Automatic classification of HITS into artifacts or solid or gaseous emboli by a wavelet representation combined with dual-gate TCD.

Background and Purpose: Transcranial Doppler (TCD) can detect high-intensity transient signals (HITS) in the cerebral circulation. HITS may correspond to artifacts or solid or gaseous emboli. The aim of this study was to develop an offline automated Doppler system allowing the classification of HITS...

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Publicado en:Stroke (00392499) Vol. 32; no. 12; pp. 2803 - 2810
Autores principales: Devuyst G, Darbellay GA, Vesin J, Kemény V, Ritter M, Droste DW, Molina C, Serena J, Sztajzel R, Ruchat P, Lucchesi C, Dietler G, Ringelstein EB, Despland P, Bogousslavsky J, Devuyst, G, Darbellay, G A, Vesin, J M, Kemény, V, Ritter, M
Formato: research tables/charts tracings Journal Article
Publicado: Lippincott Williams & Wilkins 2001 Dec
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2001 Dec
      vid: 32
      iid: 12
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        106931473
        106931473
        NLM11739977
        2002063225
        10.1161/hs1201.099714
        NLM11739977
        106931473
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        atl: Automatic classification of HITS into artifacts or solid or gaseous emboli by a wavelet representation combined with dual-gate TCD.
      aug:
        au:
          Devuyst G
          Darbellay GA
          Vesin J
          Kemény V
          Ritter M
          Droste DW
          Molina C
          Serena J
          Sztajzel R
          Ruchat P
          Lucchesi C
          Dietler G
          Ringelstein EB
          Despland P
          Bogousslavsky J
          Devuyst, G
          Darbellay, G A
          Vesin, J M
          Kemény, V
          Ritter, M
        affil: Department of Neurology, CHUV, the Signal Processing Laboratory, Swiss Federal Institute of Technology, Lausanne, Geneva, Switzerland
      sug:
        subj:
          Ultrasonography, Doppler, Transcranial Methods
          Intracranial Embolism and Thrombosis Diagnosis
          Intracranial Embolism and Thrombosis Classification
          Algorithms
          Signal Processing, Computer Assisted
          Sensitivity and Specificity
          Cerebral Arteries Ultrasonography
          Artifacts
          Reproducibility of Results
          Predictive Value of Tests
          kappa Statistic
          Human
      ab: Background and Purpose: Transcranial Doppler (TCD) can detect high-intensity transient signals (HITS) in the cerebral circulation. HITS may correspond to artifacts or solid or gaseous emboli. The aim of this study was to develop an offline automated Doppler system allowing the classification of HITS.Methods: We studied 600 HITS in vivo, including 200 artifacts from normal subjects, 200 solid emboli from patients with symptomatic internal carotid artery stenosis, and 200 gaseous emboli in stroke patients with patent foramen ovale. The study was 2-fold, each part involving 300 HITS (100 of each type). The first 300 HITS (learning set) were used to construct an automated classification algorithm. The remaining 300 HITS (validation set) were used to check the validity of this algorithm. To classify HITS, we combined dual-gate TCD with a wavelet representation and compared it with the current "gold standard," the human experts.Results: A combination of the peak frequency of HITS and the time delay makes it possible to separate artifacts from emboli. On the validation set, we achieved a sensitivity of 97%, a specificity of 98%, a positive predictive value (PPV) of 99%, and a negative predictive value (NPV) of 94%. To distinguish between solid and gaseous emboli, where positive refers now to the solid emboli, we used the peak frequency, the relative power, and the envelope symmetry of HITS. On the validation set, we achieved a sensitivity of 89%, a specificity of 86%, a conditional PPV of 89%, and a conditional NPV of 89%.Conclusions: An automated wavelet representation combined with dual-gate TCD can reliably reject artifacts from emboli. From a clinical standpoint, however, this approach has only a fair accuracy in differentiating between solid and gaseous emboli.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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