Spiral electrode for continuous fetal heart rate monitoring during in-utero myelomeningocele repair.

Continuous fetal hemodynamic monitoring during in-utero surgery is desirable, but it is often not feasible without intermittent interruption. We report the use of a fetal spiral electrode for continuous heart rate monitoring during fetal myelomeningocele repair. Fetal echocardiography and a fetal spiral electrode were used to monitor fetal heart rate during in-utero repair at 25 weeks' gestation. We observed good agreement between echocardiographic and spiral electrode heart rate measurements. Using the Bland-Altman approach, the mean (SD) difference between measurements was 1.8 (3.5) beats per minute with limits of agreement of -5.3 to 8.8 beats per minute. This case illuminates a potential role for a fetal spiral electrode as a real-time adjunct in fetal interventions.

Quantitative characterization of lung disease.

The increase in prevalence, incidence and variety of pulmonary diseases has precipitated the need for more non-invasive quantitative assessment of structure/function relationships in the lung. This need requires concise description not only of lung anatomy but also of associated underlying mechanics of pulmonary function, as well as deviation from normal in specific diseases. This can be facilitated through the use of adaptive deformable surface models of the lung at end inspiratory and expiratory volumes. Lung surface deformation may be used to represent tissue excursion, which can characterize both global and regional lung mechanics. In this paper, we report a method for robust determination and visualization of pulmonary structure and function using clinical CT scans. The method provides both intuitive 3D parametric visualization and objective quantitative assessment of lung structure and associated function, in both normal and pathological cases.