Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Rosalyn H Hargraves

Second Advisor

Kayvan Najarian

Third Advisor

Afroditi V Filippas

Fourth Advisor

Kevin R Ward

Fifth Advisor

Alen Docef


Traumatic pelvic injuries associated with high-energy pelvic fractures are life-threatening injuries. Extensive bleeding is relatively common with pelvic fractures. However, bleeding is especially prevalent with high-energy fractures. Hemorrhage remains the major cause of death that occur within the first 24 hours after a traumatic pelvic injury. Emergent-life saving treatment is required for high-energy pelvic fractures associated with hemorrhage. A thorough understanding of potential sources of bleeding within a short period is essential for diagnosis and treatment planning. Computed Tomography (CT) images have been widely in use in identifying the potential sources of bleeding. A pelvic CT scan contains a large number of images. Analyzing each slice in a scan via simple visual inspection is very time consuming. Time is a crucial factor in emergency medicine. Therefore, a computer-assisted pelvic trauma decision-making system is advantageous for assisting physicians in fast and accurate decision making and treatment planning. The proposed project presents an automated system to detect and segment hemorrhage and combines it with the other extracted features from pelvic images and demographic data to provide recommendations to trauma caregivers for diagnosis and treatment. The first part of the project is to develop automated methods to detect arteries by incorporating bone information. This part of the project merges bone edges and segments bone using a seed growing technique. Later the segmented bone information is utilized along with the best template matching to locate arteries and extract gray level information of the located arteries in the pelvic region. The second part of the project focuses on locating the source of hemorrhage and its segmentation. The hemorrhage is segmented using a novel rule based hemorrhage segmentation approach. This approach segments hemorrhage through hemorrhage matching, rule optimization, and region growing. Later the position of hemorrhage in the image and the volume of the hemorrhage are determined to analyze hemorrhage severity. The third part of the project is to automatically classify the outcome using features extracted from the medical images and patient medical records and demographics. A multi-stage feature selection algorithm is used to select the predominant features among all the features. Finally, boosted logistic model tree is used to classify the outcome. The methods are tested on CT images of traumatic pelvic injury patients. The hemorrhage segmentation and classification results seem promising and demonstrate that the proposed method is not only capable of automatically segmenting hemorrhage and classifying outcome, but also has the potential to be used for clinical applications. Finally, the project is extended to abdominal trauma and a novel knowledge based heuristic technique is used to detect and segment spleen from the abdominal CT images. This technique is tested on a limited number of subjects and the results are promising.


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VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

April 2013

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Engineering Commons