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Chen Y, Li J, Yang H, Lv F, Sheng B, Lv F. Differences in Patellofemoral Alignment Between Static and Dynamic Extension Positions in Patients With Patellofemoral Pain. Orthop J Sports Med 2024; 12:23259671231225177. [PMID: 38444568 PMCID: PMC10913515 DOI: 10.1177/23259671231225177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/18/2024] [Indexed: 03/07/2024] Open
Abstract
Background Considering that patellofemoral pain (PFP) is related to dynamic factors, dynamic extension on 4-dimensional computed tomography (4-DCT) may better reflect the influence of muscles and surrounding soft tissue than static extension. Purpose To compare the characteristics of patellofemoral alignment between the static and dynamic knee extension position in patients with PFP and controls via 4-DCT. Study Design Cross-sectional study; Level of evidence, 3. Methods Included were 39 knees (25 patients) with PFP and 37 control knees (24 participants). For each knee, an image of the dynamic extension position (a single frame of the knee in full extension [flexion angle of -5° to 0°] selected from 21 frames of continuous images acquired by 4-DCT during active flexion and extension) and an image of the static extension position (acquired using the same equipment with the knee fully extended and the muscles relaxed) were selected. Patellofemoral alignment was evaluated between the dynamic and static extension positions and between the PFP and control groups with the following parameters: patella-patellar tendon angle (P-PTA), Blackburne-Peel ratio, bisect-offset (BO) index, lateral patellar tilt (LPT), and tibial tuberosity-trochlear groove (TT-TG) distance. Results In both PFP patients and controls, the P-PTA, Blackburne-Peel ratio, and BO index in the static extension position were significantly lower (P < .001 for all), while the LPT and TT-TG distance in the static extension position were significantly higher (P ≤ .034 and P < .001, respectively) compared with values in the dynamic extension position. In the comparison between groups, only P-PTA in the static extension position was significantly different (134.97° ± 4.51° [PFP] vs 137.82° ± 5.63° [control]; P = .027). No difference was found in the rate of change from the static to the dynamic extension position of any parameter between the study groups. Conclusion The study results revealed significant differences in patellofemoral alignment characteristics between the static and dynamic extension positions of PFP patients and controls. Multiplanar measurements may have a role in subsequent patellofemoral alignment evaluation.
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Affiliation(s)
- Yurou Chen
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Jia Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Haitao Yang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Bo Sheng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Furong Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
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Vallée M, Knecht S, Blum A, Henriques M, Savall F, Chaumoitre K, Adalian P, Martrille L. Technical note: Interest of focused fields in post-mortem computed tomography using photorealistic images for age at death estimation from the pubic symphysis. Forensic Sci Int 2024; 354:111903. [PMID: 38096752 DOI: 10.1016/j.forsciint.2023.111903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION The morphological assessment of the pubic symphysis using the Suchey-Brooks method is considered a reliable age at death indicator. Age at death estimation methods can be adapted to the images obtained from post-mortem computed tomography (PMCT). The aim of this study is to evaluate the utility of pubic symphysis photorealistic images obtained through Global illumination rendering (GIR) for age at death estimation from whole-body PMCT and from focused PMCT on the pubic bone. MATERIALS AND METHODS We performed virtual age at death estimation using the Suchey Brooks method from both the whole-body field of view (Large Field of View: LFOV) and the pubis-focused field of view (Small and Field of View: SFOV) of 100 PMCT. The 3D photorealistic images were evaluated by three forensic anthropologists and the results were statistically evaluated for accuracy of the two applied PMCT methods and the intra- and inter-observer errors. RESULTS When comparing the two acquisitions of PMCT, the accuracy rate reaches 98.5% when using a pubic-focused window (SFOV) compared to 86% with a whole-body window (LFOV). Additionally, the intra- and inter-observer variability has demonstrated that the focused window provides better repeatability and reproducibility. CONCLUSION Adding a pubic-focused field of view to standard PMCT and processing it with GIR appears to be an applicable technique that increases the accuracy rate for age at death estimation from the pubic symphysis.
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Affiliation(s)
- Marion Vallée
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
| | - Siam Knecht
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
| | - Alain Blum
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, Nancy CEDEX 54035, France
| | | | - Frédéric Savall
- Service de Médecine Légale, Hôpital de Rangueil, Toulouse, France; Laboratory Centre for Anthropology and Genomics of Toulouse, Université Paul Sabatier, Toulouse, France, Hôpital de Rangueil, Toulouse, France
| | - Kathia Chaumoitre
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France; Aix Marseille Univ, APHM, Hôpital Nord, Service de Radiologie, Marseille, France
| | | | - Laurent Martrille
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France; EDPFM, Univ Montpellier, Department of legal medicine CHU Montpellier, Montpellier, France
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Ferrero A, Powell GM, Adaaquah DK, Rajendran K, Thorne JE, Krych AJ, Horst KK, McCollough CH, Baffour FI. Feasibility of photon-counting CT for femoroacetabular impingement syndrome evaluation: lower radiation dose and improved diagnostic confidence. Skeletal Radiol 2023; 52:1651-1659. [PMID: 36971838 DOI: 10.1007/s00256-023-04325-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The feasibility of low-dose photon-counting detector (PCD) CT to measure alpha and acetabular version angles of femoroacetabular impingement (FAI). MATERIAL AND METHODS FAI patients undergoing an energy-integrating detector (EID) CT underwent an IRB-approved prospective ultra-high-resolution (UHR) PCD-CT between 5/2021 and 12/2021. PCD-CT was dose-matched to the EID-CT or acquired at 50% dose. Simulated 50% dose EID-CT images were generated. Two radiologists evaluated randomized EID-CT and PCD-CT images and measured alpha and acetabular version angles on axial image slices. Image quality (noise, artifacts, and visualization of cortex) and confidence in non-FAI pathology were rated on a 4-point scale (3 = adequate). Preference tests of standard dose PCD-CT, 50% dose PCD-CT, and 50% dose EID-CT relative to standard dose EID-CT were performed using Wilcoxon Rank test. RESULTS 20 patients underwent standard dose EID-CT (~ CTDIvol, 4.5 mGy); 10 patients, standard dose PCD-CT (4.0 mGy); 10 patients, 50% PCD-CT (2.6 mGy). Standard dose EID-CT images were scored as adequate for diagnostic task in all categories (range 2.8-3.0). Standard dose PCD-CT images scored higher than the reference in all categories (range 3.5-4, p < 0.0033). Half-dose PCD-CT images also scored higher for noise and cortex visualization (p < 0.0033) and equivalent for artifacts and visualization of non-FAI pathology. Finally, simulated 50% EID-CT images scored lower in all categories (range 1.8-2.4, p < 0.0033). CONCLUSIONS Dose-matched PCD-CT is superior to EID-CT for alpha angle and acetabular version measurement in the work up of FAI. UHR-PCD-CT enables 50% radiation dose reduction compared to EID while remaining adequate for the imaging task.
