- 作者列表："Zhu J","Fan J","Guo S","Ai D","Song H","Wang C","Zhou S","Yang J
:The 3D/2D registration of pre-operative computed tomography angiography (CTA) and intra-operative x-ray angiography (XRA) images in vascular intervention is imperative for guiding surgical instruments and reducing the dosage of toxic contrast agents. In this study, 3D/2D vascular registration is formulated as a search tree problem on the basis of the topological continuity of vessels and the fact that matching can be decomposed into continuous states. In each node of the tree, a closed-solution of 3D/2D transformation is used to obtain the registration results based on the dense correspondences of vessel points, and the results of matching and registration are calculated and recorded. Then, a hand-crafted score that quantifies the qualities of matching and registration of vessels is used, and the remaining problem focuses on finding the highest score in the search tree. An improved heuristic tree search strategy is also proposed to find the best registration. The proposed method is evaluated and compared with four state-of-the-art methods. Experiments on simulated data demonstrate that our method is insensitive to initial pose and robust to noise and deformation. It outperforms other methods in terms of registering real model data and clinical coronary data. In the 3D/2D registration of uninitialized and initialized coronary arteries, the average registration errors are 1.85 and 1.79 mm, respectively. Given that the proposed method is independent of the initial pose, it can be used to navigate vascular intervention for clinical practice.
: 血管介入中术前计算机断层扫描血管造影 (CTA) 和术中x射线血管造影 (XRA) 图像的3D/2D配准对于引导手术器械和减少毒性造影剂的剂量是必不可少的。在本研究中，基于血管的拓扑连续性和匹配可以分解为连续状态的事实，将3D/2D血管配准公式化为搜索树问题。在树的每个节点中，基于血管点的密集对应关系，使用3D/2D变换的闭合解获得配准结果，并计算和记录匹配和配准的结果。然后，使用量化船只的匹配和登记质量的手工制作的分数，并且剩余的问题集中于在搜索树中找到最高分数。还提出了一种改进的启发式树搜索策略来寻找最佳配准。对所提出的方法进行了评估，并与四种最先进的方法进行了比较。在模拟数据上的实验表明，该方法对初始姿态不敏感，对噪声和变形具有鲁棒性。它在配准真实模型数据和临床冠状动脉数据方面优于其他方法。在未初始化和初始化冠状动脉的3D/2D配准中，平均配准误差分别为1.85和1.79mm。鉴于所提出的方法独立于初始姿态，它可以用于临床实践的血管介入导航。
METHODS:OBJECTIVES:The aim was to evaluate the image quality and sensitivity to artifacts of compressed sensing (CS) acceleration technique, applied to 3D or breath-hold sequences in different clinical applications from brain to knee. METHODS:CS with an acceleration from 30 to 60% and conventional MRI sequences were performed in 10 different applications in 107 patients, leading to 120 comparisons. Readers were blinded to the technique for quantitative (contrast-to-noise ratio or functional measurements for cardiac cine) and qualitative (image quality, artifacts, diagnostic findings, and preference) image analyses. RESULTS:No statistically significant difference in image quality or artifacts was found for each sequence except for the cardiac cine CS for one of both readers and for the wrist 3D proton density (PD)-weighted CS sequence which showed less motion artifacts due to the reduced acquisition time. The contrast-to-noise ratio was lower for the elbow CS sequence but not statistically different in all other applications. Diagnostic findings were similar between conventional and CS sequence for all the comparisons except for four cases where motion artifacts corrupted either the conventional or the CS sequence. CONCLUSIONS:The evaluated CS sequences are ready to be used in clinical daily practice except for the elbow application which requires a lower acceleration. The CS factor should be tuned for each organ and sequence to obtain good image quality. It leads to 30% to 60% acceleration in the applications evaluated in this study which has a significant impact on clinical workflow. KEY POINTS:• Clinical implementation of compressed sensing (CS) reduced scan times of at least 30% with only minor penalty in image quality and no change in diagnostic findings. • The CS acceleration factor has to be tuned separately for each organ and sequence to guarantee similar image quality than conventional acquisition. • At least 30% and up to 60% acceleration is feasible in specific sequences in clinical routine.
METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.
METHODS:OBJECTIVE:The primary purpose of this study was to evaluate the effectiveness of a three-dimensional (3D) software tool (smart planes) for displaying fetal brain planes, and the secondary purpose was to evaluate its accuracy in performing automatic measurements. MATERIAL AND METHODS:This prospective study included singleton fetuses with a gestational age (GA) greater than 18 weeks. Transabdominal two-dimensional ultrasound (2DUS) and 3D smart planes images were respectively used to obtain the basic planes of the fetal brain, with five parameters measured. The images, by either two-dimensional (2D) manual or 3D automatic operation, were reviewed by two experienced sonographers. The agreements between two measurements were analyzed. RESULTS:A total of 226 cases were included. The rates of successful detection by automatic display were as high as 80%. There was substantial agreement between the measurements of the biparietal diameter, head circumference and transcerebellar diameter, but poor agreement between the measurements of cisterna magna and lateral ventricle width. CONCLUSIONS:Smart Planes might be valuable for the rapid evaluation of fetal brain, because it simplifies the evaluation process. However, the technology requires improvement. In addition, this technology cannot replace the conventional manual US scans; it can only be used as an additional approach.