3D Reconstructed Computed Tomography Images Research Articles

Associations Among Temporomandibular Joint Osteoarthritis, Airway Dimensions, and Head and Neck Posture

This study sought to investigate associations among progressive temporomandibular joint osteoarthritis (TMJ OA), airway dimensions, and head and neck posture. In total, 114 temporomandibular disorders (TMDs) patients were enrolled. Among 114 patients, 28 had no pathologic bony changes in the TMJ condyles (TMDnoOA), 45 had progressive TMJ OA (TMJOApro), and 41 demonstrated TMJ OA which had not progressed for 12months (TMJOAnopro). TMJ OA was diagnosed based on the Diagnostic Criteria for TMD axis I. Computed tomography (CT) images and lateral cephalograms were obtained at baseline (T0) and 12months after treatment (T1). The head and neck posture and airway area in upright position were analyzed using lateral cephalograms whereas airway volume in supine position was determined by 3D reconstructed CT images. The volume change of the oropharynx in supine position was more prominent in the TMJOApro than in the TMDnoOA but no significant differences in changes in the pharyngeal airway while in upright position were detected. The retrognathic facial profile became more remarkable at T1 in the TMJOApro and TMJOAnopro compared to those at T0. The forward head posture seemed to be progressed in the TMJOApro than in either the TMJOAnopro or TMDnoOA. Progressive TMJ OA may have associations with retrognathia and decreased oropharyngeal airway volume in the supine position but not in the upright position. Progressive TMJ OA may be related with altered head posture in the upright position to compensate for reduced airway dimensions.

Acoustic emission and CT investigation on fracture evolution of granite containing two flaws subjected to freeze–thaw and cyclic uniaxial increasing-amplitude loading conditions

The deterioration mechanism and fatigue fracturing evolution of granite with two pre-existing flaws experiencing freeze–thaw (F-T) treatment are investigated in this work. The flaws in the rock sample were prepared as a combination of a horizontal flaw with an upper inclined flaw above the horizontal flaw according to the joint characteristics in an open pit slope. In-situ acoustic emission monitoring combined with the post-test 3D computed tomography (CT) technique was employed to reveal the fracture evolution behaviors of rock treated with 0, 50, and 80 freeze–thaw cycles. Results show that the freeze–thaw damage impacts the frost heaving force, cyclic deformation, AE activates, crack coalescence pattern and fatigue life of the granite samples. The accumulative AE count/energy decreases with increasing number of freeze–thaw cycles, and the accumulated AE count/energy in a loading stage gradually grows faster. In addition, AE spectral frequency analysis reveals the impact of previous freeze–thaw damage on the formation of the crack scale, the sample is prone to producing large scale cracks under high freeze–thaw treatment. Moreover, 3D reconstructed CT images present an internal crack network pattern, and the most striking finding is that a simple crack network forms for a sample experiencing high F-T fatigue damage. It is suggested that deterioration of the rock bridge structure is strongly impacted by the accumulative freeze–thaw damage. The testing results are helpful to understand the influence of freeze–thaw and fatigue loading on the fracture evolution characteristics of rock in cold regions.

Development of bone regeneration strategies using human periosteum-derived osteoblasts and oxygen-releasing microparticles in mandibular osteomyelitis model of miniature pig.

Hypoxia and limited vascularization inhibit bone growth and recovery after surgical debridement to treat osteomyelitis. Similarly, despite significant efforts to create functional tissue-engineered organs, clinical success is often hindered by insufficient oxygen diffusion and poor vascularization. To overcome these shortcomings, we previously used the oxygen carrier perfluorooctane (PFO) to develop PFO emulsion-loaded hollow microparticles (PFO-HPs). PFO-HPs act as a local oxygen source that increase cell viability and maintains the osteogenic differentiation potency of human periosteum-derived cells (hPDCs) under hypoxic conditions. In the present study, we used a miniature pig model of mandibular osteomyelitis to investigate bone regeneration using hPDCs seeded on PFO-HPs (hPDCs/PFO-HP) or hPDCs seeded on phosphate-buffered saline (PBS)-HPs (hPDCs/PBS-HP). Osteomyelitis is characterized by a series of microbial invasion, vascular disruption, bony necrosis, and sequestrum formation due to impaired host defense response. Sequential plain radiography, computed tomography (CT), and 3D reconstructed CT images revealed new bone formation was more advanced in defects that had been implanted with the hPDCs/PFO-HPs than in defects implanted with the hPDCs/PBS-HP. Thus, PFO-HPs are a promising tissue engineering approach to repair challenging bone defects and regenerate structurally organized bone tissue with 3D architecture.