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Affiliation(s)
- Andrea Ferrero
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA
| | - Garret M Powell
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA
| | - Dennis K Adaaquah
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA
| | - Kishore Rajendran
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA
| | - Jamison E Thorne
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA
| | - Aaron J Krych
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kelly K Horst
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA
| | - Cynthia H McCollough
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA
| | - Francis I Baffour
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, 55902, MN, USA.
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Gillet R, Boubaker F, Hossu G, Thay A, Gillet P, Blum A, Teixeira PAG. Computed Tomography Bone Imaging: Pushing the Boundaries in Clinical Practice. Semin Musculoskelet Radiol 2023; 27:397-410. [PMID: 37748463 DOI: 10.1055/s-0043-1768451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Bone microarchitecture has several clinical implications over and above estimating bone strength. Computed tomography (CT) analysis mainly uses high-resolution peripheral quantitative CT and micro-CT, research imaging techniques, most often limited to peripheral skeleton assessment. Ultra-high-resolution (UHR) CT and photon-counting detector CT, two commercially available techniques, provide images that can approach the spatial resolution of the trabeculae, bringing bone microarchitecture analysis into clinical practice and improving depiction of bone vascularization, tumor matrix, and cortical and periosteal bone. This review presents bone microarchitecture anatomy, principles of analysis, reference measurements, and an update on the performance and potential clinical applications of these new CT techniques. We also share our clinical experience and technical considerations using an UHR-CT device.
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Affiliation(s)
- Romain Gillet
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
- Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
- Université de Lorraine, INSERM, IADI, Nancy, France
| | - Fatma Boubaker
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Gabriela Hossu
- Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
- Université de Lorraine, INSERM, IADI, Nancy, France
| | | | | | - Alain Blum
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
- Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
- Université de Lorraine, INSERM, IADI, Nancy, France
| | - Pedro Augusto Gondim Teixeira
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
- Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
- Université de Lorraine, INSERM, IADI, Nancy, France
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Singh P, Agrawal K, Tripathy SK, Patro SS, Velagada S. Emerging role of bone scintigraphy single-photon emission computed tomography/computed tomography in foot pain management. Nucl Med Commun 2023; 44:571-584. [PMID: 37114428 DOI: 10.1097/mnm.0000000000001698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Foot and ankle joints being weight-bearing joints are commonly subjected to wear and tear and are prone to traumatic and other pathologies. Most of these foot and ankle pathologies present with pain. The diagnosis of pathology and localization of pain generators is difficult owing to the complex anatomy of the foot and similar clinical presentation. This makes the management of foot pain clinically challenging. Conventional anatomical imaging modalities are commonly employed for evaluation of any anatomical defect; however, these modalities often fail to describe the functional significance of the anatomical lesions, especially in presence of multiple lesions which is common in ankle and foot; however, hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) by virtue of its dual modalities, that is, highly sensitive functional imaging and highly specific anatomical imaging can serve as a problem-solving tool in patient management. This review attempts to describe the role of hybrid SPECT/CT in overcoming the limitation of conventional imaging and describes its potential application in the management of foot and ankle pain.
