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Direct 3-Dimensional Diagnosis of Ex Vivo Facial Fractures.

qua, 03/20/2019 - 07:44

Direct 3-Dimensional Diagnosis of Ex Vivo Facial Fractures.

J Craniofac Surg. 2019 Mar 14;:

Authors: Sirin Y, Yildirimturk S, Horasan S, Guven K

Abstract
The aim of the present study is to assess the reliability and accuracy of different 3-dimensional (3D) reconstruction algorithms in detecting undisplaced condylar, zygomatic arc, and orbital rim fractures based on cone-beam computed tomography data set. Twenty sheep heads were used in the present study. Sixty fractured and 60 nonfractured (control) zones were randomly allocated. Three groups consisting of nondisplaced fractures of condyle (CF, n = 20), orbital (OF, n = 20), and zygomatic arc (ZF, n = 20) were created by using a diamond cutting disc. Soft tissues were only dissected and no fractures were generated in the control group (n = 60). The 3D reconstructions were created by using multiplanar reconstruction (MPR), surface rendering (SR), volume rendering (VR), and maximum intensity projection (MIP) algorithms. Final 3D models were examined in Osirix software (Pixmeo SARL, Bernex, Switzerland) by 6 observers. Diagnostic accuracies of each algorithm were statistically compared by receiver operating characteristics (ROC) and area under the ROC curves (AUCs). For the detection of CF, AUC for VR algorithm was found to be statistically larger than that of MIP while AUCs for VR and MIP were larger than those of MPR and SR for OF detection. For the detection of ZF, AUCs for MPR and VR were significantly larger than those of MIP and SR (P < 0.05 for each). Within the limitations of this experimental study, it can be concluded that for maxillofacial surgeons, it is more likely to detect condylar, orbital, and zygomatic fractures by using VR algorithm in 3D reconstruction.

PMID: 30889064 [PubMed - as supplied by publisher]

Microsurgical Anatomy of the Jugular Process as an Anatomical Landmark to Access the Jugular Foramen: A Cadaveric and Radiological Study.

sab, 03/16/2019 - 07:12
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Microsurgical Anatomy of the Jugular Process as an Anatomical Landmark to Access the Jugular Foramen: A Cadaveric and Radiological Study.

Oper Neurosurg (Hagerstown). 2019 Apr 01;16(4):486-495

Authors: Komune N, Matsuo S, Miki K, Matsushima K, Akagi Y, Kurogi R, Iihara K, Matsushima T, Inoue T, Nakagawa T

Abstract
BACKGROUND: The jugular process forms the posteroinferior surface of the jugular foramen and is an important structure for surgical approaches to the foramen. However, its morphological features have not been well described in modern texts.
OBJECTIVE: To elucidate the microsurgical anatomy of the jugular process and examine its morphological features.
METHODS: Five adult cadaveric specimens were dissected in a cadaveric study, and computed tomography data from 31 heads (62 sides) were examined using OsiriX (Pixmeo SARL, Bernex, Switzerland) to elucidate the morphological features of the jugular process.
RESULTS: The cadaveric study showed that it has a close relationship with the sigmoid sinus, jugular bulb, rectus capitis lateralis, lateral atlanto-occipital ligament, and lateral and posterior condylar veins. The radiographic study showed that 9/62 sigmoid sinuses protruded inferiorly into the jugular process and that in 5/62 sides, this process was pneumatized. At the entry of the jugular foramen, if the temporal bone has a bulb-type jugular bulb, and if surgery concerns the right side of the head, the superior surface of the jugular process is more likely to be steep.
CONCLUSION: The jugular process forms the posteroinferior border of the jugular foramen. Resection of the jugular process is a critical step for opening the jugular foramen from the posterior and lateral aspects. Understanding the morphological features of the jugular process, and preoperative and radiographical examination of this process thus help skull base surgeons to access the jugular foramen.

PMID: 30873560 [PubMed - in process]

Free DICOM-Viewers for Veterinary Medicine : Survey and Comparison of Functionality and User-Friendliness of Medical Imaging PACS-DICOM-Viewer Freeware for Specific Use in Veterinary Medicine Practices.

qua, 03/13/2019 - 09:46
Related Articles

Free DICOM-Viewers for Veterinary Medicine : Survey and Comparison of Functionality and User-Friendliness of Medical Imaging PACS-DICOM-Viewer Freeware for Specific Use in Veterinary Medicine Practices.

