罹患肌肉失養症孩童之超音波逆散射訊號瞬時頻率變化

Changes in the instantaneous frequency of ultrasound backscattered signals from children with DMD

沈彙中(Hui-Chung Shen)

指導教授 ： 張建成

共同指導教授 ： 崔博翔(Po-Hsiang Tsui)

國立臺灣大學/工學院/應用力學研究所/碩士(2017年)

https://doi.org/10.6342/NTU201702224

摘要

裘馨式肌肉失養症是ㄧ種罕見的遺傳疾病，病患四肢會因為肌肉逐漸地纖維化和脂肪浸潤而感到無力，下肢的肌肉變化猶為明顯，但目前針對裘馨式肌肉失養症病況程度的分級都是依據較為主觀的理學檢測進行評估。故本研究引入超音波醫學影像的方式由客觀的角度切入進行病況程度的分級和評估，並進一步找出從行走階段到不能行走階段的標準參數，來啟動對於病患、家屬和社會ㄧ個預警的機制。
本研究是以病患的下肢分析為主包括：腓腸肌、前脛肌和股直肌，利用希爾伯特黃轉換計算出各病況階段的瞬時頻率，並觀察瞬時頻率與各病況階段變化之趨勢，發現所分析三個肌群的瞬時頻率都會有隨著病況嚴重程度的增加而有越明顯衰減的趨勢，而三個肌群中腓腸肌擁有最大的接受者操作曲線下面積0.9717，可謂肌肉變化最為顯著的肌群，其下肢功能評估也是最佳的，因此以腓腸肌之瞬時頻率7.0865 MHz為行走能力損失的最佳標準參數。最後利用總體經驗模式分解進行分析發現結果大致上不如經驗模式分解，因此綜合以上結果推論腓腸肌其經驗模式分解所得到的第一個本質模態的結果評估效果最好。

關鍵字

裘馨式肌肉失養症 ； 超音波 ； 希爾伯特黃轉換 ； 瞬時頻率 ； 總體經驗模式分解

並列摘要

Duchenne muscular dystrophy (DMD) is a rare genetic disease which weakens the patients’ limbs by replacing the muscle with fibrosis and fat infiltration progressively. The change is more evident in the lower limbs. Currently, classifying of the patient’s condition are usually carried out through physical examination, results in a subjective diagnoses. In this research, we introduce medical image by ultrasound to assess and classify patients’ condition from a more objective point of view to find standard parameters to discriminate walker and non-walker stage in order to active the warning mechanism to the patients, patients’family and the society.
This research focuses on analyzing lower limbs, which include Gastrocnemius, Tibialis Anterior, and Rectus Femoris, and calculates the instantaneous frequency of each disease stage by using Hilbert-Huang Transform. By observing the trend of instantaneous frequency, the result reveals that the instantaneous frequency among these three muscle groups obviously attenuates as severity of the disease stage increases. Among three muscle groups, Gastrocnemius is responded to the biggest area under cure (AUC) of receiver operating characteristic curve, which is 0.9717 , so changes in Gastrocnemius is the most obvious, and has the best assessment of lower limbs function. Therefore, the instantaneous frequency of Gastrocnemius, 7.0865 MHz is taken as the standard parameter of the ambulation loss . Finally, the result from Ensemble Empirical Mode Decomposition (EEMD) is roughly worse than the result from Empirical Mode Decomposition (EMD). In conclusion, the first intrinsic mode functions result of Gastrocnemius from Empirical Mode Decomposition is the best assessment tool.

並列關鍵字

Duchenne muscular dystrophy ； ultrasound ； Hilbert-Huang transform ； instantaneous frequency ； Ensemble Empirical Mode Decomposition

參考文獻

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