Impact of ultra-high-resolution imaging of the lungs on perceived diagnostic image quality using photon-counting CT.

OBJECTIVES: To compare clinical image quality and perceived impact on diagnostic interpretation of chest CT findings between ultra-high-resolution photon-counting CT (UHR-PCCT) and conventional high-resolution energy-integrating-detector CT (HR-EIDCT) using visual grading analysis (VGA) scores. MATERIALS AND METHODS: Fifty patients who underwent a UHR-PCCT (matrix 512 × 512, 768 × 768, or 1024 × 1024; FOV average 275 × 376 mm, 120 × 0.2 mm; focal spot size 0.6 × 0.7 mm) between November 2021 and February 2022 and with a previous HR-EIDCT within the last 14 months were included. Four readers evaluated central and peripheral airways, lung vasculature, nodules, ground glass opacities, inter- and intralobular lines, emphysema, fissures, bullae/cysts, and air trapping on PCCT (0.4 mm) and conventional EIDCT (1 mm) via side-by-side reference scoring using a 5-point diagnostic quality score. The median VGA scores were compared and tested using one-sample Wilcoxon signed rank tests with hypothesized median values of 0 (same visibility) and 2 (better visibility on PCCT with impact on diagnostic interpretation) at a 2.5% significance level. RESULTS: Almost all lung structures had significantly better visibility on PCCT compared to EIDCT (p < 0.025; exception for ground glass nodules (N = 2/50 patients, p = 0.157)), with the highest scores seen for peripheral airways, micronodules, inter- and intralobular lines, and centrilobular emphysema (mean VGA > 1). Although better visibility, a perceived difference in diagnostic interpretation could not be demonstrated, since the median VGA was significantly different from 2. CONCLUSION: UHR-PCCT showed superior visibility compared to HR-EIDCT for central and peripheral airways, lung vasculature, fissures, ground glass opacities, macro- and micronodules, inter- and intralobular lines, paraseptal and centrilobular emphysema, bullae/cysts, and air trapping. CLINICAL RELEVANCE STATEMENT: UHR-PCCT has emerged as a promising technique for thoracic imaging, offering improved spatial resolution and lower radiation dose. Implementing PCCT into daily practice may allow better visibility of multiple lung structures and optimization of scan protocols for specific pathology. KEY POINTS: • The aim of this study was to verify if the higher spatial resolution of UHR-PCCT would improve the visibility and detection of certain lung structures and abnormalities. • UHR-PCCT was judged to have superior clinical image quality compared to conventional HR-EIDCT in the evaluation of the lungs. UHR-PCCT showed better visibility for almost all tested lung structures (except for ground glass nodules). • Despite superior image quality, the readers perceived no significant impact on the diagnostic interpretation of the studied lung structures and abnormalities.

Diagnostic accuracy of an artificial intelligence algorithm versus radiologists for fracture detection on cervical spine CT.

OBJECTIVES: To compare diagnostic accuracy of a deep learning artificial intelligence (AI) for cervical spine (C-spine) fracture detection on CT to attending radiologists and assess which undetected fractures were injuries in need of stabilising therapy (IST). METHODS: This single-centre, retrospective diagnostic accuracy study included consecutive patients (age ≥18 years; 2007-2014) screened for C-spine fractures with CT. To validate ground truth, one radiologist and three neurosurgeons independently examined scans positive for fracture. Negative scans were followed up until 2022 through patient files and two radiologists reviewed negative scans that were flagged positive by AI. The neurosurgeons determined which fractures were ISTs. Diagnostic accuracy of AI and attending radiologists (index tests) were compared using McNemar. RESULTS: Of the 2368 scans (median age, 48, interquartile range 30-65; 1441 men) analysed, 221 (9.3%) scans contained C-spine fractures with 133 IST. AI detected 158/221 scans with fractures (sensitivity 71.5%, 95% CI 65.5-77.4%) and 2118/2147 scans without fractures (specificity 98.6%, 95% CI 98.2-99.1). In comparison, attending radiologists detected 195/221 scans with fractures (sensitivity 88.2%, 95% CI 84.0-92.5%, p < 0.001) and 2130/2147 scans without fracture (specificity 99.2%, 95% CI 98.8-99.6, p = 0.07). Of the fractures undetected by AI 30/63 were ISTs versus 4/26 for radiologists. AI detected 22/26 fractures undetected by the radiologists, including 3/4 undetected ISTs. CONCLUSION: Compared to attending radiologists, the artificial intelligence has a lower sensitivity and a higher miss rate of fractures in need of stabilising therapy; however, it detected most fractures undetected by the radiologists, including fractures in need of stabilising therapy. Clinical relevance statement The artificial intelligence algorithm missed more cervical spine fractures on CT than attending radiologists, but detected 84.6% of fractures undetected by radiologists, including fractures in need of stabilising therapy. KEY POINTS: The impact of artificial intelligence for cervical spine fracture detection on CT on fracture management is unknown. The algorithm detected less fractures than attending radiologists, but detected most fractures undetected by the radiologists including almost all in need of stabilising therapy. The artificial intelligence algorithm shows potential as a concurrent reader.

