医学图像中的边缘分析

根据医学图像处理的要求,需要将图像划分若干区域,其划分过程要求迅速、精确。本文结合实际经验,介绍了图像分割的重要方法——边缘提取,并着重分析了其中边缘检测和边缘跟踪的过程和方法,同时还给出了用计算机模拟得到的边缘提取的结果。     

基于区域相似性测量的CT／PET图像配准

图像配准在临床诊断中有重要意义,针对这一问题已经提出了许多方法。本文以区域相似性匹配测度,运用改进的分割方法,结合Powell寻优算法实现了CT／PET多模医学图像配准。实验结果表明,该算法易于实现,配准速度快、精度高,鲁棒性较好。     

基于局部调整动态轮廓模型提取超声图像乳腺肿瘤边缘

提出一种基于局部调整动态轮廓模型提取超声图像乳腺肿瘤边缘的算法。该算法在Chan—Vese（CV）模型基础上,定义了一个局部调整项,采用基于水平集的动态轮廓模型提取超声图像乳腺肿瘤边缘。将该算法应用于89例临床超声图像乳腺肿瘤的边缘提取实验,结果表明：该算法比CV模型更适用于具有区域非同质性的超声图像的分割,可有效实现超声图像乳腺肿瘤边缘的提取。     

PFNA内固定在老年人股骨转子间骨折的手术效果及对髋关节功能改善效果

目的:研究股骨近端螺旋刀片抗旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折的效果及对髋关节功能影响。方法:研究对象选取我院2012年8月到2015年5月间收治的老年股骨转子间骨折患者86例,采用随机数字法将其分为对照组(43例)和观察组(43例)。对照组患者接受动力髋螺钉(DHS)内固定治疗,观察组患者接受PFNA内固定治疗。比较两组患者的手术效果和并发症发生率,同时术后随访,比较两组患者的髋关节功能评分和炎症因子表达水平。结果:在手术时间、术中出血量、卧床时间及骨折愈合时间方面,观察组均明显低于对照组(P0.01);观察组的总并发症发生率(4.66%)明显低于对照组(20.94%)(x~2=5.11,P=0.02);术后随访6个月,两组的Harris髋关节功能评分优良率比较无明显差异(P0.05);手术后,血清IL-6、IL-10、TNF-α表达水平,观察组均明显低于对照组(P0.01)。结论:PFNA治疗老年股骨转子间骨折的效果显著,手术创伤较小,术中出血量低,且并发症较低,且术后髋关节功能恢复效果较好,值得在临床推广。     

人工股骨头置换术与股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折患者的疗效比较研究

目的:探讨人工股骨头置换术(AFHR)与股骨近端防旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折(IFF)患者的疗效。方法:选择2010年3月至2016年8月本院收治的老年IFF患者102例为研究对象,采用随机数字表法分为AFHR组(n=51)和PFNA组(n=51),比较两组手术一般情况(包括手术时间、术中出血量、下地活动时间、完全负重时间、术后住院时间),术前与术后第3、6、12个月采用Harris评分量表对患者进行髋关节功能评分,观察术后病死率及并发症的发生情况。结果:PFNA组手术时间、术中出血量少于AFHR组,下地活动时间、完全负重时间多于AFHR组,差异有统计学意义(P0.05),两组术后住院时间比较差异无统计学意义(P0.05)。两组患者术前、术后6个月、术后12个月Harris评分比较差异无统计学意义(P0.05),术后3个月AFHR组患者Harris评分高于PFNA组,且两组患者术后Harris评分较治疗前均升高,差异有统计学意义(P0.05)。PFNA组病死率和并发症发生率分别为0.00%和5.88%,与AFHR组的1.96%和9.80%比较,差异无统计学意义(P0.05)。结论:在老年IFF的手术治疗中,PFNA内固定具有手术时间短、术中出血量少的优势,AFHR后患者可早期进行功能锻炼,术后髋关节功能恢复快。     

基于SIFT特征和近似最近邻算法的医学CT图像检索

针对医学X线计算机断层（Computed Tomography,CT）图像,提出了一种基于尺度不变特征变换（Scale InvariantFeature Transform,SIFT）特征和近似最近邻算法的检索方法。首先通过SIFT算法得到图像的特征点和相应的特征向量,再采用近似最近邻算法进行SIFT特征向量的匹配搜索,得到数据库中与参考图像最相似的图像序列。实验结果表明,该法能检索到与目标图像细节相符的结果,大大提高了检索速度。与传统的基于纹理的检索方法相比,查准率和检索结果与目标图像的相似程度方面更佳,符合医学CT图像检索的要求。     

