Patent Publication Number: US-2022225966-A1

Title: Devices, systems, and methods for guilding repeatd ultrasound exams for serial monitoring

Description:
TECHNICAL FIELD 
     The present disclosure relates to providing serial medical monitoring of a patient, and in particular, to guiding repeated ultrasound examinations of a patient in one or more specific anatomical zones. This monitoring may include receiving imaging data representative of an anatomical zone from one or more external ultrasound transducers, generating a severity score associated with the imaging data, and comparing this severity score to other severity scores associated with the anatomical zone. 
     BACKGROUND 
     Non-invasive point of care ultrasound imaging devices are used to diagnose various diseases including cardiovascular diseases and diseases within the lungs. The devices may require scanning at several locations within the anatomy of a patient. For example, ultrasound transducers may be used to scan several locations within the heart or lungs of a patient to evaluate cardiovascular problems or pneumonia. In the case of heart failure, pulmonary edema may occur leading to reverberation features referred to as B-lines. Since the location of these B-lines in the chest may vary, a typical examination may include imaging several locations in both the right and left sides of the chest of the patient. 
     Another example is evaluation of consolidation within the lungs in the case of pneumonia. This may require ultrasound imaging of various locations within the lungs. In a medical setting such as an intensive care unit (ICU), the patient may need to be monitored continually in order to evaluate if conditions in the heart or lungs are improving. This may need to be done in response to medications or interventions. 
     Repeating a full monitoring procedure for all locations may be time consuming, especially in a critical care setting, such as an ICU. For example, if several patients need to be monitored with limited instruments, the time allotted to each patient may be limited. Existing methods for tracking and analyzing ultrasound imaging data are often manual and ineffective in allowing a physician to synthesize and assess the complete health of the patient over time. 
     SUMMARY 
     Systems, devices, and methods for performing ultrasound imaging are provided. The ultrasound imaging system may include an ultrasound probe with an ultrasound transducer array that is used to gather imaging data from an area of anatomy of the patient. In some embodiments, the area of anatomy is divided into a number of sections or zones. The imaging data for each zone may be analyzed and the sections may be assigned a severity level for a particular time based on one or more parameters of the imaging data for the section. The system may be used to monitor the severity level for each zone over time. For example, a medical professional may be able to select a particular zone and access the temporal history for the zone over time. This may assist medical professionals to serially monitor a patient over time and be particularly useful for patients with more than one doctor. The system may also be used to assess the severity of medical conditions within the various zones and highlight severe areas for further watch by a medical professional. This may allow medical professionals to focus on the important areas of anatomy and reduce evaluation burden, especially in critical care situations. 
     An ultrasound imaging system is provided, which may include: an ultrasound transducer array, wherein the ultrasound transducer array is arranged to obtain imaging data associated with an anatomy of a patient, wherein the anatomy of the patient is spatially arranged in a plurality of zones; and a processor circuit in communication with the ultrasound transducer array, wherein the processor circuit is arranged to receive a first set of imaging data obtained by the ultrasound transducer array, wherein the first set of imaging data is representative of at least one of the plurality of zones, wherein the processor circuit is arranged to determine, for the at least one of the plurality of zones, a first severity score associated with an anatomical parameter based on the first set of imaging data, wherein the processor circuit is arranged to receive a second set of imaging data obtained by the ultrasound transducer array, wherein the second set of imaging data is representative of the at least one of the plurality of zones, wherein the processor circuit is arranged to determine, for the at least one of the plurality of zones, a second severity score associated with the anatomical parameter based on the second set of imaging data, wherein the processor circuit is arranged to output, to a display device in communication with the processor, a visual representation of the plurality of zones including indications of the first severity score and the second severity score. 
     In some embodiments, the first set of imaging data is representative of a first zone at a first time, and the second set of imaging data is representative of a second zone at the first time. In other embodiments, the first set of imaging data is representative of a first zone at a first time, and the second set of imaging data is representative of the first zone at a different, second time. The visual representation may illustrate a change in severity score over time based on the first severity score and the second severity score. The visual representation may include a plot of the change in severity score over time. The visual representation may include a chronological representation of at least one of the first set of imaging data, the second set of imaging data, the first severity score, or the second severity score. The processor circuit may be further arranged to spatially correlate the first and second sets of imaging data to the plurality of zones. 
     In some embodiments, the visual representation of the plurality of zones includes selectable representations of the plurality of zones such that selection of a zone by a user displays the first and second sets of imaging data correlated to the selected zone. The ultrasound array may be arranged to obtain imaging data associated with a lung of the patient. The parameter may include at least one of a degree of consolidation, a measurement of fluid in the lungs, a degree of lung collapse, a B-line number, a measurement of air bronchogram, or a measurement of plural effusion. The ultrasound array may be arranged to obtain imaging data associated with the heart of the patient. The parameter may be one or more of a physical dimension of heart chamber, an ejection fraction, a degree of blockage of a blood vessel, or a volume measurement. 
