||Auditory-based signal processing for cardiovascular sound pattern analysis
||Department of Electrical Engineering
Human-like auditory processing
sound pattern analysis
跟據世界衛生組織統計，心血管疾病是全球的頭號死因，在2008年有1730萬人死於心血管疾病，佔全球總數的30%．估計到2030年，死於心血管疾病的人數將增加到2330萬人。現有的心血管疾病早期檢測設備中，非侵入式儀器，如杜普勒(Doppler)超音波心臟顯影(Echocardiography)，雖具精確， 非侵入性等優點．唯該設備較為昂貴，且需具心臟專科專業訓練之醫事人員才具能力判讀，無法成為居家自我檢測醫材．而其他非侵入式心臟監測之方法，如心電圖（Electrocardiography）雖為目前醫學界普遍使用的標準檢測方式，然僅能檢測心臟電氣特性，並無法偵測心臟機械功能之缺損與血管栓塞等疾病．本論文提出利用類人耳聽覺模型在處理語音訊息與聲音辨識上的強健性特徵，利用電子聽診器進行心血管聲音採集，並結合電腦輔助聽診技術，可將心血管的雜音透過3D耳蝸聽覺頻譜呈現，並進一步利用基於聽覺原理之時頻特徵分析，可將心血管之聲紋，如心音圖，脈聲圖等轉為聽覺上的辨識特徵，用以作為先天性心臟病與洗腎廔管栓篩等心血管疾病的早期偵測系統．目前是用此法於開放性動脈導管(Patent Ducturs Arteriosus)的偵測上具100%的敏感度與91.17%的特異度，而在洗腎廔管阻塞(Vascular access stenosis)的判定上則可達83.87 %的準確率．
For cardiovascular disease patients, non-invasive diagnosis methods, such as echocardiogram and electrocardiography (ECG), provide an accurate and safe method to assess the heart function. However, the echocardiogram is expensive and requires the operation of trained cardiologist. Although ECG is a standard method to diagnosis the heart disease in the first screening process, it cannot detect the mechanical disorder of heart function and thrombosis of blood vessel. Accordingly, this study proposed a Human-like auditory processing (HAP) to analysis the cardiovascular signal. The HAP had been verified and performed well at speech processing and robust speech recognition. It was further combined with electrical stethoscope and computerized-auscultation method for mimicking a trained practitioner in performing the auscultation process. In the proposed approach, the bruit obtained by a standard phonoangiography and phonocardiography of heart murmur are transformed into the time-frequency domain, and two spectro-temporal features, namely the auditory spectrum flux and the auditory spectral centroid, are then extracted. The distributions of the two features are analyzed using a multivariate Gaussian distribution (MGD) model. Finally, the distribution parameters of the MGD model are used to detect the presence (or otherwise) of vascular access stenosis. The results show an accuracy of 83.87% in detecting significant vascular access stenosis. Besides, the PDA murmurs, are used in the blind test for algorithm effectiveness assessment. The results demonstrate that the proposed computer-assisted auscultation method can achieve a high sensitivity of 100% and a specificity of 91.67% for PDA detection. The above results demonstrate that the proposed human-like auditory processing system used for cardiovascular sound analysis is robust, cost-effective and convenient for the non-invasive early detection.
List of Figures VII
List of Tables IX
List of Acronyms X
Chapter 1 Introduction 1
1.1 Motivations and Aims 1
1.2 Thesis Outline 3
Chapter 2 Literature Review 4
2.1. Auditory processing for speech enhancement and Recognition 4
2.2. Computer-aided Auscultation (CAA) for cardiovascular sound analysis 8
2.2.1. Patent Ductus Arteriosus Detection 8
2.2.2. Hemodialysis vascular access stenosis detection 11
Chapter 3 Methods 15
3.1. Human-like Auditory Processing (HAP) 15
3.1.1. Peripheral Auditory Processing 17
3.1.2. Cortical Auditory Processing 20
3.2. Auditory Spectro-Temporal Feature 22
3.2.1. Auditory Spectrum Flux 22
3.2.2. Auditory Spectral Centroid 23
3.2.3. Multivariate Gaussian Distribution 24
Chapter 4 Patent Ductus Arteriosus Detection 24
4.1. Subjects and Data Acquisition 25
4.2. Auditory Spectro-Temporal Analysis 26
4.3. Results 27
4.4. Discussion 33
Chapter 5 Hemodialysis Vascular Access Detection 36
5.1. Subjects and Data Acquisition 36
5.2. Auditory Spectro-Temporal Features 37
5.3. Results 38
5.4. Discussion 46
Chapter 6 Summary and Future Work 49
6.1. Summary 49
6.2. Future Work 50
A. Auditory-based feature extraction 52
A.1 Mel Frequency Cepstrum Coefficients 52
A.2 Gammatone Wavelet Cepstral Coefficients 54
A.3 Basilar-membrane Frequency-band Cepstral Coefficients (BFCC) 55
Publication List 62
 S. F. Boll, "Suppression of acoustic noise in speech using spectral subtraction," IEEE Transactions on Acoustics Speech and Signal Processing, vol. 27, pp. 113-120, 1979 1979.
