{"id":2846,"date":"2023-12-11T11:42:15","date_gmt":"2023-12-11T03:42:15","guid":{"rendered":"https:\/\/www.bebi.ntu.edu.tw\/?p=2846"},"modified":"2023-12-11T11:44:36","modified_gmt":"2023-12-11T03:44:36","slug":"%e7%94%9f%e9%86%ab%e9%9b%bb%e8%b3%87%e6%89%80%e6%95%99%e5%b8%ab%e7%a0%94%e7%a9%b6%e4%ba%ae%e9%bb%9e-112%e5%b9%b411%e6%9c%88%e4%bb%bd%e3%80%8c%e9%83%ad%e6%9f%8f%e9%bd%a1%e6%95%99%e6%8e%88%e3%80%8d","status":"publish","type":"post","link":"https:\/\/www.bebi.ntu.edu.tw\/?p=2846","title":{"rendered":"\u751f\u91ab\u96fb\u8cc7\u6240\u6559\u5e2b\u7814\u7a76\u4eae\u9ede-112\u5e7411\u6708\u4efd\u300c\u90ed\u67cf\u9f61\u6559\u6388\u300d"},"content":{"rendered":"

\u7814\u7a76\u4e3b\u984c-\u8d85\u97f3\u6ce2\u5c0e\u5f15\u6ce8\u5c04\u8f14\u5177\u7814\u767c\u53ca\u6df1\u5ea6\u5b78\u7fd2\u65bc\u795e\u7d93\u5f71\u50cf\u5206\u5272\u4e4b\u61c9\u7528<\/strong><\/h2>\n