     A method of conducting ultrasound imaging is also provided, including: receiving, with a processor circuit, a first set of imaging data representative of at least one of the plurality of zones, wherein the processor circuit is in communication with an ultrasound transducer array, wherein the ultrasound transducer array is arranged to obtain imaging data associated with an anatomy of a patient spatially arranged in a plurality of zones; determining, with the processor circuit, a first severity score associated with an anatomical parameter based on the first set of imaging data, wherein the first severity score is associated with at least one of the plurality of zones; receiving, with the processor circuit, a second set of imaging data representative of the at least one of the plurality of zones; determining, with the processor circuit, a second severity score associated with the anatomical parameter based on the second set of imaging data, wherein the second severity score is associated with the at least one of the plurality of zones; and outputting, to a display device in communication with the processor circuit, a visual representation of the plurality of zones including indications of the first severity score and the second severity score. 
     In some embodiments, the first set of imaging data is representative of a first zone at a first time, and the second set of imaging data is representative of a second zone at the first time. In other embodiments, the first set of imaging data is representative of a first zone at a first time, and the second set of imaging data is representative of the first zone at a different, second time. The visual representation may illustrate a change in severity score over time based on the first severity score and the second severity score. The visual representation may include a plot of the change in severity score over time. The visual representation may include a chronological representation of at least one of the first set of imaging data, the second set of imaging data, the first severity score, or the second severity score. In some embodiments, the method further includes spatially correlating the first and second sets of imaging data to the plurality of zones by the processor circuit. The visual representation of the plurality of zones may include selectable representations of the plurality of zones such that selection of a zone by a user displays the first and second sets of imaging data correlated to the selected zone. 
     Additional aspects, features, and advantages of the present disclosure will become apparent from the following detailed description. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Illustrative embodiments of the present disclosure will be described with reference to the accompanying drawings, of which: 
         FIG. 1  is a schematic diagram of an ultrasound imaging system according to embodiments of the present disclosure. 
         FIG. 2  is a schematic diagram of a processor circuit, according to embodiments of the present disclosure. 
         FIG. 3  is an exemplary illustration of a screen display, according to aspects of the present disclosure. 
         FIG. 4  is an exemplary illustration of another screen display, according to aspects of the present disclosure. 
         FIG. 5  is an exemplary illustration of another screen display, according to aspects of the present disclosure. 
         FIG. 6  is a flow chart of method of ultrasound imaging, according to aspects of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the embodiments illustrated in the drawings, and specific language will be used to describe the same. It is nevertheless understood that no limitation to the scope of the disclosure is intended. Any alterations and further modifications to the described devices, systems, and methods, and any further application of the principles of the present disclosure are fully contemplated and included within the present disclosure as would normally occur to one skilled in the art to which the disclosure relates. In particular, it is fully contemplated that the features, components, and/or steps described with respect to one embodiment may be combined with the features, components, and/or steps described with respect to other embodiments of the present disclosure. For the sake of brevity, however, the numerous iterations of these combinations will not be described separately. 
       FIG. 1  is a diagrammatic schematic view of an ultrasound imaging system  100 , according to aspects of the present disclosure. The ultrasound imaging system  100  may include an imaging device  102 , a processing system  106 , and a display  108 . The imaging system  100  may be used to provide non-invasive imaging of body anatomy. This imaging may include 2 D or 3D B-mode ultrasonography and color flow maps. For example, the imaging device  102  may be an ultrasound probe configured to visualize anatomy inside the patient&#39;s body, while the probe is positioned outside of the patient&#39;s body. In some embodiments, the ultrasound imaging system  100  is a Doppler ultrasound imaging system. In some circumstances, the system  100  may include additional elements and/or may be implemented without one or more of the elements illustrated in  FIG. 1 . 
     The ultrasound imaging system  100  may be used in situations of blunt chest trauma, pulmonary edema, heart failure, lung failure, and other medical conditions. The system  100  may be used in pre-hospital settings, initial evaluation in the emergency room, and follow-up treatments. The system  100  is applicable to all ultrasound systems, including point-of-care application including mobile platforms. The system  100  may also be used at home by patients with remote guidance who have been discharged from a hospital, such as after lung treatment or heart failure treatment. 
     In some embodiments, the imaging device  102  is sized and shaped, structurally arranged, and/or otherwise configured to be placed on or near the anatomy of the subject to perform an ultrasound imaging procedure. The imaging device  102  may be positioned outside the body of a patient. In some embodiments, the device  102  is positioned proximate to and/or in contact with the body of the patient. For example, the imaging device  102  may be placed directly on the body of the subject and/or adjacent the body of the subject. For example, the imaging device  102  may be directly in contact with the body of the subject while obtaining imaging data. In some embodiments, the device  102  includes one or more imaging elements which may be placed directly on or adjacent the body of the subject. In other embodiments, a housing of the imaging device is placed directly in contact with the body of the subject such that the imaging elements are adjacent the body of the subject. The operator of the imaging device  102  may contact a distal portion of the imaging device to the body of the patient such that the anatomy is compressed in a resilient manner. The view of the anatomy shown in the ultrasound image depends on the position and orientation of the imaging device  102 . To obtain imaging data of the anatomy, the imaging device  102  can be suitably positioned either manually by a clinician and/or automatically by the operator so that a transducer  124  emits ultrasound waves and receives ultrasound echoes from the appropriate portion of the anatomy. The subject may be a human patient or animal. The imaging device  102  may be portable and may be suitable to be used by a user in a medical setting. For example, the imaging device  102  may be a Doppler ultrasound imaging probe. 
