颏下超声视频舌骨运动人工测量信度及半自动追踪的效度

doi:10.3969/j.issn.1006-9771.2026.10.007

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (10): 1186-1193.doi: 10.3969/j.issn.1006-9771.2026.10.007

颏下超声视频舌骨运动人工测量信度及半自动追踪的效度

牛镇远¹^,², 杨雅玲¹, 邓钰萍¹, 陈善佳¹, 雷蕾¹, 何晓阔¹()

¹ 厦门市第五医院，福建厦门市 361100
² 福建中医药大学康复医学院，福建福州市 350122

收稿日期:2026-07-17 修回日期:2026-09-17 接受日期:2026-09-18 出版日期:2026-10-25 发布日期:2026-10-23
通讯作者: 何晓阔，男，汉族，博士，主任医师，主要研究方向：神经康复、神经调控技术。E-mail： HeXK@Sohu.com
作者简介:牛镇远(1991-)，男，汉族，山西晋城市人，硕士，主治医师，博士研究生，主要研究方向：疼痛康复、吞咽康复。
基金资助:
厦门市医疗卫生指导性项目(3502Z20224ZD1295)

Measurement of hyoid motion using submental ultrasound videos: reliability of manual measurements and validity of a semi-automated tracking method

Niu Zhenyuan¹^,², Yang Yaling¹, Deng Yuping¹, Chen Shanjia¹, Lei Lei¹, He Xiaokuo¹()

¹ Xiamen Fifth Hospital, Xiamen, Fujian 361100, China
² School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China

Received:2026-07-17 Revised:2026-09-17 Accepted:2026-09-18 Published:2026-10-25 Online:2026-10-23
Supported by:
Xiamen Medical and Health Guidance Project(3502Z20224ZD1295)

摘要/Abstract

摘要：

目的构建颏下超声舌骨运动半自动追踪分析流程，评价舌骨位移人工测量信度和半自动追踪测量效度及其分析效率。

方法 2024年10月至2025年8月，在厦门市第五医院招募健康成人46例，完成空吞咽，吞咽5 mL和10 mL中稠度液体吞咽任务，采集414段颏下矢状位超声视频；经视频质量筛查和追踪质控，286段视频纳入配对分析。融合通道与空间可靠性追踪器和第8版小型单阶段目标检测模型(YOLOv8s)，搭建半自动追踪流程。采用绝对一致性单次测量模型计算人工测量的重测组内相关系数〔ICC(A,1)〕和测量者间ICC(A,1)；以人工复测结果作为参照，计算半自动测量的Pearson相关系数(r)、ICC(A,1)和一致性相关系数(CCC)；采用基于受试者聚类的5 000次Bootstrap抽样估计95%置信区间；对比人工测量与半自动流程的累计分析时间。

结果 YOLOv8s独立测试集精确率0.940，召回率0.956；平均精度均值在交并比阈值0.5时为0.974，在0.5~0.95各阈值下的均值为0.609。人工测量舌骨最大水平、垂直位移重测ICC(A,1)分别为0.925和0.912；测量者间ICC(A,1)分别为0.815和0.775。与人工参照对比，半自动测量最大水平位移r = 0.865，ICC(A,1) = 0.843，CCC = 0.843；最大垂直位移r = 0.754，ICC(A,1) = 0.746，CCC = 0.745；水平、垂直方向平均偏倚分别为-0.772 mm、-0.229 mm，95%一致性界限依次为-4.567~3.023 mm、-2.918~2.460 mm。测量者A、B测量累计耗时分别为526 min、713 min；半自动测量流程总耗时155 min，其中数据处理40 min，人工复核115 min。

结论采用颏下超声视频测量舌骨最大位移信度良好；半自动追踪测量与人工测量具有较好一致性，可显著降低视频分析耗时。

关键词: 舌骨运动, 吞咽, 颏下超声, 半自动追踪, 深度学习, 信度, 效度

Abstract:

Objective To establish a semi-automated workflow for hyoid motion tracking based on submental ultrasound videos, evaluate the reliability of manual measurements and the validity of semi-automated tracking, and compare the analytical efficiency.

Methods A total of 46 healthy adults were recruited at Xiamen Fifth Hospital from October, 2024 to August, 2025, and performed dry swallows and swallows of 5 mL and 10 mL moderately-thick liquid boluses. A total of 414 sagittal-plane submental ultrasound videos were acquired. After video quality screening and tracking quality-control procedures, 286 videos were included for paired analysis. A semi-automated tracking pipeline was constructed combining the channel-and-spatial-reliability tracker and You Only Look Once version 8 small (YOLO v8s). Intra-class correlation coefficients [ICC(A,1)] based on the absolute-agreement single-measurement model were calculated for test-retest and inter-rater manual measurements. Using the manual repeated-measurement results as the reference standard, Pearson correlation coefficient (r), ICC(A,1) and concordance correlation coefficient (CCC) were computed for the semi-automated measurements. A total of 5 000 subject-clustered bootstrap resamples were performed to calculate 95% confidence intervals. Cumulative analysis time of manual and semi-automated workflows was compared.

