Song Jie, Udupa Jayaram K, Tong Yubing, Xiao Liang, Wu Caiyun, McDonough Joseph, Capraro Anthony, Torigian Drew A, Campbell Robert M
Medical Image Processing Group, 602 Goddard building, 3710 Hamilton Walk, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104.
Department of Computer Science and Technology, Nanjing University of Science and Technology, Nanjing, 210094.
Proc SPIE Int Soc Opt Eng. 2018 Feb;10576. doi: 10.1117/12.2294551. Epub 2018 Mar 13.
The major hurdles currently preventing advance and innovation in thoracic insufficiency syndrome (TIS) assessment and treatment are the lack of standardizable objective diagnostic measurement techniques that describe the 3D thoraco-abdominal structures and the dynamics of respiration. Our goal is to develop, test, and evaluate a quantitative dynamic magnetic resonance imaging (QdMRI) methodology and a biomechanical understanding for deriving key quantitative parameters from free-tidal-breathing dMRI image data for describing the 3D structure and dynamics of the thoraco-abdominal organs of TIS patients. In this paper, we propose an idea of a shape sketch to codify and then quantify the overall thoracic architecture, which involves the selection of 3D landmark points and computation of 3D dynamic distances over a respiratory cycle. We perform two statistical analyses of distance sketches on 25 different TIS patients to try to understand the pathophysiological mechanisms in relation to spine deformity and to quantitatively evaluate improvements from pre-operative to post-operative states. This QdMRI methodology involves developing: (1) a 4D image construction method; (2) an algorithm for the 4D segmentation of thoraco-abdominal structures; and (3) a set of key quantitative parameters. We illustrate that the TIS dynamic distance analysis method produces results previously unknown and precisely describes the morphologic and dynamic alterations of the thorax in TIS. A set of 3D thoraco-abdominal distances and/or distance differences enables the precise estimation of key measures such as left & right differences, differences over tidal breathing, and differences from pre- to post-operative condition.
目前阻碍胸廓发育不全综合征（TIS）评估和治疗取得进展与创新的主要障碍是缺乏可标准化的客观诊断测量技术，这些技术能够描述三维胸腹结构以及呼吸动力学。我们的目标是开发、测试和评估一种定量动态磁共振成像（QdMRI）方法以及一种生物力学理解，以便从自由呼吸的dMRI图像数据中得出关键定量参数，用于描述TIS患者胸腹器官的三维结构和动力学。在本文中，我们提出了一种形状草图的概念，用于编纂并量化整体胸廓结构，这涉及到三维地标点的选择以及在一个呼吸周期内三维动态距离的计算。我们对25名不同的TIS患者的距离草图进行了两项统计分析，试图了解与脊柱畸形相关的病理生理机制，并定量评估术前到术后状态的改善情况。这种QdMRI方法包括开发：（1）一种四维图像构建方法；（2）一种用于胸腹结构四维分割的算法；以及（3）一组关键定量参数。我们表明，TIS动态距离分析方法产生了以前未知的结果，并精确描述了TIS患者胸廓的形态和动态变化。一组三维胸腹距离和/或距离差异能够精确估计关键指标，如左右差异、潮气呼吸时的差异以及术前到术后状态的差异。
