Computed Tomography Studies Research Articles

The prevalence of Stafne bone cavity: A meta-analysis of 355,890 individuals

Background/purposeA Stafne bone cavity (SBC) is an incidental depression in the lingual surface of the mandible. The aim of this study is to provide pooled estimates of the frequency of Stafne bone cavity and to correlate its presence with such variables as sex, laterality, diagnostic methods and population. Materials and methodsPotential studies were searched through four electronic databases: Google Scholar, PubMed, Scopus, and Journal Storage. Titles, abstracts, and full texts of the articles were screened. ResultsA total of 54 studies relating to 355,890 subjects met the inclusion criteria for meta-analysis. A meta-analysis using the DerSimonian-Laird model revealed an overall prevalence of 0.17% (CI:0.14%–0.21%, I2 = 80.7%). SBC was four times more common in males than females (z = 6.94, P < 0.01), and was unilateral in almost all cases (z = 12.90, P < 0.01). Radiographic studies yielded a lower SBC prevalence at 0.12% (CI:0.09%–0.15%, I2 = 71.7%) than computed tomography studies, skeletal studies and excavation studies. Ancient populations had three times higher SBC prevalences (0.47%, CI:0.21%–0.73%, I2 = 89.5%) than the average populations today (z = 3.21, P < 0.01). ConclusionThe prevalence of Stafne bone cavity is approximately 0.17%, and was four times more prevalent in males than females. This variant bone cavity was also present unilaterally in the majority of cases. Awareness of SBC is important for dentists, maxillofacial surgeons and other practitioners performing routine dental practices and interpreting panoramic radiographs.

Impact of iodinated contrast allergies on emergency department operations

ObjectivesAdverse reactions to intravenous (IV) iodinated contrast media are classified by the American College of Radiology (ACR) Manual on Contrast Media as either allergic-like (ALR) or physiologic (PR). Premedication may be beneficial for patients who have prior documented mild or moderate ALR. We sought to perform a retrospective analysis of patients who received computed tomography (CT) imaging in our emergency department (ED) to establish whether listing of an iodinated contrast media allergy results in a delay in care, increases the use of non-contrast studies, and to quantify the incidence of listing iodinated contrast allergies which do not necessitate premedication. MethodsWe performed a retrospective analysis of CT scans performed in our academic medical center ED during a 6-month period. There were 12,737 unique patients of whom 454 patients had a listed iodinated contrast allergy. Of these, 106 received IV contrast and were categorized as to whether premedication was necessary. Descriptive statistics were used to evaluate patient demographics, clinical characteristics, and operational outcomes. A multivariate linear regression model was used to predict time from order to start (OTS time) of CT imaging while controlling for co-variates. ResultsNon-allergic patients underwent contrast-enhanced CT imaging at a significantly higher rate than allergic patients (45.9% vs. 23.3%, p < 0.01). The OTS time for allergic patients who underwent contrast-enhanced CT imaging was 360 min and significantly longer than the OTS time for non-allergic patients who underwent contrast-enhanced CT imaging (118 min, p < 0.001). Of the 106 allergic patients who underwent contrast-enhanced CT imaging, 27 (25.5%) did not meet ACR criteria for necessitating premedication. The average OTS time for these 27 patients was 296 min, significantly longer than the OTS for non-allergic patients (118 min, p < 0.01) and did not differ from the OTS time for the 79 patients who did meet premedication criteria (382 min, p = 0.23). A multivariate linear regression showed that OTS time was significantly longer if a contrast allergy was present (p < 0.001). ConclusionA chart-documented iodinated contrast allergy resulted in a significant increase in time to obtain a contrast-enhanced CT study. This delay persisted among patients who did not meet ACR criteria for premedication. Appropriately deferring premedication could potentially reduce the ED length-of-stay by over 4 h for these patients.

Ideal entry point and trajectory for C2 pedicle screw placement in children: a 3D computed tomography study.