Accuracy of sex estimation by morphometric evaluation of foramen magnum using computed tomography - a systematic review and meta-analysis.

The objective of this study is to determine whether the morphometric evaluation of the foramen magnum using computed tomography can be used as an accurate tool in estimating the sex of an individual. An extensive search of the databases, PubMed, ProQuest, Google Scholar, and Scopus, was carried out to procure articles that fulfilled the inclusion criteria. The AQUA tool was used to assess the quality of the included studies. A random effects model was used for the meta-analysis of the eligible studies using the STATA software, version 16, 2019 at 95% CI and p ≤ 0.05. Eleven eligible articles that measured the transverse and sagittal diameters of the foramen magnum using computed tomography were included in this study. The sagittal diameter of the foramen magnum was greater than the transverse diameter, and both the diameters were greater in males than in females. Meta-analysis revealed that both transverse and sagittal diameters were more reliable for male sex estimation. Since there is a dimensional variation between the male and female foramen magnum, it can be used for initial sex identification and also as an auxiliary to other advanced methods of sex estimation.

Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT.

AIM AND BACKGROUND: To compare the root canal volume in primary teeth using hand and rotary instruments and to evaluate root canal filling techniques and flow of root canal obturation materials in the postinstrumented root canal volume using spiral computed tomography (SCT). MATERIALS AND METHODS: Freshly extracted 16 primary molars were randomly divided into two groups and subjected to SCT analysis before and after instrumentation. For the manual technique (group I) with eight teeth were prepared using K files, and rotary (group II) eight teeth preparation was performed with ProTaper files. The filled volume in each canal was measured using SCT, and the percentage of obturated volume was calculated. The data were statistically analyzed using the Mann-Whitney U test. RESULTS: There was a statistically significant difference in both groups' volume of root canals enlarged. Even though both K files and the ProTaper system brought about enlarged canals after instrumentation, there was a statistically significant increase in volume after using K files in two canals. In three canals, there was a statistically significant increase in volume after using ProTaper. Irrespective of the obturation technique and materials used, there is no statistically significant difference in the volume after obturation. CONCLUSION: From the results of this study, the ProTaper file system shows suitable volumetric enlargement up to an optimum level, which is needed in primary root canal walls, and is better in canal shaping, as evidenced by good postobturation volume. CLINICAL SIGNIFICANCE: The traditional method of cleaning and shaping the root canals in permanent teeth using manual stainless-steel files can lead to undesirable curvatures in root canal morphology, making correctly filling the root canals difficult. It is also time-consuming and sometimes leads to iatrogenic errors. Rotary nickel-titanium (Ni-Ti) instrumentation techniques have been developed to overcome these problems. How to cite this article: Yadav DBUC, Varma RB, Kumar JS, et al. Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT. J Contemp Dent Pract 2024;25(3):250-259.

Imaging-based diagnosis and classification of radioactive iodine-induced sialadenitis.

