Jagadale Basavaraj N, Udupa Jayaram K, Tong Yubing, Wu Caiyun, McDonough Joseph, Torigian Drew A, Campbell Robert M
Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104,United States.
Center for Thoracic Insufficiency Syndrome, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States.
Proc SPIE Int Soc Opt Eng. 2018 Feb;10575. doi: 10.1117/12.2295012. Epub 2018 Feb 27.
General surgeons, orthopedists, and pulmonologists individually treat patients with thoracic insufficiency syndrome (TIS). The benefits of growth-sparing procedures such as Vertical Expandable Prosthetic Titanium Rib (VEPTR)insertionfor treating patients with TIS have been demonstrated. However, at present there is no objective assessment metricto examine different thoracic structural components individually as to their roles in the syndrome, in contributing to dynamics and function, and in influencing treatment outcome. Using thoracic dynamic MRI (dMRI), we have been developing a methodology to overcome this problem. In this paper, we extend this methodology from our previous structural analysis approaches to examining lung tissue properties. We process the T2-weighted dMRI images through a series of steps involving 4D image construction of the acquired dMRI images, intensity non-uniformity correction and standardization of the 4D image, lung segmentation, and estimation of the parameters describing lung tissue intensity distributions in the 4D image. Based on pre- and post-operative dMRI data sets from 25 TIS patients (predominantly neuromuscular and congenital conditions), we demonstrate how lung tissue can be characterized by the estimated distribution parameters. Our results show that standardized T2-weighted image intensity values decrease from the pre- to post-operative condition, likely reflecting improved lung aeration post-operatively. In both pre- and post-operative conditions, the intensity values decrease also from end-expiration to end-inspiration, supporting the basic premise of our results.
普通外科医生、骨科医生和肺科医生分别治疗胸廓发育不全综合征（TIS）患者。诸如植入垂直可扩展人工钛肋（VEPTR）等保肢手术治疗TIS患者的益处已得到证实。然而，目前尚无客观评估指标来单独检查不同的胸廓结构成分在该综合征中的作用、对动力学和功能的影响以及对治疗结果的影响。我们一直在利用胸部动态磁共振成像（dMRI）开发一种方法来解决这个问题。在本文中，我们将这种方法从之前的结构分析方法扩展到检查肺组织特性。我们通过一系列步骤处理T2加权dMRI图像，包括对采集的dMRI图像进行4D图像构建、强度非均匀性校正和4D图像标准化、肺分割以及估计描述4D图像中肺组织强度分布的参数。基于25例TIS患者（主要为神经肌肉和先天性疾病）的术前和术后dMRI数据集，我们展示了如何通过估计的分布参数来表征肺组织。我们的结果表明，标准化的T2加权图像强度值从术前到术后降低，这可能反映了术后肺通气改善。在术前和术后两种情况下，强度值从呼气末到吸气末也会降低，这支持了我们结果的基本前提。
