Multi-plane based heart wall motion detection in medical ultrasound

Abstract

To improve data quality in detecting heart wall motion, areas of anomalous wall motion are detected from a view. The scan settings are then changed to focus the scan on each region, providing improved data, such as data where more speckles are present. The scan settings may include changing the orientation of the scan plane, reducing out-of-plane motion, and / or increasing speckle content. The improved data is used to determine the strain more accurately.

Description

Background Art

[0001] The present embodiment relates to medical ultrasound imaging. In particular, cardiac wall motion analysis is performed using ultrasound.

[0002] Two-dimensional (2D) B-mode echocardiography provides important information about cardiac procedures, such as volumes, diastolic function, right ventricular function, hemodynamics, and valvular regurgitation. In addition, the detection of heart failure is facilitated by assessing global longitudinal strain and regional strain in the heart wall. Myocardial mechanics, ischemic heart disease, cardiomyopathy, left ventricular (LV) diastolic dysfunction, and subclinical myocardial dysfunction can be detected in patients.

[0003] In current clinical tools, the sonographer obtains multiple standard views of the cardiac chambers, such as A2C, A3C, A4C, and longitudinal views, while optimizing image quality, maximizing frame rate, and minimizing perspective foreshortening, all of which are critical to reducing measurement variability. Global and segmental strains are calculated for each view by first creating an initial contour at the myocardial border, which is then tracked for all frames using speckle. A 17-segment bulls-eye model (or 16 or 18 segments) is constructed from six segmental strains for each view. Specifically, a quantitative wall motion score can be assigned to each segment. A four-level score is typically applied based on the segmental model: (1) normal or hyperkinetic, (2) hypokinetic, (3) akinetic, and (4) dyskinetic.

[0004] Unfortunately, semiquantitative wall motion scores for each segment may not always be reliable. Problems in speckle tracking may negatively impact the accuracy of segmental strain due to poor imaging in certain locations. Selecting a set of acquisition parameters that results in capturing wall motion in all zones of a standard view may be challenging. If there is significant motion in out-of-plane directions in certain locations, it may be difficult to track speckle. Summary of the invention

[0005] By way of introduction, the preferred embodiments described below include methods, systems, and non-transitory computer readable media for detecting cardiac wall motion. To improve data quality, regions of abnormal wall motion are detected from a view. Scan settings are then changed to focus the scan on each region, providing improved data, such as data with more speckle. The scan settings may include changing the orientation of the scan plane, reducing out-of-plane motion, and / or increasing speckle content. The improved data is used to more accurately determine strain.

[0006] In a first aspect, a method for detecting cardiac wall motion using a medical ultrasound scanner is provided. The medical ultrasound scanner performs a first scan of a first plane through a patient's heart using a first value of a scan setting. The first plane is scanned at different times, providing first ultrasound data representing the heart at the different times. Abnormal wall motion is detected from the first ultrasound data. The medical ultrasound scanner performs a second scan of an area of ​​abnormal wall motion in a second plane using a second value of the scan setting. The second setting is different from the first value of the scan setting. The second plane is different from the first plane, and the second scan results in second ultrasound data. Strain of the abnormal wall motion is determined based on the second ultrasound data. An image representing the strain is provided.

[0007] In one embodiment, a standardized view of the heart is scanned first. A second scan is performed with a smaller field of view just covering the area of ​​abnormal wall motion, which is smaller than the field of view of the standardized view.

[0008] In another embodiment, the machine-learned model detects abnormal wall motion.

[0009] Various scan settings, such as gain, contrast, depth, and / or field of view, may be changed during a scan. For example, the field of view of a first scan is for the entire cardiac region (larger field of view), and the field of view of a second scan is a smaller field of view for an area of ​​abnormal motion. The scan settings may include an orientation of a plane, such as changing the scan settings to redirect from a first plane to a second plane. In one example, the scan settings of the second scanner configure the medical ultrasound scanner for generating speckle.

[0010] According to one embodiment, the second plane is selected based on the scattering level and / or the amount of relative motion of the heart wall.The abnormal region may be scanned along different planes and one plane selected as being superior compared to the others.

[0011] As one embodiment, strains are determined for segments of the multi-segment model. The multi-segment model including the strains is displayed. As another embodiment, strains are determined in multiple dimensions of the first and second planes. A multi-dimensional strain map is displayed.

[0012] The second scan and determination of strain may be repeated for different regions corresponding to different locations of abnormal wall motion. The first scan, detection of abnormal wall motion, second scan, and determination of strain may be repeated for different views of the heart (e.g., different standardized views). The strain from the different standardized views is then displayed.

