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1.
BMC Vet Res ; 20(1): 318, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014413

RESUMO

The research was designed to use computed tomography (CT) with 3D-CT reconstruction imaging techniques and the various anatomical sections-plana transversalia, frontalis, and dorsalia-to describe the anatomical architecture of the Zebu cattle head. Our study used nine mature heads. The CT bone window created detailed images of cranial bones, mandibles, teeth, and hyoid bones. All of the head cavities were evaluated, including the cranial, orbital, oral, auricular, and nasal cavities with their paranasal and conchal sinuses. The septum nasi, attached to the vomer and maxillary bones, did not reach the nasal cavity floor caudally at the level of the second premolar teeth, resulting in a single median channel from the choanae to the nasopharynx. The positions, boundaries, and connections of the paranasal sinuses were clearly identified. There were four nasal conchal sinuses (that were named the dorsal, middle, ethmoidal, and ventral) and five paranasal sinuses that were described as the following: sinus frontalis, maxillaris, palatinorum, and lacrimalis, as defined in the different anatomical sections and computed tomographic images. The complicated sinus frontalis caused the pneumatization of all bones that surrounded the cranial cavity, with the exception of the ethmoidal and body of basisphenoid bones. The sinus maxillaris was connected to the sinus lacrimalis and palatinorum through the maxillolacrimal and palatomaxillary openings, and to the middle nasal meatus through the nasomaxillary opening. Our findings provide a detailed anatomical knowledge for disease diagnosis to internal medicine veterinarians and surgeons by offering a comprehensive atlas of the Zebu cattle anatomy.


Assuntos
Cabeça , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Animais , Bovinos/anatomia & histologia , Tomografia Computadorizada por Raios X/veterinária , Imageamento Tridimensional/veterinária , Cabeça/anatomia & histologia , Cabeça/diagnóstico por imagem , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Masculino , Feminino
2.
Diagnostics (Basel) ; 14(9)2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38732291

RESUMO

In our case, the malformation was diagnosed prenatally at 40 weeks of gestation, and at the age of 14 days, the malformation was removed combined with a segmentectomy of the sixth segment of the left lung. Preoperative diagnostics focus on 3D-CT reconstruction and detailing of the anatomical variations of all arterial and venous vessels, as evident from our case. Treatment includes surgical removal or a minimally invasive interventional approach through the embolization of the vessel afferent to the malformation. After the operation, the child was discharged on the 30th day after birth in good condition and is developing normally. Early operative intervention is of great importance for the favorable outcome of the condition. In our case, this was hypoxemia with a saturation of 70-75%. The rare and often missed prenatal diagnosis of fetal AV malformation is significant for the adequate postnatal treatment and development of affected children.

3.
Leg Med (Tokyo) ; 69: 102443, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38569417

RESUMO

Depressed skull fractures occur when broken bones displace inward, meaning that a portion of the outer table of the fracture line lies below the normal anatomical position of the inner table. They typically result from force trauma, when the skull is struck by an object with a moderately large amount of kinetic energy but a small surface area, or when an object with a large amount of kinetic energy impacts only a small area of the skull. In the present case, a depressed fracture of the frontal bone was detected at the autopsy of a 52-year-old man who, according to the belated confession of the assailant, was kicked in the head. The assailant was wearing sneakers. Could such a fracture be caused "just" by a kick? In this case it was possible due to an extraordinarily thin cranial vault (0.2 cm frontal, 0.3 cm occipital), which allowed the fractures to occur from a kinetic force that might not have been sufficient with a normal cranial vault thickness. An important role in the forensic analysis of the case was played by the 3D CT reconstruction.


