Estimation of sex from femoral bone using radiological imaging methods in Turkish population.

Sex estimation is leading to determine the biological profile in forensic medicine. The aim of this study is to research the effectiveness of logistic regression (LogR) and discriminant function analysis (DFA) to create sex estimation models on femur images obtained with Computed Tomography (CT) angiography and to address the differences of femur, which show sexual dimorphism, among populations. All parameters were measured on three planes by adjusting the 300 CT angiography images from 150 women and 150 men that focused on the left femur to the orthogonal plane with standard magnification. The subgroup, which included 30 images randomly generated from these images, was measured twice with an interval of 3 weeks by the first radiologist and once by the second radiologist. According to the Fisher's Linear Discriminant analysis, which was evaluated with ten parameters in the study, it was concluded that the power of discriminating women was 96.7%, the power of discriminating men was 98.7%, and the total discrimination power was 97.7%; these results were 98%, 99.3%, and 98.7%, respectively according to LogR. In this study, DFA and LogR analysis showed that femur provided a very good rate of sexual dimorphism. A database belonging to the Turkish population was created for the femur, allowing for comparison between populations.

Evaluation of congenital rib anomalies with multi-detector computed tomography in the Turkish population.

BACKGROUND: This study aimed to evaluate the congenital anomalies of ribs in the Turkish population using multi-detector computed tomography (CT) and to reveal the prevalence and distribution of these anomalies according to sexes and body sides. MATERIALS AND METHODS: This study included 1120 individuals (592 male, 528 female) over 18 who presented to our hospital with a suspicion of COVID-19 and who had thoracic CT. Anomalies such as a bifid rib, cervical rib, fused rib, Srb anomaly, foramen rib, hypoplastic rib, absent rib, supernumerary rib, pectus carinatum, and pectus excavatum, which were previously defined in the literature, were examined. Descriptive statistics were performed with the distribution of anomalies. Comparisons were made between the sexes and body sides. RESULTS: A prevalence of 18.57% rib variation was observed. Females had 1.3 times more variation than males. Although there was a significant difference in the distribution of anomalies by sex (p = 0.000), there was no difference in terms of body side of anomaly (p > 0.05). The most common anomaly was the hypoplastic rib, followed by the absence of a rib. While the incidence of the hypoplastic rib was similar in females and males, 79.07% of the absent ribs was seen in females (p < 0.05). The study also includes a rare case of bilateral first rib foramen. At the same time, this study includes a rare case of rib spurs extending from the left 11th rib to the 11th intercostal space. CONCLUSIONS: This study demonstrates detailed information about congenital rib anomalies in the Turkish population, which may vary between people. Knowing these anomalies is essential for anatomy, radiology, anthropology, and forensic sciences.

A study on sex estimation by using machine learning algorithms with parameters obtained from computerized tomography images of the cranium.

The aim of this study is to test whether sex prediction can be made by using machine learning algorithms (ML) with parameters taken from computerized tomography (CT) images of cranium and mandible skeleton which are known to be dimorphic. CT images of the cranium skeletons of 150 men and 150 women were included in the study. 25 parameters determined were tested with different ML algorithms. Accuracy (Acc), Specificity (Spe), Sensitivity (Sen), F1 score (F1), Matthews correlation coefficient (Mcc) values were included as performance criteria and Minitab 17 package program was used in descriptive statistical analyses. p ≤ 0.05 value was considered as statistically significant. In ML algorithms, the highest prediction was found with 0.90 Acc, 0.80 Mcc, 0.90 Spe, 0.90 Sen, 0.90 F1 values as a result of LR algorithms. As a result of confusion matrix, it was found that 27 of 30 males and 27 of 30 females were predicted correctly. Acc ratios of other MLs were found to be between 0.81 and 0.88. It has been concluded that the LR algorithm to be applied to the parameters obtained from CT images of the cranium skeleton will predict sex with high accuracy.

A study on the correlation between spleen volume estimated via cavalieri principle on computed tomography images with basic hemogram and biochemical blood parameters.

Considering its hematological and immunological functions, spleen is a very important organ. A change occurs in its size as the spleen performs these functions. This study aims to examine the possible relationships between spleen volume and the basic hemogram and biochemical parameters in serum. Multidetector computed tomography images and basic hemogram and biochemical parameters of 74 adult individuals, 34 male and 40 female, who were found to be healthy, were used in the study. Spleen volume was estimated using the Cavalieri method on multidetector computed tomography images and the correlations between the volume value with basic hemogram and biochemistry parameters were researched. While negative significant correlations were found between the estimated spleen volume and lymphocyte percentage (r=-0.224) and platelet level (r=-0.271); positive significant correlations were found between hemoglobin level (r=0.228), hematocrit level (r=0.237), alanine aminotransferase (r=0.345), and erythrocyte level (r=0.375). As a result of this study, a relationship was found between spleen volume and lymphocyte percentage, hematocrit level, erythrocyte level, platelet level, and alanine aminotransferase level in serum. We believe that the results of the study will provide a larger perspective to clinicians in the diagnosis of diseases associated with spleen.

