WO2014195742A1 - The procedure for determining and counting b-lines in ultrasound diagnosis of lung diseases - Google Patents

The procedure for determining and counting b-lines in ultrasound diagnosis of lung diseases Download PDF

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Publication number
WO2014195742A1
WO2014195742A1 PCT/HR2014/000017 HR2014000017W WO2014195742A1 WO 2014195742 A1 WO2014195742 A1 WO 2014195742A1 HR 2014000017 W HR2014000017 W HR 2014000017W WO 2014195742 A1 WO2014195742 A1 WO 2014195742A1
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Prior art keywords
lines
determination
ultrasound
counting
procedure
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PCT/HR2014/000017
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French (fr)
Inventor
Alan ŠUSTIĆ
Alan PROTIĆ
Zoran Matić
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Sveučilište U Rijeci Medicinski Fakultet
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Publication of WO2014195742A1 publication Critical patent/WO2014195742A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/085Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0858Detecting organic movements or changes, e.g. tumours, cysts, swellings involving measuring tissue layers, e.g. skin, interfaces
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461Displaying means of special interest
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5223Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/30ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461Displaying means of special interest
    • A61B8/465Displaying means of special interest adapted to display user selection data, e.g. icons or menus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5269Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving detection or reduction of artifacts

Definitions

  • This invention refers to the medical field of ultrasound diagnosis of lung diseases inside the patient's chest, and under the international classification of patents (ICP) it is classified as
  • B-lines also known as comet tails, are a diagnostic indicator for the condition (state) of lung tissue in patients, which can be used to determine the severity of patient's illness, therapy and treatment path with increase precisions.
  • B-lines appear on the monitor of the ultrasound device as vertical lines flashing on the screen whose intensity and number vary. Due to this variability and the slow movement of the human eye, it is difficult to estimate the number of B-lines precisely, even in experienced experts.
  • the primary purpose of this invention is to enable precise determination of the number of B-lines in real time as well as to enable appropriate storage of the data.
  • the secondary purpose of this invention is to enable precise counting of B-lines in real time as well as to enable appropriate storage of the data.
  • the purpose is to enable a less experienced physician to use the ultrasound with more certainty since the data obtained during examination is not subject to interpretation and judgment but is absolutely precise.
  • the procedure for determining and counting B-lines in ultrasound diagnosis of lung diseases applying this invention encompasses the processing of the outgoing digital video signal from the ultrasound diagnostic device on a computer or another programmable device. Using software installed on a computer or a similar device the signals from the ultrasound device are processed in real time, which ensures the precise insight into the number of B-lines, the average number of B-lines in units of time as well as other processed information necessary for diagnosis.
  • Figure 1 is the schematic representation of the overall procedure for the determination and counting of B-lines. From the diagnostic ultrasound device (1) through video signal outlet (3) digital video signal (4) enters the computer (7) and the software package (5) where it is processed and as a processed signal (6) is directed either to the screen (11) where it is visible through the connection (9), or is directed to the storing device (10) through the connection (8) and only later visible on the screen (11), through a connection (12).
  • FIG. 2 is a diagram describing the flowchart of the software (software operation) (5) that is installed on the computer (7), showing the steps in the processing of the digital video signal (4) from the diagnostic ultrasound device (1).
  • the steps are: acceptance of the digital video signal (5.1), selection of a single picture from the row of video signals (5.2), determination of the centre of the picture in a polar coordinate plane which also represents the starting point of the ultrasound transducer (5.3), determination of the area of algorithm application (ROI) in the polar coordinate plane (5.4), application of the vertical integration within the area of algorithm application in the polar coordinate plane (5.5), application of a digital low pass filter for decreasing the noise obtained after the integration (5.6), the application of the algorithm for the detection of local peaks of the curvature according to the set standards (5.7), determination of other diagnostically necessary features of B-lines (5.8) and the graphical representation of the entire data in screen-wide format (5.9) through processed video signal outlet (6).
