A new method for registrationbased medical image interpolation

Abstract—A new technique is presented for interpolating between grey-scale images in a medical data set. Registration between neighboring slices is achieved with a modified control grid interpolation algorithm that selectively accepts displacement field updates in a manner optimized for performance. A cubic interpolator is then applied to pixel intensities correlated by the displacement fields. Special considerations are made for efficiency, interpolation quality, and compression in the implementation of the algorithm. Experimental results show that the new method achieves good quality, while offering dramatic improvement in efficiency relative to the best competing method. Index Terms—Interpolation, reconstruction, registration. I

Cleft closure and undersizing annuloplasty improve mitral repair in atrioventricular canal defects

ObjectiveReoperation rates to correct left atrioventricular valve regurgitation after primary repair of atrioventricular canal defects remain relatively high. The causes of valvular regurgitation are likely multifactorial, and simple cleft closure is often insufficient to prevent recurrence.MethodsTo elucidate the mechanisms leading to regurgitation, we conducted hemodynamic studies using isolated native mitral valves. Anatomy of these valves was altered to mimic atrioventricular canal type valves and studied under pediatric hemodynamic conditions. The impact of subvalvular geometry, cleft closure, annular dilatation, and annular undersizing on regurgitation were investigated.ResultsPapillary muscle position did not have a significant effect on regurgitation. Cleft closure had a significant impact on valvular competence, with reduction in regurgitation volume with increased cleft closure. Regurgitation volume decreased from 12.5 ± 2.4 mL/beat for an open cleft to 4.9 ± 1.9 mL/beat for a partially closed cleft and to 1.4 ± 1.6 mL/beat when the cleft was completely closed. Annular dilatation had a significant impact on regurgitation even after cleft closure. A 40% increase in annular size increased regurgitation by 59% for a partially closed cleft and by 84% for a fully closed cleft. Reducing the annular size by 20% from the physiologic level decreased the regurgitation volume by 12% for a fully open cleft and by 58% for the partially closed cleft case.ConclusionsAnnular dilatation after primary repair has a potentially significant role in the recurrence of atrioventricular valve regurgitation. Reducing the annular size and restricting dilatation as an adjunct to cleft closure is a promising surgical approach in such valve anatomies

The small-scale structure of passive scalar mixing in turbulent boundary layers

The objective is to contribute to several issues regarding the traditional view of the local structure of passive scalar fields: (1) probability density function (PDF) of the scalar concentration and scalar gradient, (2) the scalar power spectrum, (3) the structure functions, and (4) correlation functions and multi-point correlators. In addition, the research provides a geometric description of two-dimensional transects of the passive scalar iso-surfaces using the tools of fractal geometry. The local structure is analyzed as a function of large-scale anisotropy, intermittency factor, Reynolds number, and initial condition of the scalar injection. Experiments were performed in the bed boundary layer produced by a uniform depth open channel flow of water in a tilting flume for Re_lamda = 63, 94, and 120. A small nozzle iso-kinetically delivers a passive scalar of high Schmidt number ( Sc = 1000) at mid-depth to generate the turbulent scalar field. Three nozzle diameters are used to study the effects of the injection length scale. High-resolution planar laser induced fluorescence (PLIF) technique is used to measure the scalar field. The local structure far from isotropic and is influenced even at the smallest scales by large-scale anisotropy, initial injection length scale and the Reynolds number of the flow. The PDF of the scalar fluctuations is non-Gaussian and dependent on large-scale anisotropy. The PDF of scalar gradients show the influence of large-scale anisotropy on the structure at the smallest scales. The spectrum of the scalar field deviates from the in the inertial convection regime and is dependent on large-scale anisotropy, external intermittency, and low Reynolds number. There is no evidence of Batchelors k^-1 scaling law. The scaling exponents of the even-ordered structure functions appear to be inversely correlated with the kurtosis of the scalar fluctuations. The fractal geometry of the two dimensional transects of passive scalar iso-surfaces is scale dependent. The fractal dimension is 1.0 at the smallest length scale and increases in a universal manner in the viscous-convective regime. The coverage length underestimate reflects this universal behavior with practical significance. The lacunarity function shows that the instantaneous scalar field is most in-homogenous around the Kolmogorov scale.Ph.D.Committee Chair: Webster, Donald; Committee Member: Cvitanovic, Predrag; Committee Member: Roberts, Phillip; Committee Member: Sturm, Terry; Committee Member: Yeung, Pui-Kue

