二维数字化超声软组织应变成像系统的研制

利用超声散射回波测量生物组织在静态压缩情况下弹性系数的超声弹性成像方法得到了很大的发展.利用国产高速数据采集卡以及商业线阵B型超声诊断仪,建立了一套二维数字化超声软组织应变成像系统.应用这一系统获得了数字化的射频组织超声散射回波信号,并对组织内的应变分布进行成像.实验结果表明,该应变成像系统在获得传统B型超声图像的同时,可以获得组织内部的应变分布图像,从而获取在B超图像上无法得到的组织弹性变化.这一系统的研制成功,不仅为超声弹性成像技术在医学临床上的应用研究打下了基础,同时也为扩宽普通商业B超的应用范围提供了途径.     

零相关窗互补码序列激励在超声血流速度剖面测量中的应用研究

为了提高超声回波信号的信噪比和空间分辨率,获取血流速度剖面,使用编码激励技术来改进传统的医学超声血流测量系统。提出一种具有"零相关窗"的互补码序列,该序列具有局部最佳非周期自相关性,可以在特定区域内完全消除旁瓣,并且采用易于硬件实现的二相编码序列。介绍了该序列的构造方法和特性,并分析了用其测量血流速度剖面的原理和方法。采用自主开发研制的激励超声测量硬件平台,通过单反射面回波实验,证实了该序列比单脉冲和13位Barker码序列具有更优良的信噪比增益。通过搭建模拟人体血流测量实验装置进行仿血流的速度剖面测量试验。实验结果表明,该序列激励超声信号同时具有优良的空间分辨率,在发射换能器的中心频率为5 MHz时,可达到0.3 mm的纵向分辨率,取得了良好的测量效果。     

基于超声回波信号的指端脉搏波提取

脉搏波可作为检测人体心血管系统生理病理状态的重要依据。为了验证用超声波测量脉搏波的可能、解决脉搏波的测量部位受限的问题,本研究提出一种从超声回波信号中提取脉搏波的方法。设计一种跟随式超声传感器,用数据采集系统采集指端超声回波信号,经过滤波、选点及小波去噪等处理后得到较为纯净的脉搏波信号;同时采集心电信号以及光电容积脉搏波信号作为参考信号。结果表明,可以从提取的指端脉搏波中准确地获取心率;与同步测得的光电容积脉搏波数据相关系数大部分在0.8以上;波形中的重搏前波、重搏波等细节部分也能明显地表现出来。本研究提出的方法实现了从指端超声回波信号中获取完整可靠的脉搏波信号,为日后获取不同部位的脉搏信号提供了基础。     

颈椎前路内植入固定系统的有限元模拟及生物力学分析

通过建立一种颈椎前路内植入固定器测试结构的有限元模型,从生物力学角度对该模型在人体生理性压力载荷下的应力-应变分布和运动特性进行分析评估.结果 表明:在生理性轴向压力载荷下,应力-应变集中分布在骨螺钉和内植入固定板的结合部位,钢板上的应力-应变以四个螺钉为定点呈梅花状分布,边缘处应力-应变分布较小,所得结论与临床结果一致.因此,通过该有限元方法可以有效分析颈椎前路内植入固定器在生理性载荷下的应力应变分布,对颈椎前路内植入固定器的外形设计和在临床上的选择提供科学的参考依据.     

坐姿下不同组织压力性损伤生物力学研究

目的 探讨坐姿下臀部压力性损伤易发部位以及不同软组织的生物力学响应,为有效预防深层组织压力性损伤提供参考。 方法 基于臀部 CT 扫描数据,建立坐位臀部有限元模型,包括骨骼、肌肉、脂肪和皮肤组织及坐垫模型,利用生死单元模拟组织损伤。 对比实验坐垫界面压力测量数据与有限元模拟结果,验证模型有效性。 模拟坐位力学状态,研究软组织的应力、应变情况,分析不同软组织中的压应力及超出极限值后可能造成的损伤情况。结果 通过对比坐垫模型仿真结果与实验界面压力测量结果,证明模型有效。 坐位时坐骨结节下方软组织区域出现应力集中现象。 其中,臀大肌组织中的横向压应力峰值约为 38 kPa,剪切应力峰值约为 3. 4 MPa;而脂肪组织中的最大压应力与剪切应力峰值分别为 22 kPa 与 4. 5 MPa,均未出现在坐骨结节正下方。 结论 软组织受到一定时间和大小的压力载荷作用,可能出现深层组织损伤。 当保持坐姿一定时间后,应及时变换体位,以降低压力性损伤出现的概率。 研究结果为预防压力性损伤提供生物力学依据,具有重要的临床研究价值。     