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Affiliation(s)
- Parneet Singh
- Nuclear Medicine, All India Institute of Medical Sciences, AIIMS, Bhubaneswar
| | - Kanhaiyalal Agrawal
- Nuclear Medicine, All India Institute of Medical Sciences, AIIMS, Bhubaneswar
| | - Sujit Kumar Tripathy
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha
| | - Sai Sradha Patro
- Nuclear Medicine, All India Institute of Medical Sciences, AIIMS, Bhubaneswar
| | - Sandeep Velagada
- Department of Orthopedics, S.L.N Medical College and Hospital, Koraput, India
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Willershausen I, Necker F, Kloeckner R, Seidel CL, Paulsen F, Gölz L, Scholz M. Cinematic rendering to improve visualization of supplementary and ectopic teeth using CT datasets. Dentomaxillofac Radiol 2023; 52:20230058. [PMID: 37015249 PMCID: PMC10170174 DOI: 10.1259/dmfr.20230058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Ectopic, impacted, and supplementary teeth are the number one reason for cross-sectional imaging in pediatric dentistry. The accurate post-processing of acquired data sets is crucial to obtain precise, yet also intuitively understandable three-dimensional (3D) models, which facilitate clinical decision-making and improve treatment outcomes. Cinematic rendering (CR) is anovel visualization technique using physically based volume rendering to create photorealistic images from DICOM data. The aim of the present study was to tailor pre-existing CR reconstruction parameters for use in dental imaging with the example of the diagnostic 3D visualization of ectopic, impacted, and supplementary teeth. METHODS CR was employed for the volumetric image visualization of midface CT data sets. Predefined reconstruction parameters were specifically modified to visualize the presented dental pathologies, dentulous jaw, and isolated teeth. The 3D spatial relationship of the teeth, as well as their structural relationship with the antagonizing dentition, could immediately be investigated and highlighted by separate, interactive 3D visualization after segmentation through windowing. RESULTS To the best of our knowledge, CR has not been implemented for the visualization of supplementary and ectopic teeth segmented from the surrounding bone because the software has not yet provided appropriate customized reconstruction parameters for dental imaging. When employing our new, modified reconstruction parameters, its application presents a fast approach to obtain realistic visualizations of both dental and osseous structures. CONCLUSIONS CR enables dentists and oral surgeons to gain an improved 3D understanding of anatomical structures, allowing for more intuitive treatment planning and patient communication.
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Affiliation(s)
- Ines Willershausen
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse, Erlangen, Germany
| | | | - Roman Kloeckner
- Institute of Interventional Radiology University Hospital of Schleswig-Holstein-Campus Lübeck, Ratzeburger Allee, Lübeck, Germany
| | - Corinna Lesley Seidel
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse, Erlangen, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy Friedrich-Alexander-University Erlangen-Nürnberg, Krankenhausstrasse, Erlangen, Germany
| | - Lina Gölz
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse, Erlangen, Germany
| | - Michael Scholz
- Institute of Functional and Clinical Anatomy Friedrich-Alexander-University Erlangen-Nürnberg, Krankenhausstrasse, Erlangen, Germany
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Hagen F, Grimmer R, Ditt H, Walder L, Wrazidlo R, Karolin B, Hofmann J, Estler A, Horger M. Effects of different virtual monoenergetic CT image data on chest wall post-processing "unfolded ribs" and proposal of an algorithm improvement. Int J Comput Assist Radiol Surg 2023; 18:339-351. [PMID: 35962904 DOI: 10.1007/s11548-022-02721-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/12/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE To find out if the use of different virtual monoenergetic data sets enabled by DECT technology might have a negative impact on post-processing applications, specifically in case of the "unfolded ribs" algorithm. Metal or beam hardening artifacts are suspected to generate image artifacts and thus reduce diagnostic accuracy. This paper tries to find out how the generation of "unfolded rib" CT image reformates is influenced by different virtual monoenergetic CT images and looks for possible improvement of the post-processing tool. MATERIAL AND METHODS Between March 2021 and April 2021, thin-slice dual-energy CT image data of the chest were used creating "unfolded rib" reformates. The same data sets were analyzed in three steps: first the gold standard with the original algorithm on mixed image data sets followed by the original algorithm on different keV levels (40-120 keV) and finally using a modified algorithm which in the first step used segmentation based on mixed image data sets, followed by segmentation based on different keV levels. Image quality (presence of artifacts), lesion and fracture detectability were assessed for all series. RESULTS Both, the original and the modified algorithm resulted in more artifact-free image data sets compared to the gold standard. The modified algorithm resulted in significantly more artifact-free image data sets at the keV-edges (40-120 keV) compared the original algorithm. Especially "black artifacts" and pseudo-lesions, potentially inducing false positive findings, could be reduced in all keV level with the modified algorithm. Detection of focal sclerotic, lytic or mixed (k = 0.990-1.000) lesions was very good for all keV levels. The Fleiss-kappa test for detection of fresh and old rib fractures was ≥ 0.997. CONCLUSION The use of different virtual monoenergetic keVs for the "unfolded rib" algorithm is generating different artifacts. Segmentation-based artifacts could be eliminated by the proposed new algorithm, showing the best results at 70-80 keV.
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Affiliation(s)
- Florian Hagen
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
| | | | | | - Lukas Walder
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany
| | - Robin Wrazidlo
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany
| | - Baumgartner Karolin
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany
| | - Johannes Hofmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany
| | - Arne Estler
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany
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Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach. World Neurosurg 2023; 173:e37-e47. [PMID: 36716853 DOI: 10.1016/j.wneu.2023.01.088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach. METHODS Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the 3D-slicer software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized. RESULTS The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period. CONCLUSIONS Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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Gondim Teixeira PA, Lombard C, Moustache-Espinola P, Germain E, Gillet R, Hossu G, Jaquet Ribeiro G, Blum A. Initial Characterization of Focal Bone Lesions with Conventional Radiographs or Computed Tomography: Diagnostic Performance and Interobserver Agreement Assessment. Can Assoc Radiol J 2022; 74:404-414. [PMID: 36207066 DOI: 10.1177/08465371221131755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: To ascertain the role of CT and conventional radiographs for the initial characterization of focal bone lesions.Methods: Images from 184 patients with confirmed bone tumors included in an ethics committee-approved study were retrospectively evaluated. The reference for benign-malignant distribution was based on histological analysis and long-term follow-up. Radiographs and CT features were analyzed by 2 independent musculoskeletal radiologists blinded to the final diagnosis. Lesion margins, periosteal reaction, cortical lysis, endosteal scalloping, presence of pathologic fracture, and lesion mineralization were evaluated. Results: The benign-malignant distribution in the study population was 68.5-31.5% (126 benign and 58 malignant). In the lesions that could be seen in both radiographs and CT, the performance of these methods for the benign-malignant differentiation was similar (accuracy varying from 72.8% to 76.5%). The interobserver agreement for the overall evaluation of lesion aggressiveness was considerably increased on CT compared to radiographs (Kappa of .63 vs .22). With conventional radiographs, 18 (9.7%) and 20 (10.8%) of the lesions evaluated were not seen respectively by readers 1 and 2. Among these unseen lesions, 50%-61.1% were located in the axial skeleton. Compared to radiographs, the number of lesions with cortical lysis and endosteal scalloping was 26-34% higher with CT. Conclusion: Although radiographs remain the primary imaging tool for lesions in the peripheral skeleton, CT should be performed for axial lesions. CT imaging can assess the extent of perilesional bone lysis more precisely than radiographs with a better evaluation of lesion fracture risk.