Comparison of pirfenidone and corticosteroid treatments at the COVID-19 pneumonia with the guide of artificial intelligence supported thoracic computed tomography.

AIM: We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 pneumonia. METHOD: Hospital files of patients hospitalised with a diagnosis of critical COVID-19 pneumonia from November 2020 to March 2021 were retrospectively reviewed. Chest computed tomography images taken both before treatment and 2 months after treatment, demographic characteristics and laboratory parameters of patients receiving pirfenidone + methylprednisolone (n = 13) and only methylprednisolones (n = 9) were recorded. Pulmonary function tests were performed after the second month of the treatment. CT involvement rates were determined by machine learning. RESULTS: A total of 22 patients, 13 of whom (59.1%) were using methylprednisolone + pirfenidone and 9 of whom (40.9%) were using only methylprednisolone were included. When the blood gas parameters and pulmonary function tests of the patients were compared at the end of the second month, it was found that the FEV1, FEV1%, FVC and FVC% values were statistically significantly higher in the methylprednisolone + pirfenidone group compared with the methylprednisolone group (P = .025, P = .012, P = .026 and P = .017, respectively). When the rates of change in CT scans at diagnosis and second month of treatment were examined, it was found that the involvement rates in the methylprednisolone + pirfenidone group were statistically significantly decreased (P < .001). CONCLUSION: Antifibrotic agents can reduce fibrosis that may develop in the future. These can also help dose reduction and/or non-use strategy for methylprednisolone therapy, which has many side effects. Further large series and randomised controlled studies are needed on this subject.

Popliteal Artery Branching Variations: A Study on Multidetector CT Angiography.

Determining the branching pattern of the popliteal artery (PA) is an important step in planning some radiological and surgical procedures. The aim of this study was to investigate the course and morphology of the terminal branches of the popliteal artery using multidetector computed tomography (MDCT) angiography, and also to determine possible role gender in branching pattern. Three-hundred forty lower extremity MDCT angiography images for 170 patients (118 M, 52 F), who were between 20-80 years old, were examined. Popliteal artery branching types were grouped as percentage incidences. TPT diameters and lengths in Type IA extremities were compared based on gender and right or left side. Anterior tibial artery (ATA), posterior tibial artery (PTA) and peroneal artery dominance rates were calculated. 5000 times measurement data was mixed so that the cascade mean filter values were calculated for the right and left TPT length each time. It was observed that Type IA was the most common branching pattern (89.4%). The variational pattern incidence was 10.6% and the most common category was Type III (4.1%). The most common pattern was Type IB (3.2%). Variational pattern was 2 times more prevalent in females when compared to the males. The mean TPT diameter was 4.5 mm (2.7-7.3 mm) and there was no difference based on gender and the right-left side. The most common dominant artery for the right and left legs was PTA in both genders. The cut-off values calculated for the right and left TPT independent of gender were 31.30 ± 2.40 and 28.36 ± 2.58, respectively. Three new subtypes were identified as short (S ≤ 2 cm), standard (N = 2-4 cm) and long (L ≥ 4 cm) in Type IA, since it is in a wide variational range although it is a typical PA branching pattern.

The Relationship Between Trunk Muscle Thickness and Static Postural Balance in Older Adults.

Trunk muscles are required for safety of movement in aging. The authors aimed to investigate the relationship between trunk muscle thickness and the static postural balance in older adults. A total of 31 females and 23 males with a mean age of 73.39 ± 6.09 completed the study. The thickness of the trunk muscles was determined with ultrasound imaging. Postural balance was assessed with force plate. There was a positive weak correlation between right and left upper rectus abdominis muscle thickness and anterior stability area (p < .05, r > .3). The negative and moderate correlation was determined between the left lower rectus abdominis and the perturbated stability sway value (p < .01, r > .5). The increase in trunk muscle thickness in older adults increases the postural stability area and decreases the postural sway especially in the mediolateral direction.

A trial on artificial neural networks in predicting sex through bone length measurements on the first and fifth phalanges and metatarsals.