     The imaging device  102  is configured to obtain ultrasound imaging data associated with any suitable anatomy of the patient. For example, the device  102  may be used to examine any number of anatomical locations and tissue types, including without limitation, organs including the liver, heart, kidneys, gall bladder, pancreas, lungs; ducts; intestines; nervous system structures including the brain, dural sac, spinal cord and peripheral nerves; the urinary tract; as well as valves within the blood vessels, blood, chambers or other parts of the heart, and/or other systems of the body. The anatomy may be a blood vessel, as an artery or a vein of a patient&#39;s vascular system, including cardiac vasculature, peripheral vasculature, neural vasculature, renal vasculature, and/or or any other suitable lumen inside the body. In addition to natural structures, the imaging device  102  may be used to examine man-made structures such as, but without limitation, heart valves, stents, shunts, filters and other devices. 
     The imaging device  102  may include a housing or handle  110  structurally arranged, sized and shaped, and/or otherwise configured for handheld grasping by a user. The handle  110  may be configured to surround and protect the various components of the imaging device  102 , such as electronic circuitry  121  and the transducer array  124 . The handle  110  may include internal structures, such as a space frame for securing the various components. For example, the transducer array  124  may be positioned at a distal portion of the handle  110 . 
     The transducer elements of the array  124  may be configured to emit ultrasound signals and receive ultrasound echo signals corresponding to the emitted ultrasound signals. The ultrasound echo signals may be processed by the electronic circuitry  121  in the imaging device  102  and/or the processing system  106 . The transducer array  124  can be part of an imaging assembly, including an acoustic lens and a matching material on a transmitting side of the transducer array  124 , and an acoustic backing material on a backside of the transducer array  124 . The transducer array  124  may include any number of transducer elements. For example, the array can include between 1 acoustic element and 10000 acoustic elements, including values such as 2 acoustic elements, 4 acoustic elements, acoustic elements, 64 acoustic elements, 128 acoustic elements, 500 acoustic elements, 812 acoustic elements, 3000 acoustic elements, 9000 acoustic elements, and/or other values both larger and smaller. In some instances, the transducer elements of the array may be arranged in any suitable configuration, such as a linear array, a planar array, a curved array, a curvilinear array, a circumferential array, an annular array, a phased array, a matrix array, a one-dimensional (1D) array, a 1.x dimensional array (e.g., a 1.5 D array), or a two-dimensional (2D) array. The array of transducer elements (e.g., one or more rows, one or more columns, and/or one or more orientations) can be uniformly or independently controlled and activated. The array can be configured to obtain one-dimensional, two-dimensional, and/or three-dimensional images of patient anatomy. The ultrasound transducer elements may comprise piezoelectric/piezoresistive elements, piezoelectric micromachined ultrasound transducer (PMUT) elements, capacitive micromachined ultrasound transducer (CMUT) elements, and/or any other suitable type of ultrasound transducer elements. 
     The ultrasound transducer elements of the transducer array  124  are in communication with (e.g., electrically coupled to) electronic circuitry  121 . The electronic circuitry  121  can be any suitable passive or active electronic components, including integrated circuits (ICs), for controlling the transducer array  124  to obtain ultrasound imaging data. For example, the electronic circuitry can include one or more transducer control logic dies. The electronic circuitry can include one or more Application Specific Integrated Circuits (ASICs) or Field Programmable Gate Array (FPGA). In some embodiments, one or more of the ICs can comprise a microbeamformer (μBF). In other embodiments, one or more of the ICs comprises a multiplexer circuit (MUX). In some instances, the electronic circuitry  121  can include a processor, a memory, a gyroscope, and/or an accelerometer. 
     In some embodiments, the imaging device  102  comprises an intraluminal device sized and shaped, structurally arranged, and/or otherwise configured to be positioned within a body lumen of a patient. For example, the imaging device  102  can be a guidewire, catheter, or guide catheter. In some instances, the imaging device  102  can include a gastroscope. The imaging device  102  may include a flexible elongate member, with a distal portion that is positioned within the body lumen and proximal portion that is positioned outside of the patient&#39;s body. The transducer array  124  can be coupled to the distal portion of the flexible elongate member such that the ultrasound data is obtained while positioned inside the body lumen. For example, the imaging device  102  can be an intravascular ultrasound (IVUS) catheter, an intracardiac echocardiography (ICE) catheter, and/or a transesophageal echocardiography (TEE) probe. 
     The processing system  106  is configured to perform one or more processing steps to generate an ultrasound image and output the ultrasound image for display by the display  108 . One or more image processing steps completed by processing system  106  and/or a processor of the imaging device  102 . The processing system  106  and/or the imaging device  102  can include one or more processor circuits arranged, operable, and/or otherwise configured to perform operations described herein. 