J Digit Imaging. 2019 Mar 11;:

Authors: Brühschwein A, Klever J, Hoffmann AS, Huber D, Kaufmann E, Reese S, Meyer-Lindenberg A

Abstract
There is increasing prevalence of digital diagnostic imaging in veterinary medicine with a progressive need to use medical imaging software. As Digital Imaging and Communications in Medicine (DICOM)-viewers for veterinary use do not require medical device approval in many countries, freeware viewers might be a practical alternative. The aim of this study was to identify and evaluate free DICOM-viewer software for veterinary purposes. The functionality and user-friendliness of various DICOM-viewers from the internet were analyzed and compared. Inclusion criteria for the evaluation were free availability, PACS (picture archiving and communication system)-connectivity, and stand-alone and client-based software. Based on this, eight viewers were found: Ginkgo CADx, Horos, K-PACS, MAYAM, MITO, OsiriX Lite, RadiAnt, Synedra personal. In these DICOM-viewers, 14 core tools were tested and rated on a score from 1 to 10 by multiple observers with different levels of training, using studies of four imaging modalities. Criteria were functionality and user-friendliness. For each viewer, the total number of a predefined set of 47 important tools was counted. The ranking based on functionality and user-friendliness of 14 core tools (mean score in brackets) was as follows: 1. Horos/OsiriX Lite (8.96), 2. RadiAnt (8.90), 3. K-PACS (8.02), 4. Synedra (7.43), 5. MAYAM (6.05), 6. Ginkgo CADx (5.53), 7. MITO (3.74). The DICOM-viewers offered between 20 and 44 tools of the predefined important tool set and are sufficient for most veterinary purposes. An increasing number of tools did not necessarily impair user-friendliness, if the user interface is well designed. Based on the results of this study, veterinarians will find suitable free DICOM-viewers for their individual needs. In combination with PACS-freeware, this allows veterinary practices to run a low-budget digital imaging environment.

PMID: 30859340 [PubMed - as supplied by publisher]

Bone and cortical bone characteristics of mandibular retromolar trigone and anterior ramus region for miniscrew insertion in adults.

seg, 03/04/2019 - 08:05

Bone and cortical bone characteristics of mandibular retromolar trigone and anterior ramus region for miniscrew insertion in adults.

Am J Orthod Dentofacial Orthop. 2019 Mar;155(3):330-338

Authors: Nucera R, Bellocchio AM, Oteri G, Farah AJ, Rosalia L, Giancarlo C, Portelli M

Abstract
INTRODUCTION: The aim of this study was to evaluate bone depth, cortical bone thickness, and vestibulolingual bone dimension of the mandibular retromolar trigone and anterior ramus region to evaluate what are its most suitable sites for miniscrew insertion in adults.
METHODS: The sample included cone-beam computerized tomography (CBCT) records of 60 adult subjects retrospectively evaluated. All CBCT examinations were performed with the use of an i-CAT CBCT scanner (Imaging Sciences International). Each exam was converted into DICOM format and processed with the use of Osirix Medical Imaging software. On reproducible sagittal scan views, bone depth and cortical bone thickness were evaluated on specific lines parallel and at a 45° angle to the occlusal plane, and at 3 mm and at 6 mm distance from it. Vestibulolingual bone dimension was computed in 4 different cross-section scans and at 3 different levels of depth (0, 6, and 11 mm).
RESULTS: All of the considered insertion sites showed on average more than 10 mm of bone depth. Inferential statistics showed significantly (P <0.05) greater bone depth (+3 mm) in cross-sectional scans parallel to the occlusal plane compared with those at a 45° angle to it. Cortical bone thickness showed average values from 3 mm to 5 mm. Vestibulolingual bone dimension showed a significant (P <0.05) reduction (-10 mm) in the posterior region of retromolar region. No significant differences were found between subjects with and without third molars.
CONCLUSIONS: The retromolar trigone and anterior ramus region showed enough bone quantity and adequate bone quality for safe miniscrew insertion in adults.

PMID: 30826035 [PubMed - in process]

Accuracy and reliability of virtual femur measurement from CT scan.

dom, 03/03/2019 - 10:52
Related Articles

Accuracy and reliability of virtual femur measurement from CT scan.

