Automatic analyses of echocardiograms may support inexperienced users in quantifying left ventricular (LV) function. We have developed an algorithm for fully automatic measurements of mitral annular plane systolic excursion (MAPSE) and mitral annular systolic (S′) and early diastolic (e′) peak velocities. We aimed to study the influence of user experience of automatic measurements of these indices in echocardiographic recordings acquired by medical students and clinicians. We included 75 consecutive patients referred for echocardiography at a university hospital. The patients underwent echocardiography by clinicians (cardiologists, cardiology residents and sonographers), who obtained manual reference measurements of MAPSE by M-mode and of S′ and e′ by colour tissue Doppler imaging (cTDI). Immediately after, each patient was examined by 1 of 39 medical students who were instructed in image acquisition on the day of participation. Each student acquired cTDI recordings from 1 to 4 patients. All cTDI recordings by students and clinicians were analysed for MAPSE, S′ and e′ using a fully automatic algorithm. The automatic measurements were compared to the manual reference measurements. Correct tracking of the mitral annulus was feasible in 50 (67%) and 63 (84%) of the students’ and clinicians’ recordings, respectively (p = 0.007). Image quality was highest in the clinicians’ recordings. Mean difference ± standard deviation of the automatic measurements of the students’ recordings compared to the manual reference was − 0.0 ± 2.0 mm for MAPSE, 0.3 ± 1.1 cm/s for S′ and 0.6 ± 1.4 cm/s for e′. The corresponding intraclass correlation coefficients for MAPSE, S′ and e′ were 0.85 (good), 0.89 (good) and 0.92 (excellent), respectively. Automatic measurements from the students’ and clinicians’ recordings were in similar agreement with the reference when mitral annular tracking was correct. In case of correct tracking of the mitral annulus, the agreement with reference for the automatic measurements was overall good. Low image quality reduced feasibility. Adequate image acquisition is essential for automatic analyses of LV function indices, and thus, appropriate education of the operators is mandatory. Automatic measurements may help inexperienced users of ultrasound, but do not remove the need for dedicated education and training.

中文翻译：

---

医学生使用超声自动量化左心室功能


超声心动图的自动分析可以帮助缺乏经验的用户量化左心室 (LV) 功能。我们开发了一种算法，用于全自动测量二尖瓣环平面收缩期偏移 (MAPSE) 以及二尖瓣环收缩期 (S') 和舒张早期 (e') 峰值速度。我们的目的是研究医学生和临床医生获得的超声心动图记录中这些指数的自动测量的用户体验的影响。我们纳入了 75 名在大学医院转诊接受超声心动图检查的连续患者。临床医生（心脏病专家、心脏病住院医生和超声医师）对患者进行了超声心动图检查，并通过 M 模式获得了 MAPSE 的手动参考测量值，并通过彩色组织多普勒成像 (cTDI) 获得了 S' 和 e' 的手动参考测量值。随后，每位患者立即接受了 39 名医学生中的 1 名的检查，这些学生在参与当天接受了图像采集方面的指导。每个学生获得 1 至 4 名患者的 cTDI 记录。使用全自动算法对学生和临床医生的所有 cTDI 记录进行 MAPSE、S' 和 e' 分析。将自动测量值与手动参考测量值进行比较。分别有 50 名 (67%) 和 63 名 (84%) 学生和临床医生的记录能够正确追踪二尖瓣环 (p = 0.007)。临床医生记录中的图像质量最高。与手动参考相比，学生记录的自动测量值的平均差±标准偏差对于 MAPSE 为 − 0.0 ± 2.0 mm，对于 S' 为 0.3 ± 1.1 cm/s，对于 e' 为 0.6 ± 1.4 cm/s。 MAPSE、S' 和 e' 相应的组内相关系数分别为 0.85（良好）、0.89（良好）和 0.92（优秀）。 当二尖瓣环跟踪正确时，学生和临床医生记录的自动测量结果与参考值相似。在正确跟踪二尖瓣环的情况下，与自动测量参考的一致性总体良好。低图像质量降低了可行性。充分的图像采集对于左心室功能指数的自动分析至关重要，因此，必须对操作人员进行适当的教育。自动测量可以帮助缺乏经验的超声波用户，但并不能消除专门教育和培训的需要。