Annu Int Conf IEEE Eng Med Biol Soc. 2021 Nov;2021:3141-3144. doi: 10.1109/EMBC46164.2021.9630726.
After Total Knee Arthroplasty (TKA), a global post-operative rehabilitation programme is commonly performed. However, this current program is not always adapted to every patient and it could be improved by deeply reinforcing weaker thigh muscles. To do this, a muscle volume estimation coupled with force evaluation is required to therefore adapt the rehabilitation as a specific patient exercise plan. In this paper, we presented an MRI protocol allowing the acquisition of the whole thigh as well as a semi-automated pipeline to segment two main groups of thigh muscles, i.e., the quadriceps femoris and the hamstrings muscles. The pipeline is based on a few cross-sections manually labelled and a 3D-spline interpolation using directed graphs corresponding points. The seven muscles of ten thighs (70 muscles in total) were segmented and reconstructed in 3D. To assess this pipeline, three types of metrics (volumetric similarity, surface distance, and classical measures) were employed. Furthermore, the inter-muscle overlapping was calculated as an additional metric. The results showed mean DICE was 99.6% (±0.1), Hausdorff Distance was 4.9 mm (±1.8) and Absolute Volume Difference was 2.97 cm3 (±1.94) in comparison to the manual ground truth. The average overlap was 2.05% (±0.54).Clinical Relevance- The proposed segmentation method is fast, accurate and possible to integrate in the clinical workflow of TKA.
全膝关节置换术后（TKA），通常会进行全球术后康复计划。然而，这个现行的计划并不总是适用于每个患者，通过深度强化较弱的大腿肌肉，可以对其进行改进。为此，需要对肌肉体积进行估计并进行力量评估，从而为每位患者制定专门的康复锻炼计划。在本文中，我们提出了一种 MRI 协议，可以采集整个大腿的图像，并提供了一种半自动的流水线，用于分割大腿的两个主要肌群，即股四头肌和腘绳肌。该流水线基于少数手动标记的横截面和使用对应点的有向图的 3D 样条插值。共分割和重建了十个人大腿的七个肌肉（共 70 个肌肉）。为了评估该流水线，我们使用了三种类型的指标（体积相似性、表面距离和经典测量）。此外，还计算了肌肉之间的重叠作为额外的指标。结果表明，与手动真值相比，平均 DICE 为 99.6%（±0.1），Hausdorff 距离为 4.9 毫米（±1.8），绝对体积差异为 2.97 立方厘米（±1.94）。平均重叠为 2.05%（±0.54）。临床意义- 所提出的分割方法快速、准确，可集成到 TKA 的临床工作流程中。