 Y. Ephraim and D. Malah, "Speech enhancement using a minimum-mean square error short-time spectral amplitude estimator," Acoustics, Speech and Signal Processing, IEEE Transactions on, vol. 32, pp. 1109-1121, 1984.
 Y. Ephraim, "Statistical-model-based speech enhancement systems," Proceedings of the IEEE, vol. 80, pp. 1526-1555, 1992.
 K. Hermus, P. Wambacq, and H. Van hamme, "A review of signal subspace speech enhancement and its application to noise robust speech recognition," Eurasip Journal on Advances in Signal Processing, 2007.
 S. Khalfa, R. Bougeard, N. Morand, E. Veuillet, J. Isnard, M. Guenot, et al., "Evidence of peripheral auditory activity modulation by the auditory cortex in humans," Neuroscience, vol. 104, pp. 347-358, 5/10/ 2001.
 R. D. Patterson, Robinson, K., Holdsworth, J. W., McKeown, D., Zhang, C. and Allerhand, M., "Complex sounds and auditory images," Pergamon, Oxford, CH3_Method1992.
 M. Slaney, "Auditory Toolbox version2," Interval Research Corporation1998.
 L. Qi, "An auditory-based transfrom for audio signal processing," in Applications of Signal Processing to Audio and Acoustics, 2009. WASPAA '09. IEEE Workshop on, 2009, pp. 181-184.
 R. M. Stern and C. Trahiotis, Models of binaural interaction, 1995.
 A. Aertsen and P. I. M. Johannesma, "THE SPECTRO-TEMPORAL RECEPTIVE-FIELD - A FUNCTIONAL CHARACTERISTIC OF AUDITORY NEURONS," Biological Cybernetics, vol. 42, pp. 133-143, 1981.
 X. Yang, K. Wang, and S. A. Shamma, "Auditory representations of acoustic signals," Information Theory, IEEE Transactions on, vol. 38, pp. 824-839, 1992.
 T. S. Chi, Y. J. Gao, M. C. Guyton, P. W. Ru, and S. Shamma, "Spectro-temporal modulation transfer functions and speech intelligibility," Journal of the Acoustical Society of America, vol. 106, pp. 2719-2732, Nov 1999.
 A. Potamianos and P. Maragos, "Speech analysis and synthesis using an AM–FM modulation model," Speech Communication, vol. 28, pp. 195-209, 7// 1999.
 K. Paliwal, K. Wójcicki, and B. Schwerin, "Single-channel speech enhancement using spectral subtraction in the short-time modulation domain," Speech Communication, vol. 52, pp. 450-475, 5// 2010.
 L. Qin and L. Atlas, "Coherent modulation filtering for speech," in Acoustics, Speech and Signal Processing, 2008. ICASSP 2008. IEEE International Conference on, 2008, pp. 4481-4484.
 H. Rongqing and J. H. L. Hansen, "Advances in unsupervised audio classification and segmentation for the broadcast news and NGSW corpora," Audio, Speech, and Language Processing, IEEE Transactions on, vol. 14, pp. 907-919, 2006.
 R. P. a. I. Nimmo-Smith, "An efficient auditory filterbank based on the gammatone function," RSRE, Malvern14-15 December 1987 1987.
 A. a. M. Adiga, M. and Seelamantula, C.S., "Gammatone wavelet Cepstral Coefficients for robust speech recognition," presented at the TENCON 2013 - 2013 IEEE Region 10 Conference, 2013.
 S. a. D. W. Yang Shao and SRINIVASAN, "Incorporating Auditory Feature Uncertainties in Robust Speaker Identification," presented at the Acoustics, Speech and Signal Processing, 2007. ICASSP 2007. IEEE International Conference on, 2007.
