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MR-based quantitative measurement of human soft tissue internal strains for pressure ulcer prevention

Article dans une revue avec comité de lecture
Author
TREBBI, Alessio
1069746 Biomécanique des Tissus Vivants et des Matériaux – Modélisation et Caractérisation [TIMC-BIOMÉCA]
MUKHINA, Ekaterina
1069746 Biomécanique des Tissus Vivants et des Matériaux – Modélisation et Caractérisation [TIMC-BIOMÉCA]
ROHAN, Pierre-Yves
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
CONNESSON, Nathanaël
1069746 Biomécanique des Tissus Vivants et des Matériaux – Modélisation et Caractérisation [TIMC-BIOMÉCA]
BAILET, Mathieu
PERRIER, Antoine
1069746 Biomécanique des Tissus Vivants et des Matériaux – Modélisation et Caractérisation [TIMC-BIOMÉCA]
PAYAN, Yohan
1069746 Biomécanique des Tissus Vivants et des Matériaux – Modélisation et Caractérisation [TIMC-BIOMÉCA]

URI
http://hdl.handle.net/10985/22743
DOI
10.1016/j.medengphy.2022.103888
Date
2022-10
Journal
Medical Engineering and Physics

Abstract

Pressure ulcers are a severe disease affecting patients that are bedridden or in a wheelchair bound for long periods of time. These wounds can develop in the deep layers of the skin of specific parts of the body, mostly on heels or sacrum, making them hard to detect in their early stages. Strain levels have been identified as a direct danger indicator for triggering pressure ulcers. Prevention could be possible with the implementation of subject-specific Finite Element (FE) models. However, generation and validation of such FE models is a complex task, and the current implemented techniques offer only a partial solution of the entire problem considering only external displacements and pressures, or cadaveric samples. In this paper, we propose an in vivo solution based on the 3D non-rigid registration between two Magnetic Resonance (MR) images, one in an unloaded configuration and the other deformed by means of a plate or an indenter. From the results of the image registration, the displacement field and subsequent strain maps for the soft tissues were computed. An extensive study, considering different cases (on heel pad and sacrum regions) was performed to evaluate the reproducibility and accuracy of the results obtained with this methodology. The implemented technique can give insight for several applications. It adds a useful tool for better understanding the propagation of deformations in the heel soft tissues that could generate pressure ulcers. This methodology can be used to obtain data on the material properties of the soft tissues to define constitutive laws for FE simulations and finally it offers a promising technique for validating FE models.

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