Biomedical subjects

K H Englmeier

Publications and source records attributed to K H Englmeier.

At least 19 recordsLinked to original sources

PubMed2000

Effect of gradient and section orientation on quantitative analysis of knee joint cartilage.

The object of this study was to determine the influence of the gradient and section orientation on cartilage thickness and volume measurements in the knee joint. Eight specimens were imaged with a fat-suppressed gradient-echo sequence, applying sagittal, transverse, and coronal section orientations. Images were additionally acquired with exchanged gradient directions, and with computed tomography (CT) arthrography. After segmentation and three-dimensional (3D) reconstruction, the volume, the mean, and the maximal 3D cartilage thickness were computed. No effect of changes in the gradient orientation was found, suggesting that susceptibility-induced geometric distortion is not a relevant problem in quantitative cartilage imaging. Sagittal images produced similar data to that obtained with transverse (patella) or coronal (tibia) sections, demonstrating that all knee joint cartilages can be accurately quantified from a single sagittal data set. Whereas no significant systematic deviation between magnetic resonance imaging (MRI) and CT arthrography was recorded in the patella, there was a 10%-15% underestimation of tibial cartilage thickness in MRI.

Cartilage, Articular↗

PubMed2000

[Dynamic MR mammography. Multidimensional visualization of contrast medium enhancement in virtual reality].

BACKGROUND: The purpose of this study was the development of a method for fast and efficient analysis of dynamic MR images of the female breast. The image data sets were acquired with a saturation-recovery turbo-FLASH sequence which enables the detection of the kinetics of the contrast agent concentration in the whole breast with a high temporal and spatial resolution. In addition, a morphologic 3D-FLASH data set was acquired. METHODS: The dynamic image datasets were analyzed by a pharmacokinetic model which enables the representation of the relevant functional tissue information by two parameters. In order to display simultaneously morphologic and functional tissue information, we developed a multidimensional visualization system, which enables a practical and intuitive human-computer interface in virtual reality. DISCUSSIONS: The developed system allows the fast and efficient analysis of dynamic MR data sets. An important clinical application is the localization and definition of multiple lesions of the female breast.

Adult↗

PubMed2000

Precision of tibial cartilage morphometry with a coronal water-excitation MR sequence.

The aim of this study was to analyze the precision of tibial cartilage morphometry, by using a fast, coronal water-excitation sequence with high spatial resolution, to compare the reproducibility of 3D thickness vs volume estimates, and to test the technique in patients with severe osteoarthritis. The tibiae of 8 healthy volunteers and 3 patients selected for total knee arthroplasty were imaged repeatedly with a water-excitation sequence (image time 6 h 19 min, resolution 1.2 x 0.31 x 0.31 mm(3)), with the knee being repositioned between each replicate acquisition. After 3D reconstruction, the cartilage volume, the mean, and the maximal tibial cartilage thickness were determined by 3D Euclidean distance transformation. In the volunteers, the precision of the volume measurements was 2.3 % (CV%) in the medial and 2.6 % in the lateral tibia. The reproducibility of the mean cartilage thickness was similar (2.6 and 2.5 %, respectively), and that of the maximal thickness lower (6.5 and 4.4 %). The patients showed a considerable reduction in volume and thickness, the precision being comparable with that in the volunteers. We find that, using a new imaging protocol and computational algorithm, it is possible to determine tibial cartilage morphometry with high precision in healthy individuals as well as in patients with osteoarthritis.

Adult↗

PubMed2000

Patellar cartilage deformation in vivo after static versus dynamic loading.

The objective of this study was to test the hypothesis that static loading (squatting at a 90 degrees angle) and dynamic loading (30 deep knee bends) cause different extents and patterns of patellar cartilage deformation in vivo. The two activities were selected because they imply different types of joint loading and reflect a realistic and appropriate range of strenuous activity. Twelve healthy volunteers were examined and the volume and thickness of the patellar cartilage determined before and from 90 to 320s after loading, using a water excitation gradient echo MR sequence and a three-dimensional (3D) distance transformation algorithm. Following knee bends, we observed a residual reduction of the patellar cartilage volume (-5.9+/-2.1%; p<0.01) and of the maximal cartilage thickness (-2.8+/-2.6%), the maximal deformation occurring in the superior lateral and the medial patellar facet. Following squatting, the change of patellar cartilage volume was -4.7+/-1.6% (p<0.01) and that of the maximal cartilage thickness -4.9+/-1.4% (p<0.01), the maximal deformation being recorded in the central aspect of the lateral patellar facet. The volume changes were significantly lower after squatting than after knee bends (p<0.05), but the maximal thickness changes higher (p<0.05). The results obtained in this study can serve to validate computer models of joint load transfer, to guide experiments on the mechanical regulation of chondrocyte biosynthesis, and to estimate the magnitude of deformation to be encountered by tissue-engineered cartilage within its target environment.

