Medical Devices: Evidence and Research (Oct 2020)
Auscultation System for Acquisition of Vascular Sounds – Towards Sound-Based Monitoring of the Carotid Artery
Abstract
Thomas Sühn,1 Moritz Spiller,1 Rutuja Salvi,2 Stefan Hellwig,2 Axel Boese,1 Alfredo Illanes,1 Michael Friebe1 1INKA - Innovation Laboratory for Image Guided Therapy, Medizinische Fakultät, Otto-Von-Guericke-Universität, Magdeburg, Sachsen-Anhalt, Germany; 2IDTM GmbH, Castrop-Rauxel, Nordrhein-Westfalen, GermanyCorrespondence: Thomas Sühn Email [email protected]: Atherosclerotic diseases of the carotid are a primary cause of cerebrovascular events such as stroke. For the diagnosis and monitoring angiography, ultrasound- or magnetic resonance-based imaging is used which requires costly hardware. In contrast, the auscultation of carotid sounds and screening for bruits – audible patterns related to turbulent blood flow – is a simple examination with comparably little technical demands. It can indicate atherosclerotic diseases and justify further diagnostics but is currently subjective and examiner dependent.Methods: We propose an easy-to-use computer-assisted auscultation system for a stable and reproducible acquisition of vascular sounds of the carotid. A dedicated skin-transducer-interface was incorporated into a handheld device. The interface comprises two bell-shaped structures, one with additional acoustic membrane, to ensure defined skin contact and a stable propagation path of the sound. The device is connected wirelessly to a desktop application allowing real-time visualization, assessment of signal quality and input of supplementary information along with storage of recordings in a database. An experimental study with 5 healthy subjects was conducted to evaluate usability and stability of the device. Five recordings per carotid served as data basis for a wavelet-based analysis of the stability of spectral characteristics of the recordings.Results: The energy distribution of the wavelet-based stationary spectra proved stable for measurements of a particular carotid with the majority of the energy located between 3 and 40 Hz. Different spectral properties of the carotids of one individual indicate the presence of sound characteristics linked to the particular vessel. User-dependent parameters such as variations of the applied contact pressure appeared to have minor influence on the general stability.Conclusion: The system provides a platform for reproducible carotid auscultation and the creation of a database of pathological vascular sounds, which is a prerequisite to investigate sound-based vascular monitoring.Keywords: stenosis, screening, computer-assisted auscultation, vascular disease, bruit, long-term monitoring, heart sound