To identify the ideal entry point for pediatric C2 pedicle screw and to obtain parameters of it for the indication of pediatric atlantoaxial fusion arthrodesis. The pediatric cervical CT images were reconstructed into the 3D digital models and the C2 vertebrae were separated. The location of ideal entry point and screw placement related linear and angular parameters were assessed on the 3D digital models. A total of 214 pedicles from 107 C2 digital models were analyzed. The average entry point for C2 was 3.80 ± 2.78mm medial to the lateral notch (LN) and 2.57 ± 1.70mm superior to the LN. The average pedicle diameter (PD) was 6.02 ± 1.31mm, and the average pedicle screw length (PSL) was 25.63 ± 3.46mm. Statistical differences were found between different sex for PD and PSL (P < 0.05). As patient age increases, using the most lateral and inferior edge of the lateral mass as a reference marker, the entry point tends to move medial and cephalad, when using the LN as a reference marker, the entry point tends to move medial and slightly caudad. Univariate linear regression analysis suggested that these linear parameters were associated with age (P < 0.01). In this study, we found that the measurement results of C2 pedicle screw varied based on sex, laterality, and ages for children younger than 18years. The entry point of the screws facilitating ideal trajectory tends to change in a linear way as a function of age. This information helps the surgeon to establish the specific anatomy related to C2 pedicle screw placement to facilitate fixation in the pediatric patients.

Morphological and Imaging Features of Male Pseudohermaphroditism in a Feral Cat

Abstract A one-year-old European shorthair feral cat with signs of heat was presented at the Veterinary Teaching Hospital of Las Palmas de Gran Canaria University. After the physical exam, histology, hormonal analysis, ultrasound and computed tomography (CT) studies were performed. Examination of the external genitalia revealed the absence of one of the testes in the scrotal sac and the presence of a structure whose appearance could suggest an enlarged penis-like clitoris with small spines. The ultrasound study showed compatible images with the left ovary and intra-abdominal testis and tubular structures, which closely resembled the uterine horns. Similar structures were confirmed in the CT study. Exploratory celiotomy revealed the presence of the uterus and undescended testis attached to the uterine horn. Histological examination revealed immature testicular tissue in both gonads and the presence of Persistent Müllerian Duct (PMD). Though a karyotype was not performed, it was presumed to be the standard 38 XY found in pseudohermaphrodites. To date, this type of disorder of sexual development (DSD) has been scarcely reported in cats. Further studies are on the way to knowing the genetic mechanism of this disease.

Maxillary sinus volume in patients with canted occlusal plane: A cone-beam computed tomography study.

To compare the maxillary sinus volume between both sides in adult patients with upper occlusal canting (>2 mm cant) and a control group (≤2 mm cant) using cone-beam computed tomography scans. This retrospective study included a total of 84 scans (42 scans per group) according to predetermined selection criteria. OnDemand 3-D™ software was used for volumetric and linear measurements of the maxillary sinus. Maxillary occlusal canting was determined at the level of the maxillary first molars. It was defined as the vertical difference between right and left sides relative to the Frankfort horizontal plane. Non-parametric tests were applied. The median difference in the maxillary sinus volume between the sides was statistically significant between the control and cant groups (P< 0.001). Also, the median difference in the maxillary sinus craniocaudal height and apex sinus distance between the sides was statistically significant between the control and cant groups (P< 0.05 and P< 0.001, respectively). In adult patients, maxillary occlusal canting of more than 2 mm was associated with asymmetric maxillary sinus volumes. In the cant group, maxillary first molars on the canted-down side were in close proximity to the sinus floor, which suggests a limited leeway for molar intrusion.

Does the horizontal condylar angle have a relationship to temporomandibular joint osteoarthritis and condylar position? A cone-beam computed tomography study.