Assuntos
Imageamento Tridimensional , Fratura do Crânio com Afundamento , Tomografia Computadorizada por Raios X , Humanos , Masculino , Pessoa de Meia-Idade , Fratura do Crânio com Afundamento/diagnóstico por imagem , Fratura do Crânio com Afundamento/patologia , Autopsia/métodos , Crânio/diagnóstico por imagem , Crânio/lesões , Crânio/patologia , Fraturas Cranianas/diagnóstico por imagem , Fraturas Cranianas/patologia , Patologia Legal/métodos
4.
Orthop Traumatol Surg Res ; 110(4): 103891, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38641206

RESUMO

Surgical procedures to correct hip dysplasia associated with subluxation or dislocation of the femoral head are complex. The 3D geometric abnormalities of the acetabulum and proximal femur vary across patients. We, therefore, suggest a patient-specific surgical treatment involving computer-assisted 3D planning of the peri-acetabular osteotomies, taking into account the femoral head position; 3D printing of patient-specific guides for the cuts, repositioning, and fixation; and intra-operative application of the simulated displacements with their fixation. LEVEL OF EVIDENCE: IV.


Assuntos
Acetábulo , Imageamento Tridimensional , Osteotomia , Impressão Tridimensional , Cirurgia Assistida por Computador , Humanos , Osteotomia/métodos , Acetábulo/cirurgia , Acetábulo/diagnóstico por imagem , Criança , Adolescente , Cirurgia Assistida por Computador/métodos , Masculino , Feminino , Cuidados Pré-Operatórios/métodos , Luxação do Quadril/cirurgia , Luxação do Quadril/diagnóstico por imagem , Luxação Congênita de Quadril/cirurgia , Luxação Congênita de Quadril/diagnóstico por imagem , Tomografia Computadorizada por Raios X
5.
J Shoulder Elbow Surg ; 33(7): 1503-1511, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38182017

RESUMO

BACKGROUND: Reproducible methods for determining adequate bone densities for stemless anatomic total shoulder arthroplasty (aTSA) are currently lacking. The purpose of this study was to evaluate the utility of preoperative computed tomography (CT) imaging for assessing the bone density of the proximal humerus for supportive differentiation in the decision making for stemless humeral component implantation. It was hypothesized that preoperative 3-dimensional (3-D) CT bone density measures provide objective classifications of the bone quality for stemless aTSA. METHODS: A 3-part study was performed that included the analysis of cadaveric humerus CT scans followed by retrospective application to a clinical cohort and classification with a machine learning model. Thirty cadaveric humeri were evaluated with clinical CT and micro-CT (µCT) imaging. Phantom-calibrated CT data were used to extract 3-D regions of interest and defined radiographic scores. The final image processing script was applied retrospectively to a clinical cohort (n = 150) that had a preoperative CT and intraoperative bone density assessment using the "thumb test," followed by placement of an anatomic stemmed or stemless humeral component. Postscan patient-specific calibration was used to improve the functionality and accuracy of the density analysis. A machine learning model (Support vector machine [SVM]) was utilized to improve the classification of bone densities for a stemless humeral component. RESULTS: The image processing of clinical CT images demonstrated good to excellent accuracy for cylindrical cancellous bone densities (metaphysis [ICC = 0.986] and epiphysis [ICC = 0.883]). Patient-specific internal calibration significantly reduced biases and unwanted variance compared with standard HU CT scans (P < .0001). The SVM showed optimized prediction accuracy compared with conventional statistics with an accuracy of 73.9% and an AUC of 0.83 based on the intraoperative decision of the surgeon. The SVM model based on density clusters increased the accuracy of the bone quality classification to 87.3% with an AUC of 0.93. CONCLUSIONS: Preoperative CT imaging allows accurate evaluation of the bone densities in the proximal humerus. Three-dimensional regions of interest, rescaling using patient-specific calibration, and a machine learning model resulted in good to excellent prediction for objective bone quality classification. This approach may provide an objective tool extending preoperative selection criteria for stemless humeral component implantation.


