315 research outputs found
Intracranial Hemorrhage Annotation for CT Brain Images
In this paper, we created a decision-making model to detect intracranial hemorrhage and adopted Expectation Maximization(EM) segmentation to segment the Computed Tomography (CT) images. In this work, basically intracranial hemorrhage is classified into two main types which are intra-axial hemorrhage and extra-axial hemorrhage. In order to ease classification, contrast enhancement is adopted to finetune the contrast of the hemorrhage. After that, k-means is applied to group the potential and suspicious hemorrhagic regions into one cluster. The decision-making process is to identify whether the suspicious regions are hemorrhagic regions or non-regions of interest. After the hemorrhagic detection, the images are segmented into brain matter and cerebrospinal fluid (CSF) by using expectation-maximization (EM) segmentation. The acquired experimental results are evaluated in terms of recall and precision. The encouraging results have been attained whereby the proposed system has yielded 0.9333 and 0.8880 precision for extra-axial and intra-axial hemorrhagic detection respectively, whereas recall rate obtained is 0.9245 and 0.8043 for extra-axial and intra-axial hemorrhagic detection respectively
Imaging in Minor Head Injury: Early complications and late consequences
Head injury is traditionally
divided into minor, moderate or
severe head injury, depending on
the patientâs presenting level of consciousness
as expressed in the Glasgow Coma Scale
(GCS) score. Th e vast majority of patients
(>90%) present with a normal or nearnormal
level of consciousness (GSC score of
13â15) and are thus classifi ed as minor head
injury patients (1, 2). With an estimated
60 000 patients annually in the Netherlands,
minor head injury forms a major health care
and societal burden. Despite being classifi ed
as âminorâ, the injury is not inconsequential.
Consequences of minor head injury can
be divided into early, potentially lifethreatening
complications, and long-term
functional disability as well as a wide range of postconcussive complaints
Control techniques for mechatronic assisted surgery
The treatment response for traumatic head injured patients can be improved by
using an autonomous robotic system to perform basic, time-critical emergency neurosurgery,
reducing costs and saving lives. In this thesis, a concept for a neurosurgical robotic system is proposed to perform three specific emergency neurosurgical procedures; they are the placement of an intracranial pressure monitor, external
ventricular drainage, and the evacuation of chronic subdural haematoma. The control
methods for this system are investigated following a curiosity led approach. Individual problems are interpreted in the widest sense and solutions posed that are general in nature. Three main contributions result from this approach: 1)
a clinical evidence based review of surgical robotics and a methodology to assist in their evaluation, 2) a new controller for soft-grasping of objects, and 3) new propositions and theorems for chatter suppression sliding mode controllers. These contributions directly assist in the design of the control system of the neurosurgical robot and, more broadly, impact other areas outside the narrow con nes of the target application. A methodology for applied research in surgical robotics is proposed. The methodology sets out a hierarchy of criteria consisting of three tiers, with the most important being the bottom tier and the least being the top tier. It is argued that
a robotic system must adhere to these criteria in order to achieve acceptability. Recent commercial systems are reviewed against these criteria, and are found to conform up to at least the bottom and intermediate tiers. However, the lack of
conformity to the criteria in the top tier, combined with the inability to conclusively
prove increased clinical benefit, particularly symptomatic benefit, is shown to be hampering the potential of surgical robotics in gaining wide establishment. A control scheme for soft-grasping objects is presented. Grasping a soft or fragile object requires the use of minimum contact force to prevent damage or deformation. Without precise knowledge of object parameters, real-time feedback
control must be used to regulate the contact force and prevent slip. Moreover, the controller must be designed to have good performance characteristics to rapidly modulate the fingertip contact force in response to a slip event. A fuzzy sliding mode controller combined with a disturbance observer is proposed for contact force control and slip prevention. The robustness of the controller is evaluated through
both simulation and experiment. The control scheme was found to be effective and robust to parameter uncertainty. When tested on a real system, however, chattering phenomena, well known to sliding mode research, was induced by the
unmodelled suboptimal components of the system (filtering, backlash, and time delays). This reduced the controller performance. The problem of chattering and potential solutions are explored. Real systems using sliding mode controllers, such as the control scheme for soft-grasping, have a tendency to chatter at high frequencies. This is caused by the sliding mode
controller interacting with un-modelled parasitic dynamics at the actuator-input
and sensor-output of the plant. As a result, new chatter-suppression sliding mode controllers have been developed, which introduce new parameters into the system. However, the effect any particular choice of parameters has on system performance
is unclear, and this can make tuning the parameters to meet a set of performance
criteria di cult. In this thesis, common chatter-suppression sliding mode control
strategies are surveyed and simple design and estimation methods are proposed.
