Fetal congenital heart disease (CHD) is the most common type of fatal congenital malformation. Fetal four-chamber (FC) view is a significant and easily accessible ultrasound (US) image among fetal echocardiography images. Automatic detection of four fetal heart chambers considerably contributes to the early diagnosis of fetal CHD. Furthermore, robust and discriminative features are essential for detecting crucial visualizing medical images, especially fetal FC views. However, it is an incredibly challenging task due to several key factors, such as numerous speckles in US images, the fetal four chambers with small size and unfixed positions, and category confusion caused by the similarity of cardiac chambers. These factors hinder the process of capturing robust and discriminative features, hence destroying the fetal four chambers’ precise detection. Therefore, we propose an intelligent feature learning detection system (FLDS) for FC views to detect the four chambers. A multistage residual hybrid attention module (MRHAM) presented in this paper is incorporated in the FLDS for learning powerful and robust features, helping FLDS accurately locate the four chambers in the fetal FC views. Extensive experiments demonstrate that our proposed FLDS outperforms the current state-of-the-art, including the precision of 0.919, the recall of 0.971, the $F_{1}$ score of 0.944, the mAP of 0.953, and the frames per second (FPS) of 43. In addition, our proposed FLDS is also validated on other visualizing nature images such as the PASCAL VOC dataset, achieving a higher mAP of 0.878 while input size is 608 × 608.

Four-chamber (FC) views are the primary ultrasound (US) images that cardiologists diagnose whether the fetus has congenital heart disease (CHD) in prenatal diagnosis and screening. FC views intuitively depict the developmental morphology of the fetal heart. Early diagnosis of fetal CHD has always been the focus and difficulty of prenatal screening. Furthermore, deep learning technology has achieved great success in medical image analysis. Hence, applying deep learning technology in the early screening of fetal CHD helps improve diagnostic accuracy. However, the lack of large-scale and high-quality fetal FC views brings incredible difficulties to deep learning models or cardiologists. Hence, we propose a Pseudo-Siamese Feature Fusion Generative Adversarial Network (PSFFGAN), synthesizing high-quality fetal FC views using FC sketch images. In addition, we propose a novel Triplet Generative Adversarial Loss Function (TGALF), which optimizes PSFFGAN to fully extract the cardiac anatomical structure information provided by FC sketch images to synthesize the corresponding fetal FC views with speckle noises, artifacts, and other ultrasonic characteristics. The experimental results show that the fetal FC views synthesized by our proposed PSFFGAN have the best objective evaluation values: SSIM of 0.4627, MS-SSIM of 0.6224, and FID of 83.92, respectively. More importantly, two professional cardiologists evaluate healthy FC views and CHD FC views synthesized by our PSFFGAN, giving a subjective score that the average qualified rate is 82% and 79%, respectively, which further proves the effectiveness of the PSFFGAN.

Echocardiography is essential for evaluating cardiac anatomy and function during early recognition and screening for congenital heart disease (CHD), a widespread and complex congenital malformation. However, fetal CHD recognition still faces many difficulties due to instinctive fetal movements, artifacts in ultrasound images, and distinctive fetal cardiac structures. These factors hinder capturing robust and discriminative representations from ultrasound images, resulting in CHD's low prenatal detection rate. Hence, we propose a multi-scale gated axial-transformer network (MSGATNet) to capture fetal four-chamber semantic information. Then, we propose a SPReCHD: four-chamber semantic parsing network for recognizing fetal CHD in the clinical treatment of the medical metaverse, integrating MSGATNet to segment and locate four-chamber arbitrary contours, further capturing distinguished representations for the fetal heart. Comprehensive experiments indicate that our SPReCHD is sufficient in recognizing fetal CHD, achieving a precision of 95.92%, a recall of 94%, an accuracy of 95%, and a $F_{1}$ score of 94.95% on the test set, dramatically improving the fetal CHD's prenatal detection rate.

Objective: Kawasaki syndrome (KS) is an acute vasculitis that affects children < 5 years of age and leads to coronary artery lesions (CAL) in about 20-25% of untreated cases. Machine learning (ML) is a branch of artificial intelligence (AI) that integrates complex data sets on a large scale and uses huge data to predict future events. The purpose of the present study was to use ML to present the model for early risk assessment of CAL in children with KS by different algorithms. Methods: A total of 158 children were enrolled from Women and Children’s Hospital, Qingdao University, and divided into 70–30% as the training sets and the test sets for modeling and validation studies. There are several classifiers are constructed for models including the random forest (RF), the logistic regression (LR), and the eXtreme Gradient Boosting (XGBoost). Data preprocessing is analyzed before applying the classifiers to modeling. To avoid the problem of overfitting, the 5-fold cross validation method was used throughout all the data. Results: The area under the curve (AUC) of the RF model was 0.925 according to the validation of the test set. The average accuracy was 0.930 (95% CI, 0.905 to 0.956). The AUC of the LG model was 0.888 and the average accuracy was 0.893 (95% CI, 0,837 to 0.950). The AUC of the XGBoost model was 0.879 and the average accuracy was 0.935 (95% CI, 0.891 to 0.980). Conclusion: The RF algorithm was used in the present study to construct a prediction model for CAL effectively, with an accuracy of 0.930 and AUC of 0.925. The novel model established by ML may help guide clinicians in the initial decision to make a more aggressive initial anti-inflammatory therapy. Due to the limitations of external validation and regional population characteristics, additional research is required to initiate a further application in the clinic.

Echocardiography is essential in evaluating fetal cardiac anatomical structures and functions when clinicians conduct early treatment and screening for congenital heart defects, a common and intricate fetal malformation. Nevertheless, the prenatal detection rate of fetal CHD remains low since the peculiarities of fetal cardiac structures and the variousness of fetal CHD. Precisely segmenting four cardiac chambers can assist clinicians in analyzing cardiac morphology and further facilitate CHD diagnosis. Hence, we design a dual-path chain multi-scale gated axial-transformer network (DPC-MSGATNet) that simultaneously models global dependencies and local visual cues for fetal ultrasound (US) four-chamber (FC) views and further accurately segments four chambers. Our DPC-MSGATNet includes a global and a local branch that simultaneously operates on an entire FC view and image patches to learn multi-scale representations. We design a plug-and-play module, Interactive dual-path chain gated axial-transformer (IDPCGAT), to enhance the interactions between global and local branches. In IDPCGAT, the multi-scale representations from the two branches can complement each other, capturing the same region’s salient features and suppressing feature responses to maintain only the activations associated with specific targets. Extensive experiments demonstrate that the DPC-MSGATNet exceeds seven state-of-the-art convolution- and transformer-based methods by a large margin in terms of F1 and IoU scores on our fetal FC view dataset, achieving a F1 score of 96.87 $$\%$$% and an IoU score of 93.99 $$\%$$% . The codes and datasets can be available at https://github.comQiaoSiBo/DPC-MSGATNet.