 W. R. T. Po-Hsun Sung, Jieh-Neng Wang, Jhing-Fa Wang, Ling-Sheng Jang, "Computer-assisted Auscultation: Patent Ductus Arteriosus Detection based on Auditory Time Frequency Analysis," Journal of Medical and Biological Engineering, 2014.
 M. B. Rappaport and H. B. Sprague, "Physiologic and physical laws that govern auscultation, and their clinical application: The acoustic stethoscope and the electrical amplifying stethoscope and stethograph," American Heart Journal, vol. 21, pp. 257-318, 3// 1941.
 R. L. Watrous, W. R. Thompson, and S. J. Ackerman, "The Impact of Computer-assisted Auscultation on Physician Referrals of Asymptomatic Patients with Heart Murmurs," Clinical Cardiology, vol. 31, pp. 79-83, 2008.
 E. Delgado-Trejos, A. F. Quiceno-Manrique, J. I. Godino-Llorente, M. Blanco-Velasco, and G. Castellanos-Dominguez, "Digital Auscultation Analysis for Heart Murmur Detection," Annals of Biomedical Engineering, vol. 37, pp. 337-353, 2009/02/01 2009.
 H. a. L. Liang, S. and Hartimo, I., "Heart sound segmentation algorithm based on heart sound envelogram," presented at the Computers in Cardiology, 1997.
 M. E. Tavel, "Cardiac Auscultation: A Glorious Past—But Does It Have a Future?," Circulation, vol. 93, pp. 1250-1253, 1996.
 M. Kluckow and N. Evans, "Early echocardiographic prediction of symptomatic patent ductus arteriosus in preterm infants undergoing mechanical ventilation," The Journal of Pediatrics, vol. 127, pp. 774-779, 11// 1995.
 D. J. Schneider and J. W. Moore, "Patent Ductus Arteriosus," Circulation, vol. 114, pp. 1873-1882, October 24, 2006 2006.
 Patent Ductus Arteriosus. Available: https://en.wikipedia.org/wiki/Patent_ductus_arteriosus
 Y.-C. K. a. L.-H. H. Shih-Fang Huang, "Identification of cardiac dysfunction using a normalized spectrum of oscillometric pulses," Journal of Medical and Biological Engineering, vol. 29, pp. 25-28, 2009.
 L. D. Avendaño-Valencia, J. I. Godino-Llorente, M. Blanco-Velasco, and G. Castellanos-Dominguez, "Feature Extraction From Parametric Time–Frequency Representations for Heart Murmur Detection," Annals of Biomedical Engineering, vol. 38, pp. 2716-2732, 2010/08/01 2010.
 J. P. de Vos and M. M. Blanckenberg, "Automated Pediatric Cardiac Auscultation," Biomedical Engineering, IEEE Transactions on, vol. 54, pp. 244-252, 2007.
 "USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States," N. I. o. D. a. D. a. K. D. National Institutes of Health, Ed., ed, 2012.
 H. I. Feldman, S. Kobrin, and A. Wasserstein, "Hemodialysis vascular access morbidity," Journal of the American Society of Nephrology, vol. 7, pp. 523-535, April 1, 1996 1996.
 R. K. Dhingra, E. W. Young, T. E. Hulbert-Shearon, S. F. Leavey, and F. K. Port, "Type of vascular access and mortality in U.S. hemodialysis patients," Kidney Int, vol. 60, pp. 1443-1451, 10//print 2001.
 N. Tessitore, G. Mansueto, V. Bedogna, G. Lipari, A. Poli, L. Gammaro, et al., "A Prospective Controlled Trial on Effect of Percutaneous Transluminal Angioplasty on Functioning Arteriovenous Fistulae Survival," Journal of the American Society of Nephrology, vol. 14, pp. 1623-1627, June 1, 2003 2003.
 J. Alvarez-Linera, J. Benito-León, J. Escribano, J. Campollo, and R. Gesto, "Prospective Evaluation of Carotid Artery Stenosis: Elliptic Centric Contrast-Enhanced MR Angiography and Spiral CT Angiography Compared with Digital Subtraction Angiography," American Journal of Neuroradiology, vol. 24, pp. 1012-1019, May 1, 2003 2003.
 A. Diegeler, H. Thiele, V. Falk, R. Hambrecht, N. Spyrantis, P. Sick, et al., "Comparison of Stenting with Minimally Invasive Bypass Surgery for Stenosis of the Left Anterior Descending Coronary Artery," New England Journal of Medicine, vol. 347, pp. 561-566, 2002.