[0013] In a second aspect, an ultrasound system for detecting cardiac wall motion is provided. The ultrasound scanner is configured to detect a location of an abnormality of cardiac wall motion of a patient, scan the location with different values ​​of one or more settings, and determine strain of the cardiac wall motion at the location based on ultrasound data from at least one of the scans using the different values ​​of the one or more settings. The display is configured to display an image of the strain.

[0014] In one embodiment, one or more settings are used for scanning of different planes, such that the ultrasound scanner is configured to scan locations in different planes. In another embodiment, one or more settings are gain, contrast, and / or depth, such that the ultrasound scanner is configured to scan locations to image with different speckle levels.

[0015] In another embodiment, the ultrasound scanner is configured to scan the patient's heart in a standardized view, detect the location from the standardized view, and scan the location with a field of view smaller than the standardized view.

[0016] In a third aspect, a non-transitory computer-readable storage medium has stored therein data representing instructions executable by a programmed processor for detecting heart wall motion. The storage medium includes instructions for: scanning a patient's heart in a standardized view; detecting abnormal wall motion of the heart from the standardized view; acquiring B-mode data in a patch at the abnormal wall motion; determining strain from the B-mode data of the patch; and displaying a strain map, the strain map including a first segment of the strain map and a second segment of a training map, the first segment of the strain map having a strain determined from the B-mode data of the patch, the second segment of the training map having another strain determined from the standardized view.

[0017] According to one embodiment, the instructions for acquiring B-mode data in the patch include acquiring B-mode data with the patch in a different plane than the standardized view. The instructions also include selecting a different plane based on an amount of speckle or motion.

[0018] As another embodiment, the instructions for acquiring B-mode data include acquiring B-mode data at locations of abnormal wall motion in a patch with a greater speckle level than in a normalized view.

[0019] In yet another embodiment, the instructions further include repeating the scanning, detecting, acquiring and determining for different standardized views.The instructions for displaying the strain map include displaying 16, 17 or 18 segment bull's eye views.

[0020] The following claims define the present invention, and nothing in this section should be taken as limiting those claims.Additional aspects and advantages of the present invention are discussed below in conjunction with the preferred embodiments. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] The components and drawings are not necessarily drawn to scale, emphasis instead being placed upon illustrating the principles of the present invention. Moreover, in the drawings, like reference numerals designate corresponding parts throughout the different views.

[0022] Figure 1 is a flow chart of one embodiment of a method for detecting cardiac wall motion; Figure 2 Abnormal motion detection using targeted scanning of areas of abnormal motion is shown; Figure 3 shows different planes used for scanning to acquire ultrasound data for strain determination; and Figure 4 is a block diagram of one embodiment of a system for detecting cardiac wall motion. DETAILED DESCRIPTION

[0023] Tracking-assisted acquisitions are provided, such as fusion of 2D B-mode echocardiograms for 2D global and / or regional cardiac mechanics. Helps the user acquire the best possible or sufficient B-mode echocardiogram data for quantifying global and / or regional strain, such as by sampling in multiple planes for any areas of abnormal wall motion.

[0024] Automated solutions calculate global and regional cardiac mechanics from 2B echo data. The strain analysis of these solutions strongly relies on image quality. A set of parameters or settings of an ultrasound scanner (such as gain settings) may not capture wall motion in all zones. For example, one or more gaps appear in the heart wall due to lack of speckle, shadowing, and / or other artifacts.

[0025] To assist the user and / or automatic solution for better images in certain areas, the patch is scanned using different scan setting values. Areas with abnormal wall motion, whether due to actual abnormalities or due to poor scanning, are scanned again with different settings to improve the data by additional acquisition and / or by better settings for scanning these locations. In one method, different settings are used to scan abnormal areas along different scanning planes. The field of view is shifted not only in terms of area (smaller) and focus (in the area), but also in terms of the plane being scanned. This multi-plane analysis of cardiac wall motion abnormalities from 2D echoes can provide data that can be used for more accurate tracking and corresponding strain analysis. Improved data, and even confidence metrics, can be provided for tracking and image quality. Image quality is improved, especially in low confidence areas, by changing acquisition parameters, such as slightly rotating the detector when necessary. Tracking can be run again only in low confidence areas.

[0026] In one embodiment, during 2D B-mode echocardiography acquisition, the sonographer is helped to obtain good quality data in the patch and the results are fused for strain analysis. When the sonographer acquires 2D B-mode echocardiography images in a standard orientation view such as A2C, the system first detects the myocardial boundaries with abnormal wall motion and acquires (automatically or through user guidance) more data by adjusting input parameters and orientation planes, for example, only for areas of abnormal wall motion. The system rotates the detector by a certain angle through automation and / or guidance to the sonographer, and quantifies in real time the motion in multiple planes near only the abnormal wall motion. For example, tracking is run only in these corrected areas. The resulting calculated strain is collected or fused with previously acquired results from other areas. The multi-plane system can result in more robust strain analysis and less inter- and intra-user variability. Image quality is improved, especially for images acquired by less experienced sonographers. A framework is established for 2D B-mode echocardiography image acquisition based on semi-autonomous or fully autonomous robotic devices.