BACKGROUND: Predicting sex is an important problem in forensic medicine. The femur, patella, mandible and calcaneus bones are frequently used in predicting sex. In our study, we aimed to use the artificial neural network (ANN) technique to predict sex by measuring the values of the phalanges of the first and fifth toes and the first and fifth metatarsal bones. METHOD: All bone measurements were conducted on the direct X-ray images of 176 males and 178 females in the age range of 24-60 years. The multilayer perceptron classifier (MLPC) input layer included parameters on the bone length measurements of phalanx proximalis I, phalanx distalis I, metatarsal I, phalanx proximalis V, phalanx medialis V, phalanx distalis V and metatarsal V. The output layer contained two neurons to define the male and female sexes. The present study used an MLPC model that had two hidden layers, and the first and second hidden layers contained 14 and 7 nodes, respectively. RESULTS: The model had an overall accuracy (Acc) of 0.95, specificity (Spe) of 0.97, sensitivity (Sen) of 0.95 and Matthews correlation coefficient (Mcc) of 0.92. While the sex prediction success of our proposed model was higher in women, the results were more specific in men and more sensitive in women (AccMale = 0.93, AccFemale = 0.98, SenMale = 0.93, SpeMale = 0.98, SenFemale = 0.98 and SpeFemale = 0.93). CONCLUSIONS: This study demonstrated that the ANN model for length measurements on small bones is a highly effective instrument for sex prediction.

Sex estimation using sternum part lenghts by means of artificial neural networks.

In addition to the pelvis, cranium and phalanges, the sternum is also used for postmortem sex identification. Bone measurements may be obtained on cadaveric bones. Alternatively, computerized tomography may be used to obtain measurements close to the original ones. Moreover, usage of artificial neural networks (ANNs) in the field of medicine has started to provide new horizons. In this study, we aimed to identify sex by an ANN using lengths of manubrium sterni (MSL), corpus sterni (CSL) and processus xiphoideus (XPL) and sternal angle (SA) from computerized tomography (CT) images brought to an orthogonal plane. This study used the thin-slice thoracic CT images of 422 cases (213 female, 209 male) with an age range of 27-60 years brought to the orthogonal plane. Measurements of MSL, CSL, XPL and SA were analyzed with a multilayer artificial neural network that used stochastic gradient descent (SGD) for optimization and two hidden layers. MSL, CSL and XPL were longer, and SA was wider in men (MSL p = 0.000, CSL p = 0.000, XPL p = 0.000, SA p = 0.02). In the case of the two hidden layers of the network with 20 and 14 neurons in the hidden layers, respectively, learning rate of 0.1 and momentum coefficient of 0.9, the accuracy (Acc) of sex prediction was 0.906. In order to define a more realistic performance of the network, bootstrap was run with the confidence interval of 94%. A sensitivity (Sen) value of 0.91 and a specificity (Spe) value of 0.90 were calculated. The success rates that were achieved in sex identification with measurements on the skeleton using ANN were observed to be higher than those achieved by linear models. Also, sometimes all parts of the bones may not be found or might be deformed. In this case, the number of parameters used for the estimation will be incomplete. The ANN has the strong advantage to be able to estimate despite the missing parameter.

Evaluation of superior concha bullosa by computed tomography.

OBJECTIVE: Concha bullosa is generally regarded as pneumatisation of the middle turbinate in the nose. However, pneumatisation may also be seen in the superior and inferior turbinate. Computed tomography (CT) of paranasal sinuses is extremely helpful for the examination of this inaccessible area. Coronal CT sections of paranasal sinuses are particularly useful for surgical anatomy, as these images show nearly the same regions as the endoscopic examinations. The aim of this retrospective study was to evaluate the presence, incidence and unilaterality-bilaterality of superior turbinate pneumatisation and concomitant nasal pathologies. METHODS: A total of 1000 patients who underwent CT of the paranasal sinuses because of headaches, nasal obstructions, anosmia, facial pain or facial trauma were evaluated retrospectively. RESULTS: Among the 1000 patients, superior pneumatized turbinate was seen on CT images of the paranasal sinuses in 149 (14.9%) cases. Of these patients, 84 were female, 65 were male, and the mean age was 38.14 years. Among 149 patients, 58 patients had bilateral superior pneumatized turbinate and the remaining 91 patients had unilateral superior pneumatized turbinate. 60.4% of the patients with superior pneumatized turbinate also had middle pneumatized turbinate. CONCLUSION: The superior pneumatized turbinate is an anatomical variation with an incidence ranging from 12.2 to 50%. The present study revealed that there is no relationship between volume size of the superior pneumatized turbinates and sinusitis, nasal septum deviation and paradoxical middle concha. It is very important to define anatomical variations in the preoperative CT evaluation of the paranasal sinuses.