The aim of the study was to evaluate the relationship between the horizontal condylar angle (HCA), temporomandibular joint osteoarthritis (TMJ OA), and condylar position on cone-beam computed tomography (CBCT) images. Based on TMJ OA, joints were classified as affected and the unaffected. According to the OA condition of their joints, three groups of patients were formed: control group (n = 159, 41.1%), unilateral group (n = 121, 31.3%), and bilateral group (n = 107, 27.6%). In total, the HCAs of 774 TMJs of 387 patients were measured and their condylar positions were determined as concentric (n = 184, 23.8%), posterior (n = 338, 43.7%), and anterior (n = 252, 32.5%). The mean HCA of the bilateral group (22.7 ± 7.6°) was greater than those in both the control (19.5 ± 6.4°) and the unilateral (20.5 ± 6.5°) groups (p < 0.05). However, the difference was not statistically significant between the control and unilateral group (p > 0.05). In total patients, unlike the unilateral group, the affected joints had a greater mean HCA than the unaffected joints (p < 0.05). The mean HCAs of the joints according to the condylar position were as concentric: 20.6 ± 6.7°, posterior: 21.1 ± 7.8°, and anterior: 20.2 ± 7.9° (p > 0.05). While the HCA increased in the presence of TMJ OA, no relationship was found between HCA and three different condylar positions.

Crown-root angulations of the maxillary anterior teeth according to malocclusions: A cone-beam computed tomography study in Korean population.

To compare crown-root angulations of the permanent maxillary anterior teeth in skeletal Class I, Class II, and Class III Korean malocclusion patients using cone-bean computed tomography (CBCT) images. Sixty CBCT images were collected from orthodontic patients archive based on skeletal Class I (0˚< A point-nasion-B point angle [ANB] < 4˚), Class II (ANB ≥ 4˚), and Class III (ANB ≤ 0˚) to have 20 samples in each group. Mesiodistal crown-root angulation (MDCRA) and labiolingual crown-root angulation (LLCRA) were evaluated after orientation of images. Crown-root angulations were compared among Class I, Class II, and Class III groups and among the maxillary anterior teeth in each group. LLCRAs of the maxillary central incisor and the lateral incisor were significantly lower in Class III group than those in Class I group. However, those of the canine showed no significant differences among groups. MDCRAs of the maxillary anterior teeth did not significantly differ among groups either. Our results suggest that skeletal Class III malocclusion might affect LLCRA of the maxillary incisors, especially the central incisor.

Unsupervised Domain Adaptation for Vertebrae Detection and Identification in 3D CT Volumes Using a Domain Sanity Loss.

A variety of medical computer vision applications analyze 2D slices of computed tomography (CT) scans, whereas axial slices from the body trunk region are usually identified based on their relative position to the spine. A limitation of such systems is that either the correct slices must be extracted manually or labels of the vertebrae are required for each CT scan to develop an automated extraction system. In this paper, we propose an unsupervised domain adaptation (UDA) approach for vertebrae detection and identification based on a novel Domain Sanity Loss (DSL) function. With UDA the model’s knowledge learned on a publicly available (source) data set can be transferred to the target domain without using target labels, where the target domain is defined by the specific setup (CT modality, study protocols, applied pre- and processing) at the point of use (e.g., a specific clinic with its specific CT study protocols). With our approach, a model is trained on the source and target data set in parallel. The model optimizes a supervised loss for labeled samples from the source domain and the DSL loss function based on domain-specific “sanity checks” for samples from the unlabeled target domain. Without using labels from the target domain, we are able to identify vertebra centroids with an accuracy of %. By adding only ten target labels during training the accuracy increases to %, which is on par with the current state-of-the-art for full supervised learning, while using about 20 times less labels. Thus, our model can be used to extract 2D slices from 3D CT scans on arbitrary data sets fully automatically without requiring an extensive labeling effort, contributing to the clinical adoption of medical imaging by hospitals.

Craniomaxillofacial trauma in immature dogs-etiology, treatments, and outcomes.