Adult↗

PubMed2000

Validation of high-resolution water-excitation magnetic resonance imaging for quantitative assessment of thin cartilage layers.

OBJECTIVE: To employ a magnetic resonance (MR) imaging technique for quantitative assessment of thin cartilage layers, and to validate the cartilage volume and thickness measurements. METHODS: We investigated 10 normal elbow joints (age 20 to 69 years) with a 3D gradient echo sequence with selective water excitation (TR 18 ms; TE 9 ms; FA 25 degrees, resolution 1x0.25x0.25 mm2, imaging time 19 min). After interpolating the image data to a 0.125x0.125 mm2 in-plane resolution, the cartilage plates were segmented, reconstructed in 3D, and the cartilage volume and thickness determined with a 3D Euclidean distance transformation algorithm, independent of the original section plane. The cartilage volume and thickness values were compared with CT arthrography and A-mode ultrasound. RESULTS: The mean systematic difference between the elbow cartilage volume obtained from MR imaging and CT arthrography was -0.11% (-6.0 mm3) and the mean random difference 5.7% (314 mm3). Except for the fovea capitis radii, the deviations were not statistically significant (range -7.6 to +11.7%). In the humerus, the mean cartilage thickness (average = 1.35 mm) was overestimated relative to CT arthrography (+20.7%/+0.23 mm), and slightly underestimated relative to A-mode ultrasound (-6.0%/-0.05 mm). With few exceptions, there were no significant differences between MRI, CT arthrography and ultrasound in the other joint surfaces of the elbow (random deviations between 0.08 and 0.39 mm). CONCLUSIONS: The technique presented can be applied for determining the cartilage volume and 3D thickness in joints with thin cartilage layers with a reasonable degree of accuracy.

Adult↗

PubMed2000

Magnetic resonance-based motion analysis of the shoulder during elevation.

Changes in shoulder motion patterns are relevant in various shoulder diseases, but no in vivo information exists about the relative positions in vivo of the shoulder girdle bones and the supraspinatus muscle in three-dimensional space. Thus, the objective of this study was to perform a motion analysis of these structures during passive arm elevation using open magnetic resonance imaging and three-dimensional image processing. Fourteen volunteers were examined in five positions of abduction (30 degrees-150 degrees) with an open magnetic resonance system. After segmentation and three-dimensional reconstruction, the axis of the supraspinatus, humerus, clavicle, and the plane of the glenoid were determined, and the relative movements were calculated. The ratio for glenohumeral to scapulothoracic motion was 1.5:1 at 60 degrees and 2.4:1 at 120 degrees abduction. At 30 degrees, the axis of the supraspinatus was nearly horizontal, and during abduction a continuous elevation (+123 degrees at 150 degrees abduction) was measured. In the transverse plane, the angle between the supraspinatus and the clavicle axes became larger during abduction because of an increasing retroversion of the clavicle. The study shows specific three-dimensional motion patterns for each bone of the shoulder girdle and the supraspinatus muscle during passive elevation. The technique and results can be used for future studies in patients with pathologic changes of shoulder girdle motion.

Adult↗

PubMed1999

Determination of 3D cartilage thickness data from MR imaging: computational method and reproducibility in the living.

The objective of this work was to develop a computational approach for quantifying the three-dimensional (3D) thickness distribution of articular cartilage with magnetic resonance (MR) imaging, independent of the imaging plane, and to test the reproducibility of the method in the living. An algorithm was implemented, based on a 3D Euclidean distance transformation, and its accuracy was assessed in geometric test objects, for which an analytic solution was available. The precision of the method was evaluated in six replicated MR data sets of the knee joint cartilage of eight volunteers. The algorithm produced 3D thickness values identical to those of the analytic solutions in the test objects. The reproducibility of the mean cartilage thickness in the patellar and tibial cartilages was 1.5-3.4% (root-mean-square average of the individual coefficient of variation percent), that of the maximal thickness 2.1-7.9%, and that of the thickness distribution 2.3-6.1%. The method presented allows for noninvasive analysis of 3D cartilage thickness from MR images in biomechanical and clinical investigations.