       FIG. 2  is a block diagram illustrating an example processor  200  according to embodiments of the disclosure. Processor  200  may be used to implement one or more processors described herein, for example, the electronic circuitry  121  of the imaging device  102  and/or electronic circuitry of the processing system  106  shown in  FIG. 1 . The processor  200  may be used to carry out all or a portion of the processor steps described herein with respect to  FIGS. 3-6 . Processor  200  may be any suitable processor type including, but not limited to, a microprocessor, a microcontroller, a Digital Signal Processor (DSP), a Field Programmable Gate Array (FPGA) where the FPGA has been programmed to form a processor, a Graphical Processing Unit (GPU), an Application Specific Integrated Circuit (ASIC) where the ASIC has been designed to form a processor, or a portion of custom integrated circuit or a combination thereof. The functionality of one or more of the processors described herein, including processor  200 , may be incorporated into a fewer number or a single processing unit (e.g., a CPU), which may be programmed responsive to executable instruction to perform the functions described herein. In particular, the functionality of the one or more processors may be provided by a non-transitory computer-readable medium comprising executable instructions, which when executed cause a processor circuit of an ultrasound imaging system to perform the method(s) as described herein. 
     The processor  200  may include one or more cores  202  (one shown). The core  202  may include one or more arithmetic logic units (ALU)  204  (one shown). In some embodiments, the core  202  may include one or more Floating Point Logic Unit (FPLU)  206  (one shown) and/or one or more Digital Signal Processing Unit (DSPU)  208  (one shown) in addition to or instead of the one or more ALU  204 . 
     The processor  200  may include one or more registers  212  communicatively coupled to the core  202 . The registers  212  may be implemented using dedicated logic gate circuits (e.g., flip-flops) and/or any suitable memory technology. In some embodiments the registers  212  may be implemented using static memory. The register may provide data, instructions and addresses to the core  202 . 
     In some embodiments, processor  200  may include one or more levels of cache memory  210  communicatively coupled to the core  202 . The cache memory  210  may provide computer-readable instructions to the core  202  for execution. The cache memory  210  may provide data for processing by the core  202 . In some embodiments, the computer-readable instructions may be provided to the cache memory  210  by a local memory, for example, local memory attached to the external bus  216 . The cache memory  210  may be implemented with any suitable cache memory type, for example, Metal-Oxide Semiconductor (MOS) memory such as Static Random Access Memory (SRAM), Dynamic Random Access Memory (DRAM), and/or any other suitable memory technology. 
     The processor  200  may include a controller  214 , which may control input to the processor  200  from other processors and/or components included in the system  100  ( FIG. 1 ) and/or outputs from the processor  200  to other processors and/or components included in the system  100 . Controller  214  may control the data paths in the ALU  204 , FPLU  206  and/or DSPU  208 . Controller  214  may be implemented as one or more state machines, data paths and/or dedicated control logic. The gates of controller  214  may be implemented as standalone gates, FPGA, ASIC or any other suitable technology. 
     The registers  212  and the cache  210  may communicate with controller  214  and core  202  via internal connections  220 A,  220 B,  220 C and  220 D. Internal connections may be implemented as a bus, multiplexor, crossbar switch, and/or any other suitable connection technology. 
     Inputs and outputs for the processor  200  may be provided via a bus  216 , which may include one or more conductive lines. The bus  216  may be communicatively coupled to one or more components of processor  200 , for example the controller  214 , cache  210 , and/or register  212 . The bus  216  may be coupled to one or more components of the system, such as electronic circuitry  121 , device  102 , processing system  106 , and/or display  108 . Bus  216  may be implemented as a bus, multiplexor, crossbar switch, and/or any other suitable connection technology 
     The bus  216  may be coupled to one or more external memories. The external memories may include Read Only Memory (ROM)  232 . ROM  232  may be a masked ROM, Electronically Programmable Read Only Memory (EPROM)  235  or any other suitable technology. The external memory may include Random Access Memory (RAM)  233 . RAM  233  may be a static RAM, battery backed up static RAM, DRAM, SRAM or any other suitable technology. The external memory may include Electrically Erasable Programmable Read Only Memory (EEPROM)  235 . The external memory may include Flash memory  234 . The External memory may include a magnetic storage device such as disc  236 . In some embodiments, the external memories may be included in a system, such as system  100  and/or processing system  106  shown in  FIG. 1   
     Referring again to  FIG. 1 , the system  100  may be deployed in a medical setting, such as procedure room, catherization laboratory, operating room, emergency room, etc. The device  102  can be deployed adjacent to or in contact with the patient. The processing system  106  may be located near to the patient, e.g., in the same room as the patient. The processing system  106  can be remote from the patient, such as in a different room or different building. In some embodiments, imaging data from the device  102  is uploaded to the cloud, where it may be downloaded and processed at a remote location. The medical setting may be used to perform any number of medical imaging procedures such as Doppler ultrasound imaging, angiography, fluoroscopy, computed tomography (CT), magnetic resonance imaging (MM), intravascular ultrasound (IVUS), virtual histology (VH), forward looking IVUS (FL-IVUS), intravascular photoacoustic (IVPA) imaging, a fractional flow reserve (FFR) determination, a coronary flow reserve (CFR) determination, optical coherence tomography (OCT), intracardiac echocardiography (ICE), forward-looking ICE (FLICE), intravascular palpography, transesophageal ultrasound (TEE), and other medical imaging modalities, or combinations thereof. 