J Forensic Leg Med. 2019 Feb 21;63:11-17

Authors: Ismail NA, Abdullah N, Mohamad Noor MH, Lai PS, Shafie MS, Nor FM

Abstract
BACKGROUND: In the application of scientific human skeletal variation in medico-legal matters, virtual anthropology is the current technique performed to examine skeleton and its body parts. Hence, this study was conducted to assess the accuracy and reliability of virtual femur measurement through intra and inter-observer error analysis, and comparison was made between the virtual and conventional methods.
METHODS: A total of 15 femora were examined with four parameters i.e. maximum length of femur (FeMl), diameter of femoral head (FeHd), transverse diameter of midshaft (FeMd) and condylar breadth (FeCb). Osteometric board and vernier calipers were employed for the conventional method, while CT reconstructed images and Osirix MD software was utilised for the virtual method.
RESULTS: Results exhibited that there were no significant differences in the measurements by conventional and virtual methods. There were also no significant differences in the measurements by the intra or inter-observer error analyses. The intraclass correlation coefficients (ICC) were more than 0.95 by both intra and inter-observer error analyses. Technical error of measurement had displayed values within the acceptable ranges (rTEM <0.08 for intra-observer, <2.25 for inter-observer), and coefficient of reliability (R) indicated small measurement errors (R > 0.95 for intra-observer, R > 0.92 for inter-observer). By parameters, FeMl showed the highest R value (0.99) with the least error in different methods and observers (rTEM = 0.02-0.41%). Bland and Altman plots revealed points scattered close to zero indicating perfect agreement by both virtual and conventional methods. The mean differences for FeMl, FeHd, FeMd and FeCb measurements were 0.01 cm, -0.01 cm, 0.02 cm and 0.01 cm, respectively.
CONCLUSION: This brought to suggest that bone measurement by virtual method was highly accurate and reliable as in the conventional method. It is recommended for implementation in the future anthropological studies especially in countries with limited skeletal collection.

PMID: 30825771 [PubMed - as supplied by publisher]

Sex-dependent posterior fossa anatomical differences in trigeminal neuralgia patients with and without neurovascular compression: a volumetric MRI age- and sex-matched case-control study.

qua, 02/06/2019 - 09:28
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Sex-dependent posterior fossa anatomical differences in trigeminal neuralgia patients with and without neurovascular compression: a volumetric MRI age- and sex-matched case-control study.

J Neurosurg. 2019 Feb 01;:1-8

Authors: Hardaway FA, Holste K, Ozturk G, Pettersson D, Pollock JM, Burchiel KJ, Raslan AM

Abstract
OBJECTIVEThe pathophysiology of trigeminal neuralgia (TN) in patients without neurovascular compression (NVC) is not completely understood. The objective of this retrospective study was to evaluate the hypothesis that TN patients without NVC differ from TN patient with NVC with respect to brain anatomy and demographic characteristics.METHODSSix anatomical brain measurements from high-resolution brain MR images were tabulated; anterior-posterior (AP) prepontine cistern length, cerebellopontine angle (CPA) cistern volume, nerve-to-nerve distance, symptomatic nerve length, pons volume, and posterior fossa volume were assessed on OsiriX. Brain MRI anatomical measurements from 232 patients with either TN type 1 or TN type 2 (TN group) were compared with measurements obtained in 100 age- and sex-matched healthy controls (control group). Two-way ANOVA tests were conducted on the 6 measurements relative to group and NVC status. Bonferroni adjustments were used to correct for multiple comparisons. A nonhierarchical k-means cluster analysis was performed on the TN group using age and posterior fossa volume as independent variables.RESULTSWithin the TN group, females were found to be younger than males and less likely to have NVC. The odds ratio (OR) of females not having NVC compared to males was 2.7 (95% CI 1.3-5.5, p = 0.017). Patients younger than 30 years were much less likely to have NVC compared to older patients (OR 4.9, 95% CI 1.3-18.4, p = 0.017). The mean AP prepontine cistern length and symptomatic nerve length were smaller in the TN group than in the control group (5.3 vs 6.5 mm and 8.7 vs 9.7 mm, respectively; p < 0.001). The posterior fossa volume was significantly smaller in TN patients without NVC compared to those with NVC. A TN group cluster analysis suggested a sex-dependent difference that was not observed in those without NVC. Factorial ANOVA and post hoc testing found that findings in males without NVC were significantly different from those in controls or male TN patients with NVC and similar to those in females (female controls as well as female TN patients with or without NVC).CONCLUSIONSPosterior fossa volume in males was larger than posterior fossa volume in females. This finding, along with the higher incidence of TN in females, suggests that smaller posterior fossa volume might be an independent factor in the pathophysiology of TN, which warrants further study.

