Abstract
The blind placement of an epidural needle is among the most difficult regional anesthetic techniques. The challenge is to insert the needle in the mid-sagittal plane and to avoid overshooting the needle into the spinal cord. Prepuncture 2D ultrasound scanning has been introduced as a reliable tool to localize the target and facilitate epidural needle placement. Ideally, real-time ultrasound should be used during needle insertion. However, several issues inhibit the use of standard 2D ultrasound, including the obstruction of the puncture site by the ultrasound probe, low visibility of the target in ultrasound images, and increased pain due to longer needle trajectory. An alternative is to use 3D ultrasound imaging, where the needle and target could be visible within the same reslice of a 3D volume; however, novice ultrasound users (i.e., many anesthesiologists) still have difficulty interpreting ultrasound images of the spine and identifying the target epidural space. In this paper, we propose to augment 3D ultrasound images by registering a multi-vertebrae statistical shape+pose model. We use such augmentation for enhanced interpretation of the ultrasound and identification of the mid-sagittal plane for the needle insertion. Validation is performed on synthetic data derived from the CT images, and 64 in vivo ultrasound volumes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Belavy, D., Ruitenberg, M., Brijball, R.: Feasibility study of real-time three-/four-dimensional ultrasound for epidural catheter insertion. British Journal of Anaesthesia 107(3), 438–445 (2011)
Bossa, M., Olmos, S.: Multi-object statistical pose+shape models. In: IEEE International Symposium on Biomedical Imaging, ISBI, pp. 1204–1207 (2007)
Chen, T.K., Thurston, A.D., Ellis, R.E., Abolmaesumi, P.: A real-time freehand ultrasound calibration system with automatic accuracy feedback and control. Ultrasound in Medicine & Biology 35(1), 79–93 (2009)
Coq, G.L., Ducot, B., Benhamou, D.: Risk factors of inadequate pain relief during epidural analgesia for labour and deliver. Anaesthesia 45, 719–723 (1998)
Duta, N., Sonka, M.: Segmentation and interpretation of MR brain images. an improved active shape model. IEEE TMI 17(6), 1049–1062 (1998)
Fletcher, P., Lu, C., Joshi, S.: Statistics of shape via principal geodesic analysis on lie groups. In: IEEE CVPR, vol. 1, pp. 95–101 (2003)
Foroughi, P., Boctor, E., Swartz, M., et al.: 2-D ultrasound bone segmentation using dynamic programming. In: IEEE Ultras Symp., pp. 2523–2526 (2007)
Grau, T., Bartusseck, E., Conradi, R., et al.: Ultrasound imaging improves learning curves in obstetric epidural anesthesia: a preliminary study. Canadian Journal of Anesthesia 50(10), 1047–1050 (2003)
Khallaghi, S., et al.: Registration of a statistical shape model of the lumbar spine to 3D ultrasound images. In: Jiang, T., Navab, N., Pluim, J.P.W., Viergever, M.A. (eds.) MICCAI 2010, Part II. LNCS, vol. 6362, pp. 68–75. Springer, Heidelberg (2010)
Lu, C., Pizer, S.M., Joshi, S., Jeong, J.: Statistical multi-object shape models. International Journal of Computer Vision 75(3), 387–404 (2007)
Nickalls, R., Kokri, M.: The width of the posterior epidural space in obstetric patients. Anaesthesia 41(4), 432–433 (1986)
Okada, T., Yokota, K., Hori, M., Nakamoto, M., Nakamura, H., Sato, Y.: Construction of hierarchical multi-organ statistical atlases and their application to multi-organ segmentation from CT images. In: Metaxas, D., Axel, L., Fichtinger, G., Székely, G. (eds.) MICCAI 2008, Part I. LNCS, vol. 5241, pp. 502–509. Springer, Heidelberg (2008)
Rasoulian, A., Abolmaesumi, P., Rohling, R., Kamani, A., Charles, L., Lessoway, V.: Porcine thoracic epidural depth measurement using 3D ultrasound resliced images. In: Canadian Anesthesiologists Society Annual Meeting (2011)
Rasoulian, A., Rohling, R., Abolmaesumi, P.: Group-wise registration of point sets for statistical shape models. IEEE TMI 31(11), 2025–2034 (2012)
Rasoulian, A., Rohling, R., Abolmaesumi, P.: Probabilistic registration of an unbiased statistical shape model to ultrasound images of the spine. In: SPIE Medical Imaging, vol. 8316, pp. 83161P–1 (2012)
Sprigge, J., Harper, S.: Accidental dural puncture and post dural puncture headache in obstetric anaesthesia: presentation and management: A 23-year survey in a district general hospital. Anaesthesia 63(1), 36–43 (2007)
Steiner, H., Staudach, A., Spitzer, D., Schaffer, H.: Diagnostic techniques: Three-dimensional ultrasound in obstetrics and gynaecology: technique, possibilities and limitations. Human Reproduction 9(9), 1773–1778 (1994)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Rasoulian, A., Rohling, R.N., Abolmaesumi, P. (2013). Augmentation of Paramedian 3D Ultrasound Images of the Spine. In: Barratt, D., Cotin, S., Fichtinger, G., Jannin, P., Navab, N. (eds) Information Processing in Computer-Assisted Interventions. IPCAI 2013. Lecture Notes in Computer Science, vol 7915. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38568-1_6
Download citation
DOI: https://doi.org/10.1007/978-3-642-38568-1_6
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-38567-4
Online ISBN: 978-3-642-38568-1
eBook Packages: Computer ScienceComputer Science (R0)