     The imaging device  102  and display  108  may be communicatively coupled directly or indirectly to the processing system  106 . For example, the imaging device  102  may be connected to the processing system  106  via connection  132 , and the display  108  may be connected to the processing system via connection  107 . The connections  107  and  132  can be the same type of connection or different types. Connections  107  and  132  may include a wired connection such as a standard copper link or a fiber optic link. For example, any suitable communication lines, such as conductors and/or optical fibers, can allow for data transmission between the processing system  106  and the imaging device  102  and/or the display  108 . In some embodiments, the connections  107  and  132  can be a cable. In such embodiments, a connector  130  at a distal portion of the connection cable  132  can be coupled to a proximal portion of the handle  110  of the imaging device  102 . The connections  107  and  132  can include any suitable communication standard, such as Ethernet, Universal Serial Bus (USB), and/or a proprietary communication protocol. In some embodiments, the connections  107  and  132  can be wireless connections using IEEE 802.11 Wi-Fi standards, Ultra Wide-Band (UWB) standards, wireless FireWire, wireless USB, or another high-speed wireless networking standard. In such embodiments, the imaging device  102 , the processing system  106 , and/or the display  108  may include one or more wireless transmission devices such as an antenna. The processing system  106  may be communicatively coupled to one or more data networks, e.g., a TCP/IP-based local area network (LAN). In other embodiments, different protocols may be utilized such as Synchronous Optical Networking (SONET). In some cases, the processing system  106  may be communicatively coupled to a wide area network (WAN). The processing system  106  may utilize network connectivity to access various resources. For example, the processing system  106  may communicate with a Digital Imaging and Communications in Medicine (DICOM) system, a Picture Archiving and Communication System (PACS), and/or a Hospital Information System via a network connection. It should be understood that a connector such as connector  130  enables the use of one or more different imaging devices  102 , such as different ultrasound transducer arrays, with processing system  106  when separate imaging procedures are conducted over time. For example, a second imaging procedure may be conducted with the same or a different ultrasound transducer arrays than was used in a first imaging procedure. 
     The imaging system  100  may be used to provide non-invasive imaging of anatomy, such as the heart or lungs of a patient. For example, the imaging device  102  may be configured to emit ultrasonic energy in order to create an image of a vessel or lumen and/or surrounding anatomy within the body of a patient. Ultrasonic waves emitted by a transducer array  124  of the device  102  may be reflected off tissue structures and other features within the anatomy. Echoes from the reflected waves are received by the imaging device  102  and passed along to the processing system  106 . The processing system  106  processes the received ultrasound echoes to produce an image of the anatomy of the patient based on the acoustic impedance associated with the ultrasound echoes. The image may be a two-dimensional cross-sectional image or a three-dimensional image of the vessel. The imaging device  102  and/or the processing system  106  may include features similar or identical to those found in commercially available ultrasound imaging elements, e.g., the L12-4U Lumify probe and system, EPIQ, Affiniti, and/or CX50 ultrasound systems, each available from Koninklijke Philips N.V. 
     The imaging device  102  may be positioned outside the body of a patient. In some embodiments, the device  102  is positioned proximate to and/or in contact with the body of the patient near a vessel or lumen. The operator of the imaging device  102  may contact a distal portion of the imaging device to the body of the patient such that the anatomy is compressed in a resilient manner. The view of the anatomy shown in the ultrasound image depends on the position and orientation of the imaging device  102  and the imaging device  102  can be suitably positioned either manually by a clinician and/or automatically by the operator so that the transducer array  124  emits ultrasound waves and receives ultrasound echoes from the desired area of the anatomy. 
     This imaging may include dividing imaging areas into particular zones within anatomy, such as 8-28 zones. The images for each zone may be monitored over time to provide a temporal history. In some embodiments, the imaging device  102  may be used to measure one or more imaging parameters, such as B-line number, size and severity of lesions, volume and diameter of vessels, cardiac output, heart rate, light and dark zones in the lungs, amount of collapse within a lung, lung water content, and degree of consolidation. Imaging data associated with these parameters may be received by the processing system  106  and output to the display  108  to show visual representations of the anatomy, including B-mode ultrasonography and color flow maps. The imaging procedures may include measuring parameters at multiple times, such as for every one or every two breathing cycles. In some embodiments, the parameters for each zone are displayed independently, such that a medical professional can monitor changes in the parameters for each zone over time, as shown in more detail with reference to  FIG. 3 . The imaging data including the parameters discussed above may be transmitted to the processing system  106  for analysis. In some embodiments, imaging data and associated measurements are transmitted to the cloud and may be accessed remotely. 
