to review the PICC catheter positioning according to the PICC catheter tip position information text and the position evaluation result.

[0107] Figure 4 The schematic diagram of the structure of the computing device embodiment of the present invention is shown. The specific embodiment of the present invention does not limit the specific implementation of the computing device.

[0108] like Figure 4 As shown, the computing device may include: a processor (processor) 402 , a communications interface (Communications Interface) 404 , a memory (memory) 406 , and a communication bus 408 .

[0109] The processor 402, the communication interface 404, and the memory 406 communicate with each other via the communication bus 408. The communication interface 404 is used to communicate with other devices such as a client or other server network elements. The processor 402 is used to execute the program 410, which can specifically execute the relevant steps in the above-mentioned embodiment of the PICC positioning review method based on the chest X-ray.

[0110] Specifically, the program 410 may include program codes, which include computer operation instructions.

[0111] The processor 402 may be a central processing unit (CPU), or an application-specific integrated circuit (ASIC), or one or more integrated circuits configured to implement the embodiments of the present invention. The one or more processors included in the computing device may be processors of the same type, such as one or more CPUs; or processors of different types, such as one or more CPUs and one or more ASICs.

[0112] The memory 406 is used to store the program 410. The memory 406 may include a high-speed RAM memory, and may also include a non-volatile memory (non-volatile memory), such as at least one disk memory.

[0113] According to the scheme provided by the present invention, an X-ray chest image of a target patient is obtained through a hospital information system; an X-ray chest PICC positioning model is established to identify the anatomical structure and the PICC catheter path in the X-ray chest image; wherein the X-ray chest PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit, and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour, and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest image, and the PICC catheter path includes the starting point, running path, and terminal position of the catheter; the position evaluation unit is used to evaluate the catheter terminal position according to the anatomical structure and the PICC catheter path, and generate a position evaluation result; according to the anatomical structure and the PICC catheter path, a PICC catheter tip position information text that integrates visual features and text coding features is generated; and the PICC catheter positioning is reviewed according to the PICC catheter tip position information text and the position evaluation result. The present invention improves the accuracy and efficiency of PICC positioning review through the X-ray chest PICC positioning model. Specifically, by identifying key anatomical structures such as the trachea, clavicle, ribs, spine, heart contours, and mediastinal anatomical landmarks, a reliable reference is provided for the positioning of the PICC catheter. By identifying the starting point, running path, and end position of the catheter, it helps to determine whether the catheter has abnormal running. An objective position assessment result is generated based on the anatomical structure and catheter path, reducing the bias of subjective judgment. Based on the generated PICC catheter tip position information text that integrates visual features and text coding features, it is convenient for doctors to quickly understand the catheter position information.

[0114] Those skilled in the art will appreciate that the modules in the devices in the embodiments can be adaptively changed and set in one or more devices different from the embodiments. The modules or units or components in the embodiments can be combined into one module or unit or component, and in addition they can be divided into multiple submodules or subunits or subcomponents. Except that at least some of such features and / or processes or units are mutually exclusive, all features disclosed in this specification (including the accompanying claims, abstracts and drawings) and all processes or units of any method or device disclosed in this manner can be combined in any combination. Unless otherwise explicitly stated, each feature disclosed in this specification (including the accompanying claims, abstracts and drawings) can be replaced by an alternative feature that provides the same, equivalent or similar purpose. In addition, those skilled in the art will appreciate that although some embodiments herein include certain features included in other embodiments but not other features, the combination of features of different embodiments means being within the scope of the present invention and forming different embodiments. For example, in the following claims, any one of the claimed embodiments can be used in any combination. The present invention can be implemented by hardware including several different elements and by appropriately programmed computers. In a unit claim that lists several means, several of these means may be embodied by the same hardware item. The steps in the above embodiments should not be understood as limiting the execution order unless otherwise specified.

Claims

1. A PICC positioning review method based on chest X-ray, characterized in that: include: Obtain chest X-ray images of target patients through the hospital information system; Establish an X-ray chest film PICC positioning model to identify the anatomical structure and PICC catheter path in the X-ray chest film image; wherein the X-ray chest film PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest film image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest film image, and the PICC catheter path includes the starting point, running path and terminal position of the catheter; the position evaluation unit is used to evaluate the terminal position of the catheter according to the anatomical structure and the PICC catheter path, and generate a position evaluation result; Generate PICC catheter tip position information text that integrates visual features and text coding features according to the anatomical structure and PICC catheter path; and review PICC catheter positioning according to the PICC catheter tip position information text and position assessment results.

2. The PICC positioning review method based on chest X-ray according to claim 1, characterized in that: The anatomical structure recognition unit uses skip connections to fuse features of corresponding levels in the encoder, and outputs a pixel-level segmentation mask for each anatomical structure; wherein the pixel values ​​of the segmentation mask are all 0 or 1, 0 represents the background, and 1 represents the anatomical structure; The precision and recall of the segmentation mask of each anatomical structure are calculated, and the F1 score is used as the evaluation indicator for each anatomical structure.

