Track 6. Technological innovations in biomedical training and practice Authors: Lourdes Asensio Romero, Manuel Asensio Gómez, Alberto Prats-Galino and Juan A. Juanes Mendez

1. Technological development of
visualization of magnetic resonance
sectional images and pelvic floor
ultrasonography for teaching purposes.
Lourdes Asensio Romero

2. Introduction
- The progress of medical informatics, initiated many years ago and
intensified in the last decade, has opened a revolution in medical training.
- Computer developments as didactic resources are gaining an increasingly
relevant role as new technologies are integrated into the teaching activity.
- Imaging studies can facilitate knowledge of the anatomy and diagnosis of
pathological processes that affect various anatomical structures.

3. Objetive
- Our purpose has been to develop a computer program to have a teaching
tool, based on tutorial systems that present magnetic resonance images
(MRI) and ultrasound (endovaginal-transperineal-endoanal) visual
information, which will guide users in their learning task using this
interactive procedure. All this constitutes a true anatomo-radiological atlas
of the pelvic floor.

4. Methodology
- Acquisition and processing of radiological images: All images were
obtained from a 29-year-old volunteer woman with no known history of
gynecological pathology.
- Nuclear magnetic resonance: High resolution images were obtained,
enhanced in different sequences, T1, T2 and proton density (DP) in the
three orthogonal planes (axial, coronal and sagittal) of the abdominopelvic
region, for the global anatomical study of the pelvis.
- Ultrasound: Ultrasound images of the pelvic floor and pelvis were
obtained by using two ultrasound equipment (Siemens Acuson Antares and
Voluson E6) that support different image modes.

6. Results
Teaching computer programs have three main modules:
- the module that manages the communication with the user.
- the module that contains the information of the program.
- the module that manages the actions of the computer and their responses
to the actions of the users.

7. Results
- Interface: is the environment through which computer programs establish
the dialogue with their users and is what enables the interactivity
characteristic of these materials.
- An interface like the one we show in this computer development for the
visualization of anatomical structures of the female pelvis, using diagnostic
imaging techniques such as MRI and ultrasound, is simple to understand
and very easy to use, allowing users (students or resident doctors) perform
a learning or training task in a simple and fast way.

8. Results
- Our computer program leaves the users free to navigate through the application as they
wish.
-A toolbar of small illustrative icons indicates the possibilities of working with the image.

9. Results
- MRI sections can be analyzed from any spatial position and in its three
planes of space (axial, coronal and sagittal).

10. Results
- A list of the main anatomical structures of the female pelvis appears in the lower
area of the screen: the selection of any of them allows us to see where it is located in
the MRI.

11. Results
- Allows to carry out radiological correlations between the MRI and the ultrasound images.

12. Results
- Ultrasound images can be evaluated serially, including an identification of
each structure that is displayed, when the cursor is moved over the image.

13. Results

14. Conclusions
- Technological and computer resources are increasingly incorporated into our daily lives,
innovating and facilitating many aspects of it. This is not different in the field of education.
- The use of computer programs in the study of human anatomy and the use of diagnostic tests
based on anatomical representation and analysis, such as radiological studies, are particularly
important.
- Imaging studies can facilitate knowledge of the anatomy and diagnosis of pathological
processes that affect anatomical structures. Diagnostic imaging techniques play a major role in
the analysis of the pathological processes of the pelvis.
- In the field of Urogynecology, the images obtained through the use of MRI and ultrasound
(abdominal, transvaginal, transperineal or endoanal) are considered increasingly useful in the
management of patients with pelvic floor disease.
- Computer developments such as the one we present are a good tool for medical teaching,
either in the university environment or in the performance of a specific specialty such as
Gynecology.

15. Conclusions
Our computer development:
- present MRI and ultrasound images with their joint assessment, allowing
the user to correlate both images and the anatomical information that is
provided.
- the user interface is simple and intuitive and helps the user to focus on a
specific pelvic structure, its information and its location in different planes
of space and through different imaging techniques.
For all of this, we consider our computer development as a good teaching
tool that can be useful for the diagnosis and treatment of pelvic floor
pathology.

16. Thank you