       FIG. 3  shows an exemplary display  300  produced by the imaging system  100 . The display may be shown on a screen of the display  108 , as shown in  FIG. 1 . The display  300  may include windows  308 ,  310  showing views of the anatomy of the patient. These windows  308 ,  310  may include a plurality of zones  302  that may represent subdivisions of the anatomy. In the example of  FIG. 3 , eight zones  302  with roughly equal area are shown across the chest of a patient. Any suitable number of zones is contemplated, such as 2, 4, 6, 10, 12, 16, 20, 28, and other numbers of zones, both larger and smaller. The zones  302  may have different sizes. For example, the zones  302  may conform to a portion of the patient&#39;s anatomy e.g. a lung. The zones  302  may be based on the physiology associated with the anatomy (e.g., pulmonary edema of the lung). The size, shape, quantity, and/or location of the zones may be selected such that sufficient ultrasound data of different portions of the anatomy are obtained. The zones  302  may be selectable, such than an operator select the zone to access the imaging data associated with the zone. In some embodiments, an operator may select one or more zones via an input device (such as clicking on them with a mouse). Zones of unequal size are also contemplated and may be shown in an alternate embodiments. 
     In some instances, the number of zones corresponds to an ultrasound imaging protocol utilized by medical professionals to carry out ultrasound examination of the patient&#39;s anatomy. Exemplary ultrasound imaging protocols are described in Doerschug et al.,  Intensive Care Ultrasound: III. Lung and Pleural Ultrasound for the Intensivist  (Annals of the American Thoracic Society, December 2013, Vol. 10, No. 6, pp. 708-712) and Volpicelli et al.,  International evidence - based recommendations for point - of - care lung ultrasound  (Intensive Care Medicine, April 2012, Vol. 38, No. 4, pp. 577-591), the entireties of which are incorporated by reference herein. In some instances, a complete lung examination may include 12 zones, with 6 zones on each side of the patient&#39;s body. Each hemithorax can be divided into an anterior zone, a lateral zone, and a posterior zone, which are demarcated by the anterior axillary line and the posterior axillary line. Each of the anterior zone, the lateral zone, and the posterior zone can be divided into an upper zone and a lower/basal zone. In some instances, a lung examination includes 8 zones, omitting the two posterior zones on each side of the body described above. In some instances, a lung examination includes 2 zones. While these examples specifically mention ultrasound examination of the lungs, it is understood that the present disclosure contemplates any suitable anatomy of the patient. 
     The zones  302  may be colored to provide an indication of the severity of the patient&#39;s physiological condition, based on one or more imaging parameters. For example, zones 4, 5, 6, 7, and 8 are not colored, representing that they have not been imaged or have a low severity, zones 1 and 2 are colored lightly representing an acceptable severity, and zone 3  304  is darkly colored representing a high severity. The colors may be accompanied with other visual or textual cues, such as images, alerts, measurements, or messages. While colors are specifically mentioned in the description above, it is understood that the screen display  300  can include any suitable visual representation of the zones  302 , including one or more shadings, patterns, textures, or images. The zones  302  may be shown with reference to the anatomy of the patient  306  (such as overlaid on a representation of the anatomy of the patient  306 ) in the anatomy reference window  302  as well in a standalone window  310  showing an overview of the zones  302  and accompanying information, such as measurements of the imaging parameters. The windows  308 ,  310  may be displayed simultaneously on the display  108 . The zones  302  may be updated continuously throughout a medical procedure or across several procedures, such than a medical professional can view changes in the zones over time. This may be helpful for patients being overseen by multiple medical professionals, because a newly assigned professional can easily access the medical history for each zone  302  through the received imaging data. 
       FIG. 4  shows an exemplary display  400  of the imaging system  100  which may also be shown on the display  108 , as shown in  FIG. 1 . The display  400  may include an anatomy reference window  308  and a zone detail window  410  showing imaging information associated with a selected window. In some embodiments, a patient ID  413  is associated with all medical procedures for a particular patient. This patient ID  413  may be displayed on the display  400  and may be used to look up all medical data associated with the patient. In some embodiments, when the patient associated with the patient ID  413  is scanned by the ultrasound imaging system  100 , the system  100  may automatically display the location of the zone  302  having the highest ultrasound feature score or severity score(s) in the last examination (e.g., zone 3  304 ). 
     In the example of  FIG. 4 , the zone detail window  410  shows severity scores over time, which are calculated by the processing system  106  based on the received ultrasound imaging data from the imaging device  102 . The severity scores for a particular zone (e.g., zone 3 in the example of  FIG. 4 , as shown by label  412 ) over time may be represented by a plot, chart, or graph  314 . In some embodiments, the plot  314  of the severity scores over time may be based one or more of imaging parameters of the received imaging data that are indicative of the severity of physiological condition of the patient. Generally, the severity score is a numerical quantification of the imaging parameters. Evaluation of the severity scores over time may provide an indication of whether the patient&#39;s condition is improving, worsening, or staying the same. For example, the imaging parameters can include B-line number, size and severity of lesions, volume and diameter of vessels, cardiac output, heart rate, light and dark zones in the lungs, amount of collapse within a lung, lung water content, and degree of consolidation. The plot  414  of the severity scores may include one or more reference positions  416  identifying the timing of previous treatments. The reference position  416  may represent medical procedures, administration of medication, or intervention and may be represented by a symbol, shape, point, line, color, or other visual representation. In the example of  FIG. 4 , the plot  414  of the severity scores shows a degree of consolidation over time for a patient with pneumonia. The disease is shown to be increasing in the patient until the reference point  416  (represented by a dotted line), where a medication was administered to the patient. After this point, the degree of consolidation (and associated severity scores in the graph  414 ) can be seen to be steadily decreasing over time. A medical professional may access a zone detail window  410  corresponding to each of the zones  302  with severity scores similarly measured over time. 