[0027] Figure 1 A method of detecting cardiac wall motion using a medical ultrasound scanner is shown. Strain and / or other indicators of abnormal and / or normal movement or operation of the heart are detected. For areas that appear to have abnormal cardiac wall motion, the detection relies on acquiring additional data using different settings (such as different fields of view, gains, and / or scan planes). By configuring the scan with different values ​​to collect this additional data, improved ultrasound data is provided for strain or other analysis in those areas.

[0028] This method is Figure 4 In one embodiment, the ultrasound imaging system or medical ultrasound scanner performs Figure 1 In other embodiments, the processor performs actions 110, 130, 140, and 150. The ultrasound scanner performs actions 100 and 120. A display may be used for action 150.

[0029] Additional, different, or fewer actions may be performed. For example, actions are provided for determining volume flow, ejection fraction, information about cardiac surgery, or other flow analysis of the heart. As another example, actions are provided for using strain or other cardiac wall motion analysis, such as for classifying cardiac conditions, segmental scoring, and / or for diagnosis. As another example, action 150 is not provided.

[0030] The actions are performed in the order shown (top to bottom or numerically) or in a different order.

[0031] An ultrasound scanner scans the patient's heart in act 100. The patient's heart is scanned in B-mode using a transducer that scans through a rib window from outside the patient, a transesophageal transducer that scans from inside the patient's throat, or an intracardiac echocardiography catheter that scans from inside the heart.

[0032] The scan is performed using the values ​​of the scan settings. The values ​​are used for the beamformer, transducer, image processing, and / or post-processing. The values ​​of the field of view (e.g., depth, width, and / or scan mode), gain, contrast, frequency, and / or other settings or acquisition parameters used for the scan of act 100 are set by the sonographer operator and / or are default values ​​for cardiac imaging.

[0033] The values ​​create a field of view that scans the entire heart and / or a region of a chamber of the heart. In one embodiment, the scan is for a standardized view of the heart, such as a longitudinal, A4C, A3C, or A2C view. The scan of action 100 can be used for other standardized or non-standard views. The scan is 2D, so it is a scan along a plane through the heart.

[0034] The scan of action 100 is repeated to collect two or more images representing the patient's heart at different times. For example, a sequence of five or more images per cardiac cycle is collected. The ECG can be used to specify the timing of the images relative to the cardiac cycle. Gating or triggering can be used to collect images at desired times of the cardiac cycle, such as end diastole (ED) and end systole (ES).

[0035] 2D B-mode echocardiographic data (eg, images) are acquired for a plane in the heart, such as in one of the standard views (eg, A2C). Figure 2 A B-mode image 200 of a plane through the heart is shown.

[0036] In act 110, an image processor detects abnormal wall motion from ultrasound data generated by the scanning of act 100. Ultrasound images from different times are used to detect abnormal wall motion. Prior to scan conversion, the images are used for ultrasound data from the scan in a display format or scan format. Data representative of the patient that can or will be used to generate images from the ultrasound scan is used as image data. The detection uses images from different times during the cardiac cycle, such as multiple images of standardized views.

[0037] After obtaining an image of optimal or acceptable quality for the 2D view, the image processor detects the endocardial and / or epicardial borders (eg, myocardial borders). Figure 2An example of detecting a boundary 216 in act 210 in ED and ES images 212, 214 is shown. Any detection may be used, such as by random walker, thresholding, or pattern or model fitting. In one embodiment, a machine learning algorithm or machine-learned model detects the boundary 216. Detection is performed for each image at other times in the cardiac cycle. In another embodiment, the boundary 216 is automatically detected on the ED frame or image. The detected boundary 216 is tracked in other frames, such as using speckle or local feature tracking (e.g., optical flow, motion prior, or speckle tracking). The result is that the boundary 216 is located in each image of the cardiac cycle.

[0038] Any location along the boundary 216 (act 110) with abnormal motion is detected in act 220. For example, global and regional strains are calculated from the tracking points along the boundary 216. Example tracking points are at Figure 2 The images 212, 214 are displayed as white dots. Strain indicates the lengthening or shortening of the boundaries between points at a given portion of the cardiac cycle, such as ED-ES. Strain greater than or less than a threshold value can indicate abnormal motion. Machine-learned models or image processing can be used to detect abnormal motion. Segment boundaries with abnormal motion are identified. Segments or regions with abnormal motion can be larger or smaller than the standard segmentation used in the bull's-eye visualization, such as the standard six-segment division. No, one or more regions of abnormal wall motion are detected. For example, myocardial boundary regions with abnormal motion, if any, are selected. Strain from regions of normal operation is calculated and can be saved for strain maps (e.g., bull's-eye models).