Assuntos
Artroplastia do Ombro , Densidade Óssea , Úmero , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Humanos , Artroplastia do Ombro/métodos , Tomografia Computadorizada por Raios X/métodos , Estudos Retrospectivos , Masculino , Feminino , Úmero/diagnóstico por imagem , Úmero/cirurgia , Idoso , Pessoa de Meia-Idade , Cadáver , Cuidados Pré-Operatórios/métodos , Aprendizado de Máquina , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/cirurgia , Idoso de 80 Anos ou mais
6.
Phys Imaging Radiat Oncol ; 26: 100444, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37197152

RESUMO

Background and purpose: Radiotherapy is commonly chosen to treat thoracic and abdominal cancers. However, irradiating mobile tumors accurately is extremely complex due to the organs' breathing-related movements. Different methods have been studied and developed to treat mobile tumors properly. The combination of X-ray projection acquisition and implanted markers is used to locate the tumor in two dimensions (2D) but does not provide three-dimensional (3D) information. The aim of this work is to reconstruct a high-quality 3D computed tomography (3D-CT) image based on a single X-ray projection to locate the tumor in 3D without the need for implanted markers. Materials and Methods: Nine patients treated for a lung or liver cancer in radiotherapy were studied. For each patient, a data augmentation tool was used to create 500 new 3D-CT images from the planning four-dimensional computed tomography (4D-CT). For each 3D-CT, the corresponding digitally reconstructed radiograph was generated, and the 500 2D images were input into a convolutional neural network that then learned to reconstruct the 3D-CT. The dice score coefficient, normalized root mean squared error and difference between the ground-truth and the predicted 3D-CT images were computed and used as metrics. Results: Metrics' averages across all patients were 85.5% and 96.2% for the gross target volume, 0.04 and 0.45 Hounsfield unit (HU), respectively. Conclusions: The proposed method allows reconstruction of a 3D-CT image from a single digitally reconstructed radiograph that could be used in real-time for better tumor localization and improved treatment of mobile tumors without the need for implanted markers.

8.
Int Wound J ; 20(3): 725-731, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36787267

RESUMO

Chronic post-pneumonectomy empyema (CPPE) associated with bronchopleural fistula (BPF) is a potentially fatal complication and remains a surgical challenge. This study aims to propose a treatment protocol for managing this severe disease. From July 2009 to June 2021, 47 CPPE with BPF patients were treated in our department. CT scan with 3D reconstruction was used to detect BPF and to evaluate the location and volume of empyema cavity. Different surgical techniques were used to close BPFs according to they sizes. Multiple pedicled muscle flaps were chosen to fill the empyema cavity, and among them, latissimus dorsi (LD) was the mostly used flap. For cases that regional flaps were not suitable, free flaps were used. Patients were followed-up from 7.9 to 102.8 months. Forty-four patients (93.6%) healed after the operation. Closure of BPFs failed in three patients (6.4%), leading to regional infection. These patients were treated by bronchoscopic application of sealants, continuous drainage and antibiotics, and they eventually healed. Total or partial flap loss was not seen in any of the cases. Treatment protocol was proposed based on these results. CT scan with 3D reconstruction is an effective examination to evaluate pleural cavity defect and BPF. Proper technique to close the BPF and right choice of flap to fulfil the empyema cavity are the two most important key points to treat CPPE associated with BPF patients.


Assuntos
Fístula Brônquica , Empiema , Retalhos de Tecido Biológico , Doenças Pleurais , Humanos , Pneumonectomia/efeitos adversos , Estudos Retrospectivos , Fístula Brônquica/cirurgia , Fístula Brônquica/complicações , Doenças Pleurais/etiologia , Doenças Pleurais/cirurgia , Empiema/etiologia , Empiema/cirurgia , Protocolos Clínicos
9.
Knee Surg Sports Traumatol Arthrosc ; 31(1): 169-176, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35674771