人工髋关节置换术发生股骨假体周围骨折的影响因素分析

目的:探讨人工髋关节置换术患者发生股骨假体周围骨折的相关危险因素,为临床预防和治疗提供参考资料。方法:回顾性分析2012年5月~2015年5月在我院接受人工髋关节置换术的92例患者的临床资料。根据是否发生股骨假体周围骨折将所选患者分为研究组和对照组,每组46例,比较两组患者的性别分布、年龄、骨折类型及假体固定方式等,分析影响患者发生股骨假体周围骨折的危险因素。结果:研究组患者骨折类型多为A2型,患者平均年龄、女性患者数及使用生物假体的比例均高于对照组,差异具有统计学意义(P0.05)。患者性别、年龄、骨折类型及假体固定方式是人工髋关节置换术患者发生股骨假体周围骨折的危险因素(OR=1.993、2.012和2.363,P0.05)。结论:高龄女性患者是发生股骨周围假体骨折的高危人群,骨质疏松及骨量减少是引发该并发症的主要危险因素。     

基于图像重建的CT三维重建提升腹部增强扫描图像质量的价值

摘要 目的：探讨基于图像重建的电子计算机断层扫描仪器(Computed Tomography,CT)三维成像提升腹部增强扫描图像质量的价值。方法：2019年11月到2020年10月选择在本院进行腹部CT增强扫描的患者76例作为研究对象,采用电脑随机数字法将研究对象分为对照组和重建组各38例,对照组给予常规扫描成像,重建组给予基于自适应统计迭代重建(adaptive statistical iterative reconstruction,ASIR)的CT三维成像,记录两组成像质量与噪声情况。结果：两名医师对重建组的图像主观质量评分都高于对照组(P<0.05)。重建组的图像相对细腻柔和,能清晰显示图像细小血管断面,末梢血管显示良好,血管壁光滑柔和。重建组的动脉期、门静脉期、平衡期的肝脏CT值高于对照组(P<0.05),动脉期、门静脉期、平衡期的肝脏、胰腺对比噪声比(contrast to noise ratio,CNR)值低于对照组(P<0.05)。重建组的容积剂量指数(volume CT dose index,CTDIvol)和剂量长度乘积(Dose-Length product,DLP)、有效剂量(effective dose,ED)值都低于对照组(P<0.05)。结论：基于图像重建的CT三维成像能提升腹部增强扫描主客观图像质量,降低图像噪声,更利于腹部疾病的显示,从而提高正确诊断率。     

人工髋关节置换术中股骨假体周围骨折的影响因素回归分析及其相关性

目的:研究人工髋关节置换术中股骨假体周围骨折的影响因素及其相关性,为人工髋关节置换术中股骨假体周围骨折的预防和诊治提供科学依据。方法:选取本院2012年11月至2013年9月施行髋关节置换手术的患者780例,搜集各研究对象的一般资料(年龄、性别等)以及随访观察其髋关节置换手术后股骨假体周围骨折的发生情况,把股骨假体周围骨折的发生情况与性别、年龄、固定类型等因素进行Logistic回归分析。结果:780例施行髋关节置换手术的患者中,有52例患者术后出现股骨假体周围骨折,总发生率为6.7%;其中A型31例,B型18例(B1型6例,B2型7例,B3型5例),C型3例。女性的发生率(8.5%)高于男性(4.7%),老年患者中股骨假体周围骨折的发生率最高(10.1%),生物型假体固定者的发生率(8.7%)高于骨水泥型假体固定者(3.8%),人工髋关节翻修术中股骨假体周围骨折的发生率最高(11.4%),股骨假体周围骨折发生的危险因素为女性、高龄、使用生物型假体固定,OR值分别为5.301、3.675和2.336。结论:人工髋关节置换术中的危险因素为女性、高龄、使用生物型假体固定,临床医生应在术前对行人工髋关节置换术手术者进行充分的评估,制定合理的手术方案及选择合适的固定方式。     

