Effect of a metal artifact reduction algorithm on dehiscence and fenestration detection around zirconia implants with cone beam computed tomography.

OBJECTIVE: To assess the efficacy of the metal artifact reduction algorithm (MARA) of the Cranex 3D cone beam computed tomography (CBCT) device in the detection of peri-implant dehiscence and fenestration around zirconia implants. STUDY DESIGN: In total, 60 implants were placed in bovine ribs. Dehiscence and fenestration defects were created around the implants, after which 60 CBCT images were obtained with and 60 without activation of MARA. Three radiologists examined the images for the presence of defects. The area under the curve (AUC) from receiver operating characteristic analysis, sensitivity, and specificity were calculated to assess the ability to discriminate the presence vs absence of bone defects. One-way analysis of variance was employed to analyze outcome measures. The significance level was established at 5% (α = 0.05). RESULTS: AUC values indicated excellent discrimination of dehiscence on images with MARA activation and an excellent to outstanding range of discrimination with MARA deactivation. For fenestration, MARA activation and deactivation both led to outstanding discrimination. Sensitivity and specificity values revealed that activation of MARA was helpful in distinguishing the presence vs. absence of dehiscence, while both MARA conditions were helpful for fenestration. However, there were no statistically significant differences between MARA activation and deactivation for any outcome measure (P >.05). CONCLUSION: CBCT is suitable for detecting peri-implant defects, but MARA application does not significantly affect peri-implant dehiscence and fenestration detection.

Necrosis intestinal asociada a la nutrición enteral por yeyunostomía / Intestinal necrosis associated with enteral nutrition by jejunostomy

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Facial nerve canal dehiscence: evaluation of a new middle eardissection technique and digitalized image analysis

Thorough knowledge of the variation of intrahepatic course of the portal vein is essential for pre-operative assessment of various hepatic surgeries like hepatectomy and live donor liver transplant. This study aims to determine the variation in the branching pattern of the portal vein in South Indian population. The branching pattern of the portal vein was studied by 3D reconstruction of 100 contrast-enhanced computed tomography images and in 15 formalin fixed livers using modified luminal casting technique. Radiologically, the normal portal vein anatomy was seen in 89%. The most common variation was trifurcation of portal vein (5%). A rare anomaly was noted in one case where the left portal vein gave a branch to segment VII. Using the modified luminal casting technique all the 15 specimens displayed Type I portal vein anatomy. The most common variation in the intrahepatic branching pattern observed was the right posterior segmental division supplying segment VIII. A rare left portal vein variation, in which it gave branches to segments V and VIII was noted. In this study, variations in the segmental supply of the portal vein were observed, which have not been studied in detail previously in the Indian population. Variations on the left portal vein are infrequent. A prior knowledge of such variations will help the interventional radiologists to reduce misinterpretations and subsequent misdiagnosis and guide the hepatobiliary

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Ante la sospecha de abdomen agudo, ¿es necesario el contraste oral positivo en la tomografía computarizada? / Is positive oral contrast material necessary for computed tomography in patients with suspected acute abdomen?

En la actualidad, el número de tomografías computarizadas realizadas en el ámbito de las urgencias ha aumentado sustancialmente, y con ello la controversia sobre si realmente es útil el contraste oral positivo en todos los pacientes. La gran calidad de imagen que ofrecen los equipos de tomografía computarizada multidetector, el incremento de la grasa intraabdominal (como elemento natural de contraste para separar las asas intestinales) relacionado con el aumento de la tasa de obesidad poblacional, así como los potenciales inconvenientes que asocia el contraste oral de alta densidad son argumentos que cuestionan su uso generalizado. El propósito de este artículo es valorar el efecto de omitir el uso de este contraste oral para las TC requeridas en la urgencia por sospecha de patología abdominal aguda a partir de una búsqueda eficiente en las publicaciones recientes

The number of computed tomography studies done in emergency departments has increased substantially, and with this increase the controversy about whether positive oral contrast agents are necessary in all patients has also grown. The great image quality provided by multidetector computed tomography scanners, the increase in intraabdominal fat (as a natural element that provides contrast for separating the bowel loops) related with the increased prevalence of obesity in the population, and the potential drawbacks associated with the use of high-density oral contrast agents argue against the generalized us of these agents. This article aims to evaluate the effects of omitting the use of this type of oral contrast material for computed tomography examinations required in the emergency department for suspicion of acute abdominal pathology through an efficient literature search among recent publications