基于整数小波变换和零树编码算法的医学图像压缩研究

现代医疗成象设备产生了大量高价值的医学图像,如何对信息的进行有效的存储、查询以及网络传输是一个亟待解决的问题.本文利用整数小波变换和零树编码算法对医学图像进行了压缩研究,试验表明,同传统JPEG标准相比,相同压缩比下本算法的峰值信噪比有明显的提高,同时本算法具有逐渐显现的特性,能够满足医学图像存储、查询以及网络传输的需求.     

医学图像的零树小波编码

背景:医学数字图像必须是高质量的、高分辨率,所以数据量很大,如此巨大的数据量不利于图像存档与传输系统的运行和数字化医院、远程医疗的实现.因此,图像压缩成为图像存档与传输系统要解决的重要问题.目的:分析零树小波变编码算法原理并编程实现对医学数字图像的压缩,使之能够满足医学图像的传输和诊断要求.方法:应用嵌入式零树小波编码算法,探讨小波基和小波变换层数的选择,编程实现对医学数字图像的压缩.结果与结论:选择双正交小波基对医学图像进行4层小波变换实现压缩,获得了较高的峰值信噪比,取得了较好的压缩效果.     

基于目标区域小波CT图像压缩算法

目的:在以往对二维X射线影像进行基于SPIHT的区域压缩编码算法研究的基础上,探讨基于目标区域小波SPIHT算法对三维CT图像的压缩方法。方法:利用目标区域的SPIHT小波算法压缩CT图像。通过灰度门限法分割目标和背景,检测并膨胀边缘以确定目标区域。对体数据分块,并进行快速小波变换。利用SPIHT算法对小波系数重要性进行判断、排序和分类形成多层位流结构。排序过程首先对小波系数建立空间树结构,然后沿空间方向树对系数进行重要性测试,分类过程对重要系数从高位到低位分成不同分辨率的位平面依次输出。结果:基于优化分割的SPIHT算法对CT目标区域压缩好于JPEG2000及JPEG算法,对CT图像目标区域以1bpp的高码率进行小波SPIHT压缩,背景以0.15bpp低码率JPEG压缩压缩,全图平均压缩码率为0.5bpp,目标区域的PSNR为43.2dB,目标区域PSNR比JPEG2000区域压缩算法提高0.8dB。结论:对于CT图像,基于目标区域的SPIHT小波压缩算法优于JPEG2000、JPEG和传统的SPIHT算法,并能在高压缩比情况下保证医学图像的质量。     

JPEG 2000标准在医学图像存储与传输系统中的应用

目的 在医学图像存储与传输系统中应用新一代图像压缩标准JPEG2000。方法 分析JPEG2000的基本原理和算法以及DICOM标准，确定PACS系统中应用JPEG2000的数据结构和编码方法。结果 在PACS系统中实现了JPEG2000的基本功能和感兴趣区域编码。结论 该方法具有无损压缩、高效有损压缩和感兴趣区域编码等优点。对于进一步探索JPEG2000在医学图像存储与传输系统中的应用具有深远的意义。     

一种应用于视皮质假体图像压缩及编码系统的设计

背景:目前,视皮质假体已成为视觉修复实现的主要方法之一,图像压缩在视皮质假体的前期图像处理过程中占有重要地位.目的:探讨从空域及亮度信息两个方面分别对图像信息进行压缩的方法.方法:选取哈尔小波基对原始图像进行空间分辨率的压缩,并采用多尺度小波变换的方法对空间频率信号进行合理选取,实现信息的进一步压缩.同时,结合视觉皮质放大的特性,通过模拟视网膜对图像的前期处理,建立了非均匀压缩模型,使得图像压缩过程更接近视觉处理过程.还对亮度信息进行压缩及编码,实现了图像信息最终的压缩编码.结果与结论:构建了基于数字信号处理器的前期图像压缩及编码系统,最终实现了在10*10的点阵图阵列中进行图像信息的表达.     

小波变换医学DICOM图像压缩的研究

目的　利用小波变换实现对医学DICOM图像压缩。方法　分析小波变换技术特点及医学DICOM标准的数据结构 ,确定DICOM图像压缩的小波变换算法及编码方法。结果　用VC 实现基于小波技术的DICOM图像压缩。结论　该方法具备无损压缩、低比特速率有损压缩及渐进传输的优点 ,对我国远程医学和图像建档及通信系统的发展具有深远的意义     

医学图像处理中的小波变换应用

医学图像在现代医疗诊断中有重要作用,近年来小波变换在医学图像处理如边缘提取、去噪、增强、图像压缩、融合等方面得到了广泛的应用.本文利用小波变换的理论分析和相关文献报道对以上处理方法进行综述.     

基于图像中值的Sigmoid函数自适应X线图像增强

目的：改善医学图像质量,使低对比度的图像得到增强。方法：针对数字X线医学图像的特点,提出一种基于图像中值的非线性变换函数的增强处理方法。结果：在变换函数中引入可调节的参数,实现了对X线图像的自适应增强。结论：本文算法将低对比度图像拉伸到一个较大的亮度动态范围,提高了对比度,增强了图像细节信息,是一种有效的对比度增强方法。     

轮廓波及曲波和小波变换用于显微图像消噪的比较

背景:小波变换只能反映信号的零维奇异性,无法最优表示图像中的线奇异;而且小波变换只存在3个方向,这些都显著影响了它在图像处理领域的应用效果.针对小波变换的缺点,多尺度几何分析理论正在逐步发展,轮廓波变换和曲波变换就是其中的典型代表.目的:定性、定量地比较轮廓波、曲波和小波变换在图像消噪处理中的效果.方法:在简要介绍3种变换基本原理的基础上,比较它们在图像消噪领域的应用,以均方误差和峰值信噪比作为定量指标评价消噪效果,并将其应用于显微镜图像的消噪处理.结果与结论:综合定量评价指标和人眼视觉感受,曲波变换的消噪结果最佳,轮廓波变换效果次之,小波变换效果则不够理想.     

基于平稳小波变换的减小MR图像截断伪影的方法

如何缩短磁共振成像的时间一直是磁共振成像领域研究的热点问题之一.在实际工作中只采集部分相位编码的磁共振信号进行磁共振图像重建,不但可以缩短成像的时间,而且可以使图像保持较高的信噪比,但在重建的图像上出现了截断伪影.采用平稳小波变换和图像模板技术消除图像截断伪影及噪声,可有效地提高图像质量.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil

Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques, and we developed 4 multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes; more severe disease; higher number of VRGs; and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, whereas S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup specificity in Shigella spp. and increased bacterial VRGs.     

护理干预对面部中重度寻常型痤疮的临床疗效影响分析

目的研究护理干预对面部中重度寻常型痤疮的临床疗效影响。方法选取本院在2014年4月~2016年7月诊治的136例面部中重度寻常型痤疮患者,随机分为研究组与对照组,每组68例;所有患者均依据其情况给予对应的治疗,其中对照组在治疗期间给予常规护理,研究组在对照组的基础上再给予综合性护理干预,比较两组的治疗效果及护理满意度情况等。结果患者在接受治疗和护理后,研究组中度与重度患者的治疗效果较对照组均明显提高(P0.05),研究组护理满意度较对照组明显增高(P0.05)。结论对面部中重度寻常型痤疮患者在其治疗期间给予综合性护理干预,具有良好的效果。