RESUMO

PURPOSE: To investigate the relationship between glenoid width and other morphologic parameters using three-dimensional (3D) computed tomography (CT) images of native shoulders, and to create a new measurement tool to assess glenoid defects in a Canadian population with established anterior shoulder instability. METHODS: Forty-three glenoid CT scans were analyzed for patients who underwent contralateral shoulder glenoid reconstruction for anterior shoulder instability between 2012 and 2020. Demographic data were obtained including age, gender and BMI. The subjects were excluded if they had a prior history of ipsilateral shoulder instability, shoulder fractures, or bone tumors. The following glenoid parameters were measured: width (W), height (H), anteroposterior (AP) depth, superior-inferior (SI) depth and version. The shape of the glenoid was also classified into pear, inverted comma or oval. RESULTS: There were 35 male and 8 females with a mean age of 34.5 ± 12.9 years. The glenoid width was strongly correlated with the height (R2 = 0.9) and a regression model equation was obtained: W (mm) = 2.5 + 0.7*H (mm). There was also strong correlation with gender (P < 0.001), glenoid shape (P = 0.030), AP and SI depths (P = 0.006 and P < 0.001, respectively). Male gender was associated with higher measurement values for all parameters. The most common glenoid shapes were the pear (46.5%) and oval morphotypes (39.6%) for the whole study group. CONCLUSION: The native glenoid width can be estimated based on glenoid height using ipsilateral 3D CT. This may help with preoperative planning and surgical decision-making for patients with anterior shoulder instability and glenoid bone loss. LEVEL OF EVIDENCE: III.


Assuntos
Doenças Ósseas Metabólicas , Instabilidade Articular , Articulação do Ombro , Feminino , Humanos , Masculino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/cirurgia , Articulação do Ombro/patologia , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia , Instabilidade Articular/patologia , Imageamento Tridimensional/métodos , Canadá , Tomografia Computadorizada por Raios X/métodos , Doenças Ósseas Metabólicas/patologia
10.
Front Oncol ; 12: 959502, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36408132

RESUMO

Lung adenocarcinoma, the most common subtype of lung cancer, has been always imposed serious threat to human health. Congenital pulmonary dysplasia (CPD) lacking typical clinical manifestations is a rare developmental anomaly. Pulmonary aplasia, the rarest subtype of CPD, may present with a variety of symptoms and is frequently associated with other abnormalities. This report describes an 81-year-old woman who presented with an irritant cough. Chest computed tomography (CT) and three-dimensional (3D) reconstruction revealed an irregular mass with a diameter of 5 cm in right lower lobe adjacent to the hilum. CT also indicated a rightward mediastinal shift and the complete absence of ipsilateral upper lobar tissue with bronchus ending in a terminal cecum, resulting in a diagnosis of pulmonary aplasia. The patient accepted lobectomy and lymph node dissection without complication, histopathologic examination combined HE staining with immunohistochemistry identified the tumor as adenocarcinoma. Three months after surgery, the patient was free of respiratory symptoms without chest pain. This report highlights the necessity of comprehensive evaluation for lung malignancy concurrent with CPD and the importance of identifying the diagnosis of pulmonary dysplasia.

11.
Rinsho Shinkeigaku ; 62(4): 298-300, 2022 Apr 27.
Artigo em Japonês | MEDLINE | ID: mdl-35354726

RESUMO

A 68-year-old woman with Parkinson's disease, who had previously undergone Roux-en-Y gastrojejunostomy for early gastric cancer, complained of wearing-off and troublesome dyskinesia that had progressed over 7-years. After the introduction of levodopa-carbidopa intestinal gel therapy (LCIG) by nasojejunal tube, she had a good clinical response. Percutaneous endoscopic gastrostomy with a jejunal extension tube was difficult in this case, due to lack of gastrostomy site and fibrous postoperative adhesion. We introduced LCIG by direct percutaneous endoscopic jejunostomy (D-PEJ) which offers a less invasive procedure to operative tube placement. The factors affecting the success of D-PEJ could interfere with transillumination, abdominal thickness and the location of other organs. We determined the optimum site of catheter insertion with the assistance of real-time 3D reconstruction CT-jejunography. She was discharged home on postoperative day 14 without any procedure-related complications. Real-time 3D reconstructive CT-jejunography guided D-PEJ is a useful method for a patient who benefit from LCIG with prior gastrojejunostomy.