足部三维有限元建模方法及其生物力学应用

目的探讨建立足部三维有限元模型的方法,应用模型模拟分析研究鞋垫设计参数,不同软组织刚度和受力情况下对足部的生物力学影响。方法建立基于解剖结构,包括软组织,韧带和腱膜,考虑材料的非线性和关节接触的足部三维有限元模型。有限元模型的可靠性利用模拟足踝关节在不同病理、手术和鞋垫矫治情况下的生物力学反应来验证。结果有限元分析结果表明,定制型鞋垫的形状比鞋垫材料的刚度对减少足底最大压力有更重要影响。软组织刚度的增加引起足底接触面积的减小,从而会导致足底跖骨区最大压力增加。部分和完全松解足底腱膜都会降低足弓高度,并增加足底韧带的张力和增加中足和跖骨的应力。体重增加和跟腱拉力增加都将成倍足底筋膜的拉力。结论所建足部有限元模型能预测足底压力分布和足内部骨骼软组织应力、应变情况,可以成为设计鞋垫和研究足部各种临床状况提供有力的分析工具。     

基于强迫振荡技术的肺功能测量系统研究

强迫振荡技术是一种通过对呼吸系统施加外部强迫振荡气体,并检测经气道后气体压力和流量变化,结合系统辨识方法来获得呼吸系统阻力特性的主动型肺功能检测技术。本文研制了强迫振荡法的肺功能测量系统,对振荡气体发生单元主要构件、压力和流量传感器选型、振荡气体激励信号的设计以及压力、流量传感信号同步数据采集等进行了深入分析,搭建了基于LabVIEW的软硬件测量系统。基于该测量系统,分析了压力和流量传感器性能,得到了系统振荡压力频响曲线,基于该频响曲线,修正了振荡气体发生单元在各频率点(4~40 Hz)的压力信号幅度。最后,使用主动模拟肺ASL5000进行了呼吸阻抗的模拟测试。测试结果表明,本系统可以正确测量呼吸系统阻抗。     

医用超声系统增益补偿电路的设计

背景:为使深度不同但性质相同的界面反射的回波信号能显示出相同的幅值,必须根据深度(即时间)逐步增大放大器的增益,而使超声波在传播衰减过程中所引起远距离反射波弱的情况得到相应补偿。目的:为了补偿医学超声系统中回波信号的传输衰减问题,提出了一种时间增益补偿电路设计方案,阐述电路设计依据和原理。方法:针对医用超声系统的特点选择高信噪比、高带宽的可变增益放大器件VCA610,实现超声的增益补偿电路。结果与结论:该设计方案有效地解决了医用超声软组织测量过程中由声程导致的回波信号的非线性补偿问题。与传统的分立元件电路相比,该方案具有电路简单,TGC控制信号稳定可靠以及调节灵活等优点,能准确地补偿超声波在人体内的衰减,从而为医学测量系统的设计提供了一个新的可靠方法。     

人腰背筋膜的动态响应

本研究对人胸腰段脊柱的粘弹特性作了观察，对两组４０～８５岁的人体胸腰椎标本作了单轴拉伸断裂试验。根据解剖学纤维方向（即尾内侧和尾外侧方向）来选择两组标本。以五种不同的应变速率来判断标本的生物力学特性。获得每组标本的最大断裂应力、应变和杨氏模量。结果表明，两种解剖方向之间各种生物力学参数均无显著差异。然而，实验发现最大断裂应力、应变和杨氏模量随应变速率增加而增加。应变速率大于３／秒，则断裂应变和杨氏模量保持不变，提示已达到上限。     