Algorithms↗

PubMed1999

Subacromial space width changes during abduction and rotation--a 3-D MR imaging study.

The objectives of this study were to determine systematic changes of the normal subacromial space width during abduction and rotation, and to analyze the spatial relationship of the supraspinatus muscle with the acromion and clavicle. 12 healthy volunteers were imaged by an open MR scanner in 5 different positions of abduction and in 3 positions of rotation. After three dimensional (3D) reconstruction and 3D Euclidian distance transformation, the minimal spatial distances between the humerus and the acromion and the humerus and clavicle were computed. The minimal acromio-humeral distance decreased significantly from 30 degrees of abduction (mean 7.0 mm +/- 1.6 mm) to 120 degrees (mean 3.9 mm; +/- 1.8 mm; p < 0.0001). At 30 degrees, the minimal distance penetrated the supraspinatus, whereas at 120 degrees it was always located lateral to the supraspinatus tendon. At 90 degrees with internal rotation (7.6 mm, +/- 2.3 mm) the minimal acromio-humeral distance was larger than in neutral rotation (5.4 mm, +/- 2.3 mm) or external rotation (4.4 mm, +/- 2.2 mm; p < 0.05), but it penetrated the supraspinatus tendon at its most vulnerable part, reaching the acromion at its anterior inferior border. We conclude that the subacromial space width changes during abduction and rotation and that the supraspinatus is in closest contact to the anterior inferior border of the acromion in 90 degrees of abduction with 45 degrees internal rotation. These values obtained in volunteers can be used as a basis for further investigations in patients with the impingement syndrome.

Acromion↗

PubMed1999

Evaluation of the middle and inner ear structures: comparison of hybrid rendering, virtual endoscopy and axial 2D source images.

Recent developments in 3D reconstructions can enhance the quality and diagnostic value of axial 2D image data sets with direct benefits for clinical practice. To show the possible advantages of a hybrid rendering method [color-coded 3D shaded-surface display (SSD)- and volume rendering method] with the possibility of virtual endoscopy we have specifically highlighted the use in relation to the middle and inner ear structures. We examined 12 patients with both normal findings and postoperative changes, using image data sets from high-resolution spiral computed tomography (HRSCT). The middle and inner ear was segmented using an interactive threshold interval density volume-growing method and visualized with a color-coded SSD rendering method. The temporal bone was visualized using a transparent volume rendering method. The 3D- and virtual reconstructions were compared with the axial 2D source images. The evaluated middle and inner ear structures could be seen in their complete form and correct topographical relationship, and the 3D- and virtual reconstructions indicated an improved representation and spatial orientation of these structures. A hybrid and virtual endoscopic method could add information and improve the value of imaging in the diagnosis and management of patients with middle or inner ear diseases making the understanding and interpretation of axial 2D CT image data sets easier. The introduction of an improved rendering algorithm aids radiological diagnostics, medical education, surgical planning, surgical training, and postoperative assessment.

Adult↗

PubMed1999

Translation-invariant pattern recognition based on Synfire chains.

Most of current neural network architectures are not suited to recognize a pattern at various displaced positions. This lack seems due to the prevailing neuron model which reduces a neuron's information transmission to its firing rate. With this information code, a neuronal assembly cannot distinguish between different combinations of its entities and therefore fails to represent the fine structure within a pattern. In our approach, the main idea of the correlation theory is accepted that spatial relationships in a pattern should be coded by temporal relations in the timing of action potentials. However, we do not assume that synchronized spikes are a sign for strong synapses between the neurons concerned. Instead, the synchronization of Synfire chains can be exploited to produce the relevant timing relationships between the neuronal signals. Therefore, we do not require fast synaptic plasticity to account for the precise timing of action potentials. In order to illustrate this claim, we propose a model for translation-invariant pattern recognition which does not depend on any changes in synaptic efficacies.

Action Potentials↗

PubMed1999

A non-destructive technique for 3-D microstructural phenotypic characterisation of bones in genetically altered mice: preliminary data in growth hormone transgenic animals and normal controls.