Assuntos
Carbidopa , Derivação Gástrica , Idoso , Antiparkinsonianos , Combinação de Medicamentos , Feminino , Géis/uso terapêutico , Humanos , Imageamento Tridimensional , Jejunostomia , Levodopa , Tomografia Computadorizada por Raios X
12.
Acta Radiol ; 63(11): 1497-1503, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34609193

RESUMO

BACKGROUND: Rapid and accurate quantification of the supraspinatus outlet view (SOV) is a clinical challenge. PURPOSE: To quantify the X-ray beam angle of the SOV using the horizontal angle of the subscapular spine line (SSSL) and to further verify the feasibility of this method. MATERIAL AND METHODS: A total of 119 patients who underwent shoulder computed tomography (CT) examination were enrolled in the retrospective study. Three-dimensional (3D) CT reconstruction was performed and manually adjusted to provide the position similar to SOV. The rotation angle of the 3D image along the long axis of the human body (marked as ß) was obtained. The horizontal angle of SSSL (marked as α) was measured on the anteroposterior localizer image of shoulder CT. Pearson correlation and linear regression correlation analysis were performed. In addition, the first-time success rate between the experience-based group and the measurement-based group were compared to verify the novel method. RESULTS: We found a linear correlation between α and ß (r = 0.962; P = 0.000). There was no significant correlation between the experience-based group and the measurement-based group in terms of age (P = 0.500), sex (P = 0.397), and side (P = 0.710), but there was a significant statistical difference in the first success rate between the two validation groups (χ2 = 5.808a, P = 0.016). CONCLUSION: This novel quantitative measurement method for determining the X-ray beam angle of SOV using the horizontal angle of SSSL is feasible.


Assuntos
Imageamento Tridimensional , Manguito Rotador , Humanos , Imageamento Tridimensional/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Raios X
13.
BMC Surg ; 21(1): 101, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622276

RESUMO

BACKGROUND: A pulmonary arteriovenous fistula (PAVF) is a rare condition that is associated with pulmonary arteriovenous malformation (PAVM). Few reports have described managing PAVMs using uniportal video-assisted thoracoscopic surgery (VATS). CASE PRESENTATION: A 13-year-old child with PAVF in the left inferior pulmonary artery was treated by uniportal VATS with left lower lobectomy. After surgery, hemoptysis did not recur and there were no postoperative complications. Six months after the operation, postoperative review of computerized tomography showed no recrudescence of PAVF. CONCLUSIONS: PAVF is a rare case that should be diagnosed and treated early. 3D- computerized tomography (CT) reconstruction is useful for diagnosis and preoperative assessment. The case shows that PAVF can be managed with uniportal VATS.


Assuntos
Fístula Arteriovenosa , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Cirurgia Torácica Vídeoassistida , Adolescente , Fístula Arteriovenosa/cirurgia , Humanos , Artéria Pulmonar/cirurgia , Veias Pulmonares/cirurgia , Cirurgia Torácica Vídeoassistida/métodos
14.
Orthop Traumatol Surg Res ; 106(2): 341-346, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32165131

RESUMO

BACKGROUND: Small fracture fragments of the palmar lunate facet of the distal radius can be difficult to stabilize and may cause loss of reduction and even subluxation of the radiocarpal joint. MATERIAL & METHODS: The aims of the study were to investigate fracture patterns of the intermediate column in 101 intra-articular distal radius fractures with three-dimensional computed tomography, and to determine the prevalence of palmar lunate facet fracture fragments. The size of the fragments was measured to find out how many fragments were small. RESULTS: The palmar lunate facet fragment was present in 61 fractures. Mean length of the palmar cortex measured 13.5mm (range: 3 to 26.9) and mean area of the lunate facet 115 mm2 (range: 31 to 267). Seventeen percent of intra-articular distal radius fractures had a palmar lunate facet fragment with a short palmar cortex. CONCLUSION: With accurate analysis of the preoperative computed tomography scans the typical fracture patterns of the palmar lunate facet are recognisable and adequate fixation technique can be chosen to avoid loss of reduction. LEVEL OF EVIDENCE: IV.