3. The PICC positioning review method based on chest X-ray according to claim 1, characterized in that: The catheter path identification unit uses a multi-scale edge response algorithm to identify the catheter edge; The straight line segments in the edge of the catheter are detected by Hough transform algorithm, and the straight line segments are optimized by dynamic program method; Each straight line segment is processed through a bidirectional LSTM network to obtain the coordinates of the starting point, middle node, and end position of the PICC catheter; According to the coordinates of the starting point, middle node and terminal position of the PICC catheter, the PICC catheter path is connected and generated, and the PICC catheter path is smoothed by B-spline curve.

4. The PICC positioning review method based on chest X-ray according to claim 1, characterized in that: The assessing of the catheter tip position according to the anatomical structure and the PICC catheter path further comprises: Calculate the distance between the PICC catheter tip and the entrance of the superior vena cava; If the distance is less than a preset threshold, the end position is located in the superior vena cava; wherein the entrance point of the superior vena cava is determined by the relative positions of the trachea mask and the clavicle mask; If the catheter tip is located in the right atrium, the tip is located in the right atrium; if the catheter tip is located in the right ventricle, the tip is located in the right ventricle; wherein the ranges of the right atrium and the right ventricle are determined by the heart contour mask.

5. The PICC positioning review method based on chest X-ray according to claim 1, characterized in that: The generating of the PICC catheter tip position information text integrating the visual features and the text coding features further comprises: Extract the local image of the PICC catheter end position in the X-ray chest image, and use the ResNet network to extract the visual features of the local image to obtain the visual feature vector; Generate a location description text based on the location evaluation result, and encode the location description text through the BERT model to obtain a text encoding vector; The visual feature vector and the text encoding vector are concatenated to generate a fusion vector and obtain the PICC catheter tip position information text.

6. The PICC positioning review method based on chest X-ray according to claim 5, characterized in that: The review of PICC catheter positioning according to the PICC catheter tip position information text and position assessment results further includes: Assign different confidence scores to the classification of each evaluation result to obtain the confidence score of the evaluation result; The PICC catheter tip position information text and position evaluation results are input into the multi-layer perceptron network, and the position category of the PICC catheter tip and the corresponding confidence score are output; The confidence score of the assessment result and the confidence score of the position category of the PICC catheter tip were weighted and summed to obtain the review confidence score.

7. The PICC positioning review method based on chest X-ray according to claim 5, characterized in that: The step of extracting the visual features of the local image using the ResNet network to obtain the visual feature vector further includes: Use the ResNet network as the basic feature extractor and remove the fully connected layer of the ResNet network; An attention mechanism module is introduced to weight the extracted feature map, wherein the attention mechanism module includes at least one convolution layer and a sigmoid activation layer; The weighted feature map is subjected to global average pooling to obtain a visual feature vector.

8. The PICC positioning review method based on chest X-ray according to claim 6, characterized in that: Before the input layer of the multi-layer perceptron, a Transformer encoder layer is introduced to capture the context dependency between the PICC catheter tip position information text and the position evaluation result; A cross-modal fusion module is introduced between the output of the Transformer encoder layer and the input layer of the multi-layer perceptron network to concatenate the fused feature vector of the text output by the Transformer encoder and the evaluation result with the global visual feature vector. Wherein, the Transformer encoder layer includes: The embedding layer maps the word vector of the PICC catheter tip location information text and the category one-hot encoding vector of the location assessment result to a high-dimensional space; Position encoding layer, which adds position information to the embedded vector to preserve the sequence order; A plurality of interlaced and stacked multi-head self-attention sublayers and feedforward neural network sublayers, wherein the multi-head self-attention sublayer uses a self-attention mechanism to calculate the correlation between input vectors, and the feedforward neural network sublayer performs nonlinear transformation.

9. A PICC positioning review device based on chest X-ray, characterized in that: include: A data acquisition module is used to obtain the chest X-ray images of the target patient through the hospital information system; A model building module is used to establish an X-ray chest film PICC positioning model to identify the anatomical structure and PICC catheter path in the X-ray chest film image; wherein the X-ray chest film PICC positioning model includes an anatomical structure recognition unit, a catheter path recognition unit and a position evaluation unit; the anatomical structure recognition unit is used to recognize the anatomical structure in the X-ray chest film image, and the anatomical structure includes the trachea, clavicle, ribs, spine, heart contour and mediastinal anatomical landmarks; the catheter path recognition unit is used to recognize the PICC catheter path in the X-ray chest film image, and the PICC catheter path includes the starting point, running path and terminal position of the catheter; the position evaluation unit is used to evaluate the terminal position of the catheter according to the anatomical structure and the PICC catheter path, and generate a position evaluation result; The positioning review module is used to generate a PICC catheter tip position information text that integrates visual features and text coding features according to the anatomical structure and the PICC catheter path; and to review the PICC catheter positioning according to the PICC catheter tip position information text and the position evaluation result.

10. A computing device comprising: A processor, a memory, a communication interface and a communication bus, wherein the processor, the memory and the communication interface communicate with each other via the communication bus; The memory is used to store at least one executable instruction, and the executable instruction enables the processor to execute operations corresponding to the above-mentioned PICC positioning review method based on chest X-ray.

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