Operative Planning in Thoracic Surgery: A Pilot Study Comparing Imaging Techniques and Three-Dimensional Printing

Careful preoperative planning in thoracic surgery is essential for positive outcomes, especially in video-assisted thoracic surgery (VATS), where palpation and 3-dimensional (3D) imaging is restricted. This study evaluated the ability of different imaging techniques, such as computed tomography (CT) scanning, maximal intensity projection imaging, 3D reconstruction, and 3D printing, to define the anatomy of the hilar structures before anatomical lung resection. All patients undergoing elective lung resections by VATS for cancer under a single surgeon were identified over a 3-month period. The surgeon was asked to record the number of pulmonary artery branches supplying the lobe to be resected by using the preoperative CT scans, maximal intensity projection images, and 3D-reconstructed CT images. The lung hilum in 3 patients was printed. These were then compared with the intraoperative findings. The preoperative imaging of 16 patients was analyzed. The lung hilum was printed in a further 3 patients. Although not statistically significant, the 3D prints of the hilum were the most accurate measurement, with a correlation of 0.92. CT, 3D-reconstructed CT, and maximal intensity projection images tended to underrecognize the number of arterial branches and therefore scored between 0.26 and 0.39 in absolute agreement with the number of arteries found at operation. 3D printing in the planning of thoracic surgery may suggest a benefit over contemporary available imaging modalities, and the use of 3D printing in practicing operations is being established.

Prognostic significance of combined radiologic imaging modalities for prognosis of clinical IA adenocarcinomas.

BackgroundWe previously proposed measuring tumor size using mediastinal window setting on high-resolution computed tomography (CT) as a simple and useful modality for preoperative prognostication of small adenocarcinoma. Hence, the importance of tumor volume and positron emission tomography (PET) for preoperative prognostication of clinical stage IA (cIA) adenocarcinoma was studied.Materials and MethodsWe retrospectively evaluated total 324 patients who underwent pulmonary resection of cIA adenocarcinoma between July 2008 and August 2015. Reconstructed three-dimensional (3D) images from 1–1.5 mm-sliced CT were evaluated for whole tumor volume including ground grass opacity, consolidation volume on lung window setting, and mediastinal window volume (MWV). The values examined by PET were total lesion glycolysis (TLG), and maximum standardized uptake (SUV max) and mean. Pathologic status was evaluated according to tumor maximum size, invasive size (IS), lymphatic and vascular vessels, pleural invasion (ly/v/pl), and TNM staging.ResultsAccording to ly/v/pl invasion and lymph node positivity, no variables were superior to IS. We used Mean/MWV (SUV mean x MWV) to evaluate tumor quality and quantity in the role of surrogate TLG. Mean/MWV were superior to IS. Additionally, Mean/MV was associated with lymph node metastases. Among the various histologic subtypes, solid-predominant had the highest expression of Mean/MV. The higher Mean/MV significantly contributed to unfavorable disease-free survival in cIA adenocarcinomas, but not to overall survival.ConclusionsThe mean/MWV value determination on 3D-reconstructed CT images was a simple and useful preoperative modality for predicting invasive facet in cIA adenocarcinoma. However, higher values didn't significantly affect overall survival.

Three-dimensional computed tomography angiography reconstruction of the origin of the uterine artery and its clinical significance.

In women, the uterine artery is the main branch of the internal iliac artery, vascularizing most of the uterus. Knowledge of its origin and variations is essential during extensive gynaecological surgery and interventional radiological procedures. We aimed to investigate its origin and explore its anatomical variations by three-dimensional (3D) reconstructed computed tomography (CT) angiography. This was a retrospective, monocentric observational study involving CT scans of the abdomen and lower limbs of women < 50years old with 3D reconstructed CT images of the internal and external iliac arterial axes. Between 01 January 2014 and 31 December 2015, among 986 cases of CT scans performed in women, for all indications, 3D reconstructed images for 43 women could be analysed. The uterine artery originated from a common trunk with the umbilical artery in 62.7% of cases, from a direct branch of the internal iliac artery in 25.6% of cases, directly from the superior gluteal artery in 9.3% of cases and from the internal pudendal artery in 2.3%. Three-dimensional(3D) reconstructed CT angiography can detect the point of origin of the uterine artery. Therefore, it can be used as a mapping tool of the pelvic arterial tree. Our study corroborates data from the literature that the uterine artery most often originates from a common trunk with the umbilical artery. However, surgeons and intervention radiologists must be aware of the variability of its origin to facilitate the safety of the patients during procedures.