Assuntos
Ossos do Carpo , Fraturas Intra-Articulares , Osso Semilunar , Fraturas do Rádio , Humanos , Fraturas Intra-Articulares/diagnóstico por imagem , Fraturas Intra-Articulares/cirurgia , Osso Semilunar/diagnóstico por imagem , Osso Semilunar/cirurgia , Rádio (Anatomia) , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/cirurgia
15.
Arch Orthop Trauma Surg ; 140(4): 465-472, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31428850

RESUMO

INTRODUCTION: Although degenerative osteoarthritis of the acromioclavicular joint is a common finding on technical investigations, not every patient experiences pain or function loss. The difference between symptomatic and asymptomatic patients is currently not elucidated. Therefore, we want to investigate the acromioclavicular relationship in normal, asymptomatic, and symptomatic degenerated ACJ. MATERIALS AND METHODS: 84 normal ACJ, 39 asymptomatic degenerated ACJ, and 30 symptomatic degenerated ACJ were 3D reconstructed. The morphological dimensions and the relationship of the acromion and distal clavicle were measured using computational software. The reproducibility of this technique was evaluated using inter- and intra-observer reliability. RESULTS: The mean anteroposterior and superoinferior distance of both the clavicle and acromion was significantly larger in asymptomatic and symptomatic degenerative ACJ compared to the normal ACJ (p < 0.001). In symptomatic osteoarthritic ACJ, both the anterior and posterior borders of the acromion were significantly more anterior to the borders of the clavicle than in the normal group and asymptomatic group (p < 0.001). Subsequent ROC curve analysis resulted in a sensitivity of 86.7% and a specificity of 88.6% for anterior subluxation of the ACJ. This technique showed an excellent inter- and intra-observer reliability. CONCLUSIONS: In patients with degenerative ACJ, both the distal clavicle and acromion are enlarged. In asymptomatic patients, the AC relationship is the same as in normal patients, in contrast, in patients with symptomatic degenerative ACJ, the acromion is subluxated anteriorly compared to the clavicle.


Assuntos
Articulação Acromioclavicular , Acrômio , Clavícula , Artropatias , Articulação Acromioclavicular/anatomia & histologia , Articulação Acromioclavicular/diagnóstico por imagem , Articulação Acromioclavicular/fisiologia , Acrômio/anatomia & histologia , Acrômio/diagnóstico por imagem , Acrômio/fisiologia , Clavícula/anatomia & histologia , Clavícula/diagnóstico por imagem , Clavícula/fisiologia , Humanos , Imageamento Tridimensional , Artropatias/diagnóstico por imagem , Artropatias/patologia , Artropatias/fisiopatologia , Curva ROC
16.
Ann Transl Med ; 7(18): 460, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31700896

RESUMO

BACKGROUND: The EOS imaging system is an advanced piece of equipment for full-body imaging, but its reliability and reproducibility should be further verified. METHODS: A prospective study was conducted including 18 adult volunteers (36 lower extremities) (24±2 years old). Femoral and tibial torsion were measured by both EOS imaging and three-dimensional computed tomography (3D CT) reconstruction. Bland-Altman plots were performed to evaluate the difference between femoral and tibial torsion measurements obtained by these two methods. The intraclass correlation coefficient (ICC) was used to evaluate intrareader agreement. RESULTS: The mean difference between the two methods was 3° (range, -9° to 4°) for femoral torsion, 0° (range, -6° to 6°) for tibial torsion and 0° (range, -4° to 5°) for femorotibial torsion. No statistically significant difference between the measurements of the two methods was detected by Bland-Altman plots. With the exception of one measurement of femoral torsion, one measurement of tibial torsion and one measurement of femorotibial torsion, all EOS imaging measurements were within the 95% limits of agreement (the mean ± 1.96 SD). Intrareader agreement was statistically significant (P<0.001) for all measurements, with high ICCs. For EOS imaging, the ICC was 0.92 for the femoral measurement, 0.92 for the tibial measurement and 0.918 for the femorotibial measurement; the corresponding values for CT were 0.950, 0.927 and 0.889. CONCLUSIONS: There was good agreement between EOS imaging based and 3D CT reconstruction based technique in measuring femoral, tibial and femorotibial torsion; and good reliability and reproducibility of EOS Imaging in measuring femoral, tibial and femorotibial torsion was also verified.