OBJECTIVES: To establish an inflammation grading system for radioactive iodine-induced sialadenitis (RAIS) based on spiral computed tomography (CT), ultrasonography and sialography. METHODS: In all, 120 RAIS patients (18 males and 102 females) were retrospectively included. Spiral CT, ultrasonography and sialography appearances were analysed and categorized as follows: grade I, approximately normal or mild sialadenitis; grade II, moderate sialadenitis; and grade III, severe sialadenitis. Adenitis severity was analysed relative to sex, age, RAI treatment sessions and cumulative doses. RESULTS: Spiral CT showed heterogeneous (78.9%) and atrophic changes (36.8%) in the parotid glands (PGs) and duct ectasia (24.8%) in the submandibular glands (SMGs). Ultrasonography showed heterogeneous echogenicity (54.3%) and diminished gland size (30.2%) in PGs and duct ectasia in SMGs (34.7%). Sialography showed duct obliteration in 25.3% PGs and 3.2% SMGs. Statistical analysis showed good consistency among the three imaging grading results. The incidence and severity of PG lesions were significantly higher than that of SMGs (p < 0.001). As for PGs, adenitis severity was associated with both treatment sessions and cumulative doses; but in SMGs, disease severity was only related to treatment sessions. CONCLUSIONS: A grading system for severity of RAIS was established based on spiral CT, ultrasonography and sialography appearances.

Detection of pulmonary nodules with scoutless fixed-dose ultra-low-dose CT: a prospective study.

OBJECTIVES: To determine the accuracy of scoutless, fixed-dose ultra-low-dose (ULD) CT compared to standard-dose (SD) CT for pulmonary nodule detection and semi-automated nodule measurement, across different patient sizes. METHODS: Sixty-three patients underwent ULD and SD CT. Two readers examined all studies visually and with computer-aided detection (CAD). Nodules detected on SD CT were included in the reference standard by consensus and stratified into 4 categories (nodule category, NODCAT) from the Dutch-Belgian Lung Cancer Screening trial (NELSON). Effects of NODCAT and patient size on nodule detection were determined. For each nodule, volume and diameter were compared between both scans. RESULTS: The reference standard comprised 173 nodules. For both readers, detection rates on ULD versus SD CT were not significantly different for NODCAT 3 and 4 nodules > 50 mm3 (reader 1: 93% versus 89% (p = 0.257); reader 2: 96% versus 98% (p = 0.317)). For NODCAT 1 and 2 nodules < 50 mm3, detection rates on ULD versus SD CT dropped significantly (reader 1: 66% versus 80% (p = 0.023); reader 2: 77% versus 87% (p = 0.039)). Body mass index and chest circumference did not influence nodule detectability (p = 0.229 and p = 0.362, respectively). Calculated volumes and diameters were smaller on ULD CT (p < 0.0001), without altering NODCAT (84% agreement). CONCLUSIONS: Scoutless ULD CT reliably detects solid lung nodules with a clinically relevant volume (> 50 mm3) in lung cancer screening, irrespective of patient size. Since detection rates were lower compared to SD CT for nodules < 50 mm3, its use for lung metastasis detection should be considered on a case-by-case basis. KEY POINTS: • Detection rates of pulmonary nodules > 50 mm3are not significantly different between scoutless ULD and SD CT (i.e. volumes clinically relevant in lung cancer screening based on the NELSON trial), but were different for the detection of nodules < 50 mm3(i.e. volumes still potentially relevant in lung metastasis screening). • Calculated nodule volumes were on average 0.03 mL or 9% smaller on ULD CT, which is below the 20-25% interscan variability previously reported with software-based volumetry. • Even though a scoutless, fixed-dose ULD CT protocol was used (CTDIvol0.15 mGy), pulmonary nodule detection was not influenced by patient size.

Objective analysis of the effectiveness of facial massage using breakthrough computed tomographic technology: A preliminary pilot study.

BACKGROUND: Facial massage is empirically known to be associated with morphological changes, such as improvements in facial sagging. However, quantified objective evaluations of massage-induced changes have not been performed to date. This preliminary pilot study aimed to verify the effectiveness of facial massages by using breakthrough computed tomographic technology. MATERIALS AND METHODS: Five healthy adult volunteers (three women and two men; age, 29-37 years) were enrolled, and computed tomography (CT) examinations using a 320 detectors-spiral CT system known as 320-multidetector-row CT (MDCT) were performed before and after facial massages. Each participant performed a self-massage twice daily for 2 weeks. Massage-induced changes in the cheeks and the superficial musculoaponeurotic system (SMAS) were analyzed by two radiologists on a workstation with a high-accuracy imaging analysis system. RESULTS: After facial massage, the malar top became thinner by -0.8% ± 0.45% and shifted cranially and horizontally over a distance of 3.9 ± 1.94 mm. The SMAS-height, defined as the highest vertical distance of the SMAS, increased by 2.6% ± 2.6%. The change rate in cheek thickness and SMAS-height showed a significant correlation (r = -0.63; P < 0.05). These changes were attributed to the lifting and tightening effects of facial massage. CONCLUSION: We conducted a detailed analysis of the effects of facial massages by using the breakthrough CT technology. Our results provide useful information for beauty treatments and could contribute to the collection of objective scientific evidence for facial massages.

