医学图像处理：信号与系统基础

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"医学图像：信号与系统（第二版）" 这本书是医学图像处理领域的一本经典教材，由Jerry L. Prince和Jonathan M. Links两位专家合著。作者分别来自约翰斯·霍普金斯大学的电气与计算机工程和环境健康科学专业，他们的专业知识确保了教材的权威性和实用性。该书的第二版旨在深入讲解医学图像的信号处理和系统分析方法。书中涵盖了从基础到高级的医学成像技术，包括X射线、MRI（磁共振成像）等常见医学成像方式。通过实例，如手部的X射线图像、大脑的MRI横截面图像以及头部和颈部的X射线图像，读者可以直观地理解这些技术的工作原理和应用。这些图片来自GE Healthcare，展示了实际医疗成像设备的高质量图像。教材的结构设计严谨，包含全面的项目管理和服务，由专业团队进行编辑、排版和印刷。此外，书中还引用并获得了其他来源的信用和认可，确保了所有信息的准确性和合规性。版权归属于2015年和2006年的培生教育公司，以Prentice Hall品牌出版。在内容上，"医学图像：信号与系统"可能涵盖以下关键知识点： 1. **医学图像基础**：介绍医学图像的基本概念，如成像设备的工作原理、图像类型和特性。 2. **信号处理**：探讨信号的获取、增强、滤波和分析，包括噪声处理、图像恢复和压缩技术。 3. **系统理论**：解释医学成像系统的建模和分析，如傅里叶变换在医学图像中的应用。 4. **图像重建**：讨论如何从原始数据重建高质量的图像，如CT（计算机断层扫描）和MRI的重建算法。 5. **图像分析与解析**：涉及图像分割、特征提取、模式识别等，用于疾病诊断和治疗规划。 6. **成像技术的最新进展**：可能包括PET（正电子发射断层扫描）、超声成像和光学成像等领域的创新。 7. **伦理和法规**：讨论医学图像处理中的隐私保护、数据安全和相关法律法规问题。此教材适合对医学图像处理感兴趣的工程师、科研人员、医学生以及医疗行业的专业人士阅读，它将帮助读者理解医学成像背后的科学原理，并掌握分析和解释图像的关键技能。

Preface

Although the underlying principles of medical imaging have not changed in the

nine years since the ﬁrst edition of this book was published, the instrumentation

and practices have continued to evolve and improve. This second edition

maintains the signals and systems focus of the ﬁrst edition, with up-to-date

descriptions of instrumentation. We still cover the most important imaging

modalities in radiology: projection radiography, x-ray computed tomography,

nuclear medicine scintigraphy and emission tomography, ultrasound imaging,

and magnetic resonance imaging. But we now provide additional material

on digital radiography, multi-row detector CT systems, 3D ultrasound, both

functional and diffusion-weighted magnetic resonance imaging, and much more.

As before, we expect the reader to be familiar with signals and systems, which are

usually covered in the sophomore year of most engineering curricula, and with

elementary probability. Freshman courses in physics, chemistry, and calculus

are also assumed.

As with the ﬁrst edition, the book is organized into parts emphasizing

key overall conceptual divisions. Part I introduces basic imaging principles,

including an introduction to medical imaging systems in Chapter 1, a review

of signal processing (with emphasis on two-dimensional signals) in Chapter 2,

and a discussion of image quality in Chapter 3. Our presentation of the theory

of medical imaging systems is strongly based on continuous signals; however, a

development of discrete signals is included to permit discussions on sampling and

implementation. Issues of image quality, including resolution, noise, contrast,

geometric distortion, and artifacts are described in a general context here, and

are revisited within each modality in subsequent chapters.

Part II describes key modalities in radiographic imaging. It begins in

Chapter 4 with a brief presentation of the physics of radiography, including

the generation and detection of ionizing radiation and its effect on the human

body. Chapter 5 describes projection radiography systems, including chest x-ray,

ﬂuoroscopy, and mammography systems. As in all subsequent chapters, cover-

age focuses on signals, including only enough physics and biology to motivate

the modality and provide a model for the analysis. Chapter 5 also presents the

mathematics of projection imaging, a very fundamental idea in medical imaging.

Chapter 6 covers x-ray computed tomography, expanding on the instrumen-

tation and mathematics of projection imaging and introducing the concept

of image reconstruction in medical imaging. Computed tomography produces

true tomograms (images of cross sections of the body) rather than projections

of the body.

Part III presents the physics and modalities of nuclear medicine imaging.

Chapter 7 describes the physics of nuclear medicine, focusing primarily on the

concept of radioactivity. The major modalities in nuclear medicine imaging are

described in Chapter 8, which covers planar scintigraphy, and Chapter 9, which

covers emission computed tomography.

xvi Preface

Part IV covers ultrasound imaging. It begins in Chapter 10 with a brief

presentation of the physics of sound, and continues in Chapter 11 with the

various imaging modes offered within this rich modality. Part V covers mag-

netic resonance imaging. Chapter 12 presents the physics of nuclear magnetic

resonance, and Chapter 13 continues with a presentation of various magnetic

resonance imaging techniques.

We have used the ﬁrst edition of this book for a one-semester upper-

level/graduate course on medical imaging systems. In order to cover the material

in one semester, we routinely skip some material in the book, and we move

at a very brisk pace. Although it was very tempting to add more depth

in modern instrumentation, reconstruction methods, and diagnostic uses of

medical imaging, we feel that this breadth of material could not be covered in

one semester with sufﬁcient depth, and would be inconsistent with our primary

goal of providing a uniﬁed view of medical imaging from a signals and systems

point of view. On the other hand, we feel that this book could be used as the basis

for a two-semester course, perhaps by covering Parts I–III in the ﬁrst semester

and Parts IV–V in the second semester. A two-semester approach would allow

instructors to use supplementary materials for additional depth in the physics

and instrumentation of medical imaging, or to present current research topics.