17.
JSES Open Access ; 3(3): 168-173, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31709357

RESUMO

BACKGROUND: Long-term function and survival of reverse shoulder arthroplasties (RSAs) are reliant on component positioning and fixation. Conventional postoperative analysis is performed using plain radiographs or 2-dimensional (2D) computed tomography (CT) images. Although 3-dimensional (3D) CT would be preferred, its use is limited by metal artifacts. This study proposes a new 3D CT method for postoperative RSA evaluation and compares its interobserver reliability with conventional methods. MATERIALS AND METHODS: Preoperative and postoperative CT scans, as well as postoperative radiographs, were obtained from 18 patients who underwent RSA implantation; the scapula, implant, and screws were reconstructed as 3D CT models. The postoperative 3D scapula and implant were imported into preoperative coordinates and matched to the preoperative scapula. Standardized scapula coordinates were defined, in which the glenoid baseplate version and inclination angle were measured. The percentage of screw volume in bone was measured from a Boolean intersection operation between the preoperative scapula and screw models. Four independent reviewers performed the measurements using 3D CT and conventional 2D methods. Intraclass correlation coefficients (ICCs) were used to compare the reliability of the methods. RESULTS: The 3D CT method showed excellent reliability (ICC > 0.75) in baseplate inclination (ICC = 0.92), version (ICC = 0.97), and screw volume in bone (ICC = 0.99). Conventional 2D methods demonstrated poor reliability (ICC < 0.4). For radiographs, inclination showed poor reliability (ICC = 0.09) and the screw percentage in bone showed fair reliability (ICC = 0.54). Version was not measured with plain radiographs. For 2D CT slice measurements, inclination showed poor reliability (ICC = 0.02), version showed excellent reliability (ICC = 0.81), and the screw percentage in bone showed poor reliability (ICC = 0.28). CONCLUSION: The new 3D CT-based method for evaluating RSA glenoid implant positioning and screw volume in bone showed excellent reliability and overcame the metal-artifact limitation of postoperative CT and 3D CT reconstruction.

18.
Khirurgiia (Mosk) ; (10): 5-12, 2019.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-31626233

RESUMO

OBJECTIVE: To analyze immediate and long-term results of anatomical resections for lung cancer with subsequent comparison of the results of segmentectomy and lobectomy in patients with peripheral NSCLC stage IA1-2. MATERIAL AND METHODS: There were 52 sublobular anatomical resections of the lung for peripheral non-small cell carcinoma and carcinoid T1a-bN0M0, IA1-2 stage. 3D-CT reconstruction with separation of bronchial and vascular structures was used to schedule complex segmentectomy. We retrospectively analyzed 200 patients with cT1a-bN0M0 peripheral non-small cell lung cancer (NSCLC) and tumor dimension ≤2 cm who underwent lobectomy (n=148) and segmentectomy (n=52). Mortality, morbidity and overall 5-year survival were compared in two propensity score matched groups (46 pairs, segmentectomy vs. lobectomy). RESULTS: There was no mortality in both groups. Morbidity was similar after segmentectomy and lobectomy (8.69 and 6.52%; p=0.32). 3D-CT with separation of bronchial and vascular structures enabled surgeons to perform atypical segmentectomies and VATS procedures more often (from 13.5 to 31.3%; p>0.05 and from 11.5 to 50.0%; p<0.05). Five-year survival was 82 and 86% (p=0.652) after segmentectomy and lobectomy, respectively. CONCLUSION: Postoperative results and long-term outcome after segmentectomy and lobectomy are comparable in patients with NSCLC cT1a-bN0M0, stage IA1-2. Segmentectomy is advisable surgery in patients with low pulmonary capacity and severe comorbidities.