[0039] The abnormality may be due to actual adverse heart wall motion, or it may be due to poor tracking. Figure 2 An example is shown. The anomaly detection of act 220 detects an area 224 of abnormal wall motion. As shown in image 222, and highlighted in a magnified portion 226 of image 222, there is a lack of B-mode returns in this area 224. There is less speckle. The resulting tracking to find the boundary 216 may be inaccurate, resulting in incorrect strain calculations and corresponding indications of abnormal wall motion.

[0040] To improve strain calculations of region 224, further targeted acquisition is provided in act 230. Targeted acquisition may acquire an image 232 of region 224 with more B-mode returns (such as speckle). The acquisition is focused and targeted to region 224. A smaller field of view and corresponding settings are used to acquire better data for tracking and / or strain calculations in that region rather than the entire view of the heart chamber.

[0041] exist Figure 1In act 120, an ultrasound scanner scans region 224. Different regions 224 of detected abnormal wall motion may be scanned as separate patches. The scanning results in ultrasound data or images representing region 224 as it changes over time in one or more cardiac cycles.

[0042] The ultrasound scanner is configured with values ​​(e.g., acquisition parameters) for settings used to scan the region 224 or patch. The values ​​for action 120 are different from the values ​​used in action 100. For example, a smaller field of view or patch is scanned. The depth, width, focus, and / or scanning mode are different, such as scanning only a sub-region of a region of the image 200. The field of view is set to just cover the region 224 of abnormal wall motion. The region 224 is smaller than the entire border 216 and the corresponding original image 200. Gain, contrast, or other settings may be the same or different. Different combinations of values ​​may be tried to identify a combination that provides the desired or best ultrasound data, such as increasing speckle or landmark information used in tracking. The values ​​for the patch or region 224 are set to produce speckle in the resulting image 232.

[0043] In one embodiment, the field of view is altered by changing the orientation of the scan plane relative to region 224 and / or the patient's heart. The B-mode data is acquired with the patch or scan plane being a different plane than that used for the scan of act 100. For example, the scan plane is rotated with respect to region 224 so that it is at a non-zero angle to the plane of the standardized view acquired in act 100. Figure 3 An example is shown. Region 224 is initially scanned in plane 300. The scan plane is rotated to a different plane 310 for scanning a patch around region 224. By scanning in a different plane, more speckle may be produced for patch image 232 than for region 224 (see portion 226) of original image 222. Alternatively or additionally, there is less out-of-plane motion at boundary 216 in a different plane, so more accurate heart wall motion may be detected.

[0044] Any amount of rotation may be used. One or more rotated scan planes may be used, such as sampling (e.g., scanning) at different rotations and corresponding planes. The result is additional data or samples that can be used to improve accuracy and / or find the best or better scan plane for region 224. Alternatively, only one rotation and corresponding scan plane is used.

[0045] The transducer may be capable of automatic rotation. For example, a robot controlling the transducer rotates the transducer. As another example, electronic manipulation of a spiral array or a multi-dimensional (2D) array is used. In another example, mechanical rotation of the array is used, such as in a transesophageal probe. Alternatively, instructions for rotation are output to the sonographer, and the sonographer then manually rotates the array to scan along different planes and corresponding fields of view.

[0046] In one embodiment, the user is guided to acquire higher quality images near such an inspected region 224 by optimizing machine or acquisition parameters and / or rotating the imaging plane. The system recommends that the user rotate the detector by a certain angle and quantify the motion only in this selected region 224. The detector or array is rotated by the specified angle suggested by the system, the system analyzes the motion pattern, and then estimates the next best possible position. The best orientation plane can be automatically determined by minimizing out-of-plane motion (e.g., finding the plane showing the maximum amount of motion) and / or improving the quality of the speckle pattern, which leads to improved tracking and motion field estimation. For example, if the abnormal motion region 224 is close to the apex and the speckle moves toward the apex, it is difficult to accurately track such speckle. A better orientation plane improves tracking in such a selected position or region 224, and tracking can be done in real time because the image 232 only contains a small selected region 224.

[0047] In another embodiment, the user or image processor adjusts settings in the ultrasound scanner (e.g., values ​​of acquisition parameters) until better, improved, more, or sufficient speckle patterns are visible in the selected area. The speckle can be measured by a machine-learned model and / or variance metric. The resulting improved ultrasound data can be used to verify that the abnormality is not due to low imaging quality in such an area. The strain measurement of the area 224 is updated by running tracking only on the selected area 224 using the targeted acquisition image 232. The resulting strain is fused or collected together with the strain of the previously determined segment or area without abnormal wall motion. Due to the improved image quality, the accuracy of the segmented strain is improved. If it is not possible to obtain higher quality data in such an area for other reasons, having additional data as additional sampling can lead to more accurate strain determination.