\u64b0\u5beb\u5b78\u751f\uff1a\u9673\u51a0\u5f6c<\/p>\n

Point-of-care \u6307\u7684\u662f\u91ab\u7642\u4eba\u54e1\u96a8\u6642\u96a8\u5730\u90fd\u53ef\u4ee5\u900f\u904e\u8a3a\u65b7\u5de5\u5177\u4f86\u7167\u9867\u75c5\u60a3\uff0c\u4f8b\u5982:\u8840\u7cd6\u6e2c\u8a66\u3001\u61f7\u5b55\u6aa2\u6e2c\u7b49\u3002\u800c\u96a8\u8457\u8fd1\u5e74\u4f86Point-of-care \u65e5\u76ca\u53d7\u5230\u95dc\u6ce8\uff0c\u8d85\u97f3\u6ce2\u5f15\u5c0e\u6ce8\u5c04\u6210\u70ba\u4e00\u9805\u91cd\u8981\u4e14\u53d7\u6b61\u8fce\u7684\u6280\u8853\u30022019\u5e74\u90ed\u6559\u6388\u5728Journal of Clinical Medicine\u4e0a\u767c\u8868\u4e86\u5229\u7528\u65b0\u578b\u7684\u4e8c\u7dad\u96f7\u5c04\u5c0d\u6e96\u88dd\u7f6e(1.)\uff0c\u4ee5\u5e6b\u52a9\u81e8\u5e8a\u91ab\u751f\u5728\u8d85\u97f3\u6ce2\u5f15\u5c0e\u6ce8\u5c04\u4e2d\u5c07\u91dd\u982d\u6e96\u78ba\u5b9a\u4f4d\u5728\u6383\u63cf\u5e73\u9762\u4e0a\u3002\u7531\u65bc\u65b0\u624b\u91ab\u751f\u5728\u8d85\u97f3\u6ce2\u5f15\u5c0e\u6ce8\u5c04\u7684\u719f\u6089\u4e0a\u5f80\u5f80\u9700\u8981\u5927\u91cf\u7684\u6642\u9593\u624d\u53ef\u4ee5\u638c\u63e1\u9019\u9805\u6280\u8853\uff0c\u4f8b\u5982\uff0c\u5e73\u9762\u65b9\u6cd5\u9700\u8981\u624b\u773c\u5354\u8abf\u8a13\u7df4\uff0c\u4ee5\u5728\u6383\u63cf\u5e73\u9762\u4e2d\u6e96\u78ba\u5b9a\u4f4d\u91dd\u982d\u4e26\u4ee5\u6b63\u78ba\u7684\u89d2\u5ea6\u63a8\u9032\uff0c\u6307\u5411\u76ee\u6a19\u3002\u6240\u4ee5\u958b\u767c\u80fd\u5920\u5e6b\u52a9\u65b0\u624b\u66f4\u8f15\u9b06\u7684\u627e\u5230\u76ee\u6a19\u4e26\u6539\u9032\u4ed6\u5011\u7684\u5b78\u7fd2\u66f2\u7dda\u7684\u5de5\u5177\u81f3\u95dc\u91cd\u8981\u3002\u76ee\u524d\u5e02\u9762\u4e0a\u5df2\u6709\u591a\u7a2e\u8f14\u52a9\u5c0d\u6e96\u88dd\u7f6e\uff0c\u4f46\u662f\u4ecd\u820a\u6709\u4e00\u4e9b\u7f3a\u9ede\uff0c\u4f8b\u5982\uff0cInfiniti PlusTM\u91dd\u5c0e\u7cfb\u7d71\u4e00\u65e6\u91dd\u982d\u63d2\u5165\u7d44\u7e54\u5c31\u7f3a\u4e4f\u76f4\u63a5\u8abf\u6574\u91dd\u982d\u89d2\u5ea6\u7684\u9748\u6d3b\u6027\uff1b\u96fb\u78c1\u8ffd\u8e2a\u7cfb\u7d71\u3001\u5149\u5b78\u8ffd\u8e2a\u7cfb\u7d71\u548c\u6a5f\u5668\u8f14\u52a9\u7cfb\u7d71\u592a\u5927\u4e14\u6602\u8cb4\uff0c\u7121\u6cd5\u5728\u5e38\u898f\u8a3a\u6240\u4e2d\u4f7f\u7528\u3002\u76f8\u53cd\uff0c\u57fa\u65bc\u96f7\u5c04\u7684\u8f14\u52a9\u65b9\u6cd5\u76f8\u5c0d\u4fbf\u5b9c\u4e14\u9ad4\u7a4d\u8f03\u5c0f\u3002\u7136\u800c\uff0c\u5927\u591a\u6578\u6700\u8fd1\u958b\u767c\u7684\u57fa\u65bc\u96f7\u5c04\u7684\u91dd\u5c0e\u7cfb\u7d71\u50c5\u5c08\u6ce8\u65bc\u5354\u52a9\u5728\u6383\u63cf\u5e73\u9762\u4e2d\u5b9a\u4f4d\u91dd\u982d\uff0c\u800c\u672a\u5354\u52a9\u5176\u63d2\u5165\u89d2\u5ea6\u3002\u90ed\u6559\u6388\u6240\u958b\u767c\u7684\u4e8c\u7dad\u96f7\u5c04\u5c0d\u6e96\u88dd\u7f6e\u4e0d\u4f46\u50f9\u683c\u4f4e\u5ec9\u3001\u91cd\u91cf\u8f15\uff0c\u6613\u65bc\u88fd\u9020\uff0c\u9084\u53ef\u9069\u61c9\u4efb\u4f55\u985e\u578b\u7684\u8d85\u97f3\u6ce2\u63a2\u982d\u3002\u9019\u9805\u88dd\u7f6e\u900f\u904e\u4e0d\u540c\u6a21\u5f0f\u7684\u5207\u63db\u70ba\u91dd\u982d\u7684\u5b9a\u4f4d\u63d0\u4f9b\u5f15\u5c0e\uff0c\u5305\u62ec\u5f71\u50cf\u5e73\u9762\u548c\u63d2\u5165\u7684\u89d2\u5ea6\u3002\u9019\u9805\u7814\u7a76\u5927\u70ba\u7e2e\u77ed\u4e86\u65b0\u624b\u638c\u63e1\u8d85\u8072\u6ce2\u6280\u8853\u7684\u6642\u9593\uff0c\u5728\u8d85\u97f3\u6ce2\u5f15\u5c0e\u6ce8\u5c04\u7684\u57f9\u8a13\u4e2d\u63d0\u4f9b\u4e86\u91cd\u5927\u8ca2\u737b\u3002<\/p>\n