     In some embodiments, a numerical value of a severity score at a particular time is provided on the screen display  300 . In some embodiments, numerical values of multiple severity scores at different times are provided. For example, the multiple severity scores can be output in in a table. The coloring of the zone 3  304  (e.g., a visual representation of the severity) on the anatomy reference window  308  may be based on the severity score at a latest point in time, a selected point of time, or an average across time. 
     In some embodiments, a medical professional may be able to select an imaging parameter on the display  400 . In this case, the zones  302  would display a severity score associated with that parameter (e.g., a spatial distribution of the parameter across the various zones  202 ). In some embodiments, a medical professional adds reference points  416  manually for each medical procedure. In other embodiments, each time the patient ID  313  (in the current example, the patient ID has the value  402 ) is received by the processing system for a medical procedure, a reference point  306  may be added automatically. In some embodiments, the ultrasound imaging system  100  may automatically tag the zone  302  with the highest severity score (e.g., zone 3  304  in  FIG. 4 ) such that the zone  302  is automatically shown on the display  108  at the next procedure. This may assist a medical professional in monitor problematic areas. A medical professional can also manually select one or more zones  302  for observation, such as with a mouse or touch screen. The display  400  may also be used to monitor several zones  302  within the anatomy of the patient. In this case, the temporal history for each zone  302  is automatically stored by the processing system  106  and is readily available at the next procedure. In some embodiments, the ultrasound features score for each zone may be based on at least one imaging parameter in common. In other embodiments, the ultrasound features score for two different zones may be based on different imaging parameters. 
     In some embodiments, the system  100  may generate suggested locations for further imaging procedures based on the results of the imaging analysis. For example, the processing system  106  may determine that zone 3 has a maximum severity score or a severity score above a chosen threshold. The threshold may be selected by the operator or fixed according to medical provider policy. The display  108  may then include a prompt to place a probe of the imaging device  102  in zone 3 to conduct a further imaging procedure. 
       FIG. 5  shows an exemplary display  500  of the imaging system  100  which may also be shown on the display  108 , as shown in  FIG. 1 . The display  500  may show various temporal representations of one or more zones  302 . In particular, the display be used to highlight scan locations that have had high severity scores in past scans. For example, a medical professional may select zone 3  304  on the anatomy reference window  308  which may display a temporal history window  510  on the display  108  associated with zone 3. The temporal history window  510  may include one or more visual representations of a severity score over time, such as a timeline  520 . In the example of  FIG. 5 , the timeline  520  includes severity scores represented by various colors at time 1 (severe), time 2 (moderate), time 3 (severe), and time 4 (minimal). As discussed above, the severity scores may be represented by other visual cues, such as shading, patterns, textures, images, text, or animated features. For example, a movie may be displayed with imaging data and color coding to show changes in the imaging data over time for a particular zone. The severity scores may be accompanied by corresponding imaging data. For example, the severe ultrasound scores at times 1 and 3 (reference numbers  522 ,  523 ) may include ultrasound data corresponding to those zones. The time and date of these severity scores may also be displayed, along with treatment information and notes from previous medical professionals. In some embodiments, imaging data associated with high (i.e., “severe”) severity scores may be automatically displayed on the temporal history window  510  while low severity scores are not automatically displayed. This may allow the medical professional to focus on the important areas of anatomy and reduce evaluation burden, especially in critical care situations. In other embodiments, the imaging data for each severity score may be manually selected by a medical professional. 
     The medical information produced by the imaging system  100  and displayed on the display device  108  may be transmitted to a central location and may be accessed remotely. For example, a medical professional may access the data via a cloud location that is off site from the hospital. In this case, the medical data shown in FIGS. 3-5 may be displayed at a remote location, such as a computer monitor. 
       FIG. 6  is a flow chart of a method  600  of ultrasound imaging. In some embodiments, the steps of the method  600  may be carried out by the ultrasound imaging system  100  and associated components as shown in  FIG. 1 , such as the electronic circuitry  121  of the imaging device  102 , electronic circuitry of the processing system  106 , and/or the display  108 . For example, the processor  200  ( FIG. 2 ) can implement all or a portion steps of the method  600 . It is understood that the steps of method  600  may be performed in a different order than shown in  FIG. 6 , additional steps can be provided before, during, and after the steps, and/or some of the steps described can be replaced or eliminated in other embodiments. 