PMID: 30717058 [PubMed - as supplied by publisher]

Near-infrared fluorescence image-guidance in anastomotic colorectal cancer surgery and its relation to serum markers of anastomotic leakage: a clinical pilot study.

dom, 02/03/2019 - 09:00

Near-infrared fluorescence image-guidance in anastomotic colorectal cancer surgery and its relation to serum markers of anastomotic leakage: a clinical pilot study.

Surg Endosc. 2019 Feb 01;:

Authors: van den Bos J, Jongen ACHM, Melenhorst J, Breukink SO, Lenaerts K, Schols RM, Bouvy ND, Stassen LPS

Abstract
OBJECTIVE: Near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG) might help reduce anastomotic leakage (AL) after colorectal surgery. This pilot study aims to analyze whether a relation exists between measured fluorescence intensity (FI) and postoperative inflammatory markers of AL, C-reactive protein (CRP), Intestinal fatty-acid binding protein (I-FABP), and calprotectin, to AL, in order to evaluate the potential of FI to objectively predict AL.
METHODS: Patients scheduled for anastomotic colorectal cancer surgery were eligible for inclusion in this prospective pilot study. During surgery, at three time points (after bowel devascularization; before actual transection; after completion of anastomosis) a bolus of 0.2 mg/kg ICG was administered intravenously for assessment of bowel perfusion. FI was scored in scale from 1 to 5 based on the operating surgeon's judgment (1 = no fluorescence visible, 5 = maximum fluorescent signal). The complete surgical procedure was digitally recorded. These recordings were used to measure FI postoperatively using OsiriX imaging software. Serum CRP, I-FABP, and calprotectin values were determined before surgery and on day 1, 3, and 5 postoperative; furthermore, the occurrence of AL was recorded.
RESULTS: Thirty patients (n = 19 males; mean age 67 years; mean BMI 27.2) undergoing either laparoscopic or robotic anastomotic colorectal surgery were included. Indication for surgery was rectal-(n = 10), rectosigmoid-(n = 2), sigmoid-(n = 10), or more proximal colon carcinomas (n = 8). Five patients (16.7%) developed AL (n = 2 (6.6%) grade C according to the definition of the International Study group of Rectal Cancer). In patients with AL, the maximum fluorescence score was given less often (P = 0.02) and a lower FI compared to background FI was measured at 1st assessment (P = 0.039). However, no relation between FI and postoperative inflammatory parameters could be found.
CONCLUSION: Both subjective and measured FI seem to be related to AL. In this study, no relation between FI and inflammatory serum markers could yet be found.

PMID: 30710314 [PubMed - as supplied by publisher]

Assessing the fusion of the ischiopubic synchondrosis using predictive modeling.

sex, 02/01/2019 - 08:36
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Assessing the fusion of the ischiopubic synchondrosis using predictive modeling.

Clin Anat. 2019 Jan 30;:

Authors: Gregory LS, Jones LV, Amorosi NM

Abstract
INTRODUCTION: Flaring of the ischiopubic synchondrosis at the time of fusion is a common clinical observation in pediatrics and represents a normal physiological process in skeletal maturation. When presenting unilaterally, this flaring can mimic a range of serious pathological conditions such as osteomyelitis, osteal tumors and traumatic injury. An improved understanding of ischiopubic synchondrosis fusion is therefore critical to avoid potential misdiagnosis.
MATERIALS AND METHODS: Retrospective multi-slice computed tomography pelvic scans of Australian individuals aged neonate to 24 years (n=184) were assessed using a novel five stage morphological classification system of the maturation and fusion of the ischiopubic synchondrosis. Maturation scoring was conducted using both multiplanar formatting views and volume-rendered reconstructions in OsiriXTM .
RESULTS: Maturational stage was strongly related to age (p<0.001) with fusion of the ischiopubic synchondrosis observed between the ages of 4 and 9 years in females and 7 and 13 years for males. The highest probability of fusion in our Queensland Australian population based on multinomial regression predictive modeling was between 7 and 10 years of age. We documented three variants of fusion: pubic and ischial outgrowths, appearance of a secondary ossification center and a fusiform-shaped enlargement.
CONCLUSIONS: This study provides the first predictive modeling of the timing of fusion of the ischiopubic synchondrosis using a reliable morphological classification system. The significant variation in timing and progression of fusion of the ischiopubic synchondrosis reported in this study, will aid in minimizing misdiagnosis and unnecessary treatment in children presenting with asymmetrical or delayed ischiopubic synchondrosis anomalies. This article is protected by copyright. All rights reserved.