A non-destructive, three-dimensional technique for microstructural phenotypic characterisation of skeletal elements in genetically altered mice is presented. Preliminary data in bovine growth-hormone transgenic animals and control littermates are shown. The technique is based on microcomputed tomography (microCT) and digital postprocessing and allows for a differential quantitative analysis of the cortical and trabecular bone compartments in the axial and peripheral skeleton. The distal femora and the first lumbar vertebral bodies of six animals were CT scanned in the axial plane with an isotropic resolution of 20 microm. The periostal surface and the marrow spaces were segmented fully automatically, and the trabecular and cortical compartments were separated interactively. After 3-D reconstruction, various regions of interest (diaphyseal, metaphyseal and epiphyseal) were selected for the analysis. The femora and vertebrae of the transgenic animals showed obvious differences in size, shape, and trabecular arrangement compared with the control animals. The total bone mass was increased by a factor of two to three, but the trabecular bone was increased much more (up to 12 times) than the cortical bone. The transgenic animals showed an increased ratio of trabecular vs cortical bone (0.90 to 1.27 vs 0.14 to 0.36 in the femoral diaphysis) and an elevated trabecular bone volume fraction (49% to 73% vs 18% to 43% in the femoral metaphysis). The mean 3-D cortical thickness was similar in the normal and transgenic animals (values between 93 microm and 232 microm in the dia- and metaphyses), but the minimal cortical thickness was lower in the transgenic animals (22 to 31 microm vs 54 microm to 110 microm in the diaphysis). The technique presented is suitable for phenotypic characterisation of bone structure in genetically altered mice.

Animals↗

PubMed1999

Functional analysis of articular cartilage deformation, recovery, and fluid flow following dynamic exercise in vivo.

The function of articular cartilage depends on the interaction between the tissue matrix and the interstitial fluid bound to the proteoglycan molecules. Mechanical loading has been shown to be involved in both the metabolic regulation of chondrocytes and in matrix degeneration. The purpose of the present study was therefore to analyze the deformation, recovery, and fluid flow in human articular cartilage after dynamic loading in vivo. The patellae of 7 volunteers were imaged at physical rest and after performing knee bends, with a specifically optimized fat-suppressed FLASH-3D magnetic resonance (MR) sequence. To measure cartilage deformation, the total volume of the patellar cartilage was determined, employing 3D digital image analysis. Patellar cartilage deformation ranged from 2.4 to 8.6% after 50 knee bends, and from 2.4% to 8.5% after 100 knee bends. Repeated sets of dynamic exercise at intervals of 15 min did not cause further deformation. After 100 knee bends, the cartilage required more than 90 min to recover from loading. The rate of fluid flow during relaxation ranged from 1.1 to 3.5 mm(3)/min (0.08 to 0.22 mm(3)/min per square centimeter of the articular surface) and was highly correlated with the individual degree of deformation after knee bends. The data provide the first quantification of articular cartilage recovery and of the rate of fluid flow between the cartilage matrix and surrounding tissue in intact joints in vivo. Measurement in the living opens the possibility of relating interindividual variations of mechanical cartilage properties to the susceptibility of developing joint failure, to assess the load-partitioning between the fluid phase and solid cartilage matrix during load transfer, and to determine the role of mechanically induced fluid flow in the regulation of the metabolic activity of chondrocytes.

Adult↗

PubMed1999

In situ measurement of articular cartilage deformation in intact femoropatellar joints under static loading.

The deformational behavior of articular cartilage has been investigated in confined and unconfined compression experiments and indentation tests, but to date there exist no reliable data on the in situ deformation of the cartilage during static loading. The objective of the current study was to perform a systematic study into cartilage compression of intact human femoro-patellar joints under short- and long-term static loading with MR imaging. A non-metallic pneumatic pressure device was used to apply loads of 150% body weight to six joints within the extremity coil of an MRI scanner. The cartilage was delineated during the compression experiment with previously validated 2D and 3D fat-suppressed gradient echo sequences. We observed a mean (maximal) in situ deformation of 44% (57%) in patellar cartilage after 32 h of loading (mean contact pressure 3.6 MPa), the femoral cartilage showing a smaller amount of deformation than the patella. However, only around 7% of the final deformation (3% absolute deformation) occurred during the first minute of loading. A 43% fluid loss from the interstitial patellar matrix was recorded, the initial fluid flux being 0.217 +/- 0.083 microm/s, and a high inter-individual variability of the deformational behavior (coefficients of variation 11-38%). In conjunction with finite-element analyses, these data may be used to compute the load partitioning between the solid matrix and fluid phase, and to elucidate the etiologic factors relevant in mechanically induced osteoarthritis. They can also provide direct estimates of the mechanical strain to be encountered by cartilage transplants.