 W. D. Middleton, D. D. Picus, M. V. Marx, and G. L. Melson, "Color Doppler sonography of hemodialysis vascular access: comparison with angiography," American Journal of Roentgenology, vol. 152, pp. 633-639, 1989/03/01 1989.
 S. J. Schwab, M. J. Oliver, P. Suhocki, and R. McCann, "Hemodialysis arteriovenous access: Detection of stenosis and response to treatment by vascular access blood flow," Kidney Int, vol. 59, pp. 358-362, 01//print 2001.
 P. Wiese and B. Nonnast-Daniel, "Colour Doppler ultrasound in dialysis access," Nephrology Dialysis Transplantation, vol. 19, pp. 1956-1963, August 1, 2004 2004.
 R. S. Lees and C. F. Dewey, "Phonoangiography: A New Noninvasive Diagnostic Method for Studying Arterial Disease," Proceedings of the National Academy of Sciences, vol. 67, pp. 935-942, October 1, 1970 1970.
 R. M. Rosen, S. P. Parthasarathy, A. F. Turner, D. H. Blankenhorn, and E. J. Roschke, "Phonoangiography by autocorrelation," Circulation, vol. 55, pp. 626-633, April 1, 1977 1977.
 R. Knox, P. Breslau, and D. E. Strandness, "Quantitative carotid phonoangiography," Stroke, vol. 12, pp. 798-803, November 1, 1981 1981.
 R. Lees, "Phonoangiography: Qualitative and quantitative," Annals of Biomedical Engineering, vol. 12, pp. 55-62, 1984/01/01 1984.
 H. A. Mansy, S. J. Hoxie, N. H. Patel, and R. H. Sandler, "Computerised analysis of auscultatory sounds associated with vascular patency of haemodialysis access," Medical and Biological Engineering and Computing, vol. 43, pp. 56-62, 2005/02/01 2005.
 C.-H. L. Wei-Ling Chen, Tainsong Chen, Pei-Jarn Chen, Chung-Dann Kan, "Stenosis Detection using Burg Method with Autoregressive Model for Hemodialysis Patients," Journal of Medical and Biological Engineering, vol. 33, pp. 356-362, 2013 2013.
 M. Slaney, "Lyon's cochlear model," Apple Technical Report, CH3_Methods1988.
 Auditory System. Available: http://wiki.bethanycrane.com/auditorysystem
 T. Irino and R. D. Patterson, "A Dynamic Compressive Gammachirp Auditory Filterbank," Audio, Speech, and Language Processing, IEEE Transactions on, vol. 14, pp. 2222-2232, 2006.
 W. R. T. Po-Hsun Sung , Jieh-Neng Wang, Jhing-Fa Wang, Ling-Sheng Jang, "Computer-assisted Auscultation: Patent Ductus Arteriosus Detection based on Auditory Time Frequency Analysis," Journal of Medical and Biological Engineering, p. Accepted, 2014.
 M. Athineos and D. P. W. Ellis, "Frequency-domain linear prediction for temporal features," in Automatic Speech Recognition and Understanding, 2003. ASRU '03. 2003 IEEE Workshop on, 2003, pp. 261-266.
 S. M. N. Woolley, T. E. Fremouw, A. Hsu, and F. E. Theunissen, "Tuning for spectro-temporal modulations as a mechanism for auditory discrimination of natural sounds," Nat Neurosci, vol. 8, pp. 1371-1379, 10//print 2005.
 W. R. Thompson, C. S. Hayek, C. Tuchinda, J. K. Telford, and J. S. Lombardo, "Automated Cardiac Auscultation for Detection of Pathologic Heart Murmurs," Pediatric Cardiology, vol. 22, pp. 373-379, 2001/09/01 2001.
 M. E. S. a. C. F. Wooley, "Samuel A. Levine and the History of Grading Systolic Murmurs," American Journal of Cardiology, vol. 102, pp. 1107-1110, 15 October 2008 2008.
 T. Fawcett, "An introduction to ROC analysis," Pattern Recognition Letters, vol. 27, pp. 861-874, 6// 2006.
 D. G. Childers, Skinner, D.P., and Kemerait, R.C., "The cepstrum: A guide to processing," Proceedings of the IEEE, vol. 65, pp. 1428 - 1443, 1977.