Robot-based tele-echography: clinical evaluation of the TER system in abdominal aortic exploration

OBJECTIVE: The TER system is a robot-based tele-echography system allowing remote ultrasound examination. The specialist moves a mock-up of the ultrasound probe at the master site, and the robot reproduces the movements of the real probe, which sends back ultrasound images and force feedback. This tool could be used to perform ultrasound examinations in small health care centers or from isolated sites. The objective of this study was to prove, under real conditions, the feasibility and reliability of the TER system in detecting abdominal aortic and iliac aneurysms. METHODS: Fifty-eight patients were included in 2 centers in Brest and Grenoble, France. The remote examination was compared with the reference standard, the bedside examination, for aorta and iliac artery diameter measurement, detection and description of aneurysms, detection of atheromatosis, the duration of the examination, and acceptability. RESULTS: All aneurysms (8) were detected by both techniques as intramural thrombosis and extension to the iliac arteries. The interobserver correlation coefficient was 0.982 (P < .0001) for aortic diameters. The rate of concordance between 2 operators in evaluating atheromatosis was 84% +/- 11% (95% confidence interval). CONCLUSIONS: Our study on 58 patients suggests that the TER system could be a reliable, acceptable, and effective robot-based system for performing remote abdominal aortic ultrasound examinations. Research is continuing to improve the equipment for general abdominal use

TER: A Robot for Remote Ultrasonic Examination: Experimental Evaluations

This chapter: o Motivates the clinical use of robotic tele-echography o Introduces the TER system o Describes technical and clinical evaluations performed with TE

Dépistage de l'artériopathie oblitérante des membres inférieurs chez les patients porteurs d'une polyarthrite rhumatoïde

Artériopathie oblitérante des membres inférieurs est une maladie fréquente. Elle est favorisée principalement par des facteurs de risque classiques: tabagisme, diabète, dyslipidémie et hypertension artérielle mais il a été mis en évidence le rôle de l'inflammation dans la formation de la plaque athéromateuse. Il convient donc chez les patients porteurs d'une maladie chronique inflammatoire et donc chez ceux souffrant d'une polyarthrite rhumatoïde de rechercher une artériopathie oblitérante des membres inférieurs dès le début de l'évolution de la maladie par la mesure des index de pression systolique à la cheville. Dans ce travail, nous avons réalisé cette recherche dans une population de 100 patients n'ayant pas de maladie cardiovasculaire connue, suivis en consultation de rhumatologie et souffrant d'une polyarthrite rhumatoïde. Ceci nous a permis de dépister une artériopathie oblitérante des membres inférieurs chez 10 patients, chez qui l'inflammation semblait être Ie facteur déclenchant principal de l'athérosclérose. Il semble donc licite de proposer une mesure annuelle des IPSC dès Ia découverte d'une polyarthrite rhumatoïde.BREST-BU Médecine-Odontologie (290192102) / SudocSudocFranceF

Thromboses veineuses et cancers (intérêt de l'aspect échographique du thrombus)

BREST-BU Médecine-Odontologie (290192102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Thromboses veineuses de l'enfant

BREST-BU Médecine-Odontologie (290192102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Place des explorations non invasives dans la prise en charge de l'artériopathie des membres inférieurs (analyse de consensus)

BREST-BU Médecine-Odontologie (290192102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Asymptomatic carotid occlusion in a young HIV-infected patient receiving HAART.

International audienceThe discovery of an asymptomatic and spontaneous internal carotid occlusion in a young HIV-infected patient, without atherosclerosis, asks the question of cardio-vascular disease's mechanism. A pro-atherogenic profile HAART-associated does not fully explain the high cardio-vascular disease's incidence among the HIV infected population. Carotid stenosis and/or thrombophilic conditions are emergent problems among HIV-infected persons

Comparative Neural Network Based Venous Thrombosis Echogenicity and Echostructure Characterization Using Ultrasound Images

International audienceVenous thrombosis is a common pathology that creates serious public health problems. Thrombosis diagnosis, particularly the determination of their echogenicity and echostructure can be efficiently accomplished by a medical expert using ultrasound imaging. On the other hand, the predictive capability of artificial neural networks is very useful in medical applications and can support medical experts to take appropriate diagnosis decisions. Therefore, the proposed study intends to characterize by means of neural networks the thrombosis echogenicity and echostructure, using a predefined learning base that depends on the prior knowledge of physicians. We have studied six different methods to characterize the thrombosis images, along with the six corresponding neural networks. Obtained results show that the optimal feature vector size, the simplest neural network architecture, and the smallest error, are achieved by using the mean-variance approach or by the wavelet coefficients energies metho

Pulmonary embolism detection on venous thrombosis ultrasound images with bi-dimensional entropy measures: preliminary results

International audienceBackground: Venous thromboembolism (VTE) is a common health issue. A clinical expression of VTE is a deep vein thrombosis (DVT) that may lead to pulmonary embolism (PE), a critical illness. When DVT is suspected, an ultrasound exam is performed.However, the characteristics of the clot observed on ultrasound images cannot be linked with the presence of PE. Computed tomography angiography is the gold standard to diagnose PE. Nevertheless, the latter technique is expensive and requires the use of contrast agents.Purpose: In this article, we present an image processing method based on ultrasound images to determine whether PE is associated or not with lower limb DVT. In terms of medical equipment, this new approach (Doppler ultrasound image processing) is inexpensive and quite easy.Methods: With the aim to help medical doctors in detecting PE, we herein propose to process ultrasound images of patients with DVT. After a first step based on histogram equalization, the analysis procedure is based on the use of bi-dimensional entropy measures. Two different algorithms are tested: the bi-dimensional dispersion entropy (DispEn2D) mesure and the bi-dimensional fuzzy entropy (FuzEn2D) mesure. Thirty-two patients (12 women and 20 men, 67.63±16.19 years old), split into two groups (16 with and 16 without PE), compose our database of around 1490 ultrasound images (split into seven different sizes from 32x32 px to 128x128 px). p-values, computed with the Mann-Whitney test, are used to determine if entropy values of the two groups are statistically significantly different. Receiver operating characteristic (ROC) curves are plotted and analyzed for the most significant cases to define if entropy values are able to discriminate the two groups.Results: p-values show that there are statistical differences between FuzEn2D of patients with PE and patients without PE for 112x112 px and 128x128px images. Area under the ROC curve (AUC) is higher than 0.7 (threshold for a fair test) for 112x112 and 128x128 images. The best value of AUC (0.72) is obtained for 112x112 px images