  • Figure 3 represents the magnified view of the obtained results in terms of the determination and counting of B-lines on the screen (11) which shows the momentary picture from the video signal (11.6), tool box (11.1) for software use, the number of detected B-lines in real time (11.2), average number of detected B- lines in a unit of time (11.3), absolute average of the number of B-lines detected during medical examination (11.4), graphical representation of the number of B- lines in relation to the time spend on examination (11.5) and the graphical representation of the positions of B-lines (11.7).
  • Figure 1 shows the entire procedure for the determination and counting of B-lines.
  • the body of the ultrasound diagnostic device (1) contains outlets for incoming digital signals (2) and outgoing digital signals (3).
  • the computer's outgoing signal outlet (7) is connected to the ultrasound device through its outgoing signal outlet (3), which enables the flow of the digital video signal between the two devices (4).
  • the software (5) for the determination and processing of B-lines is installed on the computer (7). Using algorithms, the software processes the incoming digital signal (4) and the obtained result is through the connection (9) exhibited on the screen (11) in real time, or it is though a connection (8) stored on the data-storing device (10). Later on, the stored processed data can be shown on the screen (11) if needed, using a connection (12).
  • FIG. 2 shows the diagram of the software operation (5) that is installed on the computer (7).
  • the first step (5.1) is the incoming video outlet (4).
  • Next step (5.2) is the selection of a single picture from the row of video signals.
  • the next position (5.3) represents the determination of the centre of the picture in a polar coordinate plane, which also represents the starting point of the ultrasound transducer.
  • the next position (5.4) represents the determination of the area of algorithm application (ROI) also in the polar coordinate plane. Determining the area of algorithm application in which the B-lines actually appear optimizes the time in which the algorithm is performing and decreases the possibility of incorrect readings.
  • ROI area of algorithm application
  • Next position (5.5) represents the application of the vertical integration (summarizing) which is conducted within the area of algorithm application in the polar coordinate plane of the ultrasound transducer.
  • the following position (5.6) represents the application of the digital low pass filter for the purpose of decreasing the noise obtained after the integration.
  • the following position (5.7) represents the application of the algorithm for the detection of local peaks of the curvature according to the set standards (height, width, distance), which constitutes the most important element of the algorithm.
  • the algorithm decides which event is relevant for subsequent analysis.
  • the following position (5.8) is the point of the determination of other diagnostically necessary features of B-lines.
  • the following position (5.9) is the graphical representation of the entire data in screen-wide format through processed video signal (6).
  • Figure 3 represents the detailed and magnified view on the date shown on the screen (11).
  • the data is made available by the means of a processed digital video signal (6).
  • the screen (11) shows the momentary representation of a single selected picture from the video signal (11.6), graphically representing the position of the detected B-lines (11.7).
  • the toolbox for operating the software is situated in the upper part of the screen (11.1), while the numerical data is situated in centre on the right: the number of detected B-lines in real time (11.2), average number of detected B-lines in a unit of time (11.3), average of the number of B-lines detected during medical examination (11.4).
  • This invention enables very precise determination and counting of B-lines using the ultrasound diagnostic device during an ultrasound diagnostic examination of lung tissue within patients' chest. Determining the number of B-lines in real time, as well as determining an average number of B-lines in a unit of time provides a physician a very detailed view on the condition of patients' lungs and hence enables a correct diagnosis that predetermines all following treatments. Even an ultrasound operator with less experience can evaluate the condition of patient's lungs because the results cannot be interpreted in more ways than one.

Abstract

The procedure for determination and counting of B-lines during the ultrasound diagnosing of lung illnesses in patient's chest consists of connecting the ultrasound device (1) using the video output (3) to the computer (7) with installed software (5) which processes the incoming digital signal (4) and the processed signal (6) is exhibited on the screen (11) where result goes through the connection (9) in real time using all the necessary information to generate a diagnosis (Figure 3), or it is stored on the data- storing device (10) though a connection (8) and can be later on shown on the screen (11) using a connection (12).