PMID: 30701593 [PubMed - as supplied by publisher]

The turricephaly index: A validated method for recording turricephaly and its natural history in Apert syndrome.

dom, 01/27/2019 - 13:38
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The turricephaly index: A validated method for recording turricephaly and its natural history in Apert syndrome.

J Craniomaxillofac Surg. 2018 Dec 25;:

Authors: O'Hara J, Way B, Borghi A, Knoops PGM, Chua D, Hayward RD

Abstract
INTRODUCTION: We present the CT scan-derived turricephaly index (TI) as a quotient of the maximal occipito-frontal length of the skull to the distance from the centre of the sella to the highest point on the vertex as a validated tool for assessing turricephaly and evaluating surgical techniques aimed at reducing it.
MATERIALS AND METHODS: Measurements taken from CTs of non-operated children with Apert syndrome and age-matched controls were analysed using Centricity PACS system (from the lateral scout image) and the thick-sliced Osirix tool. CTs from non-operated children with Apert syndrome were used to investigate the natural history of their turricephaly both as a group and individually.
RESULTS: There was statistically significant agreement between measurements taken from the CT scout and Osirix for 42 control children (R2 = 0.97) and 42 children with Apert syndrome (R2 = 0.98) and between two separate observers. There was a statistically significant difference (p < 0.001) between CT scout-derived TI value between controls (1.73 ± 0.12, range 1.46-1.99) and Apert children (1.42 ± 0.15, range 1.13-1.73). Analysis of 113 CTs of 65 non-operated children with Apert syndrome showed a decrease in turricephaly with age (positive spearman correlation: r = 0.50, p < 0.001). Analysis of 37 CTs of those with multiple (>2) CT's showed a similar decrease in turricephaly in the individual child (p < 0.001).
CONCLUSIONS: TI derived from the CT scout view provides a simple, objective and validated method for assessing turricephaly. We recommend it for monitoring and for the prospective evaluation of reconstructive techniques in children with complex/syndromic craniosynostosis.

PMID: 30683622 [PubMed - as supplied by publisher]

Intracranial volume (ICV) in isolated sagittal craniosynostosis: a retrospective case-matched-control study.

qua, 01/09/2019 - 09:47
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Intracranial volume (ICV) in isolated sagittal craniosynostosis: a retrospective case-matched-control study.

Childs Nerv Syst. 2019 Jan 07;:

Authors: Holland J, Rodrigues D, Mohan S, White N

Abstract
PURPOSE: Children with sagittal craniosynostosis (SC) are at risk of developing raised intracranial pressure (ICP). This is thought to result from cephalocranial disproportion-the restriction of normal cerebral development by a small cranial vault. It remains unclear whether intracranial volume (ICV) is altered in SC. This study offers a novel volumetric analysis of the scaphocephalic skull, comparing supratentorial (ST) volume, infratentorial (IT) volume, and total ICV of patients with sagittal synostosis to normal controls.
METHODS: ICVs of 32 consecutive patients undergoing total calvarial vault remodelling (TCVR) for isolated SC were compared to 32 age- and sex-matched normal controls. ICV was measured with manual techniques on head computerised tomographic (CT) scans using OsiriX software. A paired t test was used to compare data between cases and controls.
RESULTS: Mean total ICV, ST volume and IT volume were larger in SC than in controls, except in females > 6 months of age. There was no statistical significance. Regression analysis demonstrated larger ICVs in diseased children than in controls younger than 10 months, at which age trend lines intersected and the reverse became true for older children. This likely represents an evolving risk of cephalocranial disproportion beyond 10 months of age. The IT/ST volume ratio was conserved in scaphocephaly, and very closely approximated that of controls.
CONCLUSIONS: Sagittal craniosynostosis appears to be associated with a larger cranial vault at less than 10 months and a smaller vault at greater than 10 months, although statistical significance was not achieved.