The estimation methods predict convergence, chattering amplitude, settling time,
and maximum output bounds (overshoot) using harmonic linearizations and invariant
ellipsoid sets
Intracranial Pressure Monitoring in Cerebrospinal Fluid Dynamics Disturbances
There are numerous gaps in the knowledge of Intracranial Pressure (ICP) physiology and Cerebrospinal Fluid (CSF) dynamics. This PhD answers some of the research questions posed by these gaps, through the use of invasive ICP monitoring in patients with suspected CSF dynamics
disturbances.
Research on CSF dynamics disturbances has mainly focused on conditions that cause high ICP, whilst only sparse attention has been centred on low CSF pressure/volume states. Chapter 3 and chapter 4 of this thesis are focused on Spontaneous Intracranial Hypotension (SIH). Chapter 3 is a comprehensive systematic review and meta-analysis of the clinical presentation, investigation findings and treatment outcomes of this disease.
Chapter 4 is an observational study that investigated the utility of invasive ICP monitoring when there is diagnostic uncertainty for SIH. This study demonstrates that, in selected cases, ICP monitoring can be useful and confirm a low-pressure state in 8% of the patients and identify a paradoxical clinical presentation with an underlying high-pressure state in 16% of the patients.
Chapters 5 and 6 provide evidence on the way that ICP and brain compliance respond to external variables, such as changes in posture and shunt setting adjustments. Chapter 5 is a retrospective observational study that describes the changes of ICP and pulse amplitude with different postures. Chapter 6 is a retrospective observational study investigating the effect of valve setting adjustments on ICP. This study demonstrates that paradoxical changes in ICP following differential pressure valves setting changes can occur.
Chapters 7 and 8 investigate the possibility of replacing invasive ICP monitoring with non-invasive biomarkers of raised ICP. Chapter 7 demonstrated the association between higher ICP measurements and the absence of spontaneous retinal venous pulsations detected with infrared video recordings. Chapter 8 demonstrates the utility of integrating ophthalmic and imaging biomarkers to predict raised ICP
Case series of breast fillers and how things may go wrong: radiology point of view
INTRODUCTION: Breast augmentation is a procedure opted by women to overcome sagging
breast due to breastfeeding or aging as well as small breast size. Recent years have shown the
emergence of a variety of injectable materials on market as breast fillers. These injectable
breast fillers have swiftly gained popularity among women, considering the minimal
invasiveness of the procedure, nullifying the need for terrifying surgery. Little do they know
that the procedure may pose detrimental complications, while visualization of breast
parenchyma infiltrated by these fillers is also deemed substandard; posing diagnostic
challenges. We present a case series of three patients with prior history of hyaluronic acid and
collagen breast injections.
REPORT: The first patient is a 37-year-old lady who presented to casualty with worsening
shortness of breath, non-productive cough, central chest pain; associated with fever and chills
for 2-weeks duration. The second patient is a 34-year-old lady who complained of cough, fever
and haemoptysis; associated with shortness of breath for 1-week duration. CT in these cases
revealed non thrombotic wedge-shaped peripheral air-space densities.
The third patient is a 37âyearâold female with right breast pain, swelling and redness for 2-
weeks duration. Previous collagen breast injection performed 1 year ago had impeded
sonographic visualization of the breast parenchyma. MRI breasts showed multiple non-
enhancing round and oval shaped lesions exhibiting fat intensity.
CONCLUSION: Radiologists should be familiar with the potential risks and hazards as well
as limitations of imaging posed by breast fillers such that MRI is required as problem-solving
tool
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