[0048] In action 130, the image processor selects the setting values ​​that provide the most accurate or more accurate tracking, strain and / or analysis. Where multiple different value combinations are sampled, the combination that provides adequate or better ultrasound data is selected. In one approach, speckle levels and / or out-of-plane motion are measured. In one example, different scan planes corresponding to different orientations of the region 224 may result in different speckle levels and / or out-of-plane motion. By maximizing speckle content and / or minimizing out-of-plane motion (maximizing in-plane motion), improved ultrasound data for tracking and / or strain determination is provided. The setting values ​​that produce the best available or adequate (above / below a threshold) are selected. For example, based on the scattering level and / or the amount of relative motion of the heart wall, a field of view in one plane is selected over a field of view in another plane. The selection of values ​​is the selection of ultrasound data for tracking or strain determination, and vice versa.

[0049] Alternatively, no selection is performed. Only ultrasound data from a set of attempted different values ​​are used, or data from any sampling is used together (eg, strain or wall position is calculated from each set of data and the results are averaged).

[0050] In act 140, the image processor determines strain for abnormal wall motion. The ultrasound data from the targeted acquisitions of acts 120, 230 are used to determine strain. Patches of B-mode data from region 224 at different times in the cardiac cycle are used to track a boundary 216 from which strain is calculated. Since improved data is used, the resulting tracking and / or strain may be more accurate. A combination of data and / or settings from the selected planes is used for tracking and strain determination. Data from other combinations of settings may not be used or may be used in addition (e.g., averaged results).

[0051] The strain of region 224 is determined. The strain may be interpolated, extrapolated, and / or used for the segments of the multi-segment model. Region 224 may be at a different location and / or have a different size than the segments of the multi-segment model, so the corresponding strain of the region is used or modified to represent the segment.

[0052] In another embodiment, sampling on one or more planes is used in addition to the original plane. Multi-dimensional strain is determined. For example, data from different planes is used to determine strain as a vector in three dimensions. Motion is tracked along different planes. As a result, strain in three dimensions is determined.

[0053] Figure 1Feedback from act 140 to act 120 is shown. Where the image processor detects multiple regions 224 in a given view (e.g., image 200 with corresponding images 212 and 214 at different times), the targeted scanning of act 120, the selection of act 130, and the determination of strain of act 140 are repeated for each region 224. Scanning the patch and determining the strain of the patch are repeated to provide improved strain for each region 224. This is repeated until the strain of each of the regions of the anomaly is determined. The same process is followed for all anomaly segments.

[0054] Figure 1 Feedback from act 140 to act 100 is also shown. For a multi-segment bull's-eye model, different segments may be from different views. For each view (e.g., A4C, A3C, and A2C), acts 100, 110, 120, 130, and 140 are repeated. For each standard or non-standard view, the scanning of act 100, the detection of the region 224 of abnormal wall motion in act 110, the targeted scanning of one or more patches around each region of act 120, the selection of act 130, and the strain determination 140 are repeated.

[0055] This tracking-based guidance continues until the full extent of the abnormal wall motion area is covered. The bullseye visualization is updated based on the additional strain calculations. Alternatively, a 3D motion field is constructed by fusing the tracked motion or strains from different orientations. 3D surface tracking is performed and 3D strain measurements can be calculated.

[0056] The image processor outputs the strain in act 150. The output is an image to a display, computer network transmission, or storage.

[0057] The image represents strain. The strain can be represented as text, graphics, highlights, annotations or other presentations. In one embodiment, the image is a multi-segment model including strain. For example, a 16, 17 or 18 segment bull's eye view or model is used. The strain of each segment and the global strain are represented as colors and / or alphanumeric representations. The strain can be used for scoring so that the output score reflects the strain. Other strain maps can be used. The strain in a given strain map can include one or more strains determined from a standard view, and one or more strains determined from a rescan or targeted scan of the patch using different scan setting values. For example, a 17-segment model is a strain map having strains determined from B-mode data of a segmented patch (e.g., from scan 120), and a second segment of the strain map has another strain determined from a standardized view (e.g., from scan 100). The strains determined from different data can be fused together (e.g., presented together) to better quantify the extent of the abnormal wall motion area. Targeted scanning can improve strain maps (e.g., strain maps of 17-segment models) because dense strain values ​​are now available in each segment of the map, rather than values ​​from only fused two adjacent views. In addition, a more reliable four-level score was constructed for rapid assessment of pathology and motor abnormalities.

