Quantitative method for assessing bone bloodstream

FIELD: medicine.

SUBSTANCE: method involves selecting blood vessels on area under study and measuring their parameters. Marked bone segments are selected as the area under study and radiopaque substance is introduced, angiographic examination is carried out in two projections. The area under study is marked with a contour and its area is measured. Blood vessels are marked out on image in carrying out interactive segmentation and a binary image with maximum blood vessel intensity is built. Total blood vessel area is measured in the region and blood supply index is calculated as Ifpbs=Sbvfp/Srfp, Ibssp=Sbvsp/Srsp, Irbs=(Ifpbs + Ispbs)/2, where Irbs is the blood supply index of area under study, Ifpbs is the blood supply index of area under study in frontal projection, Ibssp is the blood supply index of area under study in sagittal projection, Sbvfp, Sbvsp is the total blood vessel area in frontal and sagittal projection, Srfp, Srsp is the area of region under study in frontal and sagittal projection. Then, blood vessel diameters are measured and their orientation degree is determined.

EFFECT: high accuracy of assessment results.

6 dwg

 

The invention relates to medicine, namely to orthopedics and traumatology, in particular to methods of diagnostics of the vasculature in bone tissue, and is intended for use in experimental and clinical studies of the vascular system of the bone.

There is a method of research architectonics blood vessels in the spleen, including the definition on angiograms arterio-splenic index as the ratio of the total area of cross sections of blood vessels to the area of the spleen (Sokolov V.V. Age peculiarities of the architecture of blood vessels of the spleen / Sokolov V.V., Kaplunova O.A., Ovsienko IE // Morphology. - 2003. No. 4. - P.57-60). However, the known method is used only for the study of the vascular bed of the lung and hollow organs.

There is a method of quantitative characterization of the vasculature, bone, where as an indicator of the quantitative and structural changes of the vascular zone of the regenerate with a double fracture of the tibia of the dog used the relative specific volume of the lumen of the vessels measured point method fields Glagoleva (Proskura V.B. have been Quantitative characterization of the vasculature, bone / Proskura V.B. have been, Belobrov V.M., Chugai AV, Cherenkov P.K., Shevchuk A.V. // Ed. Groped., traumatol. and Protter. - 1990. - 16 S. - DEPT. in VINITI 29.0.90, No. 1690-V). However, the known method used to study the vascular bed only on histological preparations.

There is a method of determining the degree of spatial orientation intramural intestinal arteries, including the measurement of angles between dlinnyimi intestinal arteries and guide line drawn in the plane perpendicular to the length of the main arterial trunk (Avtandil, Medical morphometry: Manual / GG of Avtandil. - M, Medicine, 1990. - 384 C.). However, the known method used to study the vascular bed only on macroscopic and histological preparations.

The present invention is to develop a method for quantitative assessment of the vascular bed of the bone, allowing to investigate the intensity of blood supply to bone parts and to determine the orientation of intraosseous vessels.

The problem is solved in that in the method for quantitative assessment of the vascular bed of a bone, comprising measuring the area of the investigated organ and the area occupied by vessels, as the study of body use designated areas of the bones, injected contrast agent, perform angiography in two projections, followed by digitization of images, angiograms, framing the study area, measure its area and sumarno the size of vessels of this section, calculate the perfusion index (IR), using the mathematical expression: CI=Sc/Sy, where IR is the index of the blood supply, Sc - the total area of vessels, Sy - area the investigated area, then measure the diameter of the vessels and determine the degree of orientation of the vessels.

It is advisable to quantify remoteservername vascular bones as the study of the authority to use an elongated bone, which denote the following sections: proximal and distal metapelite, distraction alignment, floating fragments and the area of the junction of the bone fragments.

The invention is explained detailed description, statistical calculations, the experimental example and angiograms, on which:

Figure 1 - scheme of the investigated micropreparative tibia (proximal metapolis, b - proximal distraction regenerate, in - proximal roaming fragment, distal distraction regenerate, d - distal roaming fragment, e - part of the joint bone fragments, W - distal metaphys);

Figure 2 - image okonturennogo proximal roaming fragment;

Figure 3 - binary image of the investigated area (vessels white);

Figure 4 - selection of the investigated area standard frame for a larger image;

5 is a piece of the image, increased 18 times, and the measurement of the diameters of the vessels;

6 - measurement of angles (thick arrow guide line that is perpendicular with respect to the vector of application of the forces; thin arrow glinnik vessel).

The method is as follows.

To fill the vessels of the extremities using roentgenocontrast substances. Perform angiography in 2 standard projections.

For quantification of the vascular system using computer image analysis of angiograms performed on the analyzer images, "Neural vision" (Version 2.0) and hardware-software complex, which includes a device for capturing images, a personal computer IBM 486DX-33 and integrated package of applied programs Dyamorph - Cito (Version 1.1 Registration certificate of Ministry of health of the Russian Federation No. 98/219-137). Measure the areas, the total area of vessels in the studied sections, the diameters of the vessels, the angles between dlinnyimi vessels and the guide line that is perpendicular with respect to the vector of application of force (the direction of distraction). Digital material is processed in Microsoft Excel 97. Calculate the IR, which represents the ratio of the total area of cross sections of blood vessels to the area of the investigated area, the average diameter of the vessels, the average angle, its standard deviation and variance.

For the Holocene results in absolute units (mm, µm), prior to measuring parameters, perform geometric calibration image object scale known size - 30 mm (30000 μm), introduced simultaneously with the analyzed image.