Medical imaging is very visual—just ask any radiologist. Although the

formalism of signals and systems is mathematical, we understand the advan-

tages offered through visualization. Therefore, the book contains many images

and diagrams. Some are strictly pedagogical, offered in conjunction with the

exposition or an example problem. Others are motivational, revealing inter-

esting features for discussion or study. Special emphasis is made to provide

biologically relevant examples, so that the important context of medical imag-

ing can be appreciated by students. Many images have been added or replaced

in this edition, in order to provide better coverage of current use and to provide

reference images to help explain features and qualities of the various modalilties.

New to This Edition

The second edition of this book arose primarily from the need to provide

updates to the technology and methods in medical imaging systems, which have

undergone substantial development since the ﬁrst edition. At the same time,

we were able to incorporate changes to the organization of the book and to

improve certain aspects of pedagogy. Instructors and students alike now have

more modern material from the core medical imaging modalities while still

maintaining the signal processing perspective in a uniﬁed treatment of medical

imaging signal and systems.

The most signiﬁcant changes to this new edition include:

• Completely rewritten overview sections including many new images to better

motivate and explain the core modalities that use x-rays, radioactivity,

ultrasound, and nuclear magnetic resonance.

• New sections on digital radiography systems and mammography in projec-

tion radiography.

• A new section on multi-row detectors in computed tomography.

Preface xvii

• A new section on iterative reconstruction in emission tomography in nuclear

medicine.

• New sections on nonlinear wave propagation and harmonic imaging in

ultrasound imaging.

• New development and presentation of imaging equations in planar scintig-

raphy, single photon emission computed tomography, and positron emission

tomography.

• New sections on three-dimensional imaging, noise, and speckle in ultrasound

imaging.

• New sections on susceptibility weighted imaging, functional magnetic res-

onance imaging, and diffusion magnetic resonance imaging in magnetic

resonance imaging.

• Reorganization of the chapters on signals and systems and image quality to

encourage a better pedagological ﬂow.

• Many new problems, added primarily to the chapters having relatively fewer

problems in the ﬁrst edition. There are a total of 261 problems in this second

edition.

Acknowledgments

Many students, friends, colleagues, and teaching assistants contributed to this

book through discussions and critiques. We wish to thank Elliot R. McVeigh and

John I. Goutsias, who co-taught our course at Johns Hopkins University during

the early years and helped draft the ﬁrst edition of the book. We are grateful to

Drs. Avneesh Chhabra, Harvey Ziessman, Peter Calabresi, and David Yousem

for providing several clinical images (and their descriptions) and to Vince Blasko

and Beatrice Mudge for providing several images depicting artifacts that can arise

in clinical imaging. Xiao Han, Xiaodong Tao, Li Pan, Vijay Parthasarathy, Tara

Johnson, Minnan Xu, Abd El-Monem El-Sharkawy, Kahaled Abd-Elmoniem,

Lotta Ellingsen, Jing Wan, Snehashis Roy, Harsh Agarwal, Issel Lim, Xian

Fan, Nan Li, Sahar Soleimanifard, Nathanel Kuo, Jeffrey Pompe, Min Chen,

Chuyang Ye, and Zhen Yang contributed problems and solutions, Dhruv Lamba

helped ﬁnd new images, and Aaron Carass ﬁxed many LaTeX problems. We are

grateful for the images provided to us by GE Healthcare, Philips Healthcare,

and Osirix. We thank J. Webster Stayman for reviewing the digital radiography

section. We would also like to thank six anonymous reviewers who provided

comments on their experiences with the ﬁrst edition, which provided a basis for

many of the changes we have made to this edition, and ﬁve anonymous reviewers

who reviewed a draft of this edition, which helped us to better balance material

in several sections. Finally, we would like to thank Dr. William R. Brody, who

inspired the creation of the course out of which this book emerged.

Jerry L. Prince

Jonathan M. Links

PART

Basic Imaging

Principles

Overview

What does the human body look like on the inside? The smart answer: It depends

on how you look at it. The most direct way to look inside the human body is to

cut it open, for example, through surgery. A reﬁnement of this procedure might

be to use an endoscope, essentially a light tube that is ‘‘threaded’’ through the

body, which conveys an image to a display device. Both methods offer direct

optical viewing, but also involve cutting the body, putting something in it, or

both. These are invasive techniques, which cause (potential) damage or trauma

to the body.

The beauty of medical imaging is that we can see inside the human body

in ways that are less invasive than surgery or endoscopy. In some cases—for

example, magnetic resonance imaging (MRI) and ultrasound imaging—the

methods are completely noninvasive and risk-free so far as we know. In other

cases—for example, projection radiography, x-ray computed tomography (CT),

and nuclear medicine—there is some risk associated with the radiation exposure,

even though these methods are considered noninvasive as well.

Fundamentally, these medical imaging techniques mean that we do not need

to cut the body or put a physical device into it in order to ‘‘see inside.’’ Of perhaps

even greater importance, these techniques allow us to see things that are not

visible to the naked eye in the ﬁrst place. For example, functional magnetic

resonance imaging (fMRI) allows us to obtain images of organ perfusion or

blood ﬂow, and positron emission tomography (PET) allows us to obtain

images of metabolism or receptor binding. In other words, the various imaging

techniques allow us to see inside the body in different ways—the ‘‘signal’’ is

different in each case and can reveal information which the other methods

cannot. Each of these different methods is a different imaging modality, and the

‘‘signals’’ that arise are intrinsically different. This hearkens back to the opening

question: What does the human body look like on the inside? The answer: It

depends on the measured signal of interest.

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