[0058] In another embodiment, the image processor generates a multi-dimensional strain map for display. Volume, surface or other three-dimensional rendering is used. The strains may come from different views. Some strains may come from scans along different planes. These strains from different planes provide a 3D map or vector of strain. 3D surface tracking can be applied to any multi-plane acquisition to generate a 3D strain map only in selected areas. For these areas, higher accuracy can be provided. Full 3D B-mode echocardiography has lower temporal and spatial resolution than 2D and requires longer analysis time, so 3D strain is provided or tracked for specific subsets or areas. Alternatively, a strain vector map or another image showing strain in different dimensions is displayed.

[0059] Figure 4 One embodiment of a system for detecting cardiac wall motion is shown. By reacquiring ultrasound data of a suspected patch with different acquisition settings, cardiac wall motion can be determined more accurately.

[0060] The system implements Figure 1 For example, ultrasound scanner 400 using beamformer 408 and transducer 410 performs the scanning of actions 100 and 120. Image processor 402 implements actions 110, 130, and 140, wherein the strain of action 150 is output to display 420. Alternatively, the system implements different, additional, or fewer actions.

[0061] The system includes a medical diagnostic ultrasound scanner 400, a releasable transducer 410, a display 420, and an ECG device 430. Additional, different, or fewer components may be provided. For example, a processor for analyzing ultrasound data is provided external to the ultrasound scanner 400. As another example, the ECG device 430 is integrated within the ultrasound scanner 400. In yet another example, the ECG device 430 is not provided because the ultrasound scanner 400 uses ultrasound data to determine cardiac cycle features (e.g., intervals).

[0062] The ECG device 430 is a processor, circuit and / or electrode. Any ECG device known now or developed later can be used. By placing electrodes on the patient, a heart track of the patient's cardiac cycle is generated. The ECG device 430 detects the R wave, other phases, intervals and / or heart rate of the cardiac cycle. Alternatively, the ultrasound scanner 400 detects the phase of the cardiac cycle based on the track signal received from the ECG device 430.

[0063] The ultrasound scanner 400 is a medical diagnostic ultrasound imaging system. In other embodiments, the ultrasound scanner 400 is a therapeutic system that can also image. Any now known or later developed cardiac echocardiography system can be used. The ultrasound scanner 400 is configured with a setup for performing a cardiac echocardiogram of a patient. During an imaging session, the transducer array 410 is positioned to scan the patient's heart and generate images over one or more cardiac cycles.

[0064] The ultrasound scanner 400 includes a transducer array 410, a beamformer 408, an image processor 402, a display 420, an input 406, an image processor 402, and a memory 404. Additional, different, or fewer components may be provided. For example, the transducer array 410 and / or the display 420 are separate from the scanner 400. As another example, the memory 404 is remote or not part of the ultrasound scanner 400. As yet another example, a scan converter, a temporal filter, a spatial filter, or another ultrasound imaging component is provided.

[0065] The transducer array 410 is an array of transducer elements in a housing. The housing is adapted or shaped for handheld use outside the patient's body. Alternatively, the housing is shaped as a catheter, intraoperative probe, intercavity probe, transesophageal probe, or other sensor probe now known or later developed. The array is a linear, multi-dimensional, annular, or other now known or later developed array of piezoelectric or micro-electromechanical elements.

[0066] The transducer array 410 generates acoustic energy in response to the electrical signals from the beamformer 408. For imaging, acoustic echoes received by the transducer array 410 are converted into electrical signals, and the transducer array 410 provides the electrical signals to the beamformer 408.

[0067] The beamformer 408 is a transmit beamformer, a receive beamformer, or both a transmit and receive beamformer. As a transmit beamformer, the beamformer 408 includes waveform generators or pulse generators in multiple channels, delays, phase rotators, timing generators, amplifiers, combinations thereof, or other transmit beamformer components now known or later developed. For transmission, the beamformer 408 generates a relatively delayed and apodized waveform for each of the multiple channels of the corresponding multiple transducer elements. The transducer array 410 forms one or more acoustic beams in response to the waveform.

[0068] As a receive beamformer, the beamformer 408 includes channels with delays, phase rotators, amplifiers, or a combination thereof, and includes one or more adders for adding the signals from each channel together. For reception, the beamformer 408 generates samples representing different spatial locations.

[0069] The receive beamformed samples are provided to an image processor 402 to generate an image. The image processor 402 is a detector, filter, scan converter, 3D processor, a combination thereof, or other image generator now known or later developed. Detection is B-mode (intensity. The samples are detected, scan converted, and provided to a display 420. Other image processing may be applied.

[0070] The ultrasound scanner 400 including the beamformer 408, the transducer array 410 and / or the image processor 402 operates according to the settings. Various acquisition parameters are set to establish the field of view, contrast, gain and / or other characteristics of the imaging. The ultrasound scanner 400 is configured to scan or acquire ultrasound data based on the settings.