\u63a5\u8457\uff0c\u4eca\u5e745\u6708\uff0c\u90ed\u6559\u6388\u5728Ultrasound in Medicine and Biology\u4e0a\u767c\u8868\u4e86\u6df1\u5ea6\u5b78\u7fd2\u6a21\u578b\u61c9\u7528\u5728\u795e\u7d93\u8d85\u97f3\u6ce2\u5f71\u50cf\u81ea\u52d5\u5206\u5272\u4e0a\u7684\u7814\u7a76(2.)\u3002\u8155\u96a7\u9053\u75c7\u5019\u7fa4( Carpal Tunnel Syndrome ,CTS )\u7684\u60a3\u8005\uff0c\u662f\u56e0\u70ba\u5728\u624b\u8155\u6c34\u5e73\u8655\u767c\u751f\u7684\u6b63\u4e2d\u795e\u7d93( Median Nerve, MN )\u58d3\u8feb\u6545\u9020\u6210\u75c5\u56e0\uff0c\u800c\u52d5\u614b\u8d85\u97f3\u6ce2\u5f71\u50cf\u6aa2\u67e5\u5728\u8a3a\u65b7\u4ee5\u53ca\u6cbb\u7642CST\u60a3\u8005\u4e0a\u6709\u8457\u4e0d\u53ef\u53d6\u4ee3\u7684\u91cd\u8981\u6027\u3002\u90ed\u6559\u6388\u7684\u5718\u968a\u6210\u529f\u5229\u7528\u6df1\u5ea6\u5b78\u7fd2\u6a21\u578b\u5728\u52d5\u614b\u8d85\u97f3\u6ce2\u5f71\u50cf\u4e2d\u9032\u884c\u6b63\u4e2d\u795e\u7d93\u7684\u5f71\u50cf\u5206\u5272\u3002\u7576\u60a3\u8005\u5728\u79fb\u52d5\u624b\u6307\u6642\uff0c\u795e\u7d93\u5728\u6a6b\u622a\u9762\u4e0a\u7531\u65bc\u904b\u52d5\u800c\u8b8a\u5f62\u548c\u5e73\u79fb\u3002\u88ab\u58d3\u8feb\u7684\u795e\u7d93\u6703\u6709\u591a\u500b\u5f62\u614b\u7279\u5fb5\uff0c\u5982\u8cea\u5fc3\u4f4d\u79fb\u3001\u6a6b\u622a\u9762\u9762\u7a4d\u548c\u5713\u5ea6\u3002\u85c9\u7531\u6aa2\u6e2c\u624b\u6307\u904b\u52d5\u6642\u53d7\u58d3\u8feb\u795e\u7d93\u6240\u5448\u73fe\u7684\u7570\u5e38\u7279\u5fb5\uff0c\u53ef\u4ee5\u5e6b\u52a9\u91ab\u751f\u5224\u65b7\u75be\u75c5\u56b4\u91cd\u7a0b\u5ea6\u548c\u795e\u7d93\u5468\u570d\u6ce8\u5c04\u7684\u6548\u679c\u3002\u4f46\u52d5\u614b\u8d85\u97f3\u6ce2\u5f71\u50cf\u7684\u5206\u6790\u975e\u5e38\u5177\u6709\u6311\u6230\uff0c\u5728\u50b3\u7d71\u65b9\u6cd5\u4e2d\uff0c\u8981\u5206\u6790\u60a3\u8005\u624b\u6307\u79