arXiv:2602.09566cs.LGcs.AI2026-02被引 1

提出可解释的12导联心电图分析模型,让AI诊断过程透明可懂。

ECG-IMN: Interpretable Mesomorphic Neural Networks for 12-Lead Electrocardiogram Interpretation

  • 用超网络结构生成每例心电图专属线性权重,决策逻辑清晰
  • 在PTB-XL数据集上达到与黑箱模型相当的准确率(AUROC)
  • 能精准定位异常波形位置,适合临床信任需求高的场景

深度学习在自动心电图诊断中已达到专家水平,但其“黑箱”特性阻碍了临床应用。医疗AI的信任不仅需要高精度,还需透明揭示驱动判断的生理特征。现有解释方法多依赖事后近似(如Grad-CAM、SHAP),存在不稳定、计算成本高、与实际决策过程不符等问题。本文提出ECG-IMN,一种面向高分辨率12导联心电图分类的可解释中型神经网络。不同于标准分类器,ECG-IMN作为超网络:深层卷积主干为每例输入生成专属线性模型参数。该架构保证内在可解释性,决策逻辑数学透明,生成的权重W即为精确的高分辨率特征归因图。引入过渡解码器,有效将隐含特征映射为样本特异权重,实现对病理证据(如ST段抬高、T波倒置)在时间与导联维度的精确定位。在PTB-XL数据集上的分类任务评估表明,ECG-IMN在保持与黑箱基线相当预测性能(AUROC)的同时,提供忠实、实例特定的解释。通过显式解耦参数生成与预测执行,该框架弥合了深度学习能力与临床可信度之间的鸿沟,为心脏诊断的‘白盒’路径提供了原则性方案。

原文摘要 · Abstract (English)

Deep learning has achieved expert-level performance in automated electrocardiogram (ECG) diagnosis, yet the "black-box" nature of these models hinders their clinical deployment. Trust in medical AI requires not just high accuracy but also transparency regarding the specific physiological features driving predictions. Existing explainability methods for ECGs typically rely on post-hoc approximations (e.g., Grad-CAM and SHAP), which can be unstable, computationally expensive, and unfaithful to the model's actual decision-making process. In this work, we propose the ECG-IMN, an Interpretable Mesomorphic Neural Network tailored for high-resolution 12-lead ECG classification. Unlike standard classifiers, the ECG-IMN functions as a hypernetwork: a deep convolutional backbone generates the parameters of a strictly linear model specific to each input sample. This architecture enforces intrinsic interpretability, as the decision logic is mathematically transparent and the generated weights (W) serve as exact, high-resolution feature attribution maps. We introduce a transition decoder that effectively maps latent features to sample-wise weights, enabling precise localization of pathological evidence (e.g., ST-elevation, T-wave inversion) in both time and lead dimensions. We evaluate our approach on the PTB-XL dataset for classification tasks, demonstrating that the ECG-IMN achieves competitive predictive performance (AUROC comparable to black-box baselines) while providing faithful, instance-specific explanations. By explicitly decoupling parameter generation from prediction execution, our framework bridges the gap between deep learning capability and clinical trustworthiness, offering a principled path toward "white-box" cardiac diagnostics.

心电图分析可解释AI医学影像超网络

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