Relationship between the Height of Alveolar Bone Resorption and Sex and Age in Adolescents.

OBJECTIVES: To explore the relationship between the height of alveolar bone resorption and sex and age in the adolescent dentition. METHODS: Multi-slice computed tomography (MSCT) was used to measure the height of alveolar bone resorption at labial, lingual, mesial and distal sites of teeth in 149 adolescents aged from 10 to 20 years. SPSS 25.0 software was used to analyze the relationship between the height of alveolar bone resorption and sex and age. RESULTS: There was no significant difference in the height of alveolar bone resorption between sex (P>0.05). The height of alveolar bone resorption was positively correlated with age in all types of teeth. The model constructed by combining the alveolar bone resorption height data of four sites (y=2.569x1+3.106x2+4.108x3+1.451x4-0.082, R2max=0.756)had a better ability to infer age than that of combining two sites (y=5.942x1+4.489x2+0.612, R2max=0.706) and a single site (R2max=0.638). CONCLUSIONS: The height of alveolar bone resorption is positively correlated with the age of adolescents. The combination of four sites has a stronger ability to infer the relationship between the height of alveolar bone resorption and age in adolescents and has higher accuracy in practical application.

[Analysis of lung cancer screening through low-dose spiral computed tomography among petroleum company staffs in Sichuan-Chongqing Area in 2020].

Objective: To provide scientific evidence for early lung cancer screening, to analyze the incidence of pulmonary nodules among petroleum company staffs in Sichuan-Chongqing Area. Methods: In January 2021 , 6002 petroleum company staffs in Sichuan-Chongqing Area which scanned by low-dose spiral computed tomography (LDCT) of chest in medical examination center in 2020 were retrospectively collected as objects. Their imaging and clinical data were collected. χ(2) test was used to analyze the differences in the detection rates of lung nodules and suspected lung cancer nodules among workers in petroleum company staffs of different genders, ages and types of work. Results: Among the 6002 objects, 3853 (64.2%) were male and 2149 (35.8%) were female, with an average age of (47.25±12.13) years old. A total of 431 cases (7.2%) of pulmonary nodules and 57 cases (0.9%) of suspected lung cancer nodules were detected. 45 cases were followed up with surgical treatment, and 41 cases (91.1%) of lung cancer were diagnosed by postoperative pathology. There were significant differences in the detection rates of pulmonary nodules and suspected lung cancer nodules between different age groups (χ(2)=51.23, 18.81 , P<0.001). The detection rates of pulmonary nodules in the age groups 51-60 years old and ≥61 years old were higher than those in the age groups≤40 years old and 41-50 years old (P<0.05). The detection rate of suspected lung cancer nodules in the age group≥ 61 years old was higher than those in the age groups≤40 years old, 41-50 years old and 51-60 years old (P< 0.05) . And the detection rate of suspected lung cancer pulmonary nodules in oil workers was higher than that of ordinary workers (P<0.05) . Among female objects, the detection rate of pulmonary nodules in oil workers was higher than that in ordinary workers (χ(2)=8.09, P=0.004) . The detection rate of pulmonary nodules in oil workers aged ≥61 years old was higher than ordinary workers (χ(2)=37.94, P<0.001) . Among male objects, the detection rate of suspected lung cancer pulmonary nodules in oil workers was higher than that in ordinary workers (χ(2)=8.42, P=0.004) . The detection rates of suspected lung cancer pulmonary nodules in oil workers aged 51-60 years old and ≥61 years old groups were higher than those of ordinary workers (χ(2)=4.70, 8.74; P=0.030, 0.003) . Conclusion: LDCT is suitable for early lung cancer screening for petroleum company staffs. During the clinical screening process, LDCT should be used as a routine physical examination item for petroleum workers older than 51 years old.

