Automatic Detection of Cardiac Chambers Using an Attention-based YOLOv4 Framework from Four-chamber View of Fetal Echocardiography

Echocardiography is a powerful prenatal examination tool for early diagnosis of fetal congenital heart diseases (CHDs). The four-chamber (FC) view is a crucial and easily accessible ultrasound (US) image among echocardiography images. Automatic analysis of FC views contributes significantly to the early diagnosis of CHDs. The first step to automatically analyze fetal FC views is locating the fetal four crucial chambers of heart in a US image. However, it is a greatly challenging task due to several key factors, such as numerous speckles in US images, the fetal cardiac chambers with small size and unfixed positions, and category indistinction caused by the similarity of cardiac chambers. These factors hinder the process of capturing robust and discriminative features, hence destroying fetal cardiac anatomical chambers precise localization. Therefore, we first propose a multistage residual hybrid attention module (MRHAM) to improve the feature learning. Then, we present an improved YOLOv4 detection model, namely MRHAM-YOLOv4-Slim. Specially, the residual identity mapping is replaced with the MRHAM in the backbone of MRHAM-YOLOv4-Slim, accurately locating the four important chambers in fetal FC views. Extensive experiments demonstrate that our proposed method outperforms current state-of-the-art, including the precision of 0.919, the recall of 0.971, the F1 score of 0.944, the mAP of 0.953, and the frames per second (FPS) of 43.