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Affiliation(s)
| | - Charles Lombard
- Guilloz imaging Department, Central Hospital, 26920University Hospital Center of Nancy, Nancy, France
| | | | - Edouard Germain
- Guilloz imaging Department, Central Hospital, 26920University Hospital Center of Nancy, Nancy, France
| | - Romain Gillet
- Guilloz imaging Department, Central Hospital, 26920University Hospital Center of Nancy, Nancy, France
| | - Gabriela Hossu
- Guilloz imaging Department, Central Hospital, 26920University Hospital Center of Nancy, Nancy, France
| | | | - Alain Blum
- Guilloz imaging Department, Central Hospital, 26920University Hospital Center of Nancy, Nancy, France
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Lakhani DA, Deib G. Photorealistic Depiction of Intracranial Tumors Using Cinematic Rendering of Volumetric 3T MRI Data. Acad Radiol 2022; 29:e211-e218. [PMID: 35033449 DOI: 10.1016/j.acra.2021.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES Cinematic Rendering (CR) incorporates a complex lightning model that creates photorealistic models from isotropic 3D imaging data. The utility of CR in depicting volumetric MRI data for pre-therapeutic planning is discussed, with intracranial tumors as a demonstrative example. MATERIALS AND METHODS We present a series of Cinematically Rendered intracranial tumors and discuss their utility in multidisciplinary pre-therapeutic evaluation. Isotropic, high-resolution, volumetric MRI data was collected, and CR was performed utilizing a proprietary application, "Anatomy Education" Siemens, Munich, Germany. RESULTS Discrimination of cortex to white matter, brain surface to vessels, subarachnoid space to cortex and skull to intracranial structures was achieved and optimized by using various display settings on the Anatomy education application. Progressive removal of tissue layers allowed for a comprehensive assessment of the entire region of interest. Complex, small structures were demonstrated in very high detail. The depth and architecture of the sulci was appreciated in a format that more closely mimicked gross pathology than traditional imaging modalities. With appropriate display settings, the relationship of the cortical surface to the adjacent vasculature was also delineated. CONCLUSION CR depicts the anatomic location of brain tumors in a format that depicts the relative proximity of adjacent structures in all dimensions and degrees of freedom. This allows for better conceptualization of the pathology and greater ease of communication between radiologists and other clinical teams, especially in the context of pretherapeutic planning.
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Affiliation(s)
- Dhairya A Lakhani
- Department of Radiology (D.A.L.), West Virginia University, 1 Medical Center Drive, Morgantown, West Virginia 26506, USA; Department of Neuroradiology (G.D.), West Virginia University, Morgantown, West Virginia, USA.
| | - Gerard Deib
- Department of Radiology (D.A.L.), West Virginia University, 1 Medical Center Drive, Morgantown, West Virginia 26506, USA; Department of Neuroradiology (G.D.), West Virginia University, Morgantown, West Virginia, USA
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Lee AKX, Lin TL, Hsu CJ, Fong YC, Chen HT, Tsai CH. Three-Dimensional Printing and Fracture Mapping in Pelvic and Acetabular Fractures: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11185258. [PMID: 36142905 PMCID: PMC9506009 DOI: 10.3390/jcm11185258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 02/06/2023] Open
Abstract
Three-dimensional printing and fracture mapping technology is gaining popularity for preoperative planning of fractures. The aim of this meta-analysis is to further understand for the effects of 3D printing and fracture mapping on intraoperative parameters, postoperative complications, and functional recovery on pelvic and acetabular fractures. The PubMed, Embase, Cochrane and Web of Science databases were systematically searched for articles according to established criteria. A total of 17 studies were included in this study, of which 3 were RCTs, with a total of 889 patients, including 458 patients treated by traditional open reduction and internal fixation methods and 431 patients treated using 3D printing strategies. It was revealed that three-dimensional printing and fracture mapping reduced intraoperative surgical duration (RoM 0.74; 95% CI; 0.66–0.83; I2 = 93%), and blood loss (RoM 0.71; 95% CI; 0.63–0.81; I2 = 71%). as compared to traditional surgical approaches. In addition, there was significantly lower exposure to intraoperative imaging (RoM 0.36; 95% CI; 0.17–0.76; I2 = 99%), significantly lower postoperative complications (OR 0.42; 95% CI; 0.22–0.78; I2 = 9%) and significantly higher excellent/good reduction (OR 1.53; 95% CI; 1.08–2.17; I2 = 0%) in the three-dimensional printing and fracture mapping group. Further stratification results with only prospective studies showed similar trends. Three-dimensional printing and fracture mapping technology has potential in enhancing treatment of complex fractures by improving surgical related factors and functional outcomes and therefore could be considered as a viable tool for future clinical applications.