Seven tumor-associated autoantibodies as a serum biomarker for primary screening of early-stage non-small cell lung cancer.

OBJECTIVE: The purpose of this study was to analyze the levels of tumor-associated autoantibodies (TAAbs) in lung diseases and determine their diagnostic efficiency in early-stage non-small cell lung cancer (NSCLC). METHODS: We retrospectively analyzed the levels of 7-TAAbs in 177 newly diagnosed early-stage NSCLC patients, 202 patients with lung benign diseases and 137 healthy cases. The levels of a panel of 7-TAAbs, including p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, GBU4-5, were measured by ELISA. RESULTS: The serum levels of p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, and GBU4-5 were not statistically different among NSCLC, benign and healthy groups (p > 0.05). The area under the curve (AUC) of 7-TAAbs was all lower than 0.70. The sensitivity of combined detection was the highest (23.73%), while the specificity was the lowest (88.79%). The positive rates of PGP9.5, SOX2, and combined detection were significantly different among the three groups (p < 0.05). Among them, PGP9.5 and combined detection were significantly different between the NSCLC and benign groups (p < 0.05), PGP9.5, SOX2 and combined detection were significantly different between the NSCLC and healthy groups (p < 0.05). CONCLUSIONS: The diagnostic efficiency of 7-TAAbs in early-stage NSCLC was not high, so it cannot be used alone as a screening method for NSCLC.

Multi-Dimension and Multi-Feature Hybrid Learning Network for Classifying the Sub Pathological Type of Lung Nodules through LDCT.

In order to develop appropriate treatment and rehabilitation plans with regard to different subpathological types (PILs and IAs) of lung nodules, it is important to diagnose them through low-dose spiral computed tomography (LDCT) during routine screening before surgery. Based on the characteristics of different subpathological lung nodules expressed from LDCT images, we propose a multi-dimension and multi-feature hybrid learning neural network in this paper. Our network consists of a 2D network part and a 3D network part. The feature vectors extracted from the 2D network and 3D network are further learned by XGBoost. Through this formation, the network can better integrate the feature information from the 2D and 3D networks. The main learning block of the network is a residual block combined with attention mechanism. This learning block enables the network to learn better from multiple features and pay more attention to the key feature map among all the feature maps in different channels. We conduct experiments on our dataset collected from a cooperating hospital. The results show that the accuracy, sensitivity and specificity of our network are 83%, 86%, 80%, respectively It is feasible to use this network to classify the subpathological type of lung nodule through routine screening.

Diagnostic performance of imaging for the detection of peritoneal metastases: a meta-analysis.

PURPOSE: Detection of peritoneal metastases (PM) is key in the staging and management of gastrointestinal and ovarian cancer patients. The purpose of this meta-analysis was to determine the diagnostic performance of CT, PET(CT), and (DW)MRI in detecting PM. METHODS: A literature search in Pubmed, Embase (Ovid), and Scopus was performed (January 1997-May 2018) to identify studies reporting on the accuracy of imaging PM in the diagnostic workup of gastrointestinal or ovarian cancers. Inclusion criteria were region-based or patient-based studies comprising > 15 patients, surgery/histology/radiological follow-up as a reference standard, and sufficient data to construct a 2 × 2 contingency table. Two observers performed data extraction. The sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated using a bivariate random-effects model and hierarchical summary operating curves (HSROC) were generated. RESULTS: Of 3457 citations retrieved, twenty-four articles met all inclusion criteria. Thirty-seven datasets could be extracted for analysis including 20 for CT, 10 for PET(CT), and 7 for (DW)MRI. The pooled sensitivity, specificity, and DOR for the detection of PM for region-based studies for CT were 68% (CI, 46-84%), 88%(CI, 81-93%), and 15.9 (CI, 4.4-58.0) respectively; 80% (CI, 57-92%), 90% (CI, 80-96%), and 36.5 (CI, 6.7-199.5) for PET(CT), respectively; 92% (CI, 84-96%), 85% (CI, 78-91%), 63.3 (CI, 31.5-127.3) for (DW)MRI. In the patient-based group, not enough studies were included to make a pooled analysis for (DW)MRI and PET(CT). CONCLUSION: (DW)MRI and PET(CT) showed comparable diagnostic performance for the detection of peritoneal metastases in ovarian and gastrointestinal cancer patients. Since MRI is more widely available than PET(CT) in clinical practice, this potentially is the imaging method of choice in most centers in the future. KEY POINTS: • Detection of peritoneal metastases plays an important role in the accurate staging of cancer patients, however, there is no accepted reference standard for the imaging of peritoneal metastases • This meta-analysis shows that (DW)MRI provided the highest sensitivity for the detection of peritoneal metastases in ovarian and gastrointestinal cancer patients • Although (DW)MRI and PET(CT) show a comparable overall diagnostic performance, (DW)MRI seems to be the imaging method of choice since it is more available in daily practice than PET(CT).