[0071] The ultrasound scanner 400 is configured to scan the heart of a patient. For example, using manual guidance and / or automatic detection, the heart is scanned to identify standardized views. A sequence of images within one or more cardiac cycles of the views is acquired by scanning. Settings define the scanning and image processing of acquired ultrasound data.

[0072] The ultrasound scanner 400 is configured to scan targeted patches. One or more locations within the initial view are scanned in a targeted manner. Settings are changed to rescan localized areas, such as areas showing abnormal heart motion. Field of view, gain, contrast, or other settings are changed to scan patches around the area.

[0073] Input 406 is a user input device such as a keyboard, touch screen, trackball, mouse, button, rotatable knob, and / or slider. The input allows the sonographer to enter setting values ​​to configure the ultrasound scanner 400. Other user input information may be entered, such as instructions or selections for detection of abnormal areas and / or improved imaging.

[0074] The image processor 402 is a general purpose processor, a digital signal processor, a controller, an artificial intelligence processor, an application specific integrated circuit, a field programmable gate array, an analog circuit, a digital circuit, a combination thereof, or another now known or later developed device for tracking, determining strain, configuring the ultrasound scanner 400, and / or generating strain images. The image processor 402 is configured by hardware, software, and / or firmware to detect abnormalities, select settings, determine strain, and / or output images.

[0075] The image processor 402 is configured to detect locations of abnormalities in the patient's heart wall motion.Ultrasound data from a scan, such as a scan of a standardized view of the heart, is used to detect areas where abnormal heart wall motion exists, such as due to actual abnormalities or due to poor data quality.

[0076] The image processor 402 is configured to determine strain from cardiac wall motion at various locations along the cardiac wall. The image processor 402 detects the wall, such as using artificial intelligence. The image processor 402 tracks locations along the wall through a sequence of images, providing cardiac wall motion. The image processor 402 calculates strain based on the tracking or wall motion. Strain can be determined for different regions or segments in the original view.

[0077] In the event that abnormal wall motion is detected, the image processor 402 is configured to cause the ultrasound scanner 400 to scan a targeted patch around the area of ​​abnormal wall motion. Improved ultrasound data of the patch or area is acquired using different values ​​of one or more settings. Ultrasound data is acquired from the scan using at least one of the different values ​​of the one or more settings as compared to the setting values ​​of the original view.

[0078] The values ​​may define different scan planes for scanning the region. The image processor 402 may control the ultrasound scanner 400 to scan different planes for the patch and / or may instruct the sonographer to change the orientation of the transducer array 410. Based on the control of the image processor 402, the region is scanned in two or more different planes. For rescanning of the patch, other settings such as gain and / or contrast may be different from or in addition to the field of view (depth, azimuth range, and / or scan plane). Using different setting values ​​may result in different speckle levels and / or out-of-plane motion. The image processor 402 uses ultrasound data with more speckle and / or less out-of-plane motion to determine strain in the region.

[0079] Display 420 is a monitor, liquid crystal display, plasma display, light emitting diode display, printer, projector, or other device for outputting one or more images for viewing. Any now known or later developed display device may be used. Display 420 is part of ultrasound scanner 400, but may be a remote device, such as a wall mounted or remote workstation display.

[0080] The display 420 shows one or more images of the patient's heart. The images are generated as part of a cardiac echocardiogram. During the cardiac echocardiogram, the ultrasound scanner 400 can also output instructions on the display 420, such as rotating the transducer array 410.

[0081] The display 420 shows one or more images with strain information. The image of strain is generated by the image processor 402 and output by the display 420. The image of strain can be a bull's eye view from a multi-segment model. Other strain maps showing strain as a function of position along the heart wall can be output. 3D surface strain can be output, such as by surface or volume rendering.

[0082] Memory 404 is a non-transitory computer-readable storage medium, such as a cache, buffer, RAM, removable media, hard drive, or other computer-readable storage medium. Computer-readable storage media include various types of volatile and non-volatile storage media. Memory 404 stores ECG data, tracking, strain, detected boundaries, abnormal areas, artificial intelligence (e.g., machine-learned models), strain images, or other information for guidance of cardiac echocardiography. Stores input, output, and / or information being processed.

[0083] The memory 404 or another memory stores instructions for the image processor 402 and / or other processors. Data representing instructions for stress echocardiography guidance that can be executed by a programmed processor is stored in the memory. The instructions are used to implement the processes, methods and / or techniques discussed herein. In response to one or more sets of instructions stored in or on a computer-readable storage medium, the functions, actions or tasks shown in the drawings or described herein are performed. The functions, actions or tasks are independent of a specific type of instruction set, storage medium, processor or processing strategy, and can be performed by software, hardware, integrated circuits, firmware, microcode, etc. operating alone or in combination. Similarly, the processing strategy can include multi-processing, multi-tasking, parallel processing, etc. In one embodiment, the instructions are stored on a removable media device for reading by a local or remote system. In other embodiments, the instructions are stored in a remote location for transmission over a computer network or telephone line. In yet other embodiments, the instructions are stored within a given computer, CPU, GPU or system.

