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- Title
Visual assessment versus computer-assisted gray scale analysis in the ultrasound evaluation of neonatal respiratory status.
- Authors
Raimondi, Francesco; Migliaro, Fiorella; Verdoliva, Luisa; Gragnaniello, Diego; Poggi, Giovanni; Kosova, Roberta; Sansone, Carlo; Vallone, Gianfranco; Capasso, Letizia
- Abstract
Background and aim: Lung ultrasound has been used to describe common respiratory diseases both by visual and computer-assisted gray scale analysis. In the present paper, we compare both methods in assessing neonatal respiratory status keeping two oxygenation indexes as standards. Patients and methods: Neonates admitted to the NICU for respiratory distress were enrolled. Two neonatologists not attending the patients performed a lung scan, built a single frame database and rated the images with a standardized score. The same dataset was processed using the gray scale analysis implemented with textural features and machine learning analysis. Both the oxygenation ratio (PaO2/FiO2) and the alveolar arterial oxygen gradient (A-a) were kept as reference standards. Results: Seventy-five neonates with different respiratory status were enrolled in the study and a dataset of 600 ultrasound frames was built. Visual assessment of respiratory status correlated significantly with PaO2/FiO2 (r = -0.55; p<0.0001) and the A-a (r = 0.59; p<0.0001) with a strong interobserver agreement (K = 0.91). A significant correlation was also found between both oxygenation indexes and the gray scale analysis of lung ultrasound scans using regions of interest corresponding to 50K (r = -0.42; p<0.002 for PaO2/FiO2; r = 0.46 p<0.001 for A-a) and 100K (r = -0.35 p<0.01 for PaO2/FiO2; r = 0.58 p<0.0001 for A-a) pixels regions of interest. Conclusions: A semi quantitative estimate of the degree of neonatal respiratory distress was demonstrated both by a validated scoring system and by computer assisted analysis of the ultrasound scan. This data may help to implement point of care ultrasound diagnostics in the NICU.
- Subjects
RESPIRATORY distress syndrome; LUNG radiography; RESPIRATORY therapy for newborn infants; HYPERBARIC oxygenation; NEONATAL intensive care
- Publication
PLoS ONE, 2018, Vol 13, Issue 10, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0202397