Cerebrospinal Fluid Dynamics in Patients with Multiple Sclerosis: The Role of Phase-Contrast MRI in the Differential Diagnosis of Active and Chronic Disease.

Objective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI). Materials and Methods: We studied 16 MS patients with chronic plaques (group 1), 16 MS patients with active plaques-enhanced on MRI (group 2), and 16 healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed from the level of the cerebral aqueduct by PC-MRI. According to heart rates, 14-30 images were obtained in a cardiac cycle. Cardiac triggering was performed prospectively using finger plethysmography. Results: No statistically significant difference was found between the groups regarding average velocity, net forward volume and the average flow (p > 0.05). Compared with the controls, group 1 and group 2, showed a higher peak velocity (5.5 ± 1.4, 4.9 ± 1.0, and 4.3 ± 1.3 cm/sec, respectively; p = 0.040), aqueductal area (5.0 ± 1.3, 4.1 ± 1.5, and 3.1 ± 1.2 mm2, respectively; p = 0.002), forward volume (0.039 ± 0.016, 0.031 ± 0.013, and 0.021 ± 0.010 mL, respectively; p = 0.002) and reverse volume (0.027 ± 0.016, 0.018 ± 0.009, and 0.012 ± 0.006 mL, respectively; p = 0.000). There were no statistical significance between the MS patients with chronic plaques and active plaques except for reverse volume. The MS patients with chronic plaques showed a significantly higher reverse volume (p = 0.000). Conclusion: This study indicated that CSF flow is affected in MS patients, contrary to the hypothesis that CCSVI-induced CSF flow decreases in MS patients. These findings may be explained by atrophy-dependent ventricular dilatation, which may occur at every stage of MS.

The right vertebral artery originating from the right occipital artery and the absence of the transverse foramen: a rare anatomical variation.

Variations in the origin of the vertebral artery (VA) is a congenital anomaly that occurs during embryological development. Multiple variations related to VA origin have been reported in the literature. Abnormal VA origin is usually determined as incidental findings during angiographic or postmortem anatomical studies. Although most of the cases are asymptomatic, in patients with VA anomaly symptoms such as dizziness have been described. The anomalous variation in the origin of the right VA is rare and separated into three categories: (1) originating from the aorta, (2) originating from the carotid arteries, (3) duplicated origin. In this case, we aimed to present the right VA originating from the right occipital artery and concomitant anomalies of the transverse foramen that have not been reported previously according to our knowledge in literature. In a 32-year-old female patient referred to our hospital because of dizziness, the right VA was not observed on magnetic resonance imaging and computed tomography angiography (CTA) examination was performed. CTA showed hypoplasia of the right transverse foramen at the levels of the C1, C5 and C6 vertebrae and aplasia of the right transverse foramen at the levels of the C2, C3 and C4 vertebrae. The right VA originating from the right occipital artery continues to its normal course by entering the cranium through the foramen magnum at the level of the atlantooccipital junction.

Quantitative Evaluation of Normal Aqueductal Cerebrospinal Fluid Flow Using Phase-Contrast Cine MRI According to Age and Sex.

The aim of this study was cerebrospinal fluid (CSF) flow quantification in the cerebral aqueduct using phase-contrast cine magnetic resonance imaging (PCC-MRI) according to both sexes and three different age groups to obtain normative data. Seventy two volunteers with no cerebral pathology were included in this study. Subjects were divided into three age groups: 20-34 years, 35-49 years, and 50-65 years including equal gender groups. CSF flow's quantitatively evaluation was performed with images that were obtained by 1.5 T Magnetic Resonance (MR) unit from cerebral aqueduct level on the semi-axial plan. Between groups, peak velocity (cm sec-1 ), average velocity (cm/s), forward volume (mL), reverse volume (mL), net forward volume (mL), and average flow over range (ml/min) values of current flowing through aqueduct and average aqueductal areas were compared. There were no statistically significant differences in CSF flow parameters among different age groups and between sexes (P > 0.05). There was a statistically significant difference in average cerebral aqueduct area between the age group of 50-65 years and the other age groups (P = 0.002). The average aqueductal area was higher in the age group of 50-65 years. Normal aqueductal CSF flow parameters evaluated with PCC-MRI don't show a significant difference by age and sex. We have achieved the lower and upper values of these parameters would be useful in future clinical studies. The size of aqueductal area may also be explained by atrophy-dependent ventricular system dilatation in the elderly. Anat Rec, 300:549-555, 2017. © 2016 Wiley Periodicals, Inc.