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Affiliation(s)
- Alvin Kai-Xing Lee
- Department of Education, China Medical University Hospital, Taichung 404, Taiwan
| | - Tsung-Li Lin
- Department of Orthopedics Surgery, China Medical University Hospital, Taichung 404, Taiwan
- Department of Sports Medicine, China Medical University, Taichung 404, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
| | - Chin-Jung Hsu
- Department of Orthopedics Surgery, China Medical University Hospital, Taichung 404, Taiwan
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Yi-Chin Fong
- Department of Orthopedics Surgery, China Medical University Hospital, Taichung 404, Taiwan
- Department of Sports Medicine, China Medical University, Taichung 404, Taiwan
- Department of Orthopedics Surgery, China Medical University Hospital Beigang Branch, Yunlin 651, Taiwan
| | - Hsien-Te Chen
- Spine Center, China Medical University Hospital, Taichung 404, Taiwan
| | - Chun-Hao Tsai
- Department of Orthopedics Surgery, China Medical University Hospital, Taichung 404, Taiwan
- Department of Sports Medicine, China Medical University, Taichung 404, Taiwan
- Correspondence:
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12
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Al Khalifah A, Zimmerman SL, Fishman EK. Visualization of acute aortic injury with cinematic rendering. Emerg Radiol 2022; 29:1043-1048. [PMID: 36045229 DOI: 10.1007/s10140-022-02086-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022]
Abstract
The purpose of this study is to demonstrate the appearance of traumatic aortic injuries with the novel 3-dimensional (3D) computed tomography (CT) visualization technique known as cinematic rendering (CR). CR uses a novel lighting model to create photorealistic images with excellent anatomic detail for improved depiction of the extent of traumatic aortic injuries. Four patients with acute traumatic aortic injury identified on thoracic CT angiography were analyzed by creating standard 3D volume-rendered reconstructions and CR images on an independent 3D workstation. In this series of four patients, we present the typical patterns of aortic injury imaging findings and complications associated with traumatic aortic injury, with an emphasis on the utilization of the novel 3D technique of CR. CR can provide realistic imaging of the thoracic aortic contour with excellent spatial details. This methodology allows for an accurate assessment of aortic injury and optimal preoperative planning in patients with traumatic thoracic aortic injury.
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Affiliation(s)
- Abdullah Al Khalifah
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, USA.
| | - Stefan L Zimmerman
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Elliot K Fishman
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, USA
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13
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Imaging in Hip Arthroplasty Management Part 2: Postoperative Diagnostic Imaging Strategy. J Clin Med 2022; 11:jcm11154416. [PMID: 35956033 PMCID: PMC9369831 DOI: 10.3390/jcm11154416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 12/04/2022] Open
Abstract
Hip arthroplasty (HA) is a frequently used procedure with high success rates, but 7% to 27% of the patients complain of persistent postsurgical pain 1 to 4 years post-operation. HA complications depend on the post-operative delay, the type of material used, the patient’s characteristics, and the surgical approach. Radiographs are still the first imaging modality used for routine follow-up, in asymptomatic and painful cases. CT and MRI used to suffer from metallic artifacts but are nowadays central in HA complications diagnosis, both having their advantages and drawbacks. Additionally, there is no consensus on the optimal imaging workup for HA complication diagnosis, which may have an impact on patient management. After a brief reminder about the different types of prostheses, this article reviews their normal and pathologic appearance, according to each imaging modality, keeping in mind that few abnormalities might be present, not anyone requiring treatment, depending on the clinical scenario. A diagnostic imaging workup is also discussed, to aid the therapist in his imaging studies prescription and the radiologist in their practical aspects.
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14
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Percutaneous reinforced cementoplasty using spindles as a palliative option for malignant fractures of the humerus. Diagn Interv Imaging 2022; 103:375-377. [DOI: 10.1016/j.diii.2022.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 12/26/2022]
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15
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Percutaneous screw fixation of pelvic bone metastases using cone-beam computed tomography navigation. Diagn Interv Imaging 2022; 103:367-374. [DOI: 10.1016/j.diii.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022]
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16
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Lacroix M, Burns R, Campagna R, Larousserie F, Drapé JL. Acral fibromyxoma: Findings on dynamic contrast-enhanced perfusion MRI. Diagn Interv Imaging 2021; 103:59-61. [PMID: 34815198 DOI: 10.1016/j.diii.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Maxime Lacroix
- Department of Radiology, Hôpital Cochin, AP-HP Centre, 75014 Paris, France; Department of Radiology, Hôpital Européen Georges-Pompidou, AP-HP Centre, 75015 Paris, France; Université de Paris, Faculté de Médecine, 75006 Paris, France.