PMID: 30617577 [PubMed - as supplied by publisher]

Validation of the İşcan method in clinical MSCT scans specific to an Australian population.

dom, 01/06/2019 - 09:15
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Validation of the İşcan method in clinical MSCT scans specific to an Australian population.

Int J Legal Med. 2019 Jan 04;:

Authors: Blaszkowska M, Flavel A, Franklin D

Abstract
The transposition of traditional biological profiling methods to virtual skeletal reconstructions represents a relatively novel practice that is proving to be versatile in a variety of forensic contexts. Widespread acknowledgement of the disadvantages associated with archaeological and/or other non-contemporary skeletal collections has prompted an increase in the use of medical imaging modalities for the purposes of formulating population-specific reference standards used to estimate characteristics such as chronological age. The primary aim of the present study is to statistically evaluate the reproducibility of assessment and thereafter develop age estimation standards based on the morphoscopic evaluation of the fourth right sternal rib following the phase ageing method developed as reported by İşcan et al. (J Forensic Sci 29:1094-1104, 1984, J Forensic Sci 30:853-863, 1985) in clinical multi-slice computed tomography (MSCT) scans. A total of 335 MSCT scans representing Western Australian individuals between 10 and 80 years of age (179 male and 156 female) were retrospectively reconstructed and analysed in OsiriX following the İşcan et al. sex-specific standards (J Forensic Sci 29:1094-1104, 1984, J Forensic Sci 30:853-863, 1985) for the fourth right rib. Regression and transition analyses are employed to generate standards for the estimation of chronological age and modelling of thoracic senescence, respectively. The method was also applied to right ribs three and five to evaluate intercostal variance in age-related metamorphosis. Intra- and inter-observer accordance is 'substantial' (K = 0.76) and 'almost perfect' (K = 0.825), respectively. Intercostal variances between ribs three to five were observed in the male sample only. Multiple regression using phase scores from all three ribs produced models with the highest predictive accuracy (± 10.04 years for males and ± 9.81 years for females). The transition analyses demonstrate comparable levels of age-related morphological change across ribs and male and female samples. This study presents a novel set of reference standards for a contemporary Australian population and further demonstrates the utility of virtual analysis in forensic anthropology.

PMID: 30610446 [PubMed - as supplied by publisher]

Morphometric study of the primary ossification center of the fibular shaft in the human fetus.

sex, 12/14/2018 - 17:35
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Morphometric study of the primary ossification center of the fibular shaft in the human fetus.

Surg Radiol Anat. 2018 Dec 12;:

Authors: Baumgart M, Wiśniewski M, Grzonkowska M, Badura M, Szpinda M, Pawlak-Osińska K

Abstract
PURPOSES: Precise morphometric data on the development of ossification centers in human fetuses may be useful in the early detection of skeletal dysplasias associated with delayed ossification center development and mineralization. The present study was performed to quantitatively examine the primary ossification center of the fibular shaft with respect to its linear, planar and volumetric parameters.
MATERIALS AND METHODS: Using methods of CT, digital-image analysis (Osirix 3.9 MD) and statistics (Student's t-test, Shapiro-Wilk, Fisher's test, Tukey's test, Kruskal-Wallis test, regression analysis), the size of the primary ossification center of the fibular shaft in 47 spontaneously aborted human fetuses (25 ♂ and 22 ♀) aged 17-30 weeks was studied. In each fetus, the assessment of linear dimensions (length, transverse diameters for: proximal end, middle part and distal end), projection surface area and volume of the fibular shaft ossification center was carried out.
RESULTS: With no sex and laterality differences, the best fit growth dynamics for the primary ossification center of the fibular shaft was modelled by the following functions: y = - 13.241 + 1.567 × age ± 1.556 (R2 = 0.94) for its length, y = - 0.091 + 0.063 × age ± 0.073 (R2 = 0.92) for its proximal transverse diameter, y = - 1.201 + 0.717 × ln(age) ± 0.054 (R2 = 0.83) for its middle transverse diameter, y = - 2.956 + 1.532 × ln(age) ± 0.090 (R2 = 0.89) for its distal transverse diameter, y = - 69.038 + 4.699 × age ± 4.055 (R2 = 0.95) for its projection surface area, and y = - 126.374 + 9.462 × age ± 8.845 (R2 = 0.94) for its volume.
CONCLUSIONS: The ossification center in the fibular shaft follows linear functions with respect to its length, proximal transverse diameter, projection surface area and volume, and natural logarithmic functions with respect to its middle and distal transverse diameters. The obtained morphometric data of the fibular shaft ossification center is considered normative for their respective prenatal weeks and may be of relevance in both the estimation of fetal age and the ultrasound diagnostics of congenital defects.