Results For the independent test set of YOLOv8s, precision and recall reached 0.940 and 0.956. The mean average precision was 0.974 at an intersection-over-union threshold of 0.5, and 0.609 averaged across thresholds ranging from 0.5 to 0.95. For manual measurements of maximum horizontal and vertical hyoid displacement, the test-retest ICC(A,1) values were 0.925 and 0.912, respectively; the inter-rater ICC(A,1) values were 0.815 and 0.775. For semi-automated versus manual reference measurements, r = 0.865，ICC(A,1) = 0.843，CCC = 0.843 in maximum horizontal displacement; and r = 0.754，ICC(A,1) = 0.746，CCC = 0.745 in maximum vertical displacement. Mean biases were -0.772 mm and -0.229 mm, with 95% limits of agreement of -4.567 to 3.023 mm and -2.918 to 2.460 mm for horizontal and vertical directions. Cumulative manual analysis time was 526 minutes for rater A and 713 minutes for rater B. The semi-automated workflow consumed 155 minutes, in which 40 minutes for computational processing and 115 minutes for manual review.

Conclusion Manual measurement of maximum hyoid displacement is reliable using qualified submental ultrasound videos. Semi-automated tracking achieves acceptable agreement with manual reference and greatly reduces analysis workload.

Key words: hyoid motion, swallowing, submental ultrasonography, semi-automated tracking, deep learning, reliability, validity

中图分类号:

R493

牛镇远, 杨雅玲, 邓钰萍, 陈善佳, 雷蕾, 何晓阔. 颏下超声视频舌骨运动人工测量信度及半自动追踪的效度[J]. 《中国康复理论与实践》, 2026, 32(10): 1186-1193.

Niu Zhenyuan, Yang Yaling, Deng Yuping, Chen Shanjia, Lei Lei, He Xiaokuo. Measurement of hyoid motion using submental ultrasound videos: reliability of manual measurements and validity of a semi-automated tracking method[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(10): 1186-1193.

图/表 5

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参考文献 40

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项目	n	占原始视频比例/%	阶段内比例/%
原始吞咽任务视频	414	100.00	—
分析前筛查剔除	89	21.50	21.50
舌骨影像显示不清或无法稳定辨认	79	19.08	19.08
吞咽过程记录不完整或关键运动阶段缺失	10	2.42	2.42
视频质量合格并进入半自动追踪分析	325	78.50	78.50
人工测量成功	325	78.50	100.00
追踪质量控制剔除	39	9.42	12.00
目标丢失	8	1.93	2.46
异常跳变	20	4.83	6.15
追踪停滞	4	0.97	1.23
错误重捕获	7	1.69	2.15
半自动追踪成功并纳入配对一致性分析	286	69.08	88.00

指标	测量者间X方向	测量者间Y方向	重测X方向	重测Y方向
Pearson r	0.831(0.767~0.878)	0.841(0.786~0.878)	0.939(0.904~0.960)	0.912(0.858~0.947)
Spearman ρ	0.835(0.764~0.877)	0.830(0.758~0.878)	0.939(0.896~0.960)	0.872(0.810~0.919)
ICC(A,1)	0.815(0.755~0.858)	0.775(0.703~0.821)	0.925(0.883~0.950)	0.912(0.856~0.946)
CCC	0.815(0.754~0.857)	0.775(0.702~0.821)	0.924(0.882~0.949)	0.912(0.855~0.946)
MAE/mm	1.678(1.492~1.884)	1.245(1.081~1.412)	0.965(0.735~1.190)	0.598(0.453~0.748)
RMSE/mm	2.162(1.899~2.442)	1.536(1.350~1.711)	1.465(1.213~1.710)	0.915(0.773~1.047)
Bias/mm	0.711(0.294~1.091)	0.900(0.707~1.097)	0.631(0.391~0.876)	0.014(-0.148~0.171)
LoA下限/mm	-3.300(-4.075~-2.517)	-1.545(-1.857~-1.207)	-1.965(-2.446~-1.490)	-1.783(-2.093~-1.462)
LoA上限/mm	4.721(4.122~5.321)	3.344(2.947~3.700)	3.228(2.664~3.761)	1.811(1.490~2.110)

指标	最大水平位移	最大垂直位移
Pearson r	0.865(0.821~0.901)	0.754(0.686~0.812)
Spearman ρ	0.872(0.816~0.910)	0.747(0.664~0.814)
ICC(A,1)	0.843(0.791~0.886)	0.746(0.670~0.805)
CCC	0.843(0.790~0.886)	0.745(0.669~0.805)
MAE/mm	1.415(1.202~1.678)	1.088(0.961~1.219)
RMSE/mm	2.081(1.720~2.459)	1.389(1.230~1.540)
Bias/mm	-0.772(-1.092~-0.499)	-0.229(-0.449~0.008)
95%LoA/mm	-4.567~3.023	-2.918~2.460
LoA下限的95%CI/mm	-5.417~-3.743	-3.268~-2.540
LoA上限的95%CI/mm	2.536~3.466	2.058~2.841

数据集	目标数	精确率	召回率	mAP@0.5	mAP@0.5-0.95
验证集	296	0.957	0.980	0.992	0.707
独立测试集	204	0.940	0.956	0.974	0.609

颏下超声视频舌骨运动人工测量信度及半自动追踪的效度

Measurement of hyoid motion using submental ultrasound videos: reliability of manual measurements and validity of a semi-automated tracking method

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