Treatment of craniomaxillofacial (CMF) trauma in dogs often requires a multidisciplinary approach and a thorough understanding of the CMF anatomical structures involved. This retrospective study aimed to utilize computed tomography (CT) studies of immature dogs evaluated for CMF trauma and to describe common fracture locations, treatment modalities, and complications, as well as the fracture healing outcomes. The medical records and CT studies of 94 dogs under 1 year of age over a 13-year period were evaluated. The skeletal location of CMF fractures, as well as the severity of displacement and fragmentation of each fracture, was recorded. Case demographic data and trauma etiology were also recorded. Animal bites accounted for the majority of trauma (71.0%). The most likely bone or region to be fractured was the maxillary bones, followed by the molar region of the mandibles. Up to 37 bones or specific regions were fractured in any given patient, with an average of 8.8 ± 3.1 fractured bones or regions per dog. Rostral mandibular trauma was associated with intra-articular fractures of the temporomandibular joint (p = 0.016). Patients sustained concomitant injuries in 32% of the cases. Muzzle therapy was the main treatment performed for most dogs (53.2%), followed by soft tissue closure (47.9%) and selective dental extractions (27.6%). Healing complications were recorded in 71.6% of the dogs, with malocclusion being the most reported complication (55.2%), and associated with dentate mandibular jaw fractures (p = 0.05). The average number of complications per dog was 2.4. No statistically significant association was found between treatment modality and healing outcome. There was a positive correlation between the severity of fracture fragmentation and displacement and a negative healing outcome (all rho >0.7). Further treatment was required in 55.6% of the dogs. Additional dental extractions were performed in 77.7% of patients. Healing complications were common in the immature CMF trauma case. Thus, the need for a comprehensive assessment of the entire CMF region during the initial visit, as well as follow-up, preferably using CT or cone beam CT, is underscored.

Intrathoracic migration of a breast implant seven years after thoracotomy. A case report.

A 52-year-old woman, who had previous bilateral subpectoral breast augmentation, underwent thoracotomy for a right upper lobe pulmonary adenocarcinoma. Seven years after her thoracic surgery, the patient noticed a reduction in her right breast volume, with shortness of breath and cough. A computed tomography study of the chest revealed intrathoracic migration of her right breast implant with no sing of capsule rupture. Subsequent video-assisted thoracoscopy confirmed this diagnosis.

Real-time fully automated dosimetric computation for CT images in the clinical workflow: A feasibility study.

BackgroundCurrently, the volume computed tomography dose index (CTDIvol), the most-used quantity to express the output dose of a computed tomography (CT) patient’s dose, is not related to the real size and attenuation properties of each patient. The size-specific dose estimates (SSDE), based on the water-equivalent diameter (D W) overcome those issues. The proposed methods found in the literature do not allow real-time computation of D W and SSDE.PurposeThis study aims to develop a software to compute D W and SSDE in a real-time clinical workflow.MethodIn total, 430 CT studies and scans of a water-filled funnel phantom were used to compute accuracy and evaluate the times required to compute the D W and SSDE. Two one-sided tests (TOST) equivalence test, Bland–Altman analysis, and bootstrap-based confidence interval estimations were used to evaluate the differences between actual diameter and D W computed automatically and between D W computed automatically and manually.ResultsThe mean difference between the D W computed automatically and the actual water diameter for each slice is −0.027% with a TOST confidence interval equal to [−0.087%, 0.033%]. Bland–Altman bias is −0.009% [−0.016%, −0.001%] with lower limits of agreement (LoA) equal to −0.0010 [−0.094%, −0.068%] and upper LoA equal to 0.064% [0.051%, 0.077%]. The mean difference between D W computed automatically and manually is −0.014% with a TOST confidence interval equal to [−0.056%, 0.028%] on phantom and 0.41% with a TOST confidence interval equal to [0.358%, 0.462%] on real patients. The mean time to process a single image is 13.99 ms [13.69 ms, 14.30 ms], and the mean time to process an entire study is 11.5 s [10.62 s, 12.63 s].ConclusionThe system shows that it is possible to have highly accurate D W and SSDE in almost real-time without affecting the clinical workflow of CT examinations.