| | - Robert Burns
- Department of Radiology, Hôpital Cochin, AP-HP Centre, 75014 Paris, France; Université de Paris, Faculté de Médecine, 75006 Paris, France
| | - Raphaël Campagna
- Department of Radiology, Hôpital Cochin, AP-HP Centre, 75014 Paris, France
| | - Frédérique Larousserie
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Pathology, Hôpital Cochin, AP-HP Centre, 75014 Paris, France
| | - Jean-Luc Drapé
- Department of Radiology, Hôpital Cochin, AP-HP Centre, 75014 Paris, France; Université de Paris, Faculté de Médecine, 75006 Paris, France
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17
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Lombard C, Teixeira P, Germain E, Dodin G, Louis M, Blum A, Gillet R. Elbow Stiffness Imaging: A Practical Diagnostic and Pretherapeutic Approach. J Clin Med 2021; 10:jcm10225348. [PMID: 34830630 PMCID: PMC8622234 DOI: 10.3390/jcm10225348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Loss of elbow motion can lead to disability in everyday gestures, recreational activities, and work. Unfortunately, the elbow joint is particularly prone to stiffness because of its complex anatomy and biomechanics. The etiology of elbow stiffness is varied and must be diagnosed accurately in order to allow optimal treatment, which may be challenging for surgeons and physiotherapists. Its treatment can be either conservative, arthroscopic or surgical, with a trend for arthroscopic procedures when conservative treatment fails. There is no consensus on the optimal imaging workup for elbow joint stiffness, which may have an impact on patient management. This article reviews the current classification systems of elbow stiffness and the various imaging techniques used for diagnosis. Report checklists and clarifications on the role of each imaging method, as well as the imaging findings of normal and stiff elbows, are presented, leading to a proposed diagnostic algorithm. The main concern in imaging is to determine the cause of elbow stiffness, as many concomitant abnormalities might be present depending on the clinical scenario.
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Affiliation(s)
| | | | | | | | | | | | - Romain Gillet
- Correspondence: ; Tel.: +33-3-83-85-21-61; Fax: +33-3-83-85-97-25
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18
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Gondim Teixeira PA, Villani N, Ait Idir M, Germain E, Lombard C, Gillet R, Blum A. Ultra-high resolution computed tomography of joints: practical recommendations for acquisition protocol optimization. Quant Imaging Med Surg 2021; 11:4287-4298. [PMID: 34603984 DOI: 10.21037/qims-21-217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/19/2021] [Indexed: 12/21/2022]
Abstract
Background To assess the influence on the spatial resolution of various Ultra-high-resolution computed tomography (CT) parameters and provide practical recommendations for acquisition protocol optimization in musculoskeletal imaging. Methods All acquisitions were performed with an Ultra-high resolution scanner, and variations of the following parameters were evaluated: field-of-view (150-300 mm), potential (80-140 KVp), current (25-250 mAs), focal spot size (0.4×0.5 to 0.8×1.3 mm2), slice thickness (0.25-0.5 mm), reconstruction matrix (512×512 to 2048×2048), and iso-centering (up to 85 mm off-center). Two different image reconstruction algorithms were evaluated: hybrid iterative reconstruction (HIR) and model-based iterative reconstruction (MBIR). CATPHAN 600 phantom images were analyzed to calculate the number of visible line pairs per centimeter (lp/cm). Task transfer function (TTF) curves were calculated to quantitatively evaluate spatial resolution. Cadaveric knee acquisitions were also performed. Results Under the conditions studied, the factor that most intensely influenced spatial resolution was the matrix size (additional visualization of up to 8 lp/cm). Increasing the matrix from 512×512 to 2048×2048 led to a 28.2% increase in TTF10% values with a high-dose protocol and a 5.6% increase with a low-dose protocol with no change in the number of visually distinguishable line pairs. The second most important factor affecting spatial resolution was the tube output (29.6% TTF10% gain and 5 additional lp/cm visualized), followed by the reconstruction algorithm choice and lateral displacement (both with a 4 lp/cm gain). Decreasing the slice thickness from 0.5 to 0.25 mm, led to an increase of 3 lp/cm (from 17 to 20 lp/cm) and a 17.3% increase in TTF10% values with no change in the "in-plane" spatial resolution. Conclusions This study provides practical recommendations for spatial resolution optimization using Ultra-high-resolution CT.
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Affiliation(s)
- Pedro Augusto Gondim Teixeira
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France.,Lorraine University, Inserm, IADI, Nancy, France
| | - Nicolas Villani
- Radioprotection Unit, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Malik Ait Idir
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Edouard Germain
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Charles Lombard
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Romain Gillet
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Alain Blum
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
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19
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Pattamapaspong N, Chumsaengsri S, Ruengdit S, Madla C, Mekjaidee K, Prasitwattanaseree S, Mahakkanukrauh P. Preliminary Evaluation of Three-dimensional Cinematic Rendering Computed Tomography Images of Frontonasal Sutures in Personal Identification. FORENSIC IMAGING 2021. [DOI: 10.1016/j.fri.2021.200472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Blum AG, van Holsbeeck MT, Bianchi S. Thumb Injuries and Instabilities. Part 1: Anatomy, Kinesiology, and Imaging Techniques of the Thumb. Semin Musculoskelet Radiol 2021; 25:346-354. [PMID: 34374068 DOI: 10.1055/s-0041-1730397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The unique anatomical characteristics of the thumb offer a broad range of motion and the ability to oppose thumb and finger, an essential function for grasping. The motor function of the thumb and its orientation make it particularly vulnerable to trauma. Pathologic lesions encountered in this joint are varied, and imaging techniques play a crucial role in injury detection and characterization. Despite advances in diagnostic accuracy, acute thumb injuries pose a challenge for the radiologist. The complex and delicate anatomy requires meticulous and technically flawless image acquisition. Standard radiography and ultrasonography are currently the most frequently used imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations, and magnetic resonance imaging may be useful in equivocal cases. In this article, we present the relevant anatomy and imaging techniques of the thumb.