Description

THE PROCEDURE FOR DETERMINING AND COUNTING B-LINES IN
ULTRASOUND DIAGNOSIS OF LUNG DISEASES
DISCRETION OF THE INVENTION
1) TECHNICAL FIELD OF THE INVENTION
This invention refers to the medical field of ultrasound diagnosis of lung diseases inside the patient's chest, and under the international classification of patents (ICP) it is classified as
2) TECHNICAL PROBLEM
Determining the number of B-lines is a problem that appears when the ultrasound is used to diagnose lung diseases. B-lines, also known as comet tails, are a diagnostic indicator for the condition (state) of lung tissue in patients, which can be used to determine the severity of patient's illness, therapy and treatment path with increase precisions. B-lines appear on the monitor of the ultrasound device as vertical lines flashing on the screen whose intensity and number vary. Due to this variability and the slow movement of the human eye, it is difficult to estimate the number of B-lines precisely, even in experienced experts.
3) BACKGROUND INFORMATION
Current technology is restricted to counting the number of B-lines visible to the examiner on the screen of the ultrasound by examiner himself. Due to the dynamics of the medical examination B-lines appear as flashes that change in numbers rapidly, estimating their number is only qualitative where the estimate ranges from subjective «few» to «many», and not quantitative. Such approach may lead to inaccurate estimates of the number of B-lines and hence to inaccurate diagnosis. 4) BRIEF DESCRIPTION OF INVENTION
The primary purpose of this invention is to enable precise determination of the number of B-lines in real time as well as to enable appropriate storage of the data.
The secondary purpose of this invention is to enable precise counting of B-lines in real time as well as to enable appropriate storage of the data.
Ultimately, the purpose is to enable a less experienced physician to use the ultrasound with more certainty since the data obtained during examination is not subject to interpretation and judgment but is absolutely precise.
The procedure for determining and counting B-lines in ultrasound diagnosis of lung diseases applying this invention encompasses the processing of the outgoing digital video signal from the ultrasound diagnostic device on a computer or another programmable device. Using software installed on a computer or a similar device the signals from the ultrasound device are processed in real time, which ensures the precise insight into the number of B-lines, the average number of B-lines in units of time as well as other processed information necessary for diagnosis.
5) BRIEF DESCRIPTION OF THE DRAWINGS
Accompanying schematic representations describe the invention and illustrate the basic working principles of the invention.
Figure 1 is the schematic representation of the overall procedure for the determination and counting of B-lines. From the diagnostic ultrasound device (1) through video signal outlet (3) digital video signal (4) enters the computer (7) and the software package (5) where it is processed and as a processed signal (6) is directed either to the screen (11) where it is visible through the connection (9), or is directed to the storing device (10) through the connection (8) and only later visible on the screen (11), through a connection (12).
Figure 2 is a diagram describing the flowchart of the software (software operation) (5) that is installed on the computer (7), showing the steps in the processing of the digital video signal (4) from the diagnostic ultrasound device (1). The steps are: acceptance of the digital video signal (5.1), selection of a single picture from the row of video signals (5.2), determination of the centre of the picture in a polar coordinate plane which also represents the starting point of the ultrasound transducer (5.3), determination of the area of algorithm application (ROI) in the polar coordinate plane (5.4), application of the vertical integration within the area of algorithm application in the polar coordinate plane (5.5), application of a digital low pass filter for decreasing the noise obtained after the integration (5.6), the application of the algorithm for the detection of local peaks of the curvature according to the set standards (5.7), determination of other diagnostically necessary features of B-lines (5.8) and the graphical representation of the entire data in screen-wide format (5.9) through processed video signal outlet (6).
Figure 3 represents the magnified view of the obtained results in terms of the determination and counting of B-lines on the screen (11) which shows the momentary picture from the video signal (11.6), tool box (11.1) for software use, the number of detected B-lines in real time (11.2), average number of detected B- lines in a unit of time (11.3), absolute average of the number of B-lines detected during medical examination (11.4), graphical representation of the number of B- lines in relation to the time spend on examination (11.5) and the graphical representation of the positions of B-lines (11.7).
6) DETAILED DESCRIPTION OF AT LEAST ONE POSSIBLE WAY OF REALIZING THE INVENTION
Next we present the details of the realization of this invention with an example illustrated on the accompanying drawings.
Figure 1 shows the entire procedure for the determination and counting of B-lines.
The body of the ultrasound diagnostic device (1) contains outlets for incoming digital signals (2) and outgoing digital signals (3). The computer's outgoing signal outlet (7) is connected to the ultrasound device through its outgoing signal outlet (3), which enables the flow of the digital video signal between the two devices (4). The software (5) for the determination and processing of B-lines is installed on the computer (7). Using algorithms, the software processes the incoming digital signal (4) and the obtained result is through the connection (9) exhibited on the screen (11) in real time, or it is though a connection (8) stored on the data-storing device (10). Later on, the stored processed data can be shown on the screen (11) if needed, using a connection (12).
Figure 2 shows the diagram of the software operation (5) that is installed on the computer (7). The first step (5.1) is the incoming video outlet (4). Next step (5.2) is the selection of a single picture from the row of video signals. The next position (5.3) represents the determination of the centre of the picture in a polar coordinate plane, which also represents the starting point of the ultrasound transducer. The next position (5.4) represents the determination of the area of algorithm application (ROI) also in the polar coordinate plane. Determining the area of algorithm application in which the B-lines actually appear optimizes the time in which the algorithm is performing and decreases the possibility of incorrect readings. Next position (5.5) represents the application of the vertical integration (summarizing) which is conducted within the area of algorithm application in the polar coordinate plane of the ultrasound transducer. When the linear ultrasound transducers are applied, the integration is performed on the Cartesian coordinate system. The following position (5.6) represents the application of the digital low pass filter for the purpose of decreasing the noise obtained after the integration. The following position (5.7) represents the application of the algorithm for the detection of local peaks of the curvature according to the set standards (height, width, distance), which constitutes the most important element of the algorithm. Here, the algorithm decides which event is relevant for subsequent analysis. The following position (5.8) is the point of the determination of other diagnostically necessary features of B-lines. The following position (5.9) is the graphical representation of the entire data in screen-wide format through processed video signal (6).
Figure 3 represents the detailed and magnified view on the date shown on the screen (11). The data is made available by the means of a processed digital video signal (6). The screen (11) shows the momentary representation of a single selected picture from the video signal (11.6), graphically representing the position of the detected B-lines (11.7). The toolbox for operating the software is situated in the upper part of the screen (11.1), while the numerical data is situated in centre on the right: the number of detected B-lines in real time (11.2), average number of detected B-lines in a unit of time (11.3), average of the number of B-lines detected during medical examination (11.4). Providing additional assistance in diagnosing, situated in the lower right corner, it is located a graphical representation of the number of B-lines in relation to the time spent on examination (11.5).
7) INVENTION APPLICATION
This invention enables very precise determination and counting of B-lines using the ultrasound diagnostic device during an ultrasound diagnostic examination of lung tissue within patients' chest. Determining the number of B-lines in real time, as well as determining an average number of B-lines in a unit of time provides a physician a very detailed view on the condition of patients' lungs and hence enables a correct diagnosis that predetermines all following treatments. Even an ultrasound operator with less experience can evaluate the condition of patient's lungs because the results cannot be interpreted in more ways than one.