Assuntos
Tumor Carcinoide/cirurgia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/cirurgia , Pneumonectomia/métodos , Humanos , Estudos Retrospectivos
19.
J Thorac Dis ; 10(1): 196-201, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29600049

RESUMO

BACKGROUND: The objective of our pilot study was to assess if three-dimensional (3D) reconstruction performed by Visible Patient™ could be helpful for the operative planning, efficiency and safety of robot-assisted segmentectomy. METHODS: Between 2014 and 2015, 3D reconstructions were provided by the Visible Patient™ online service and used for the operative planning of robotic segmentectomy. To obtain 3D reconstruction, the surgeon uploaded the anonymized computed tomography (CT) image of the patient to the secured Visible Patient™ server and then downloaded the model after completion. RESULTS: Nine segmentectomies were performed between 2014 and 2015 using a pre-operative 3D model. All 3D reconstructions met our expectations: anatomical accuracy (bronchi, arteries, veins, tumor, and the thoracic wall with intercostal spaces), accurate delimitation of each segment in the lobe of interest, margin resection, free space rotation, portability (smartphone, tablet) and time saving technique. CONCLUSIONS: We have shown that operative planning by 3D CT using Visible Patient™ reconstruction is useful in our practice of robot-assisted segmentectomy. The main disadvantage is the high cost. Its impact on reducing complications and improving surgical efficiency is the object of an ongoing study.

20.
Orthop Traumatol Surg Res ; 104(2): 245-249, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29408687

RESUMO

INTRODUCTION: Cuboid fractures are very rare. Hence, their treatment has not been standardized. Advances in imaging techniques, particularly three-dimensional computed tomography (3D CT), and the introduction of cuboid-specific plates has improved the care of these injuries. The aim of this study was to determine the radiological and clinical outcomes of anatomical reconstruction of comminuted cuboid fractures with a locking plate. HYPOTHESIS: Fixation of comminuted cuboid fractures with a cuboid-specific locking plate leads to stable anatomical reduction and good functional outcomes. MATERIAL AND METHODS: This was a retrospective study of 9 consecutive cases of comminuted cuboid fracture treated at a single hospital between January 2009 and December 2015. A 3D CT scan was performed preoperatively with subtraction of the posterior tarsal bone to allow the articular facets to be viewed and analyzed. Fracture fixation was done with a Locking Cuboid Plate (DePuy Synthes™). Associated lesions in the foot were treated during the same procedure. The patients were reviewed by an independent observer who performed a clinical examination, and determined the AOFAS and Maryland Foot Score. The success of the reconstruction was determined by comparing the parameters on weight-bearing X-rays views between the fixed and non-operated cuboid. RESULTS: The mean follow-up was 4.1 years (range 1-6). The Maryland Foot Score was 93.1 [86-100] and the AOFAS was 91.9 [82-100]. The reconstruction was anatomical and long lasting in all 9 cases. There was no foot misalignment in the frontal plane, based on the radiographs (hindfoot axis 5.5° [0-9]). The mean Djian-Annonier angle was 123.9° [108-130]. CONCLUSION: Cuboid fractures can be treated effectively through appropriate imaging and with a cuboid-specific locking plate as evidenced by very good midterm clinical and radiological outcomes in this study. LEVEL OF EVIDENCE: IV Retrospective study.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Fraturas Cominutivas/cirurgia , Ossos do Tarso/cirurgia , Adulto , Idoso de 80 Anos ou mais , Placas Ósseas , Feminino , Seguimentos , Fixação Interna de Fraturas/instrumentação , Fraturas Ósseas/fisiopatologia , Fraturas Cominutivas/diagnóstico por imagem , Fraturas Cominutivas/fisiopatologia , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Ossos do Tarso/lesões , Tomografia Computadorizada por Raios X
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