Diagnostic Performance of Dual-Layer Computed Tomography for Deep Vein Thrombosis in Indirect Computed Tomography Venography.

BACKGROUND: The aim of this study was to evaluate the quality and diagnostic performance of virtual monochromatic images (VMI) obtained with dual-layer dual-energy computed tomography (DL-DECT) during indirect CT venography (CTV) for deep vein thrombosis (DVT).Methods and Results:This retrospective study was approved by the Institutional Review Board, which waived the requirement for informed consent. We retrospectively enrolled 45 patients who underwent CTV with DL-DECT, and VMI were retrospectively generated. We compared the venous attenuation, noise, contrast, and contrast-to-noise ratio (CNR) between VMI with the highest CNR and conventional CT on paired t-test. Furthermore, we compared the pooled area under the curve (AUC) of each technique with Delong's test in 34 patients who underwent color Doppler ultrasonography. The 40-keV VMI had the best CNR. The noise was significantly lower on 40-keV (9.7±2.5 HU) than on 120-kVp VMI (10.5±2.5 HU; P<0.01). The contrast (120 kVp, 38.2±15.3 HU vs. 40 keV, 131.6±43.6 HU) and CNR (120 kVp, 3.8±1.7 vs. 40 keV, 14.4±6.1) were significantly higher in 40-keV VMI than in 120-kVp VMI (P<0.01). Furthermore, the pooled AUC was significantly higher for 40-keV (0.84) than for 120-kVp VMI (0.78; P=0.03). CONCLUSIONS: In indirect CTV, 40-keV VMI obtained with DL-DECT offers better image quality and diagnostic performance for DVT than conventional CT.

Value of multi-slice spiral computed tomography for diagnosis of tracheobronchial foreign body aspiration in children: 5-year retrospective study.

BACKGROUND: Tracheobronchial foreign body (TFB) aspiration is a significant cause of respiratory problems in children. The timely diagnosis of TFB is important to decrease the mortality rate and the incidence of complications. Advances in radiology have led multi-slice spiral computed tomography (MSCT) to become the best technique for diagnosing TFB. METHODS: We performed a retrospective study over 5 years from July 2008 to June 2013. We collected information on children who were diagnosed with a TFB by bronchoscopy, and analyzed age, sex, location, type of foreign body, and various MSCT manifestations. RESULTS: A total of 382 children were included and 68.6% of them were aged 1 to <2 years. The majority (95.8%) of aspirated foreign bodies were vegetation items, and nearly half (47.6%) of them were peanut kernels, followed by sunflower seeds (26.2%). A total of 4.7% of TFBs were in the trachea, 51.0% were in the left main bronchus, and 44.2% were in the right main bronchus. Among the TFBs, 359 (95.5%) showed a high-density shadow in the tracheal / bronchial lumen using MSCT, which could establish the presence of a foreign body directly. Emphysema, localized obstruction and pneumonia were more commonly detected in the 7-21 days and ≥21 days group compared with those in the <7 days group (all P < 0.01). Bronchiectasis was found in two children who were diagnosed at least 21 days after aspiration. CONCLUSIONS: Multi-slice spiral computed tomography is very sensitive to TFBs. Timely diagnosis and treatment of TFB is important to prevent long-term sequelae in children.

Correlation between the inframammary fold and sixth rib: Application to breast reconstruction.