Relationship between palatally impacted canines and dimensions and morphology of sella turcica: A cone-beam computed tomography study

This study aimed to analyze the association of unilateral and bilateral palatal canine impaction with the dimensions and morphology of sella turcica from 3-dimensional cone-beam computed tomography (CBCT) images. CBCT images of patients with bilateral (BPI) (n= 12; 9 female 3 male; 20.75 ± 5.88 years) and unilateral (UPI) (n= 35; 22 female 13 male; 19.28 ± 5.57 years) palatally impacted canines were compared with a control group (n= 56; 34 female 22 male; 20.82 ± 4.88 years). Linear measurements regarding sella turcica were made, and its morphologic variations were categorized. Two group comparisons were made with the Student t test or Mann-Whitney U-test, whereas one-way analysis of variance or Kruskal-Wallis tests were used for multiple group comparisons. Categorical variables were compared using the chi-square or Fisher exact test as appropriate. The binary logistic regression analyses and correlations using Spearman or Pearson correlation analyses were used to determine associations between variables (P<0.05). Sella diameter was significantly smaller in the BPI group compared to UPI and control groups. There was a significant association between sella diameter and BPI when compared with the control group (χ2[1]= 9.150; P= 0.008). There were no significant differences between groups in the distribution of sella turcica morphology. Despite the similar genetic origin of the sella turcica region and teeth, the association of palatal canine impaction with dimensions and morphology of sella turcica was weak. Both local and genetic factors might contribute to the ectopic position of the canine.

A Comparative Study of Intravital CT and Autopsy Findings in Fatal Traumatic Injuries.

Objectives: Traumatic injuries are one of the severe health problems of our time. In the 21st Century, approximately 4.5 million people worldwide die each year due to trauma. Computed tomography (CT) is widely used to diagnose injuries and offers information on the specific location and extent of organ and tissue damage. In cases of severe trauma, whole-body CT is increasingly used as a standard diagnostic technique. An autopsy is the final diagnostic examination and is still considered the gold standard in diagnostic methods in medicine. The aim of the study was to assess the reliability and accuracy of CT scan results, as well as limits in detecting trauma for forensic purposes. It aims to compare traumatic findings in the antemortem CT results to those observed at autopsy. Materials and Methods: We conducted a retrospective–prospective study involving 510 deaths due to trauma. We compared selected traumatic changes in the antemortem CT scan results with the autopsy findings. We obtained data with a detailed analysis of autopsy protocols, photographic documentation from the autopsies, and the interpretation of CT scans from medical documentation. In cases of discrepancies in the findings, we borrowed CT scans, which were repeatedly reviewed by clinical radiologists. Results: By comparing the findings of selected injuries detected by antemortem CT and autopsy, we found a correlation of findings in 75.3% and a discrepancy of findings in 24.7% in a set of 510 cases. After repeated targeted assessment of CT images by clinical radiologists in cases of discrepancies in the findings, which were detected by autopsy and undescribed by CT, the discrepancy decreased to 17%. Conclusions: The results of the study are comparable with data from many studies and professional publications. They show that CT compared to autopsy is a good method for diagnosing gunshot wounds to the head and bone fractures, with a limited diagnosis of cranial base fractures, while an autopsy is better for detecting minor injuries to organs and soft tissues.

Prevalence and Characteristics of Accessory Mandibular Canals: A Cone-Beam Computed Tomography Study in a European Adult Population.