fb\u52d5\u6642\u7684\u8d85\u97f3\u6ce2\u5f71\u50cf\u9700\u8981\u4ef0\u8cf4\u5927\u91cf\u4eba\u529b\u4f86\u624b\u52d5\u5206\u5272\u9023\u7e8c\u5716\u50cf\u3002\u4e0d\u50c5\u5982\u6b64\uff0c\u5206\u5272\u7684\u6e96\u78ba\u6027\u76f8\u7576\u4f9d\u8cf4\u6aa2\u67e5\u8005\u7684\u7d93\u9a57\u6c34\u5e73\uff0c\u4e14\u5728\u6578\u64da\u7531\u4e0d\u540c\u7d93\u9a57\u6c34\u5e73\u7684\u6aa2\u67e5\u8005\u8655\u7406\u6216\u5728\u9ad8\u5ea6\u8b8a\u5316\u7684\u689d\u4ef6\u4e0b\u7372\u53d6\u6642\uff0c\u6578\u64da\u53ef\u80fd\u7522\u751f\u8aa4\u5dee\uff0c\u9019\u4e5f\u662f\u70ba\u4ec0\u9ebc\u6df1\u5ea6\u5b78\u7fd2\u7684\u5f15\u5165\u6709\u5176\u5fc5\u8981\u6027\u3002\u90ed\u6559\u6388\u7684\u5718\u968a\u901a\u904e\u5e7e\u7a2e\u6700\u5148\u9032\u7684\u7aef\u5c0d\u7aef\u5377\u7a4d\u795e\u7d93\u7db2\u7d61\uff08CNN\uff09\u6a21\u578b\u5c0d\u4f86\u81ea52\u540dCTS\u60a3\u8005\u7684\u52d5\u614b\u8d85\u8072\u6aa2\u67e5\u4e2d\u7684MN\u9032\u884c\u81ea\u52d5\u5206\u5272\uff0c\u4e26\u78ba\u5b9a\u5728\u57fa\u65bc\u55ae\u4e00\u5e40\u9032\u884c\u8a13\u7df4\u3002\u6700\u7d42\u6210\u529f\u5229\u7528\u6b64\u6df1\u5ea6\u5b78\u7fd2\u6a21\u578b\u81ea\u52d5\u5206\u5272\u4e86\u52d5\u614b\u8d85\u97f3\u6ce2\u7684\u5f71\u50cf\uff0c\u64fa\u812b\u4e86\u4ee5\u5f80\u9700\u8981\u5927\u91cf\u4eba\u529b\u624d\u80fd\u5b8c\u6210\u7684\u5de5\u4f5c! \u90ed\u6559\u6388\u7684\u5718\u968a\u662f\u9818\u5148\u4f7f\u7528\u6df1\u5ea6\u5b78\u7fd2\u6a21\u578b\u5728\u52d5\u614b\u8d85\u97f3\u6ce2\u5f71\u50cf\u4e2d\u9032\u884c\u81ea\u52d5\u5f71\u50cf\u5206\u5272\u7684\u5718\u968a\u4e4b\u4e00\uff0c\u4e5f\u662f\u7b2c\u4e00\u500b\u5be6\u73fe\u5728\u52d5\u614b\u8d85\u97f3\u6ce2\u5f71\u50cf\u4e2d\u5c0dMN\u5f62\u614b\u52d5\u614b\u9032\u884c\u53ef\u8996\u5373\u6642\u81ea\u52d5\u63d0\u53d6\u7684\u5718\u968a\u3002<\/p>\n

