Low-contrast letter acuity scores correlate well with brain MRI lesion burden in multiple sclerosis (MS), supporting validity for this vision test as a candidate for clinical trials. Disease in the postgeniculate white matter is a likely contributor to visual dysfunction in MS that may be independent of acute optic neuritis history.

For pt.I, see ibid., vol.11, no.1, p.53.61 (1992). Based on the statistical properties of X-ray CT imaging given in pt.I, an unsupervised stochastic model-based image segmentation technique for X-ray CT images is presented. This technique utilizes the finite normal mixture distribution and the underlying Gaussian random field (GRF) as the stochastic image model. The number of image classes in the observed image is detected by information theoretical criteria (AIC or MDL). The parameters of the model are estimated by expectation-maximization (EM) and classification-maximization (CM) algorithms. Image segmentation is performed by a Bayesian classifier. Results from the use of simulated and real X-ray computerized tomography (CT) image data are presented to demonstrate the promise and effectiveness of the proposed technique.

A statistical description of X-ray CT (computerized tomography) imaging, from the projection data to the reconstructed image, is presented. The Gaussianity of the pixel image generated by the convolution (image reconstruction) algorithm is justified. The conditions for two pixel images to be statistically independent (for a given probability) and the conditions for a group of pixel images to be a spatial stationary random process and ergodic in mean and autocorrelations are derived. These properties provide the basis for establishing the stochastic image model and conducting the statistical image analysis of X-ray CT images.

This paper presents a near-automatic process for separating vessels from background and other clutter as well as for separating arteries and veins in contrast-enhanced magnetic resonance angiographic (CE-MRA) image data, and an optimal method for three-dimensional visualization of vascular structures. The separation process utilizes fuzzy connected object delineation principles and algorithms. The first step of this separation process is the segmentation of the entire vessel structure from the background and other clutter via absolute fuzzy connectedness. The second step is to separate artery from vein within this entire vessel structure via iterative relative fuzzy connectedness. After seed voxels are specified inside artery and vein in the CE-MRA image, the small regions of the bigger aspects of artery and vein are separated in the initial iterations, and further detailed aspects of artery and vein are included in later iterations. At each iteration, the artery and vein compete among themselves to grab membership of each voxel in the vessel structure based on the relative strength of connectedness of the voxel in the artery and vein. This approach has been implemented in a software package for routine use in a clinical setting and tested on 133 CE-MRA studies of the pelvic region and two studies of the carotid system from six different hospitals. In all studies, unified parameter settings produced correct artery-vein separation. When compared with manual segmentation/separation, our algorithms were able to separate higher order branches, and therefore produced vastly more details in the segmented vascular structure. The total operator and computer time taken per study is on the average about 4.5 min. To date, this technique seems to be the only image processing approach that can be routinely applied for artery and vein separation.

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