Images angiograms framing under study sites and measure their area. To measure the total area of vessels allocate them on the image, performing interactive segmentation. The result is a binary image in which the blood vessels take the intensity value of 255, and have a white color, background image black and has the intensity equal to 0. The obtained values are used to calculate the IR, using the mathematical expression: CI=Sc/Sy, where IR is the index of the blood supply, Sc - the total area of vessels, Sy - area the investigated area.

To measure the diameters of vessels of a portion of an image of the investigated area produce a standard rectangular frame and increase 18 times. Then perform frequency filtering to obtain a clear picture of the boundaries of the vessels. The length of the vessel impose 10 cross sections, measured their length in microns and calculate the average diameter of each of the measured vessel. When using this technique managed to get a clear enough image of blood vessels having a diameter of 114 mm, which indicates their relationship to arter the actual channel. The diameters of microcirculatory vessels in angiograms could not be detected because of their small size (up to 100 µm).

For each of the investigated area calculate the average angle between the vessels and the guide line, as well as standard deviation and variance, which are used to determine the degree of orientation of the vessels. The results are judged by Avtandil: 1) the vessels have a strict focus (the variance is equal to zero); 2) the vessels have a preferred orientation (variance less than 900 or RMS deviation of less than 30); 3) vessels are randomly oriented (variance equal to or greater than 900, the standard deviation is equal to or greater than 30).

An example of performing the method.

Case history No. 182, animal No. 0781, age 2 years, weight 18 kg, the length of the shank 17 see

Before performing angiographic studies of experimental animal deduce from experience.

To fill the arteries of the limbs use a lot of Gauja (Gain MG, 1948), is inserted through the femoral artery. Contrasting the mass injected into the vessels of the syringe. Completeness of the injection is determined by the resistance of the piston of the syringe, and leakage control masses of small incisions in the skin of the plantar surface of the foot.

Radiography is carried out in a cassette without intensifying screen before and after layer of preparerow is of soft tissues. When the voltage 48-57 kV exposure continue 50-100 msec, depending on the volume of a limb.

Image angiograms in 2 planes (frontal and sagittal) enter into computer memory on the hardware-software complex, which includes a device for capturing images, a personal computer IBM 486DX-33 and integrated package of applied programs Dyamorph - Cito (Version 1.1 Registration certificate of Ministry of health of the Russian Federation No. 98/219-137). Computer image analysis of angiograms performed on the analyzer images, "Neural vision" (Version 2.0) and hardware-software complex, above. Measure the areas, the total area of vessels in the studied sections, the diameters of the vessels, the angles between dlinnyimi vessels and the guide line that is perpendicular with respect to the vector of application of force (the direction of distraction). Digital material is processed in Microsoft Excel 97. Calculate the IR, the average diameter of the vessels, the standard deviation and the variance of the angles.

To obtain the results in absolute units (mm, µm)prior to measuring parameters, perform geometric calibration image object scale known size - 30 mm (30000 μm), introduced simultaneously with the analyzed image.

Images angiograms in two projections framing the study area (roaming PR is ximly fragment) and measure its area. To measure the total area of vessels allocate them on the image, performing interactive segmentation. The result is a binary image in which the blood vessels take the intensity value of 255, and have a white color, background image black and has the intensity equal to 0.

Calculated IR

Icfr=S/S=750/264=0,35

Exag=Sc/Sy=1005/310=0,31

The CI=(Icfr+Exag)/2=(0,35+0,31)/2=0,33,

where IR is the index of the blood supply of the investigated area,

Icfr - the index of the blood supply of the investigated area in the frontal projection,

Exag - the index of the blood supply to the area under study in the sagittal projection

S, Sc - the total area of the vessels of the investigated area in the frontal, sagittal projection,

S, Sy - area the investigated area in the frontal, sagittal projection.

To measure the diameters of vessels of a portion of an image of the investigated area produce a standard rectangular frame and increase 18 times. Then perform frequency filtering to obtain a clear picture of the boundaries of the vessels. The length of the vessel impose 10 cross sections, measured their length in microns and calculate the average diameter of each of the measured vessel.

The average diameter of the vessels in the study area amounted to 382±81 ám (M±SD).

In the survey area measured shall allow between dlinnyimi vessels and the guide line, calculate the arithmetic mean value (M), standard deviation (SD) and variance (D). The results are judged by Avtandil.

The average angle between dlinnyimi vessels and rail line was 87°, with an average standard deviation SD=29 and dispersion D=882, indicating a preferred orientation of the vessels.

The proposed method allows to quantify the vascular bed of the bone and to assess the degree of blood supply to the area under study.

The proposed method is applied in the experimental Department of the state of RISC "RTO" them. Acad. G.A. Ilizarov and can be used in the clinic for the study of any contractorowned vascular bed.

Method for quantitative assessment of the vascular bed of the bone, including the allocation of vessels in the investigated area and the measurement of their parameters, characterized in that as the study of land use designated areas of the bones, injected contrast agent, perform angiography in two projections, framing the study area, measure the area on the image of the isolated vessels, performing interactive segmentation, get a binary image, where the image of the vessels has a maximum intensity, measure the total area of vessels of this section, calculate the indices of the blood supply And the FR, Exag, IR, using the mathematical expression: ICTR=S/S, Exag=Sc/Sy, IR=(Icfr+Exag)/2, where IK is the index of the blood supply of the investigated area; ICPR - the index of the blood supply of the investigated area in the frontal projection; Exag - the index of the blood supply to the area under study in sagitally projection; S, Sc - the total area of the vessels of the investigated area in the frontal, sagitally projection; S, Sy - area the investigated area in the frontal, sagitally projection, then measure the diameter of the vessels and determine the degree of orientation of the vessels.



 

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