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Affiliation(s)
- Alain G Blum
- Guilloz Imaging Department, CHRU of Nancy, University of Lorraine, Nancy, France.,Unité INSERM U1254 Imagerie Adaptative Diagnostique et Interventionnelle (IADI), CHRU of Nancy, Vandœuvre-lès-Nancy, France
| | | | - Stefano Bianchi
- CIM SA, Cabinet d'imagerie Médicale, Geneva, Switzerland.,Service de Radiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
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21
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Kawashima T, Sato F. First in situ 3D visualization of the human cardiac conduction system and its transformation associated with heart contour and inclination. Sci Rep 2021; 11:8636. [PMID: 33883659 PMCID: PMC8060315 DOI: 10.1038/s41598-021-88109-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/08/2021] [Indexed: 02/07/2023] Open
Abstract
Current advanced imaging modalities with applied tracing and processing techniques provide excellent visualization of almost all human internal structures in situ; however, the actual 3D internal arrangement of the human cardiac conduction system (CCS) is still unknown. This study is the first to document the successful 3D visualization of the CCS from the sinus node to the bundle branches within the human body, based on our specialized physical micro-dissection and its CT imaging. The 3D CCS transformation by cardiac inclination changes from the standing to the lying position is also provided. Both actual dissection and its CT image-based simulation identified that when the cardiac inclination changed from standing to lying, the sinus node shifted from the dorso-superior to the right outer position and the atrioventricular conduction axis changed from a vertical to a leftward horizontal position. In situ localization of the human CCS provides accurate anatomical localization with morphometric data, and it indicates the useful correlation between heart inclination and CCS rotation axes for predicting the variable and invisible human CCS in the living body. Advances in future imaging modalities and methodology are essential for further accurate in situ 3D CCS visualization.
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Affiliation(s)
- Tomokazu Kawashima
- Department of Anatomy, School of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan.
| | - Fumi Sato
- Department of Anatomy, School of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan
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22
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Zimmerman SL, Rowe SP, Fishman EK. Cinematic rendering of CT angiography for visualization of complex vascular anatomy after hybrid endovascular aortic aneurysm repair. Emerg Radiol 2021; 28:839-843. [PMID: 33651233 DOI: 10.1007/s10140-021-01922-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
The purpose of this study is to demonstrate the utility of cinematic rendering (CR) techniques for imaging of patients who have undergone hybrid repair of thoracoabdominal aortic aneurysms that are difficult to assess given anatomic complexity, particularly in the emergency setting. In this pictorial essay, we will explain why CR techniques are uniquely suited to improving anatomic visualization in patients with complex postoperative vascular anatomy. Verification of vessel patency is critical to optimal care of these patients in any setting, particularly in the emergency patient when clinical history may be lacking. Cinematic rendering (CR) is a recently developed CT post-processing technique for creating photorealistic anatomic visualization. Hybrid abdominal aortic aneurysm repairs involve the use of multiple tortuous and overlapping grafts to preserve blood flow to visceral arteries, which are difficult to adequately evaluate using standard orthogonal planes and with traditional VR techniques. Several examples of complex aortic repairs show the utility of CR for improved visualization of these structures. CR improves upon standard 3D volumetric techniques through improved depiction of the spatial relationships of anatomic structures in 3D space, permitting near life-like visualization that allows the imager to simplify the visualization of highly complex anatomy.
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Affiliation(s)
- Stefan L Zimmerman
- Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,, Baltimore, USA.
| | - Steven P Rowe
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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23
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Blum AG, Gillet R, Athlani L, Prestat A, Zuily S, Wahl D, Dautel G, Gondim Teixeira P. CT angiography and MRI of hand vascular lesions: technical considerations and spectrum of imaging findings. Insights Imaging 2021; 12:16. [PMID: 33576888 PMCID: PMC7881081 DOI: 10.1186/s13244-020-00958-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/29/2020] [Indexed: 12/30/2022] Open
Abstract
Vascular lesions of the hand are common and are distinct from vascular lesions elsewhere because of the terminal vascular network in this region, the frequent hand exposure to trauma and microtrauma, and the superficial location of the lesions. Vascular lesions in the hand may be secondary to local pathology, a proximal source of emboli, or systemic diseases with vascular compromise. In most cases, ischaemic conditions are investigated with Doppler ultrasonography. However, computed tomography angiography (CTA) or dynamic contrast-enhanced magnetic resonance angiography (MRA) is often necessary for treatment planning. MR imaging is frequently performed with MRA to distinguish between vascular malformations, vascular tumours, and perivascular tumours. Some vascular tumours preferentially affect the hand, such as pyogenic granulomas or spindle cell haemangiomas associated with Maffucci syndrome. Glomus tumours are the most frequent perivascular tumours of the hand. The purpose of this article is to describe the state-of-the-art acquisition protocols and illustrate the different patterns of vascular lesions and perivascular tumours of the hand.
