Mauren Abreu de Souza

Pode a termografia auxiliar no diagnóstico de lesões musculares em atletas de futebol

INTRODUCAO: Considerando que as lesoes musculares desencadeiam processos inflamatorios e que a inflamacao gera calor em decorrencia do aumento do metabolismo local, entao, o nivel inflamatorio pode ser avaliado por meio do gradiente de temperatura. OBJETIVO: Verificar a viabilidade da aplicacao da termografia no diagnostico de lesoes causadas pelo treinamento fisico. METODOS: O estudo foi realizado com atletas adolescentes do Parana Clube, Curitiba, PR, Brasil, que foram divididos em dois grupos, denominados controle e experimental. O grupo controle participou de uma sessao de treinamento de baixa intensidade e o grupo experimental de alta intensidade. Primeiramente, foi capturada uma imagem termografica do quadriceps femoral de cada atleta antes do inicio da sessao de treinamento. Apos a sessao de treinamento, coletou-se uma amostra de sangue para verificar o nivel serico de lactato de cada atleta. Posteriormente, 24h apos o treinamento, efetuou-se outra coleta de sangue para verificar o nivel serico de CK de cada atleta. Outra imagem termografica individual do quadriceps femoral tambem foi adquirida nessa etapa. RESULTADOS: A correlacao entre os indices de lactato e CK foi positiva e estatisticamente significativa, com valor rho = 0,661 (p = 0,038). Nao houve correlacao estatisticamente significativa entre os valores de CK 24h pos-treino e na variacao de temperatura (24h pos-treino - pre-treino) nos musculos avaliados para o grupo controle. Houve diferenca de temperatura (24h pos-treino - pre-treino) estatisticamente significativa (p < 0,05) para os tres musculos estudados apenas no grupo experimental. CONCLUSAO: Os resultados do presente estudo sugerem a possibilidade da utilizacao de imagens termograficas para, em conjunto com a creatina-quinase, determinar a intensidade e a localizacao de lesoes musculares pos-treino, uma vez que o citado marcador bioquimico nao consegue determinar a localizacao anatomica da lesao muscular.

3D Thermal Medical Image Visualization Tool: Integration between MRI and Thermographic Images

Three-dimensional medical image reconstruction using different images modalities require registration techniques that are, in general, based on the stacking of 2D MRI/CT images slices. In this way, the integration of two different imaging modalities: anatomical (MRI/CT) and physiological information (infrared image), to generate a 3D thermal model, is a new methodology still under development. This paper presents a 3D THERMO interface that provides flexibility for the 3D visualization: it incorporates the DICOM parameters; different color scale palettes at the final 3D model; 3D visualization at different planes of sections; and a filtering option that provides better image visualization. To summarize, the 3D thermographc medical image visualization provides a realistic and precise medical tool. The merging of two different imaging modalities allows better quality and more fidelity, especially for medical applications in which the temperature changes are clinically significant.

A NEW METHOD FOR GENERATING 3D THERMOGRAPHY MODELS

Medical Infrared Imaging (IR) is a noninvasive diagnostic method that allows the examiner to evaluate and quantify temperature changes on the skin surface, which is reflected as any abnormal internal temperature variation. However, thermograph images are essentially a 2D technique and its image does not provide useful anatomical information associated with it. Therefore, this paper presents a new method for combining 2D Infrared Images with Magnetic Resonance Images (MRI) and/or Computer Tomography (CT) images, employing an image registration (fusion) methodology. As a result, it is generated a new hybrid 3D model, denominated 3D THERMO. This new 3D model involves the visualization of a rendered image, which has the additional of being generated based on multi imaging modality: the temperature (functional information) originated from the thermal images (IR) and also the MRI or CT images (anatomical or structural information). This innovative tool will help improvements in clinical applications, such as medical diagnosis and for monitoring treatment of certain pathologies.

Combining 3D models with 2D infrared images for medical applications

Infrared images are very useful for providing physiological information, although the representation is two-dimensional. On the other hand, a 3D scanning system is able to generate precise 3D spatial models of the area under study. This paper presents a methodology for combining both imaging modalities into a single representation. The Structure from Motion (SfM) technique is used in order to find the correct infrared cameras positioning and rotations in the space. Then, those 2D infrared images generate a 3D SfM model. Following this stage, the SfM model is replaced by an accurate 3D model from a scanning system, which is wrapped around by the infrared images. The experiments performed with a volunteers face have shown that the proposed methodology successfully reconstruct a unique 3D surface model, which is able to deliver potential clinical applications.

