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Characterisation and assessment of lumbar disc herniation using image segmentation and modelling
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Abstract(s)
A hérnia discal lombar é o diagnóstico mais comum entre as doenças
degenerativas da coluna lombar. Manifesta-se habitualmente por dor lombar (lombalgia)
e dor irradiada nas pernas (ciatalgia) e pode estar associada a distúrbios sensoriais e
motores, que por sua vez afetam a qualidade de vida do doente. O tratamento pode incluir
uma combinação de terapêutica farmacológica, reabilitação ou até procedimentos
cirúrgicos, sendo uma das cirurgias da coluna vertebral mais frequentes. A decisão de
alocação para cada grupo de tratamento, depende dos parâmetros clínicos como dor,
limitação de movimento, incapacidade funcional e qualidade de vida. Os exames
imagiológicos permitem comprovar a existência de uma hérnia e a compressão que esta
exerce sobre um nervo. Este trabalho pretende correlacionar os parâmetros clínicos, os
parâmetros quantitativos e qualitativos das várias modalidades de imagem e os
parâmetros quantitativos dos modelos 3D, em pacientes com hérnia discal lombar
manifestada como ciática aguda.
O estudo incluiu um conjunto de 10 pacientes recrutados na consulta externa do
Serviço de Neurocirurgia do Hospital da Luz Setúbal. Para cada paciente, foi verificado
se o mesmo possuía um exame de Ressonância Magnética (MRI), Tomografia
Computadorizada (CT), Raios-X e Raios-X Funcional, para que pudessem ser medidos
parâmetros através dessas modalidades de imagem. Por fim, foram segmentados modelos
3D da coluna lombar dos pacientes que possuíam uma CT.
Os resultados obtidos mostram que as características clínicas, como sexo, idade,
IMC, ODI e NPRS não apresentam uma correlação evidente com a área da hérnia. A
altura do disco, altura da vértebra, ângulo intervertebral e ângulo de lordose lombar foram
os parâmetros quantitativos analisados com maior detalhe. Desta forma, verificou-se que
de maneira geral, as combinações de MRI com CT e modelos 3D apresentaram valores
consistentes com a literatura, ao contrário do MRI com Raios-X e Raios-X Funcional.
Assim, concluiu-se que o MRI, CT e modelos 3D são os mais semelhantes entre
si em termos das medições dos parâmetros. Por outro lado, as medições realizadas em
Raios-X e Raios-X Funcional diferem das obtidas em MRI e CT, devido à variação na
postura durante a aquisição das imagens.
Lumbar disc herniation is the most common diagnosis among degenerative diseases of the lumbar spine. It usually manifests as low back pain and radiating leg pain (sciatica) and may be associated with sensory and motor disturbances, which in turn affect the patient's quality of life. Treatment may include a combination of pharmacological therapy, rehabilitation or even surgical procedures, with spinal surgery being one of the most common. The decision to allocate a patient to a specific treatment group depends on clinical parameters such as pain, movement limitation, functional disability and quality of life. Imaging exams can confirm the existence of a herniation and the compression it exerts on a nerve. This study aims to correlate clinical parameters, qualitative and quantitative parameters from various imaging modalities and the quantitative parameters of 3D models in patients with lumbar disc herniation manifesting as acute sciatica. The study included a group of 10 patients recruited from the Neurosurgery Department of the Hospital da Luz de Setúbal. For each patient, it was verified whether they had a Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Standing X-ray and Functional X-ray, in order to measure parameters using these imaging modalities. Finally, 3D models of the lumbar spine were segmented for patients who had a CT scan available. The outputs obtained show that clinical characteristics such as sex, age, BMI, ODI and NPRS do not exhibit a clear correlation with the hernia area. Disc height, vertebra height, intervertebral angle and lumbar lordosis angle were the quantitative parameters analysed in the greatest detailed. As a result, it was found that combinations of MRI with CT and 3D models showed values consistent with the literature, unlike the combinations of MRI with Standing and Functional X-ray. Thus, it was concluded that MRI, CT and 3D models are the most similar to each other in terms of parameter measurements. On the other hand, the measurements obtained from Standing and Functional X-ray differ from those obtained from MRI and CT, due to variations in posture during image acquisition.
Lumbar disc herniation is the most common diagnosis among degenerative diseases of the lumbar spine. It usually manifests as low back pain and radiating leg pain (sciatica) and may be associated with sensory and motor disturbances, which in turn affect the patient's quality of life. Treatment may include a combination of pharmacological therapy, rehabilitation or even surgical procedures, with spinal surgery being one of the most common. The decision to allocate a patient to a specific treatment group depends on clinical parameters such as pain, movement limitation, functional disability and quality of life. Imaging exams can confirm the existence of a herniation and the compression it exerts on a nerve. This study aims to correlate clinical parameters, qualitative and quantitative parameters from various imaging modalities and the quantitative parameters of 3D models in patients with lumbar disc herniation manifesting as acute sciatica. The study included a group of 10 patients recruited from the Neurosurgery Department of the Hospital da Luz de Setúbal. For each patient, it was verified whether they had a Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Standing X-ray and Functional X-ray, in order to measure parameters using these imaging modalities. Finally, 3D models of the lumbar spine were segmented for patients who had a CT scan available. The outputs obtained show that clinical characteristics such as sex, age, BMI, ODI and NPRS do not exhibit a clear correlation with the hernia area. Disc height, vertebra height, intervertebral angle and lumbar lordosis angle were the quantitative parameters analysed in the greatest detailed. As a result, it was found that combinations of MRI with CT and 3D models showed values consistent with the literature, unlike the combinations of MRI with Standing and Functional X-ray. Thus, it was concluded that MRI, CT and 3D models are the most similar to each other in terms of parameter measurements. On the other hand, the measurements obtained from Standing and Functional X-ray differ from those obtained from MRI and CT, due to variations in posture during image acquisition.
Description
Keywords
Coluna lombar Lombalgia Ciatalgia Hérnia discal lombar Segmentação de imagem Lumbar spine Low back pain Sciatica lumbar disc hernia Segmentation