426P Combined radiologic imaging modalities for prognosis of clinical IA adenocarcinomas

Background We previously proposed measuring tumor size using mediastinal window setting on high-resolution computed tomography (CT) as a simple and useful modality for preoperative prognostication of small adenocarcinoma. Here, the importance of tumor volume and positron emission tomography (PET) for preoperative prognostication of clinical stage IA (cIA) adenocarcinoma for anatomical pulmonary resection was studied. Methods We retrospectively evaluated total 326 patients who underwent pulmonary resection of cIA adenocarcinoma between July 2008 and August 2015. Reconstructed three-dimensional (3D) images from 1-1.5 mm-slice multi-detectorrow CT were evaluated for tumor total volume (TTV), consolidation volume (CV) on lung window setting, and mediastinal volume (MV) on MWS. The values examined by PET were total lesionglycolysis, maximum standardized uptake (SUVmax), and mean SUV. Patient age, gender, preoperative CEA levels, and clinical staging were examined. Pathologic statuswasevaluatedaccordingto tumorsize (PS), invasivesize(IS), lymphaticand vascular vessels, pleural invasion, and TNM staging. Results Pathologic lymph node positivity, and IS were equivalent or superior to 3D imaging factors, preoperative patient variables, and PS, respectively. We used mean/MV to evaluate tumor quality and quantity, because only MV and CV were equivalent to IS. AUCs for mean/MV were 0.80,0.82, and 0.81 and were >IS. Mean/MV was associated with lymph node metastasis, tumor invasiveness, histologic grade, and two-dimensional mediastinal diameter on MDCT. Among the various histologic subtypes, solid- predominant tumors had the highest mean/MV; the number of genomictriple-negative adenocarcinoma was significantly higher than adenocarcinoma harboring an exclusive gene of EGFR, KRAS, or ALK. Moreover, highermean/MV significantly contributed to unfavorable disease-free survival in cIA adenocarcinomas. Conclusions The mean/MV value determination on 3D-reconstructed CT images was a simple and useful preoperative modality for predicting invasiveness, lymph node metastasis, and stage migration in cIA adenocarcinomas; higher values correlated with poorer prognosis and reflected tumor aggressiveness and extent ofinvasion. Legal entity responsible for the study N/A Funding N/A Disclosure All authors have declared no conflicts ofinterest.

64-Slice spiral computed tomography and three-dimensional reconstruction in the diagnosis of cystic pancreatic tumors.

The present study aimed to describe the characteristics of cystic pancreatic tumors using computed tomography (CT) and to evaluate the diagnostic accuracy (DA) of post-imaging three-dimensional (3D) reconstruction. Clinical and imaging data, including multi-slice spiral CT scans, enhanced scans and multi-faceted reconstruction, from 30 patients with pathologically confirmed cystic pancreatic tumors diagnosed at the Linyi People's Hospital between August 2008 and June 2014 were retrospectively analyzed. Following the injection of Ultravist® 300 contrast agent, arterial, portal venous and parenchymal phase scans were obtained at 28, 60 and 150 sec, respectively, and 3D reconstructions of the CT images were generated. The average age of the patients was 38.4 years (range, 16-77 years), and the cohort included 5 males and 25 females (ratio, 1:5). The patients included 8 cases of mucinous cystadenoma (DA), 80%]; 9 cases of cystadenocarcinoma (DA, 84%); 6 cases of serous cystadenoma (DA, 100%); 3 cases of solid pseudopapillary tumor (DA, 100%); and 4 cases of intraductal papillary mucinous neoplasm (DA, 100%). 3D reconstructions of CT images were generated and, in the 4 cases of intraductal papillary mucinous neoplasm, the tumor was connected to the main pancreatic duct and multiple mural nodules were detected in one of these cases. The DA of the 3D-reconstructed images of cystic pancreatic tumors was 89.3%. The 64-slice spiral CT and 3D-reconstructed CT images facilitated the visualization of cystic pancreatic tumor characteristics, in particular the connections between the tumor and the main pancreatic duct. In conclusion, the 3D reconstruction of multi-slice CT data may provide an important source of information for the surgical team, in combination with the available clinical data.