Claims

PATENT CLAIMS
1. The procedure for determination and counting of B-lines during the ultrasound diagnosing of lung illnesses consists of the acceptance of the outgoing video signal (4) from the diagnostic ultrasound device (1 ) and the processing of the signal in the computer (7) wherein the processing of the outgoing video signal is done by the software (5) installed in the computer (7), which shows the exact number of B-lines on a screen (1 1 ) through the outgoing digital signal of processed data (6).
2. The procedure for determination and counting of B-lines during the ultrasound diagnosing of lung illnesses according to the claim 1 , wherein the diagram of the software operation (5) according to Figure 2 consists of accepting the incoming video signal (5.1), the selection of a single picture from the row of video signals (5.2), the determination of the centre of the picture in a polar coordinate system, which also represents the starting point of the ultrasound transducer (5.3), the determination of the area of algorithm application (ROI) also in the polar coordinate plane (5.4), the application of the vertical integration (summarizing) which is conducted within the area of algorithm application in the polar coordinate system of the ultrasound transducer (5.5), the application of the digital low pass filter for the purpose of decreasing the noise obtained after the integration (5.6), the application of the algorithm for the detection of local peaks of the curvature according to the set standards (5.7), the determination of other diagnostically necessary features of B-lines (5.8) and obtaining the graphical representation of the entire data in screen-wide format (5.9).
3. The procedure for determination and counting of B-lines during the ultrasound diagnosing of lung illnesses according to the claim , wherein the outgoing digital signal of processed data (6) can be stored on a data-storing device (10) using a connection (8).
4. The procedure for determination and counting of B-lines during the ultrasound diagnosing of lung illnesses according to the claim 1 and 2 wherein on the screen (11), and according to Figure 3, exhibits the processed digital signal (6) with all the elements necessary for diagnosis: the exact number of detected B-lines in real time (11.2), average number of detected B-lines in a unit of time (11.3), absolute average of the number of B-lines detected during medical examination (11.4), graphical representation of the number of B-lines in relation to the time spend on examination (11.5) instant view of a selection of a single picture from the video signal (11.6), graphical representation of the positions of B-lines (11.7) and the tool box (11.1) for software operation (5).
PCT/HR2014/000017 2013-06-04 2014-05-28 The procedure for determining and counting b-lines in ultrasound diagnosis of lung diseases WO2014195742A1 (en)