\u90ed\u6559\u6388\u7684\u7814\u7a76\u5728\u81e8\u5e8a\u74b0\u5883\u4e2d\u975e\u5e38\u6709\u50f9\u503c\uff0c\u56e0\u70ba\u5b83\u5141\u8a31\u81e8\u5e8a\u91ab\u751f\u5728\u5f71\u50cf\u7372\u53d6\u7684\u540c\u6642\u7acb\u5373\u9032\u884c\u8a3a\u65b7\u548c\u6cbb\u7642\u6c7a\u7b56\u3002\u6df1\u5ea6\u5b78\u7fd2\u6a21\u578b\u53ef\u4ee5\u81ea\u52d5\u5206\u6790\u808c\u9aa8\u7d50\u69cb\uff0c\u4ee5\u5354\u52a9\u75be\u75c5\u8a3a\u65b7\u548c\u8a55\u4f30\uff1b\u800c\u4e8c\u7dad\u96f7\u5c04\u5c0d\u6e96\u88dd\u7f6e\uff0c\u53ef\u4ee5\u5e6b\u52a9\u91ab\u751f\u66f4\u7cbe\u6e96\u5730\u9032\u884c\u4e0b\u91dd\u6cbb\u7642\u3002<\/p>\n

\"\"\u00a0<\/span><\/p>\n

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\"\"<\/p>\n

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“Point-of-care” refers to the ability of healthcare professionals to provide patient care anytime and anywhere using diagnostic tools, such as blood glucose testing and pregnancy detection. In recent years, there has been a growing emphasis on point-of-care, and ultrasound-guided injection has emerged as an important and popular technique. In 2019, Professor Kuo published a study in the Journal of Clinical Medicine introducing a novel two-dimensional laser-align (2DLA) device (1.) designed to assist clinicians in accurately positioning the needle in the scan plane during ultrasound-guided injections. Novice physicians often require significant time to master ultrasound-guided injection techniques, particularly with in-plane approaches that demand hand-eye coordination for precise needle positioning and correct angulation toward the target. Therefore, the development of tools that facilitate novice access to the target is crucial to improving their learning curve.<\/p>\n

Currently, various alignment devices are available in the market, but they often come with limitations. For example, the Infiniti PlusTM needle guidance system lacks flexibility for adjusting the needle angle once inserted into the tissue, and larger systems like electromagnetic tracking and optical tracking are impractical for regular clinics due to their size and cost. In contrast, laser-assisted approaches are relatively inexpensive and compact. However, many existing laser-based systems focus only on guiding needle positioning in the scan plane, neglecting assistance in insertion angle.<\/p>\n

Professor Kuo’s 2DLA device addresses these limitations. It is affordable, lightweight, easy to manufacture, and compatible with any type of ultrasound transducer. The device offers guidance in three modes: 2DLA assisting, one-dimensional (1D) in-plane laser-align assisting without guidance for needle insertion angle, and no laser-align assisting, representing the traditional freehand approach. The research demonstrates that the 2DLA mode significantly reduces the time for successful targeting and retargeting frequency compared to the freehand (FH) and 1DLA modes. Rapid and accurate injection is a challenging aspect of ultrasound-guided injection training, and Professor Kuo’s device shows great potential in reducing the learning time required to master this skill and expediting the overall procedure.<\/p>\n

Continuing this innovative work, Professor Kuo published a study in May of this year in Ultrasound in Medicine and Biology (2.), applying deep learning models to automatic segementation of nerve in dynamic ultrasonography. This research focused on patients with Carpal Tunnel Syndrome (CTS), where compression of the median nerve (MN) at the wrist level causes the condition. Dynamic ultrasound imaging is invaluable for diagnosing and treating CTS, providing real-time visualization of nerve deformation and translation during finger movement.<\/p>\n

Professor Kuo’s team successfully employed deep learning models for the automated segmentation of the median nerve in dynamic ultrasound images. Abnormal features of the compressed nerve during finger movement, such as centroid displacement, cross-sectional area, and circularity, were detected to assist in evaluating disease severity and the effectiveness of perineural injections. Traditional manual segmentation of dynamic ultrasound images is labor-intensive and dependent on the examiner’s experience, leading to variability in data reproducibility. The introduction of deep learning addresses these challenges, offering an automated and consistent segmentation method.<\/p>\n

The clinical significance of Professor Kuo’s research lies in its ability to enable immediate diagnosis and treatment decisions for clinicians during image acquisition. Deep learning models can automatically analyze musculoskeletal structures to aid in disease diagnosis and evaluation. Additionally, the 2DLA device enhances precision in needle treatments. Professor Kuo’s team is at the forefront of utilizing deep learning models for automated image segmentation in dynamic ultrasound, marking a significant advancement in real-time extraction of dynamic MN morphology.<\/p>\n

In summary, Professor Kuo’s research contributes valuable tools and methodologies to the clinical environment. The combination of the 2DLA device and deep learning models holds promise for improving the efficiency and accuracy of ultrasound-guided procedures, ultimately benefiting both healthcare professionals and patients.<\/p>\n

 <\/p>\n

Ref:<\/p>\n

    \n
  1. Shiao, E.C.; Kuo, P.-L. Two-Dimensional Laser-Align Device for Ultrasound-Guided Injection. J. Clin. Med. 2019, 8, 1048.<\/li>\n
  2. Yeh, Cheng-Liang, et al. “Real-Time Automated Segmentation of Median Nerve in Dynamic Ultrasonography Using Deep Learning.”\u00a0Ultrasound in Medicine & Biology\u00a049.5 (2023): 1129-1136.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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