人工髋关节置换术治疗高龄患者股骨粗隆间骨折的临床疗效研究

目的:探究人工髋关节置换术治疗高龄患者股骨粗隆间骨折的临床疗效。方法:选择40例高龄股骨粗隆间骨折患者并将其随机分为两组,观察组给予人工髋关节置换术治疗,对照组经股骨近端髓内钉内固定术治疗。观察比较两组L2-4椎体骨密度、疼痛程度、髋关节功能恢复情况及Harris评分。结果:治疗后,两组L2-4椎体骨密度均显著高于治疗前(P0.05),且观察组显著高于对照组(P0.05);观察组疼痛比例较治疗前明显降低(P0.05),且显著低于对照组(P0.05);观察组髋关节恢复优良率为95.0%,显著高于对照组(70.0%,P0.05);两组Harris评分均显著高于治疗前(P0.05),且观察组显著高于对照组(P0.05)。结论:采用人工髋关节置换术治疗高龄股骨粗隆间骨折的疗效明显优于经股骨近端髓内钉内固定术治疗,其可有效促进髋关节功能恢复,减轻患者疼痛。     

内皮细胞-血小板血栓体外模型的建立及分析

在内皮细胞培养技术、荧光显微技术和计算机图象处理技术的基础上,建立了内皮细胞－血小板血栓体外动力学模型及其计算机定量分析系统。通过锥板血流模拟装置（Ｃｏｎｅ－ＰｌａｔｅＳｙｓｔｅｍ）结合光－色素法在体外产生血小板血栓,并利用计算机图像处理技术,研究分析了不同剪切应力作用下,内皮细胞的形态变化及血小板吸附情况,定量分析血小板和内皮细胞之间相互作用。该实验模型及其定量分析系统的建立,为深入研究血栓形成和动脉粥样硬化提供了一套在细胞及分子层次作用机理的研究方法,并可进行微量、快速、动态的抗血栓药物的筛选     

Evolution of Hominid Femur and Tibia: A morphometric approach to the evolutionary research in anthropology

Some theoretical and methodological morphometrical approaches in evolutionary anthropology and paleoanthropology are reviewed in this study. It is shown which are the contemporary possibilities of sophisticated biometrical and biostatistical methods and the role of the morphometrical approach. A new approach, experimental morphometrics, is presented, reflecting recent trends in evolutionary morphology as well as sophisticated biostatistical methods. The approach emphasizes the complex inter-related approach to the data processing and a double nature of morphometric data, i.e. biological and biostatistical one. The practical use of experimental morphometry is given for the two examples of analyses of the evolution of the hominoid and hominid femur and tibia. The hypothesis on a two stage restructuring of morphology of the hominid femur and tibia is supported by experimental results. Two different steps during this restructuring could be recognized: 1) Structural remodelling typical for the origin of hominids and australopithecine evolution, and 2) proportional remodelling of lower limb long bones which is connected with the Australopithecus/Homo transition (i.e. mainly Homo habilis stage). The results confirm the increasing trend of bipedal adaptations on the early hominid lower limb skeleton. Analysis of microevolutionary trends on the Homo sapiens femur and tibia indicates at least three different morphological patterns, Paleolithic, Neolithic and Recent, with numerous specific features in morphology and proportions. Neanderthal morphology is very derived. Upper Paleolithic/Mesolithic/Neolithic transition has a key character for the understanding of post-Paleolithic morphology. A very high sexual dimorphism of the femur and tibia has been demonstrated for Upper Paleolithic and Neolithic populations. Presented at the Foundation of Different Approaches to the Study of Human Evolution edited by B. Sigmon & V.V. Leonovicova-Liblice, September 1–3, 1989     

Bone Load Estimation for the Proximal Femur Using Single Energy Quantitative CT Data

A density-based load estimation method was applied to determine femoral load patterns. Two-dimensional finite element models were constructed using single energy quantitative computed tomography (QCT) data from two femora. basic load cases included parabolic pressure joint loads and constant tractions on the greater trochanter. An optimization procedure adjusted magnitudes of the basic load cases, such that the applied mechanical stimulus approached the ideal stimulus throughout each model. Dominant estimated load directions were generally consistent with published experimental data for gait. Other estimated loads suggested that loads at extreme joint orientations may be important to maintenance of bone structure. Remodeling simulations with the estimated loads produced density distributions qualitatively similar to the QCT data sets. Average nodal density errors between QCT data and predictions were 0·24 g/cm³ and 0·28 g/cm³. The results indicate that density-based load estimation could improve understanding of loading patterns on bones.     