Adolescent↗

PubMed1999

A study of the application sharing capabilities in telemedicine.

The main aim of this study was to find out if the image format (TIFF or JPEG) influenced the time delay for transferring radiological images by the application sharing tool of a desktop videoconferencing system. The second task of the study was to define a procedure that optimized the time delay to load and remotely visualize the images. The results were achieved by applying a test procedure called 'benchmark protocol'. The videoconferencing system used for the test was Intel ProShare 200 v2.0. The image transfer was performed by a BRI ISDN connection. We showed that the image format had no significant influence on the time delay. We presented an optimal procedure for image transfer. Furthermore, store and forward procedures with simple file transfer were shown to be inferior to the use of application sharing. For radiological image transfer we recommend to use lossless file formats and application sharing with the image already loaded in because this method achieves the lowest time delays.

Computer Communication Networks↗

PubMed1999

The Telemedicine benchmark--a general tool to measure and compare the performance of video conferencing equipment in the telemedicine area.

In this paper, we describe the 'Telemedicine Benchmark' (TMB), which is a set of standard procedures, protocols and measurements to test reliability and levels of performance of data exchange in a telemedicine session. We have put special emphasis on medical imaging, i.e. digital image transfer, joint viewing and editing and 3D manipulation. With the TMB, we can compare the aptitude of different video conferencing software systems for telemedicine issues and the effect of different network technologies (ISDN, xDSL, ATM, Ethernet). The evaluation criteria used are length of delays and functionality. For the application of the TMB, a data set containing radiological images and medical reports was set up. Considering the Benchmark protocol, this data set has to be exchanged between the partners of the session. The Benchmark covers file transfer, whiteboard usage, application sharing and volume data analysis and compression. The TMB has proven to be a useful tool in several evaluation issues.

Benchmarking↗

PubMed1999

Technical validation of low-cost videoconferencing systems applied in orthopaedic teleconsulting services.

Investigation on the applicability of low-cost videoconferencing (VC) for health care services is becoming a real need. Reduced resources drive the administrators to evaluate inexpensive solutions for telemedicine. Considering this scenario, this work is a preliminary step to validate, from a technical point of view, if low-cost VC systems could be suitable for orthopaedic teleconsulting services. For this purpose, four different videoconferencing systems were tested. Each VC system was composed of a computer and a VC device installed in. VC devices were chosen among the most popular and distributed products (made by Intel, PictureTel and Aethra). The Telemedicine Benchmark, a specific tool defined by the authors, was applied to measure the overall systems performances in terms of time delays during basic rate ISDN connections (128 Kbit/s). Results showed that it is possible to apply low-cost videoconferencing systems for orthopaedic teleconsulting services. Most of the systems provided acceptable performance for medical image visualization and real time joint working. Further developments are recommendable to enhance the VC software tools capabilities and to improve software-user interface. reserved.

Costs and Cost Analysis↗

PubMed1999

Interobserver reproducibility of quantitative cartilage measurements: comparison of B-spline snakes and manual segmentation.

The objective of this work was to develop a segmentation technique for thickness measurements of the articular cartilage in MR images and to assess the interobserver reproducibility of the method in comparison with manual segmentation. The algorithm is based on a B-spline snakes approach and is able to delineate the cartilage boundaries in real time and with minimal user interaction. The interobserver reproducibility of the method, ranging from 3.3 to 13.6% for various section orientations and joint surfaces, proved to be significantly superior to manual segmentation.

Cartilage, Articular↗

PubMed1999

Low-cost ISDN videoconferencing equipment for orthopaedic second opinions.

We validated the application of low-cost ISDN videoconferencing equipment for telemedicine. A telemedicine benchmark was designed and four different office videoconferencing systems were evaluated, all using basic-rate ISDN connections (128 kbit/s). All the low-cost systems showed generally good or acceptable performance for clinical use. We also investigated the feasibility of videoconferencing for an orthopaedic second-opinion service. Eight point-to-point conferences were conducted to discuss real clinical cases by use of interactive sharing of medical images. The average duration of each session was 35 min. Encouraging results were obtained.

Costs and Cost Analysis↗