CARDIOVASCULAR Quantitative Analysis of Extracardiac Versus Intraatrial Fontan Anatomic Geometries

Background. There exists large geometric variability among total cavopulmonary connections (TCPC) because of the patient-specific anatomies and the chosen surgical procedure. In this study we present quantitative comparison of the geometric characteristics of the extracardiac and intraatrial Fontan anatomies, the two commonly used TCPC procedures. Methods. A method of centerline approximation of the three-dimensional geometries (skeletonization) was used to quantify the TCPC geometric parameters such as vessel areas, curvature, and collinearity. The TCPC anatomies of 26 patients, 13 extracardiac and 13 intraatrial, were analyzed in this study. Results. There was no significant difference in the vessel dimensions between extracardiac and intraatrial TCPCs, with the overall magnitudes agreeing well with that seen in normal children except for the inferior vena cava. Intraatrial baffles had significant fluctuations in cross-sectional area along the length of the baffle as opposed to extracardiacs (p < 0.05). Patients with hypoplastic left heart syndrome had significant narrowing of the left pulmonary artery (p < 0.05), suggesting a possible physical constriction from the reconstructed aorta. Conclusions. This study benchmarks the anatomic variability of patient-specific TCPCs. Intraatrial Fontan geometries have significant difference in the area variations across the vessel length compared with the extracardiac geometry. Also, patients with hypoplastic left heart are at a higher risk of left pulmonary artery narrowing

DEVELOPMENT OF A NOVEL FLUID MANAGEMENT SYSTEM FOR ACCURATE CONTINUOUS HEMOFILTRATION IN EXTRACORPOREAL MEMBRANE OXYGENATION Proceedings of BioMed2007 2nd Frontiers in Biomedical Devices Conference BioMed2007-38062

INTRODUCTION Failure of the cardiac or respiratory system is a common problem in the pediatric and neonatal intensive care unit. When conventional management fails to improve the child's condition, extracorporeal life support such as extracorporeal membrane oxygenation (ECMO) can serve to provide life-saving temporary heart and lung support Continuous venovenous hemofiltration (CVVH) is a renal replacement therapy that allows meticulous minute-to-minute control of fluid balance by providing continuous fluid, electrolyte and toxin clearance even in the absence of adequate native renal function. Most centers using CVVH on ECMO add a costly and complicated dialysis machine to the ECMO circuit to provide hemofiltration. Our center has used a simplified version of CVVH in-line in the ECMO circuit that instead functions by native ECMO pump flow (see In this paper, we present a novel prototype, automated, and accurate fluid management system that effectively overcomes the current limitations. Our overall clinical goal is to promote aggressive fluid management to improve outcomes in critically ill children on ECMO by the use of CVVH. The new device is a dual chamber volume displacement management system that integrates into the CVVH in-line circuite on ECMO. Experiments are currently underway to evaluate the efficiency of fluid management of this prototype and compare to the accuracy of traditional intravenous fluid pumps. ACCURACY OF CURRENT FLUID BALANCE SYSTEM Experiments were conducted to evaluate the accuracy of current CVVH in-line in the ECMO circuit shown i

Effects of MitraClip Therapy on Mitral Flow Patterns and Vortex Formation: An In Vitro Study

MitraClip transcatheter edge-to-edge repair is used to treat mitral regurgitation (MR). While MR is reduced, diastolic left ventricular flows are altered. An in vitro left heart simulator was used to assess a porcine mitral valve in the native, MR, and MR plus MitraClip cases. Velocity, vorticity, and Reynolds shear stress (RSS) were quantified by particle image velocimetry. Peak velocity increased from 1.20 m/s for native to 1.30 m/s with MR. With MitraClip, two divergent jets of 1.18 and 0.61 m/s emerged. Higher vorticity was observed with MR than native and lessened with MitraClip. MitraClip resulted in shear layer formation and downstream vortex formation. Native RSS decreased from 33 Pa in acceleration to 29 Pa at peak flow, then increased to 31 Pa with deceleration. MR RSS increased from 27 Pa in acceleration to 40 Pa at peak flow to 59 Pa during deceleration. MitraClip RSS increased from 79 Pa in acceleration to 162 Pa during peak flow, then decreased to 45 Pa during deceleration. After MitraClip, two divergent jets of reduced velocity emerged, accompanied by shear layers and recirculation. Chaotic flow developed, resulting in elevated RSS magnitude and coverage. Findings help understand consequences of MitraClip on left ventricular flow dynamics