Bone Load Estimation for the Proximal Femur Using Single Energy Quantitative CT Data

A density-based load estimation method was applied to determine femoral load patterns. Two-dimensional finite element models were constructed using single energy quantitative computed tomography (QCT) data from two femora. Basic load cases included parabolic pressure joint loads and constant tractions on the greater trochanter. An optimization procedure adjusted magnitudes of the basic load cases, such that the applied mechanical stimulus approached the ideal stimulus throughout each model. Dominant estimated load directions were generally consistent with published experimental data for gait. Other estimated loads suggested that loads at extreme joint orientations may be important to maintenance of bone structure. Remodeling simulations with the estimated loads produced density distributions qualitatively similar to the QCT data sets. Average nodal density errors between QCT data and predictions were 0.24 g/cm(3) and 0.28 g/cm(3). The results indicate that density-based load estimation could improve understanding of loading patterns on bones.     

Computer-assisted image analysis of the distributions of peptidergic terminals in the central nucleus of the amygdala: A preliminary study

When viewed under dark-field illumination, peptidergic terminals in sections stained by the Sternberger PAP immunocytochemical method are seen as individual points of light. Under high magnification, the degree of brightness of various areas of immunoreactive terminals is seen to be a function of the density of terminals in these areas. By analyzying the relative brightness of the immunostained central nucleus of the amygdala (CNA) with an EyeCom II PDP-$\text{11}\text{34}$ image analysis system, we have obtained a relative evaluation of the density distribution of neurotensin (NT)-, substance P (SP), VIP-, angiotensin II (AII), m-enkephalin (m-ENK) and somatostatin (SS)-immunoreactive terminals in terms of normal morphology and following a brain lesion. The EyeCom II system divides the presented image into 307200 picture elements (pixels) and assigns one of 256 grey values to the average brightness with each pixel. We have aggregated the grey level frequencies into 5 levels where level 1 corresponds to the highest terminal density and level 5 to the lowest density. At level 1, only NT- and VIP-immunoreactive terminals occupy a significant percentage of the cross-sectional area of the CNA (20%). About 15% of the area of the CNA has VIP terminals with level 5 density. The distributions of the top 20% of the terminal density range of NT, SP, AII and VIP support a classical medial/lateral division of the nucleus. The distribution of the same range of SS- and ENK terminals suggests a dorsoventral division of the CNA. A preliminary study indicates that comparison of grey level frequency histograms generated by image analysis from homologous lesioned and unlesioned sections of the CNA can yield useful information regarding post-lesion changes in the distribution of immunoreactive terminals.     

Effective dose and image quality for intraoperative imaging with a cone-beam CT and a mobile multi-slice CT in spinal surgery: A phantom study

PurposeTo compare the effective dose (ED) and image quality (IQ) of O-arm cone-beam CT (Medtronic, Minneapolis, MN, USA) and Airo multi-slice CT (Brainlab AG, Munich, Germany) for intraoperative-CT (i-CT) in spinal surgery.MethodsThe manufacturer-defined protocols available in the O-arm and Airo systems for three-dimensional lumbar spine imaging were compared.Organ dose was measured both with thermo-luminescent dosimeters and GafChromic films in the Alderson Radiation Therapy anthropomorphic phantom.A subjective analysis was performed by neurosurgeons to compare the clinical IQ of the anthropomorphic phantom images acquired with the different i-CT systems and imaging protocols.Image uniformity, noise, contrast-to-noise-ratio (CNR), and spatial resolution were additionally assessed with the Catphan 504 phantom.ResultsO-arm i-CT caused 56% larger ED than Airo due to the high definition (HD) imaging protocol.The noise was larger for O-arm images leading to a lower CNR than that measured for Airo. Moreover, scattering and beam hardening effects were observed in the O-arm images. Better spatial resolution was measured for the O-arm system (9 lp/cm) than for Airo (4 lp/cm).For all the investigated protocols, O-arm was found to be better for identifying anatomical features important for accurate pedicle screw positioning.ConclusionsAccording to phantom measurements, the HD protocol of O-arm offered better clinical IQ than Airo but larger ED. The larger noise of O-arm images did not compromise the clinical IQ while the superior spatial resolution of this system allowed a better visibility of anatomical features important for pedicle screw positioning in the lumbar region.     