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US20170086794A1 (en) * 2015-09-29 2017-03-30 General Electric Company Method and system for enhanded visualization and selection of a representative ultrasound image by automatically detecting b lines and scoring images of an ultrasound scan
WO2017126753A1 (en) * 2016-01-21 2017-07-27 서울대학교병원 (분사무소) Ultrasound system and monitoring method for continuous monitoring of state of the lungs
WO2018063811A1 (en) * 2016-09-29 2018-04-05 General Electric Company Method and system for enhanced visualization and selection of a representative ultrasound image by automatically detecting b lines and scoring images of an ultrasound scan
WO2018226918A1 (en) * 2017-06-09 2018-12-13 Tokitae Llc Ultrasound systems and methods of identifying fluids in body regions using the same
WO2019101714A1 (en) * 2017-11-22 2019-05-31 Koninklijke Philips N.V. Ultrasonic pulmonary assessment
US11896433B2 (en) 2017-08-16 2024-02-13 Koninklijke Philips N.V. Ultrasound determination of dynamic air bronchogram and associated devices, systems, and methods

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US20170086794A1 (en) * 2015-09-29 2017-03-30 General Electric Company Method and system for enhanded visualization and selection of a representative ultrasound image by automatically detecting b lines and scoring images of an ultrasound scan
US10667793B2 (en) * 2015-09-29 2020-06-02 General Electric Company Method and system for enhanced visualization and selection of a representative ultrasound image by automatically detecting B lines and scoring images of an ultrasound scan
WO2017126753A1 (en) * 2016-01-21 2017-07-27 서울대학교병원 (분사무소) Ultrasound system and monitoring method for continuous monitoring of state of the lungs
JP2019535346A (en) * 2016-09-29 2019-12-12 ゼネラル・エレクトリック・カンパニイ Method and system for improved visualization and selection of representative ultrasound images by automatically detecting B-lines and scoring images of ultrasound scans
WO2018063811A1 (en) * 2016-09-29 2018-04-05 General Electric Company Method and system for enhanced visualization and selection of a representative ultrasound image by automatically detecting b lines and scoring images of an ultrasound scan
CN109788939A (en) * 2016-09-29 2019-05-21 通用电气公司 For enhancing the method and system of the visualization of representative ultrasound image and selection by detecting B line automatically and being scored the image of ultrasonic scanning
WO2018226918A1 (en) * 2017-06-09 2018-12-13 Tokitae Llc Ultrasound systems and methods of identifying fluids in body regions using the same
US11446004B2 (en) 2017-06-09 2022-09-20 Tokitae Llc Ultrasound systems and methods of identifying fluids in body regions using the same
US11896433B2 (en) 2017-08-16 2024-02-13 Koninklijke Philips N.V. Ultrasound determination of dynamic air bronchogram and associated devices, systems, and methods
WO2019101714A1 (en) * 2017-11-22 2019-05-31 Koninklijke Philips N.V. Ultrasonic pulmonary assessment
CN111511288A (en) * 2017-11-22 2020-08-07 皇家飞利浦有限公司 Ultrasound lung assessment
US20200352547A1 (en) * 2017-11-22 2020-11-12 Koninklijke Philips N.V. Ultrasonic pulmonary assessment
JP2021503999A (en) * 2017-11-22 2021-02-15 コーニンクレッカ フィリップス エヌ ヴェKoninklijke Philips N.V. Ultrasound lung evaluation
JP7308196B2 (en) 2017-11-22 2023-07-13 コーニンクレッカ フィリップス エヌ ヴェ Ultrasound lung assessment

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