     At step  602 , the method  600  may include defining a plurality of zones within the anatomy of a patient. These zones may be placed regularly across the anatomy of the patient, such as across the lungs or heart. The zones may be regular or irregular in size and shape. The number of zones may include 2, 4, 6, 10, 12, 16, 20, 28, and other numbers of zones. In some embodiments, the coordinates for each zone are also defined and stored in memory such that imaging data may be automatically spatially correlated to its zone. For example, at the start of, during, and/or at the conclusion of an imaging procedure, a user can manually indicate which zone(s) is being imaged. In some instances, the processor circuit can automatically determine, based on image processing with the obtained ultrasound data, which zone is being imaged. 
     At step  604 , the method  600  may include conducting a first imaging procedure for at least one zone of the plurality of zones. This imaging procedure may be performed using an imaging device such as imaging device  102 . The imaging procedure may include ultrasound imaging, Doppler ultrasound imaging, angiography, fluoroscopy, computed tomography (CT), magnetic resonance imaging (MRI), intravascular ultrasound (IVUS), virtual histology (VH), forward looking IVUS (FL-IVUS), intravascular photoacoustic (IVPA) imaging, optical coherence tomography (OCT), intracardiac echocardiography (ICE), forward-looking ICE (FLICE), intravascular palpography, transesophageal ultrasound (TEE), and other medical imaging modalities, or combinations thereof. In some embodiments, the imaging procedure is performed for the heart or lungs of the patient. The imaging data from the imaging procedure may be transmitted to a processing system for analysis. The imaging data may be received by a processor receiving the imaging data from the transducer array (such as during the first imaging procedure) or may be received from a processor from a memory (such as from a previously performed imaging procedure). 
     At step  606 , the method  600  may include determining a first severity score for the at least one zone based on the imaging data from the first imaging procedure. The first severity score may be determined by a processor circuit based on one or more parameters of the imaging data. For example, image processing by the processor circuit on the obtained ultrasound data can be used to determine identify and/or quantify the one or more parameters. For example, for an imaging procedure for the heart, these parameters may include a size and severity of lesions, volume and diameter of vessels, cardiac output, and heart rate. For an imaging procedure for the lungs, the parameters may include B-line number, light and dark zones in the lungs, amount of collapse within a lung, lung water content, and degree of consolidation. 
     At step  608 , the method  600  may include displaying the first severity score on a diagram of the patient with the plurality of zones. In some embodiments, the plurality of zones may be overlaid over a diagram of the anatomy, such that a medical professional can readily understand the location and extent of each zone. The first severity score may be represented visually for each zone, such as a color, pattern, shade, texture, or image displayed on the zone. For example, a high severity score may be displayed with a darker color while a lower severity score may be displayed with a lighter color, as in the example of  FIG. 3 . The zones may be selected by a medical processional, for example via a touchscreen or mouse. Selecting a zone may display further information about the zone, such as previous severity scores associated with the zone. In some embodiments, selecting a zone from the diagram may display a timeline showing the temporal history of all medical data associated with the zone. 
     At step  610 , the method  600  may include conducting a second imaging procedure for the at least one zone. The second imaging procedure may be conducted at a later time than the first imaging procedure and may be any of the types of procedures as discussed above. In some embodiments, the second imaging procedure may be conducted for different zones than the first imaging procedure. For example, the first imaging procedure may include imaging zones 1-4 while the second imaging procedure includes imaging zones 5-8. In this case, the first and second imaging procedures may be conducted at a same time or at different times. The imaging data may from the second imaging procedure may be transmitted to a processing system for analysis. It should be understood that the second imaging procedure may be conducted with the same or a different ultrasound transducer arrays than was used in the first imaging procedure. 
     At step  612 , the method  600  may include determining a second severity score for the at least one zone based on imaging data from the second imaging procedure. The second severity score may be based on any of the parameters discussed above. 
     At step  614 , the method  600  may include updating the display with the second severity score. This step  514  may include updating the visual representation of the severity score, such as darkening the color of the zone for a higher severity score or lightening the color of the zone for a lower severity score. 
     At step  616 , the method  600  may optionally include displaying a timeline including the first and second severity scores. The timeline may include accompanying information from the first and second imaging procedures, such as time and place. The timeline may also include a graph, chart, or other visual representation showing the two severity scores as well as other severity scores if available. The steps of method  600  may enable a medical professional to view the progress of the patient in particular zones of the anatomy of the patient over time. This may help to coordinate care between doctors as well as to provide special care for trouble areas of the anatomy of a patient. 
     Persons skilled in the art will recognize that the apparatus, systems, and methods described above can be modified in various ways. Accordingly, persons of ordinary skill in the art will appreciate that the embodiments encompassed by the present disclosure are not limited to the particular exemplary embodiments described above. In that regard, although illustrative embodiments have been shown and described, a wide range of modification, change, and substitution is contemplated in the foregoing disclosure. It is understood that such variations may be made to the foregoing without departing from the scope of the present disclosure. Accordingly, it is appropriate that the appended claims be construed broadly and in a manner consistent with the present disclosure.