The inframammary fold (IMF) is an essential aesthetic element that influences the outcome of breast surgery. In this study, we introduced a new method for finding the IMF based on retrospective analysis of chest computed tomography (CT) scans of women's breasts. Sagittal sections of 80 female chest CTs were analyzed. Sagittal sections of 80 female chest CTs were analyzed by a single plastic surgeon. The distances between the fifth, sixth, and seventh ribs and the IMF were measured using Photoshop, and the location of the IMF was statistically analyzed according to age and height using paired t tests and Pearson's correlation test. As determined by our new method, the average distance between the IMF and the sixth rib was 5.33 mm, which was less than that between the IMF and any other rib. The IMF was closest to the sixth rib in all age groups (P < 0.001), and all IMFs were located between 39.5 mm superior and 24 mm inferior to the sixth rib. The sixth rib, one of the most visible reference structures in women's surface anatomy, is the "sentinel rib" for the IMF and the most predictive indicator of the location of the IMF. Knowing the original anatomic location of the IMF will enable better outcomes during breast surgery. Clin. Anat. 33:165-172, 2020. © 2019 Wiley Periodicals, Inc.

[Quantitative evaluation of early stage blood flow change status after radiofrequency ablation based on multi-slice spiral CT whole-liver perfusion imaging on small hepatocellular carcinoma].

Objective: To investigate the blood flow change status in early stage tumor-related areas of hepatocellular carcinoma and its clinical significance after radiofrequency ablation using multi-slice spiral CT whole-liver perfusion imaging technology. Methods: 21 cases of primary liver cancer that underwent CT-guided radiofrequency ablation were included. CT perfusion scans were divided into four groups according to the time points of CT scans (before surgery, immediately after surgery and 1 and 3 month after surgery), and then blood perfusion parameters of the corresponding areas of the tumor were measured. Statistical analysis was performed using two independent samples of non-parametric Wilcoxon rank-sum test. The differences of blood perfusion parameters between tumor or ablation lesion and background liver parenchyma, paratumor tissue or inflammatory response zone were compared before, immediately and 1 and 3 months after surgery, respectively. Results: (1) The hepatic arterial perfusion (HAP) and hepatic arterial perfusion index (HPI) of cancerous liver tumors and background liver parenchyma was significantly increased (P < 0.01). The total liver perfusion (TLP) was higher than the background liver parenchyma (P = 0.01 < 0.05). The time to peak (TTP) was significantly lower than background liver parenchyma (P < 0.01); (2) The perfusion parameters of HAP, PVP and TLP were lower than the background liver parenchyma in the complete ablation lesions immediately after radiofrequency ablation and 1 and 3 months after surgery, and the difference was statistically significant (P < 0.05); (3) The inflammatory response zone of ablation lesions of HAP, HPI, and TLP were gradually decreased with the extended postoperative time and TTP was gradually increased, while PVP did not change significantly; (4) HAP, HPI, and TTP were compared between the tumor and the tumor inflammatory response zone immediately after surgery, and 1 and 3 months after surgery, and the difference was statistically significant (P < 0.01). However, there was no statistically significant difference between PVP and TLP (P > 0.05). Conclusion: CT whole-liver perfusion imaging can precisely evaluate the early stage blood flow change status in peritumor and tumors before and after radiofrequency ablation and then objectively evaluate tumor's blood supply and therapeutic effect on hepatocellular carcinoma.

Features of the morphological state of bone tissue of the lower wall of the maxillary sinus with the use of fixed orthodontic appliances.

AIM: The aim of the study was to identify the consequences of the use of fixed otrhodontic appliances (FOAs) on the morphological state of the tissues of the lower wall of the maxillary sinus, depending on the duration of their use. MATERIALS AND METHODS: The study involved 115 male and female patients aged 18 to 25 years. All patients were divided into 2 research groups depending on the period of wearing brace systems. The control group consisted of patients who did not require orthodontic treatment orthodontic appliances. The density and thickness of the lower wall of the maxillary sinus were calculated in all groups. RESULTS: In the control group, the average minimum thickness of the lower wall of the maxillary sinus was 4.6±1.5 mm, the minimum density was 13.46±132.6 Hu, in prolonged wearing of FOAs (from 2 to 3 years) these indicators were: 4.96±1.22 mm and -160±187.4 Hu, respectively. In less severe malocclusion in people with a period of FOAs wearing from 1 to 1.5 years, these indicators were 5.03±1.06 mm and - 80.98±167.7 Hu. When measuring the density after one year, it increased and amounted to 25.6±184.4 Hu in wearing FOAs up to 1.5 years and 105.47±173.84 Hu in prolonged wearing of brace systems. CONCLUSIONS: It can be assumed that wearing of braces affects the morphological state of not only the enamel of the teeth, but also of the surrounding tissues, and this effect is more intense in prolonged wearing of FOAs.