Benefits of biphasic calcium phosphate hybrid scaffold-driven osteogenic differentiation of mesenchymal stem cells through upregulated leptin receptor expression.

BackgroundThe use of mesenchymal stem cells (MSCs) and coralline hydroxyapatite (HA) or biphasic calcium phosphate (BCP) as a bone substitute for posterolateral spinal fusion has been reported. However, the genes and molecular signals by which MSCs interact with their surrounding environment require further elucidation.MethodsMSCs were harvested from bone grafting patients and identified by flow cytometry. A composite scaffold was developed using poly(lactide-co-glycolide) (PLGA) copolymer, coralline HA, BCP, and collagen as a carrier matrix for MSCs. The gene expression profiles of MSCs cultured in the scaffolds were measured by microarrays. The alkaline phosphatase (ALP) activity of the MSCs was assessed, and the expression of osteogenic genes and proteins was determined by quantitative polymerase chain reaction (Q-PCR) and Western blotting. Furthermore, we cultured rabbit MSCs in BCP or coralline HA hybrid scaffolds and transplanted these mixtures into rabbits for spinal fusion. We investigated the differences between BCP and coralline HA hybrid scaffolds by dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT).ResultsTested in vitro, the cells were negative for hematopoietic cell markers and positive for MSC markers. There was higher expression of 80 genes and lower of 101 genes of MSCs cultured in BCP hybrid scaffolds. Some of these genes have been shown to play a role in osteogenesis of MSCs. In addition, MSCs cultured in BCP hybrid scaffolds produced more messenger RNA (mRNA) for osteopontin, osteocalcin, Runx2, and leptin receptor (leptin-R) than those cultured in coralline HA hybrid scaffolds. Western blotting showed more Runx2 and leptin-R protein expression in BCP hybrid scaffolds. For in vivo results, 3D reconstructed CT images showed continuous bone bridges and fusion mass incorporated with the transverse processes. Bone mineral content (BMC) values were higher in the BCP hybrid scaffold group than in the coralline HA hybrid scaffold group.ConclusionsThe BCP hybrid scaffold for osteogenesis of MSCs is better than the coralline HA hybrid scaffold by upregulating expression of leptin-R. This was consistent with in vivo data, which indicated that BCP hybrid scaffolds induced more bone formation in a spinal fusion model.

Twist Drill Aspiration of Pyogenic Brain Abscesses: Our Experience in 103 Cases

Intracranial abscesses remain a significant health care problem in developing countries. Though potentially curable, brain abscess remains a diagnostic and therapeutic challenge. The effective treatment of intracranial abscess remains controversial. Various surgical procedures like drainage, aspiration, and excision have been advocated for the management of brain abscess with variable results. Aspiration is a rapid and safe procedure, especially with use of stereotactic techniques, intraoperative ultrasound, or computed tomography (CT) scan guidance. However, these are not readily available everywhere. To assess the outcome in pyogenic brain abscesses treated by twist drill aspiration (a bedside procedure) in which point of aspiration is marked with the help of three-dimensional (3D) reconstructed CT images. From September 2007 to September 2011, a total of 103 cases of brain abscesses over 2.5 cm in size were treated by twist drill aspiration. The point of aspiration was marked with the help of 3D reconstructed CT images using fixed bony landmarks as reference, and exact measurement were taken with the help of biopsy software. In the present study, 103 cases of superficial brain abscesses were treated via twist drill aspiration. Out of these, 98 patients had a single abscess and five had multiple abscesses. Out of the 103 patients, 86 (83.4%) showed good recovery, 9 (8.7%) had moderate disability, 3 (2.9%) had severe disability, and 5 (4.8%) expired. Twist drill aspiration is a rapid, safe, and very effective lifesaving procedure in the underdeveloped world where stereotaxy is not readily available.