生物医学工程学杂志

生物医学工程学杂志

基于改进型Haller指数的儿童鸡胸自动化诊断

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鸡胸是最常见的儿童胸壁畸形之一,表现为部分胸骨及与之相连的肋软骨向前突起,轻者心理健康受损,重者肺部等身体机能受损。临床上广泛使用的鸡胸评价指标——Haller 指数,其在鸡胸诊断效率以及分型上存在一定不足,因此本文提出一种改进型 Haller 指数及其自动化测量算法。首先提取患者电子计算机断层扫描(CT)图像中胸骨最凸横断面的外胸廓像素点集合;然后将其分别拟合为三次 B 样条曲线和椭圆曲线;最后基于解析曲线自动计算得出改进型 Haller 指数及分型指数。通过对 22 组患者术前术后 CT 数据的实验分析结果表明,本文提出的改进型 Haller 指数不仅可以正确诊断鸡胸,而且可用于对不同程度的鸡胸进行分型,证实了该评价指标的可行性,同时由于采用计算机自动测量技术,提高了鸡胸诊断效率,为计算机辅助个性化儿童胸壁畸形诊疗技术奠定了基础。

Pectus carinatum (PC) is one of the most common chest wall anomalies, which is characterized by the protrusion of the anterior chest wall including the sternum and adjacent costal cartilages. Mildly patients suffer from mental problems such as self-abasement, while severely suffering patients are disturbed by significant cardiopulmonary symptoms. The traditional Haller index, which is widely used clinically to evaluate the severity of PC, is deficient in diagnosis efficiency and classification. This paper presents an improved Haller index algorithm for PC: first, the contour of the patient chest in the axial computed tomography (CT) slice where the most convex thorax presents is extracted; and then a cubic B-spline curve is employed to fit the extracted contour followed by an eclipse fitting procedure; finally, the improved Haller index and the classification index are automatically calculated based on the analytic curves. The results of CT data analysis using 22 preoperative and postoperative patient CT datasets show that the proposed diagnostic index for PC can diagnose and classify PC patients correctly, which confirms the feasibility of the evaluation index. Furthermore, digital measurement techniques can be employed to improve the diagnostic efficiency of PC, achieving one small step towards the computer-aided intelligent diagnosis and treatment for pediatric chest wall malformations.

关键词: 鸡胸; 电子计算机断层扫描图像; 三次B样条曲线; 椭圆曲线; 计算机辅助诊断

Key words: pectus carinatum; computed tomography image; cubic B-spline curve; elliptic curve; computer-aided diagnosis

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1. Brochhausen C, Turial S, Müller F K, et al. Pectus excavatum: history, hypotheses and treatment options. Interact Cardiovasc Thorac Surg, 2012, 14(6): 801-806
2. Fokin A A, Steuerwald N M, Ahrens W A, et al. Anatomical, histologic and genetic characteristics of congenital chest wall deformities. Seminars in Thoracic & Cardiovascular Surgery, 2009, 21(1): 44
3. Galladay E S. Pectus carinatum and other deformities of the chest wall. New York: McGraw-Hill, 2003: 269-277
4. Knudsen M V, Grosen K, Pilegaard H K, et al. Surgical correction of pectus carinatum improves perceived body image, mental health and self-esteem. J Pediatr Surg, 2015, 50(9): 1472-1476
5. Steinmann C, Krille S, Mueller A, et al. Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. Eur J Cardiothorac Surg, 2011, 40(5): 1138-1145
6. Swanson J W, Colombani P M. Reactive pectus carinatum in patients treated for pectus excavatum. J Pediatr Surg, 2008, 43(8): 1468-1473
7. 白欣立, 欧阳彬海, 孙荷华. 小儿漏斗胸对心脏影响的探讨. 实用儿科杂志, 1993, 8(1): 19-20
8. Haller J. Alex Jr, Sandra S K, Steven A L Use of CT scans in selection of patients for pectus excavatum surgery:a preliminary report. J Pediatr Surg, 1987, 22(10): 904-906
9. St Peter S D, Juang D, Garey C L, et al. A novel measure for pectus excavatum: the correction index. J Pediatr Surg, 2011, 46(12): 2270-2273
10. Poncet P, Kravarusic D, Richart T, et al. Clinical impact of optical imaging with 3-D reconstruction of torso topography in common anterior chest wall anomalies. J Pediatr Surg, 2007, 42(5): 898-903
11. 陈诚豪. 鸡胸胸廓生物力学测试与有限元分析研究. 北京: 首都医科大学, 2017: 5, 68
12. Egan J C, Dubois J J, Morphy M, et al. Compressive orthotics in the treatment of asymmetric pectus carinatum:a preliminary report with an objective radiographic marker. J Pediatr Surg, 2000, 35(8): 1183-1186
13. Colombani P M. Preoperative assessment of chest wall deformities. Semin Thorac Cardiovasc Surg, 2009, 21(1): 58-63
14. 曾骐, 贺延儒, 李士惠. 小儿鸡胸的分型及外科治疗. 中华胸心血管外科杂志, 1999, 15(4): 225-227
15. Park H J, Lee S Y, Lee C S, et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg, 2004, 77(1): 289-295