PMID: 30542927 [PubMed - as supplied by publisher]

Analytical quantification of aortic valve 18F-sodium fluoride PET uptake.

sab, 12/01/2018 - 08:45
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Analytical quantification of aortic valve 18F-sodium fluoride PET uptake.

J Nucl Cardiol. 2018 Nov 29;:

Authors: Massera D, Doris MK, Cadet S, Kwiecinski J, Pawade TA, Peeters FECM, Dey D, Newby DE, Dweck MR, Slomka PJ

Abstract
BACKGROUND: Challenges to cardiac PET-CT include patient motion, prolonged image acquisition and a reduction of counts due to gating. We compared two analytical tools, FusionQuant and OsiriX, for quantification of gated cardiac 18F-sodium fluoride (18F-fluoride) PET-CT imaging.
METHODS: Twenty-seven patients with aortic stenosis were included, 15 of whom underwent repeated imaging 4 weeks apart. Agreement between analytical tools and scan-rescan reproducibility was determined using the Bland-Altman method and Lin's concordance correlation coefficients (CCC).
RESULTS: Image analysis was faster with FusionQuant [median time (IQR) 7:10 (6:40-8:20) minutes] compared with OsiriX [8:30 (8:00-10:10) minutes, p = .002]. Agreement of uptake measurements between programs was excellent, CCC = 0.972 (95% CI 0.949-0.995) for mean tissue-to-background ratio (TBRmean) and 0.981 (95% CI 0.965-0.997) for maximum tissue-to-background ratio (TBRmax). Mean noise decreased from 11.7% in the diastolic gate to 6.7% in motion-corrected images (p = .002); SNR increased from 25.41 to 41.13 (p = .0001). Aortic valve scan-rescan reproducibility for TBRmax was improved with FusionQuant using motion correction compared to OsiriX (error ± 36% vs ± 13%, p < .001) while reproducibility for TBRmean was similar (± 10% vs ± 8% p = .252).
CONCLUSION: 18F-fluoride PET quantification with FusionQuant and OsiriX is comparable. FusionQuant with motion correction offers advantages with respect to analysis time and reproducibility of TBRmax values.

PMID: 30499069 [PubMed - as supplied by publisher]

Guideposts for Inserting Intercuneiform Joint Arthrodesis Screws: Analysis Using Multiplanar Reconstructed Computed Tomography.

sex, 11/30/2018 - 14:36
Related Articles

Guideposts for Inserting Intercuneiform Joint Arthrodesis Screws: Analysis Using Multiplanar Reconstructed Computed Tomography.

Foot Ankle Spec. 2018 Nov 28;:1938640018816373

Authors: Maenohara Y, Matsumoto T, Chang SH, Hirose J, Tanaka S

Abstract
Intercuneiform arthrodesis is often required for various midfoot pathologies; however, intercuneiform screw insertion is not easy due to the complicated anatomical structure of cuneiforms. This study aimed to determine the advisable screw entry point and direction using intraoperatively detectable landmarks. The computed tomography (CT) scan data of feet were reformatted using OsiriX software multiplanar reconstruction. First, based on the data of 10 CT scans of normal feet, we determined the advisable screw entry point at the upper one-third in the dorsoplantar direction and center in the anteroposterior direction on the medial aspect of the medial cuneiform and insertion direction toward the outermost point of the base of the fifth metatarsal in the axial plane and parallel to the plantar surface in the coronal plane. Second, we examined the accuracy of these newly designed guideposts in the simulation using other CT scan data of the other 27 normal feet and 12 flat feet. The simulated screw trajectory penetrated the mid three-fifths of all three cuneiforms in 97% of the normal feet and 92% of the flat feet with no cases of cortical wall violation. Levels of Evidence: Level V: Expert opinion.

PMID: 30484327 [PubMed - as supplied by publisher]