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Operator auditory perception and spectral quantification of umbilical artery Doppler ultrasound signals

Thuring, Ann LU ; Brännström, Jonas LU ; Ewerlöf, Maria ; Hernandez-Andrade, Edgar LU ; Ley, David LU ; Lingman, Göran LU ; Liuba, Karina LU ; Marsal, Karel LU and Jansson, Tomas LU (2013) In PLoS ONE 8(5).
Abstract

OBJECTIVE: An experienced sonographer can by listening to the Doppler audio signals perceive various timbres that distinguish different types of umbilical artery flow despite an unchanged pulsatility index (PI). Our aim was to develop an objective measure of the Doppler audio signals recorded from fetoplacental circulation in a sheep model.

METHODS: Various degrees of pathological flow velocity waveforms in the umbilical artery, similar to those in human complicated pregnancies, were induced by microsphere embolization of the placental bed (embolization model, 7 lamb fetuses, 370 Doppler recordings) or by fetal hemodilution (anemia model, 4 lamb fetuses, 184 recordings). A subjective 11-step operator auditory scale (OAS) was... (More)

OBJECTIVE: An experienced sonographer can by listening to the Doppler audio signals perceive various timbres that distinguish different types of umbilical artery flow despite an unchanged pulsatility index (PI). Our aim was to develop an objective measure of the Doppler audio signals recorded from fetoplacental circulation in a sheep model.

METHODS: Various degrees of pathological flow velocity waveforms in the umbilical artery, similar to those in human complicated pregnancies, were induced by microsphere embolization of the placental bed (embolization model, 7 lamb fetuses, 370 Doppler recordings) or by fetal hemodilution (anemia model, 4 lamb fetuses, 184 recordings). A subjective 11-step operator auditory scale (OAS) was related to conventional Doppler parameters, PI and time average mean velocity (TAM), and to sound frequency analysis of Doppler signals (sound frequency with the maximum energy content [MAXpeak] and frequency band at maximum level minus 15 dB [MAXpeak-15 dB] over several heart cycles).

RESULTS: WE FOUND A NEGATIVE CORRELATION BETWEEN THE OAS AND PI: median Rho -0.73 (range -0.35- -0.94) and -0.68 (range -0.57- -0.78) in the two lamb models, respectively. There was a positive correlation between OAS and TAM in both models: median Rho 0.80 (range 0.58-0.95) and 0.90 (range 0.78-0.95), respectively. A strong correlation was found between TAM and the results of sound spectrum analysis; in the embolization model the median r was 0.91 (range 0.88-0.97) for MAXpeak and 0.91 (range 0.82-0.98) for MAXpeak-15 dB. In the anemia model, the corresponding values were 0.92 (range 0.78-0.96) and 0.96 (range 0.89-0.98), respectively.

CONCLUSION: Audio-spectrum analysis reflects the subjective perception of Doppler sound signals in the umbilical artery and has a strong correlation to TAM-velocity. This information might be of importance for clinical management of complicated pregnancies as an addition to conventional Doppler parameters.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Animals, Auditory Perception, Blood Flow Velocity, Female, Fetal Growth Retardation/diagnostic imaging, Fetal Hypoxia/diagnostic imaging, Fetus/blood supply, Humans, Medical Laboratory Personnel, Placental Circulation, Pregnancy, Sheep, Sound Spectrography, Ultrasonography, Doppler, Color, Ultrasonography, Prenatal/methods, Umbilical Arteries/abnormalities
in
PLoS ONE
volume
8
issue
5
article number
e64033
publisher
Public Library of Science (PLoS)
external identifiers
  • wos:000319966400044
  • pmid:23700452
  • scopus:84877884801
  • pmid:23700452
ISSN
1932-6203
DOI
10.1371/journal.pone.0064033
language
English
LU publication?
yes
id
217b6f34-ba3f-4a36-a40a-b67606fc7a1d (old id 3804234)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23700452?dopt=Abstract
date added to LUP
2016-04-01 13:43:10
date last changed
2022-03-29 08:59:55
@article{217b6f34-ba3f-4a36-a40a-b67606fc7a1d,
  abstract     = {{<p>OBJECTIVE: An experienced sonographer can by listening to the Doppler audio signals perceive various timbres that distinguish different types of umbilical artery flow despite an unchanged pulsatility index (PI). Our aim was to develop an objective measure of the Doppler audio signals recorded from fetoplacental circulation in a sheep model.</p><p>METHODS: Various degrees of pathological flow velocity waveforms in the umbilical artery, similar to those in human complicated pregnancies, were induced by microsphere embolization of the placental bed (embolization model, 7 lamb fetuses, 370 Doppler recordings) or by fetal hemodilution (anemia model, 4 lamb fetuses, 184 recordings). A subjective 11-step operator auditory scale (OAS) was related to conventional Doppler parameters, PI and time average mean velocity (TAM), and to sound frequency analysis of Doppler signals (sound frequency with the maximum energy content [MAXpeak] and frequency band at maximum level minus 15 dB [MAXpeak-15 dB] over several heart cycles).</p><p>RESULTS: WE FOUND A NEGATIVE CORRELATION BETWEEN THE OAS AND PI: median Rho -0.73 (range -0.35- -0.94) and -0.68 (range -0.57- -0.78) in the two lamb models, respectively. There was a positive correlation between OAS and TAM in both models: median Rho 0.80 (range 0.58-0.95) and 0.90 (range 0.78-0.95), respectively. A strong correlation was found between TAM and the results of sound spectrum analysis; in the embolization model the median r was 0.91 (range 0.88-0.97) for MAXpeak and 0.91 (range 0.82-0.98) for MAXpeak-15 dB. In the anemia model, the corresponding values were 0.92 (range 0.78-0.96) and 0.96 (range 0.89-0.98), respectively.</p><p>CONCLUSION: Audio-spectrum analysis reflects the subjective perception of Doppler sound signals in the umbilical artery and has a strong correlation to TAM-velocity. This information might be of importance for clinical management of complicated pregnancies as an addition to conventional Doppler parameters.</p>}},
  author       = {{Thuring, Ann and Brännström, Jonas and Ewerlöf, Maria and Hernandez-Andrade, Edgar and Ley, David and Lingman, Göran and Liuba, Karina and Marsal, Karel and Jansson, Tomas}},
  issn         = {{1932-6203}},
  keywords     = {{Animals; Auditory Perception; Blood Flow Velocity; Female; Fetal Growth Retardation/diagnostic imaging; Fetal Hypoxia/diagnostic imaging; Fetus/blood supply; Humans; Medical Laboratory Personnel; Placental Circulation; Pregnancy; Sheep; Sound Spectrography; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal/methods; Umbilical Arteries/abnormalities}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Operator auditory perception and spectral quantification of umbilical artery Doppler ultrasound signals}},
  url          = {{https://lup.lub.lu.se/search/files/3552363/4064587.pdf}},
  doi          = {{10.1371/journal.pone.0064033}},
  volume       = {{8}},
  year         = {{2013}},
}