Biofeedback baropodometry training evaluation: A study with children with equinus foot deformity

The lack of perception in the hindfoot increases the plantar flexion, causing irregular posture due to the foot position, a disability known as equinus foot deformity. A portable device, named baropodometer, that measures the pressure at the forefoot and hindfoot regions was built to help this population in terms of balance and posture correction. Ten hemiparetic teenager volunteers with equinus foot participated in the experiments. The results demonstrated that the proposed device increased the weight-bearing in upright stance in the paretic side, decreasing the weight in the non-paretic side. After 10 experimental sessions, performed along 6 months, the distribution of the pressure in the lower limbs was very similar. The baropodometer facilitates the rehabilitation, by biofeedbacking the pressure of the calcaneus, using the volunteers audiovisual system. The rehabilitation using the proposed device was able to recover the balance by posture correction, facilitating future gait training of these volunteers.

Image fusion improvements applied at the generation of 3D thermal models

The application of multimodal image registration to various medical applications has been investigated. Image fusion involving 3D thermal and MRI/CT images allows the extraction of both functional and anatomical information, which may become a powerful tool to aid in clinical diagnoses.

Generation of 3D thermal models for dentistry applications

There are a variety of medical imaging modalities available, although each modality focus into different aspects, for example: anatomical, physiological or geometrical information. This paper presents a new imaging modality (3D THERMO-SCAN) that combines anatomical computer tomography (CT) imaging slices, together with 2D infrared thermography images and 3D scanned shaped models of the area under study. Therefore, it is presented the 3D reconstructions involving a case study of a volunteer with bruxism. Some characteristics of bruxism are the hyperactivity of the chewing muscles, which changes the dynamics of microcirculation, also changing the correspondent skins temperature. The emphasis is to show the corresponding structures, such as jaw/mandibular region that will produce either decrease or increase in temperature, which are related to bruxism and the associated use of an occlusal splint, respectively.

Measurement of mandibular movements in parafunctional patient using occlusal splint with Bragg gratings: pilot study

The aim of the study is to demonstrate the potential of the fibre Braggs grating (FBG) in the measurement of different jaw movements that are performed for patients with occlusal parafunction using occlusal splints. Two silicon plates each 2mm are used, the fibre optic sensor is positioned in the maxillary left first molar region above the point of contact with opposing tooth after pressing the first plate on the model. Then the second silicon plate is pressed. The device has a final thickness of 2 mm. The occlusal splint is installed in the mouth of the patient who underwent different movements on occlusal splint. The maximum frequency bite is monitored. The results demonstrate that the bite shows a difference between grinding and clenching movements. The curves behaviour patterns are presented in order to show these different comparisons. Therefore, it is concluded that the fibre Braggs grating consists in an efficient method for monitoring the mechanical behaviour bite of patients with occlusal splints.

Additive Manufacturing of 3D Biomodels as Adjuvant in Intracranial Aneurysm Clipping: Additive Manufacturing of 3D Biomodels

One of the main difficulties in intracranial aneurysms (IA) surgery refers to the choice of the appropriate clip(s) to be implanted. Although the imaging exams currently available ensure visualization of IAs morphology, they do not bring an accurate reference positioning for the surgeon in executing the surgery procedure nor efficiently contribute to planning the surgery. Unfortunately, for IAs largely inaccessible regions, there is not an efficient method of treatment planning. Therefore, we propose a novel method that allows the generation of a 3D biomodel of the IA region under investigation using additive manufacturing technology (AM). Thus, a physical copy of the IA is produced and offers the surgeon a full view of the anatomy of that region of the brain. The aim of this study is the creation of a flexible 3D physical model (elastomer) through the AM technique, in order to allow the clip selection prior to the surgery. DICOM angio-CT images from eight patients who underwent IA surgery were transformed into STL format and then built on a 3D printer. Preoperative surgical clip selection was performed and then compared with those used in surgery. At the end of the study, all 3D IA biomodels were reproduced for microsurgical clipping selection and it was possible to predict the metal clip to be used in the surgery. In addition, the proposed methodology helps to clarify the surgical anatomy and to avoid excessive manipulation of the intracranial arteries and prolonged surgical time. The major advantage of this technology is that the surgeon can closely study complex cerebrovascular anatomy from any perspective using realistic 3D biomodels, which can be handheld, allowing simulation of intraoperative situations and anticipation of surgical challenges.

Proposal of custom made wrist orthoses based on 3D modelling and 3D printing

Accessibility to three-dimensional (3D) technologies, such as 3D scanning systems and additive manufacturing (like 3D printers), allows a variety of 3D applications. For medical applications in particular, these modalities are gaining a lot of attention enabling several opportunities for healthcare applications. The literature brings several cases applying both technologies, but none of them focus on the spreading of how this technology could benefit the health segment. This paper proposes a new methodology, which employs both 3D modelling and 3D printing for building orthoses, which could better fit the demands of different patients. Additionally, there is an opportunity for sharing expertise, as it represents a trendy in terms of the maker-movement. Therefore, as a result of the proposed approach, we present a case study based on a volunteer who needs an immobilization orthosis, which was built for exemplification of the whole process. This proposal also employs freely available 3D models and software, having a strong social impact. As a result, it enables the implementation and effective usability for a variety of built to fit solutions, hitching useful and smarter technologies for the healthcare sector.