The purpose of this observational study is to evaluate the prevalence and main characteristics of bifid canals within a European adult population, analyzing cone-beam-computed tomography (CBCT). The population study examined 300 subjects. The CBCTs were performed between 2012 and 2019, using PaX-Zenith3D with a standard protocol of acquisition. The parameters analyzed were the presence and lengths of the bifid mandibular canals. The sample included 49% male and 51% female participants. The mean age of the patients was 47.07 ± 17.7 years. Anatomical variants of the mandibular canal were identified in 28.8% of the sides and 50.3% of the patients. In 7.3% of the subjects, the anatomical variants were present bilaterally. The most frequently encountered bifid canal was Type 3 (40.5%), followed by the Type 1 canal (39.3%), the Type 2 canal (14.5%), and the Type 4 canal (5.9%), 40% on the right side and 60% on the left side. The average length of the bifid canals located on the right side of the mandible was 11.96 ± 5.57 mm, compared to 11.38 ± 4.89 mm for those measured on the left side. The bifid mandibular canal is a common anatomical variation of the mandibular canal. It is fundamental to performing an accurate preoperative evaluation using CBCT analysis to avoid and/or reduce intraoperative and postoperative complications.

Comparative CT Study on Syndesmosis Mobility after Static or Dynamic Fixation for Ankle Fractures with Syndesmotic Rupture: A Pilot Study.

The objective of this prospective randomized pilot study is to compare, by computed tomography (CT), the mobility of syndesmosis after static fixation (SF) or dynamic fixation (DF) in ankle fractures with syndesmotic rupture (AFSR) in adults, and to compare this mobility with that of healthy ankles. Forty-two patients with an AFSR were randomized to 2 groups: SF (N=21) or DF (N=21). Seven patients were lost to follow-up. Ultimately, 35 patients (SF, N=20; DF, N=15) were analyzed. The clinical results were assessed with the American Orthopedic Foot and Ankle Society scale. To assess syndesmosis mobility, CT in 30° of plantar flexion (PFlex) and 20° of dorsal flexion (DFlex) was performed on both ankles one year after the fracture. Four parameters were measured: anterior tibiofibular distance, posterior tibiofibular posterior distance, angle of fibular rotation (AFR), and anteroposterior fibular translation. The AFR between DFlex and PFlex was more similar to the non-affected side in the DF group. The other three parameters showed no statistical differences between types of fixation. The mean loss of AFR compared with the non-affected side was 1.2° in the SF group and 0.1° in the DF group. No clinical differences between the SF group and the DF group were found. No correlation between clinical and radiological results was observed. The AFR was more similar to the non-affected side in the DF group. However, this finding did not correlate with a better clinical result.

The relationships of myocardial blood flow and reserve with lipid levels in patients with non-obstructive coronary artery disease: Dynamic single photon emission computed tomography study

Background and Aims : More than half of patients with non-obstructive coronary artery disease (NOCAD) can suffer from microvascular dysfunction (MD). Dyslipidemia can play important role in the pathogenesis of MD. However, the available data regarding lipid levels and myocardial perfusion imaging are different and controversial. The aim of the study was to assess the relationships between myocardial blood flow (MBF) and myocardial flow reserve (MFR) derived by dynamic SPECT and lipid levels in patients with NOCAD.

Association between second mesiobuccal canal and apical periodontitis in retrospective cone-beam computed tomographic images.

This retrospective cone-beam computed tomography study aimed to investigate the possible associations of apical periodontitis (AP) with missed/unmissed second mesiobuccal (MB2) canals. MB2 canals and AP were investigated in 257 endodontically treated and 673 untreated maxillary molars, and the former were analyzed regarding missed/unmissed MB2 canals. The chi-squared test and odds ratio (OR) were used for statistics. The prevalence of MB2 canals in maxillary first molars was higher than that in second molars (p= 0.001). MB2 canals were 1.751 times more common in males than in females (OR: 1.751; 95% CI: 1.334-2.297), with a significant difference in the 18-39 age groups (p= 0.005). The risk for AP was 5.5 times greater in endodontically treated maxillary molars with missed MB2 canals than in those with unmissed MB2 canals (p= 0.012) (OR: 5.5, 95% CI: 1.549-19.527). The findings of this study reveal that the likelihood of the MB2 canal is higher in the maxillary first molars of young adult males.