软组织深层超声回波信号解卷处理和提高分辨率的研究

本文从声传输特性出发,针对被非均匀结构浅层组织传输影响而“模糊”了的深层组织回波信号,根据非均匀介质声传输特性,利用分层卷积模型［１,２］和最小方差解卷积技术［３］,分层估计出非均匀结构声程软组织的传输特性,进而得到整个软组织深层散射源真实传输特性的估计,使深部组织回波信号的分辨率得到提高。实验结果表明,这种方法对于非均匀结构软组织中被“模糊”了的深层超声回波信号分辨率的提高有明显效果。     

A novel MRI compatible soft tissue indentor and fibre Bragg grating force sensor

MRI is an ideal method for non-invasive soft tissue mechanical properties investigation. This requires mechanical excitation of the body's tissues and measurement of the corresponding boundary conditions such as soft tissue deformation inside the MRI environment. However, this is technically difficult since load application and measurement of boundary conditions requires MRI compatible actuators and sensors. This paper describes a novel MRI compatible computer controlled soft tissue indentor and optical Fibre Bragg Grating (FBG) force sensor. The high acquisition rate (100 Hz) force sensor was calibrated for forces up to 15 N and demonstrated a maximum error of 0.043 N. Performance and MRI compatibility of the devices was verified using indentation tests on a silicone gel phantom and the upper arm of a volunteer. The computer controlled indentor provided a highly repeatable tissue deformation. Since the indentor and force sensor are composed of non-ferromagnetic materials, they are MRI compatible and no artefacts or temporal SNR reductions were observed. In a phantom study the mean and standard deviation of the temporal SNR levels without the indentor present were 500.18 and 207.08, respectively. With the indentor present the mean and standard deviation were 501.95 and 200.45, respectively. This computer controlled MRI compatible soft tissue indentation system with an integrated force sensor has a broad range of applications and will be used in the future for the non-invasive analysis of the mechanical properties of skeletal muscle tissue.     

Bone vibration measurement using ultrasound: application to detection of hip prosthesis loosening

Hip prosthesis loosening can be determined in vivo using a vibration-based technique called vibrometry. In this technique, a low frequency (<1000Hz) sinusoidal vibration is applied to the femoral condyles and the resulting vibration is measured at the greater trochanter. If the prosthesis is securely fixed, the output vibration signal matches that of the input vibration, whereas if the prosthesis is loose, the output vibration signal is distorted and shows the marked presence of harmonics of the input frequency. One of the main problems with this application of this technique is in measuring the output vibration where significant amounts of soft tissue cover the measurement site. In order to circumvent this problem, an ultrasound probe, normally used for the measurement of blood flow, has been used to measure the output vibration. This has been evaluated by comparing the results obtained from the ultrasound probe with those from a conventional accelerometer in models representing a tight and loose hip prosthesis under simulated clinical conditions. The ultrasound probe was able to consistently detect the output vibration, for both the loose and secure prostheses. Under the test conditions used (which attempted to simulate a large thickness of soft tissue), the ultrasound probe was able to produce a greatly enhanced output vibration signal compared to the accelerometer. This suggests that the use of an ultrasound probe to detect mechanically induced vibration through significant amounts of soft tissue appears to be viable and could lead to enhanced detection of prosthesis loosening using this technique.     

Prostate cancer detection with an improved resonance sensor system: parameter evaluation in a silicone model and on human prostate tissue in vitro

The purpose of this study was to improve a resonance sensor system for prostate cancer detection and evaluate its performance on silicone with different hardness. Furthermore, to investigate if the instrument could distinguish between cancerous and normal prostate tissue in one in vitro prostate specimen. The system could measure the frequency shift, impression depth and the rise time of the force signal. The frequency shift, impression depth and the rise time described the relative hardness of silicone (n = 50, P < 0.05). The results from measurements on the prostate specimen indicated that there is a significant difference in the parameter data between cancerous and normal prostate tissue (n = 15, P < 0.05). The parameters’ impression depth and force rise time adds important information for cancer detection. Further studies on prostate tissue with different tumour types must be performed in order to understand the full value of the new sensor system.     