A METHOD OF COMPLEX EVALUATION OF MORPHOLOGICAL STRUCTURE OF OSTIOMEATAL COMPLEX COMPONENTS, LOWER WALL OF MAXILLARY AND FRONTAL SINUSES.

OBJECTIVE: The aim: Was to evaluate the anatomical variability of the frontal and maxillary sinuses, ostiomeatal complex components (OMC) and to identify factors that contribute to complications of inflammatory processes and development of odontogenic maxillary sinusitis. PATIENTS AND METHODS: Materials and methods: The study involved assessment of 100 spiral computed tomograms (SCT) of human patients without pathological processes in the PNS area. The basic parameters of the anatomical structure of the ostiomeatal complex (the area of the hooked process and the middle nasal conch, their transverse dimensions, the density and dimensions of the natural connection), the thickness and the density of the lower wall of the maxillary and frontal sinuses were determined. These parameters were investigated by the method of uncertainty calculation. RESULTS: Results: The findings showed that the bone density of the maxillary sinus on the left was 57.713 ± 440.356 Hu (minimum), 1101.507 ± 613.4882 Hu (maximum); 96.2752 ± 395.0 and 1028.691 ± 620.4051 on the right, respectively, the density of the inferior frontal sinus wall on the right was 5.5179 ± 276.43 and 831.1607 ± 732.274, on the left 12.069 ± 310.56 and 898.293 ± 748, respectively. In the same way, the probable OMC structure parameters, in the range ± U at the confidence level p = 0.95, were calculated. CONCLUSION: Conclusions: Thus, some variants of the anatomical structure of the ostiomeatal complex can be a prerequisite for hypoventilation of PNS and, as a consequence, lead to inflammatory processes in them. Features of the same structure of the walls of the PNS are a prerequisite for the propagation of the inflammatory process in the surrounding tissues and the development of complications.

[Research Status of Postmortem MSCT Angiography in Forensic Science].

ABSTRACT: Virtual autopsy is a new technique for investigating the morphological changes of cadaveric tissues and organs by medical imaging technology. It has been widely used in the identification of causes of death. Multislice spiral computed tomography （MSCT） has become a routine inspection method in some identification institutions, although it cannot completely replace traditional autopsy, it plays a key auxiliary or substitute role in the identification of certain abnormal causes of death. Plain MSCT scan cannot visualize cadaveric vessels, but can perform cadaveric angiography to determine vascular injury or disease. This technology has entered a rapid development period in recent years, and has made a considerable progress in contrast agent, perfusion methods and imaging methods. This article summarizes several common cadaveric MSCT angiography methods, such as systemic angiography, angiography through cardiopulmonary resuscitation, targeted angiography, and angiography by cardiac puncture, and analyzes and compares the application prospects.

Comparison of echocardiography and 64-slice spiral computed tomography in the diagnosis of congenital heart disease in children.

The diagnosis of congenital heart disease in children has been an issue in the medical community. Timely diagnosis and treatment can provide a greater guarantee for children's healthy growth. In recent years, there have been more and more studies on the diagnosis of congenital heart disease in children. This paper compares the advantages and disadvantages of echocardiography and 64-slice spiral computed tomography (CT) in the diagnosis of congenital heart disease in children. In clinical trials, we also tested 64 patients with spiral computed tomography (SCT) and transthoracic echocardiography (TTE) detection of patients and then confirmed the accuracy of the diagnosis by the surgical methods. The two methods of detection, the rate of missed diagnosis, and the rate of misdiagnosis were counted. Through the test results and pathological diagnosis results, the diagnostic accuracy of the two methods were all above 90%, each with its own advantages and disadvantages. The sensitivity of echocardiographic in detecting intracardiac structure abnormalities was relatively high, but when the diagnosis of extracardiac structural abnormalities less than 64-slice spiral CT method, misdiagnosis of TTE was mainly due to extracardiac vascular malformations. Therefore, it is recommended to combine the two methods to improve the diagnosis of congenital heart disease in children.