A cone-beam computed tomography study on strategic uprighting of mandibular molars using a biocreative reverse curve system.

ObjectiveTo analyze the overall treatment effects in terms of the amount of uprighting with changes in the three-dimensional positions of the mandibular posterior teeth after applying the biocreative reverse curve (BRC) system.MethodsThirty-four patients (mean age, 20.5 ± 8.56 years) were treated using the BRC system (mean period, 8.17 ± 2.19 months). Cone-beam computed tomography was performed before treatment and after treatment with the BRC system. The three-dimensional movement of each tooth was analyzed in the coordinate system at points on the crown and root apex. A paired t-test was used to analyze the treatment effects of the BRC system.ResultsThe application of the BRC system spanning from the first premolar to the second molar resulted not only in buccal and distal uprighting, but also in increased buccal and distal tipping of the teeth. The premolars and the first molar were extruded, and the second molar was intruded.ConclusionsWhen the BRC system is applied, simultaneous distal and buccal uprighting of the premolars and molars can be achieved bilaterally using a temporary skeletal anchorage device without unnecessary movement of the anterior teeth.

The role of three dimension computed tomography in Lisfranc injury diagnosis

PurposeTo evaluate the intra/inter observer and diagnostic reliability of 3-dimensional (3D) model reconstruction computed tomography (CT) compared to the traditional two-dimensional (2D) CT when evaluating Lisfranc (LF) injuries. MethodsA retrospective study was performed on CT studies of patients with clinically suspected LF injuries examined in the emergency department at medium size medical center. Each CT study was evaluated for metatarsal fractures and subluxations employing both standard 2D and 3D CT model reconstruction. Four orthopaedists, 2 senior and 2 residents, were assigned to review and evaluate each CT. Each CT study was reviewed twice by each reader in a randomized order. Descriptive statistics were calculated for all measured variables. The intra-observer and inter-observer agreement Kappa coefficients were calculated to evaluate reliability and reproducibility between and within readers for each modality. ResultsThe study included 44 patients. Median age was 41.4 years (interquartile range, 23-58). The intra-observer and inter-observer reliability was good (intra-observer; 3D Kappa; 0.76 and 2D Kappa 0.73 p<0.001, inter-observer; 3D Kappa 0.68, 2D Kappa 0.63 and combined 2D and 3D kappa 0.68, p<0.001). Three dimensional CT was found to be more sensitive than 2D CT, specifically when evaluating for second metatarsal dislocation (sensitivity: 70% vs 47%). Combined evaluation of 2D and 3D CT, greatly improved sensitivity rate to 85.7%. In terms of fracture diagnosis, combined evaluation of 2D and 3D CT showed higher sensitivity and specificity rates as compared to 2D or 3D alone. ConclusionThe employment of 3D CT in LF injury diagnosis, in isolation and in combination with 2D CT, seems to improve the diagnostic accuracy and reliability between and within observers compared to 2D CT alone.

Development of a customized three-dimensional airway model

This study aimed to develop a customized, three-dimensional airway model based on relevant medical images, using additive manufacturing techniques. We evaluated the model’s ability to replicate the dimensions of the images acquired from the chest of a patient using multi-detector computed tomography (CT). Using dedicated software, a three-dimensional mesh was created based on the images. A multi-detector CT study of the full-scale printed three-dimensional airways model was subsequently carried out to compare its dimensions with that of the original study at four predetermined points. The observed median differences at the four points were 0.4 mm (p = 0.686), -1.3 mm (p = 0.138), 0.7 mm (p = 0.141), and 0.1 mm (p = 0.892). The intraclass correlation coefficient between the measurements made on the patient and those on the model was 0.98 (95% confidence interval: 0.96–0.99, p &lt; 0.001). We successfully developed a three-dimensional model of the airway based on its corresponding medical images. The differences in the dimensions between the model and the original images were in line with those observed in previous studies and are presumably irrelevant for most applications.