The measurement of biomechanical properties of porcine articular cartilage using atomic force microscopy

We have recently demonstrated that indentation-type atomic force microscopy (IT-AFM) is capable of detecting early onset osteoarthritis (OA) (Stolz, 2009). This study was based on biopsies, using a desk-top commercial atomic force microscope (AFM). However, cartilage analysis in the knee joints needs to be non-destructive to avoid new seeding points for OA by the taking of biopsies. This requires bringing the probe tip in contact with the articular cartilage (AC) surface inside the joint. Here we present our recent progress towards a medical instrument for performing such IT-AFM measurements for in-vivo knee diagnostics. The scanning force arthroscope (SFA) integrates a miniaturized AFM into a standard arthroscopic sleeve, and is used for direct, quantitative, in situ inspection of AC (Imer et al., 2006). The stabilization and the positioning of the instrument relative to the surface under investigation were performed by means of eight inflatable balloons. An integrated three-dimensional, piezoelectric scanner allowed raster scanning and probing of a small area of cartilage around the point of insertion. An AFM probe with an integrated deflection sensor was mounted at the distal end of the instrument. Using this instrument, several measurements were performed on agarose gel and on porcine cartilage samples. The load-displacement curves obtained were analyzed and the dynamic elastic moduli | E(*) | were calculated. A good correlation between these values and those published in the scientific literature was found. Therefore, we concluded that the SFA can provide quantitative measurements to detect early pathological changes in OA.     

In Vivo Measurement of Ligament/Tendon Strains and Forces: A Review

Accurate and precise measurements of ligament and tendon biomechanics in living humans are needed to better understand function and injury and to optimize treatment. The complex structure and loadings of these internal soft tissues makes in vivo measurements difficult to obtain. A noninvasive method that can be used in the field during normal unrestricted activity would be optimal, though this goal has yet to be achieved. Instrumentation has been developed to directly measure the strains and forces in human ligaments and tendons in vivo. The current strain measurement techniques include devices that attach directly to the tissue (e.g. Differential Variable Reluctance Transducer). The current force measurement techniques include the Buckle transducer, fiber optic sensors, and other implantable force probes that are placed in or around the mid-substance of the tissue. Noninvasive methods (e.g. ultrasonography, magnetic resonance imaging) have recently emerged to measure soft tissue strains and they show considerable promise. In this paper, the different techniques are reviewed with an emphasis on their advantages, limitations, and hence clinical relevance. These must be clearly understood in order to interpret the data reported in the literature that were obtained from such technologies, to design experiments that utilize these technologies, or to improve upon these technologies.     

An Effective Non-rigid Registration Approach for Ultrasound Image Based On “Demons” Algorithm

Medical image registration is an important component of computer-aided diagnosis system in diagnostics, therapy planning, and guidance of surgery. Because of its low signal/noise ratio (SNR), ultrasound (US) image registration is a difficult task. In this paper, a fully automatic non-rigid image registration algorithm based on demons algorithm is proposed for registration of ultrasound images. In the proposed method, an “inertia force” derived from the local motion trend of pixels in a Moore neighborhood system is produced and integrated into optical flow equation to estimate the demons force, which is helpful to handle the speckle noise and preserve the geometric continuity of US images. In the experiment, a series of US images and several similarity measure metrics are utilized for evaluating the performance. The experimental results demonstrate that the proposed method can register ultrasound images efficiently, robust to noise, quickly and automatically.     

An MRI-Guided Telesurgery System Using a Fabry-Perot Interferometry Force Sensor and a Pneumatic Haptic Device

This paper presents a surgical master-slave teleoperation system for percutaneous interventional procedures under continuous magnetic resonance imaging (MRI) guidance. The slave robot consists of a piezoelectrically actuated 6-degree-of-freedom (DOF) robot for needle placement with an integrated fiber optic force sensor (1-DOF axial force measurement) using the Fabry-Perot interferometry (FPI) sensing principle; it is configured to operate inside the bore of the MRI scanner during imaging. By leveraging the advantages of pneumatic and piezoelectric actuation in force and position control respectively, we have designed a pneumatically actuated master robot (haptic device) with strain gauge based force sensing that is configured to operate the slave from within the scanner room during imaging. The slave robot follows the insertion motion of the haptic device while the haptic device displays the needle insertion force as measured by the FPI sensor. Image interference evaluation demonstrates that the telesurgery system presents a signal to noise ratio reduction of less than 17% and less than 1% geometric distortion during simultaneous robot motion and imaging. Teleoperated needle insertion and rotation experiments were performed to reach 10 targets in a soft tissue-mimicking phantom with 0.70 ± 0.35 mm Cartesian space error.     