Image quality for radiotherapy CT simulators with different scanner bore size

PurposeWe compare image quality parameters derived from phantom images taken on three commercially available radiotherapy CT simulators. To make an unbiased evaluation, we assured images were obtained with the same surface dose measured using XR-QA2 model GafChromic™ film placed at the imaging phantom surface for all three CT-simulators.MethodsRadiotherapy CT simulators GE LS 16, Philips Brilliance Big Bore, and Toshiba Aquilion LB were compared in terms of spatial resolution, low contrast detectability, image uniformity, and contrast to noise ratio using CATPHAN-504 phantom, scanned with Head and Pelvis protocols. Dose was measured at phantom surface, with CT scans repeated until doses on all scanners were within 2%.ResultsIn terms of spatial resolution, the GE simulator appears slightly better, while Philips CT images are superior in terms of SNR for both scanning protocols. The CNR results show that Philips CT images appear to be better, except for high Z material, while Toshiba appears to fit in between the two simulators.ConclusionsWhile the image quality parameters for three RT CT simulators show comparable results, the scanner bore size is of vital importance in various radiotherapy applications. Since the image quality is a function of a large number of confounding parameters, any loss in image quality due to scanner bore size could be compensated by the appropriate choice of scanning parameters, including the exposure and by balancing between the additional imaging dose to the patient and high image quality required in highly conformal RT techniques.     

First application of the GPU-based software framework TIGRE for proton CT image reconstruction

In proton therapy, the knowledge of the proton stopping power, i.e. the energy deposition per unit length within human tissue, is essential for accurate treatment planning. One suitable method to directly measure the stopping power is proton computed tomography (pCT). Due to the proton interaction mechanisms in matter, pCT image reconstruction faces some challenges: the unique path of each proton has to be considered separately in the reconstruction process adding complexity to the reconstruction problem. This study shows that the GPU-based open-source software toolkit TIGRE, which was initially intended for X-ray CT reconstruction, can be applied to the pCT image reconstruction problem using a straight line approach for the proton path. This simplified approach allows for reconstructions within seconds.To validate the applicability of TIGRE to pCT, several Monte Carlo simulations modeling a pCT setup with two Catphan® modules as phantoms were performed. Ordered-Subset Simultaneous Algebraic Reconstruction Technique (OS-SART) and Adaptive-Steepest-Descent Projection Onto Convex Sets (ASD-POCS) were used for image reconstruction. Since the accuracy of the approach is limited by the straight line approximation of the proton path, requirements for further improvement of TIGRE for pCT are addressed.     

Selection of optimal cardiac phases for ECG-triggered coronary CT angiography in pediatrics

PurposeThe use of coronary computed tomography angiography (CCTA) in children remains limited by patient’s irradiation, and motion artefacts impairing image quality. Triggering the acquisition at the appropriate moment, and acquiring only necessary components of the cardiac cycle could overcome these limitations. Yet, optimal cardiac intervals to perform CCTA as a function of heart rate (HR) have not yet been addressed in pediatrics.MethodsFifty children with coronary artery anomalies underwent a CCTA on a wide-coverage single-beat CT scanner. Multiple phases from 25% to 85% of the R-R interval were acquired and reconstructed with 10% increments. Two radiologists independently assessed motion artifacts on each cardiac phase using a 4-point semi-quantitative scale.ResultsAt patient level, the best phase for acquisition was found in diastole for patients with HR ≤ 75 bpm and in systole for patients with HR > 85 bpm. At coronary segments and structures level, median optimal phases were reported at 70%, 80%, 47%, 50%, and 54% of the R-R interval for patients with HR ≤ 60, 61–75, 86–100, 101–130, and >130 bpm respectively. For patients with HR between 76 and 85 bpm, no clear trend could be observed. Optimal acquisition durations represented 10% (2 phases), 20% (3 phases), 50% (multiphase), 20% (3 phases), and 10% (2 phases) of the R-R interval for patients with HR ≤ 60, 61–75, 76–100, 101–130, and >130 bpm, respectively.ConclusionsOptimal positioning and duration of CCTA acquisition intervals were investigated as a function of children’s HR, to reduce motion artifacts and patient’s irradiation.