[0084] Although the present invention has been described above with reference to various embodiments, it should be understood that many changes and modifications may be made without departing from the scope of the present invention. Therefore, the foregoing detailed description is intended to be regarded as illustrative rather than restrictive, and it should be understood that the following claims, including all equivalents, are intended to define the spirit and scope of the present invention.

Claims

1. A method for detecting cardiac wall motion using a medical ultrasound scanner, the method comprising: performing a first scan of a first plane through a heart of a patient using a first value of a scan setting by the medical ultrasound scanner, the first plane scanned at different times providing first ultrasound data representing the heart at different times; detecting abnormal wall motion from the first ultrasound data; performing a second scan of the region of abnormal wall motion in a second plane using second values ​​of scan settings by the medical ultrasound scanner, the second settings being different from the first values ​​of scan settings, the second plane being different from the first plane, the second scan producing second ultrasound data; determining strain of abnormal wall motion based on the second ultrasound data; and Displays a graph representing the strain.

2. The method according to claim 1, wherein: The first scan comprises a first scan of a standardized view of the heart, and wherein the second scan comprises a second scan having a smaller field of view covering only an area of ​​abnormal wall motion, the area being smaller than the field of view of the standardized view.

3. The method of claim 1, wherein detecting comprises detecting using a machine-learned model. The method of claim 1 , wherein the scanning settings include gain, contrast, depth, and / or field of view. 5 . The method of claim 4 , wherein the scan setting includes a field of view, the first value is for a larger field of view than the second value, the first value is for a first plane, and the second value is for a second plane.

6. The method of claim 1 further comprising selecting the second plane based on a scattering level and / or an amount of relative motion of a heart wall.

7. The method of claim 1, further comprising performing a third scan of the region in a third plane different from the first and second planes.

8. The method according to claim 1, wherein: The second scan includes a second scan of the medical ultrasound scanner in which the second value configuration is used to generate speckle.

9. The method of claim 1, wherein determining strains comprises determining strains of segments of the multi-segment model, and wherein displaying comprises displaying the multi-segment model including the strains.

10. The method of claim 1, wherein determining strain comprises determining strain in multiple dimensions of the first and second planes, and wherein displaying comprises displaying a multi-dimensional strain map.

11. The method of claim 1, further comprising repeating the second scan and determining different abnormal wall motions for different regions.

12. The method of claim 1, further comprising repeating the first scanning, detecting, second scanning, and determining for different standardized views of the heart, and wherein displaying comprises displaying strain from the different standardized views.

13. An ultrasound system for detecting cardiac wall motion, the system comprising: an ultrasound scanner configured to detect a location of an abnormality of heart wall motion of a patient, scan the location with different values ​​of one or more settings, and determine strain of the heart wall motion at the location based on ultrasound data from at least one of the scans using the different values ​​of the one or more settings; as well as A display is configured to display an image of the strain.

14. The ultrasound system of claim 13, wherein the one or more settings are for scanning of different planes such that the ultrasound scanner is configured to scan locations in different planes.

15. The ultrasound system of claim 13, wherein: The one or more settings are gain, contrast and / or depth, such that the ultrasound scanner is configured to scan the location for imaging with different speckle levels.

16. The ultrasound system of claim 13, wherein: The ultrasound scanner is configured to scan a heart of a patient in a standardized view, detect a location from the standardized view, and scan the location with a field of view smaller than the standardized view.

17. A non-transitory computer-readable storage medium having stored therein data representing instructions executable by a programmed processor for detecting cardiac wall motion, the storage medium comprising instructions for: Scan the patient's heart in standardized views; Detect abnormal wall motion of the heart from standardized views; Acquire B-mode data in the patch at the site of abnormal wall motion; determining strain from B-mode data of the patch; and A strain map is displayed, the strain map including a first segment of the strain map having a strain determined from B-mode data of the patch and a second segment of the training map having another strain determined from a standardized view.

18. The non-transitory computer-readable storage medium of claim 17, wherein the instructions for acquiring B-mode data in the patch include acquiring B-mode data with the patch in a different plane than the standardized view, the instructions further comprising selecting a different plane based on an amount of speckle or motion.

19. The non-transitory computer readable storage medium of claim 17, wherein the instructions for acquiring B-mode data include acquiring B-mode data having a greater speckle level in a patch than in a normalized view at a location of abnormal wall motion.

20. The non-transitory computer readable storage medium of claim 17, wherein the instructions further comprise repeating scanning, detecting, acquiring, and determining for different standardized views, and wherein the instructions for displaying the strain map comprise displaying a 16, 17, or 18 segment bull's eye view.

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