Ultrasonic characterization of cancellous bone using apparent integrated backscatter

Apparent integrated backscatter (AIB) is a measure of the frequency-averaged (integrated) backscattered power contained in some portion of a backscattered ultrasonic signal. AIB has been used extensively to study soft tissues, but its usefulness as a tissue characterization technique for cancellous bone has not been demonstrated. To address this, we performed measurements on 17 specimens of cancellous bone over two different frequency ranges using a 1 MHz and 5 MHz broadband ultrasonic transducer. Specimens were obtained from bovine tibiae and prepared in the shape of cubes (15 mm side length) with faces oriented along transverse (anterior, posterior, medial and lateral) and longitudinal (superior and inferior) principal anatomic directions. A mechanical scanning system was used to acquire multiple backscatter signals from each direction for each cube. AIB demonstrated highly significant linear correlations with bone mineral density (BMD) for both the transverse (R2 = 0.817) and longitudinal (R2 = 0.488) directions using the 5 MHz transducer. In contrast, the correlations with density were much weaker for the 1 MHz transducer (R2 = 0.007 transverse, R2 = 0.228 longitudinal). In all cases where a significant correlation was observed, AIB was found to decrease with increasing BMD.     

In vivo quantification of lead in bone with a portable x-ray fluorescence system--methodology and feasibility

This study was conducted to investigate the methodology and feasibility of developing a portable x-ray fluorescence (XRF) technology to quantify lead (Pb) in bone in vivo. A portable XRF device was set up and optimal settings of voltage, current, and filter combination for bone lead quantification were selected to achieve the lowest detection limit. The minimum radiation dose delivered to the subject was calculated by Monte Carlo simulations. An ultrasound device was used to measure soft tissue thickness to account for signal attenuation, and an alternative method to obtain soft tissue thickness from the XRF spectrum was developed and shown to be equivalent to the ultrasound measurements (intraclass correlation coefficient, ICC = 0.82). We tested the correlation of in vivo bone lead concentrations between the standard KXRF technology and the portable XRF technology. There was a significant correlation between the bone lead concentrations obtained from the standard KXRF technology and those obtained from the portable XRF technology (ICC = 0.65). The detection limit for the portable XRF device was about 8.4 ppm with 2 mm soft tissue thickness. The entrance skin dose delivered to the human subject was about 13 mSv and the total body effective dose was about 1.5 μSv and should pose minimal radiation risk. In conclusion, portable XRF technology can be used for in vivo bone lead measurement with sensitivity comparable to the KXRF technology and good correlation with KXRF measurements.     

Varying ultrasound power level to distinguish surgical instruments and tissue

We investigate a new framework of surgical instrument detection based on power-varying ultrasound images with simple and efficient pixel-wise intensity processing. Without using complicated feature extraction methods, we identified the instrument with an estimated optimal power level and by comparing pixel values of varying transducer power level images. The proposed framework exploits the physics of ultrasound imaging system by varying the transducer power level to effectively distinguish metallic surgical instruments from tissue. This power-varying image-guidance is motivated from our observations that ultrasound imaging at different power levels exhibit different contrast enhancement capabilities between tissue and instruments in ultrasound-guided robotic beating-heart surgery. Using lower transducer power levels (ranging from 40 to 75% of the rated lowest ultrasound power levels of the two tested ultrasound scanners) can effectively suppress the strong imaging artifacts from metallic instruments and thus, can be utilized together with the images from normal transducer power levels to enhance the separability between instrument and tissue, improving intraoperative instrument tracking accuracy from the acquired noisy ultrasound volumetric images. We performed experiments in phantoms and ex vivo hearts in water tank environments. The proposed multi-level power-varying ultrasound imaging approach can identify robotic instruments of high acoustic impedance from low-signal-to-noise-ratio ultrasound images by power adjustments.