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Affiliation(s)
- Alain G Blum
- Service D'imagerie Guilloz, CHRU Nancy, 54 000, Nancy, France.
| | - Romain Gillet
- Service D'imagerie Guilloz, CHRU Nancy, 54 000, Nancy, France
| | - Lionel Athlani
- Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé, CHRU de Nancy, 54 000, Nancy, France
| | | | - Stéphane Zuily
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases and Vascular Medicine Division, CHRU Nancy, INSERM UMR-S 1116 University of Lorraine, 54 000, Nancy, France
| | - Denis Wahl
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases and Vascular Medicine Division, CHRU Nancy, INSERM UMR-S 1116 University of Lorraine, 54 000, Nancy, France
| | - Gilles Dautel
- Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé, CHRU de Nancy, 54 000, Nancy, France
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24
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Blum A, Gillet R, Urbaneja A, Gondim Teixeira P. Automatic detection of rib fractures: Are we there yet? EBioMedicine 2020; 63:103158. [PMID: 33278798 PMCID: PMC7718439 DOI: 10.1016/j.ebiom.2020.103158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Blum
- Guilloz imaging department, CHRU of Nancy, University of Lorraine, 54 000 Nancy, France; Unité INSERM U1254 Imagerie Adaptative Diagnostique et Interventionnelle (IADI), CHRU of Nancy, 54511 Vandœuvre-lès-Nancy, France.
| | - R Gillet
- Guilloz imaging department, CHRU of Nancy, University of Lorraine, 54 000 Nancy, France
| | - A Urbaneja
- Guilloz imaging department, CHRU of Nancy, University of Lorraine, 54 000 Nancy, France
| | - P Gondim Teixeira
- Guilloz imaging department, CHRU of Nancy, University of Lorraine, 54 000 Nancy, France; Unité INSERM U1254 Imagerie Adaptative Diagnostique et Interventionnelle (IADI), CHRU of Nancy, 54511 Vandœuvre-lès-Nancy, France
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25
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Jacques T, Fournier L, Zins M, Adamsbaum C, Chaumoitre K, Feydy A, Millet I, Montaudon M, Beregi JP, Bartoli JM, Cart P, Masson JP, Meder JF, Boyer L, Cotten A. Proposals for the use of artificial intelligence in emergency radiology. Diagn Interv Imaging 2020; 102:63-68. [PMID: 33279461 DOI: 10.1016/j.diii.2020.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Thibaut Jacques
- Department of Musculoskeletal Imaging, Lille University Hospital, 59000 Lille, France; Lille University School of Medicine, 59000 Lille, France.
| | - Laure Fournier
- Inserm, PARCC, 75015 Paris, France; Université de Paris, 75006 Paris, France; Radiology Department, Hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France; DRIM France IA, 75013 Paris, France; Collège des Enseignants en Radiologie de France (CERF), 75013 Paris, France
| | - Marc Zins
- DRIM France IA, 75013 Paris, France; Department of Medical Imaging, Saint-Joseph Hospital, 75014 Paris, France
| | - Catherine Adamsbaum
- Faculty of Medicine, Paris-Saclay University, 94270 Le-Kremlin-Bicêtre, France; Pediatric Radiology Department, Bicêtre Hospital, AP-HP, 94270 Le-Kremlin-Bicêtre, France
| | - Kathia Chaumoitre
- Imaging Department, Hôpital Nord, APHM, 13015 Marseille, France; Aix-Marseille University, 13007 Marseille, France
| | - Antoine Feydy
- Department of Radiology B, Cochin Hospital, AP-HP, 75014 Paris, France; Université de Paris, 75006 Paris, France
| | - Ingrid Millet
- Department of Medical Imaging, Lapeyronie University Hospital, 34295 Montpellier, France; Inserm, UMR, Institut Desbrest d'Épidémiologie et de Santé publique, University of Montpellier, 34000 Montpellier, France
| | - Michel Montaudon
- Collège des Enseignants en Radiologie de France (CERF), 75013 Paris, France; Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France; Inserm U1045, IHU LIRYC, Université de Bordeaux, 33600 Pessac, France
| | - Jean-Paul Beregi
- DRIM France IA, 75013 Paris, France; Collège des Enseignants en Radiologie de France (CERF), 75013 Paris, France; Medical Imaging Group Nîmes, Nîmes University Hospital, 34000 Nîmes, France
| | - Jean-Michel Bartoli
- DRIM France IA, 75013 Paris, France; Collège des Enseignants en Radiologie de France (CERF), 75013 Paris, France; Radiology, La Timone Hospital, 13000 Marseille, France
| | - Philippe Cart
- Groupement Hospitalier Intercommunal Nord Ardennes, 08000 Charleville-Mézières, France; Syndicat des Radiologues Hospitaliers, 75004 Paris, France
| | - Jean-Philippe Masson
- DRIM France IA, 75013 Paris, France; Fédération Nationale des Médecins Radiologues, 75007 Paris, France
| | - Jean-François Meder
- Université de Paris, 75006 Paris, France; Department of Neuroradiology, Sainte-Anne Hospital, 75014 Paris, France; Inserm UMR 894, Faculty of Medicine, Pyschiatry and Neurosciences Centers, Paris Descartes University, Sorbonne Paris Cité, 75014 Paris, France; Société Française de Radiologie, 75013 Paris, France
| | - Louis Boyer
- Department of Radiology, Hôpital Montpied, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; TGI, Institut Pascal UMR 6602 UCA/CNRS/SIGMA Clermont, 63000 Clermont-Ferrand, France; Conseil National Professionnel de Radiologie (G4), 75013 Paris, France
| | - Anne Cotten
- Department of Musculoskeletal Imaging, Lille University Hospital, 59000 Lille, France; Lille University School of Medicine, 59000 Lille, France; Collège des Enseignants en Radiologie de France (CERF), 75013 Paris, France; Société Française de Radiologie, 75013 Paris, France
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26
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Fishman EK. CT scanning and data post-processing with 3D and 4D reconstruction: Are we there yet? Diagn Interv Imaging 2020; 101:691-692. [PMID: 33143856 DOI: 10.1016/j.diii.2020.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- E K Fishman
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
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