Computed Tomography Studies Research Articles

Evaluation of root and root canal morphology in maxillary premolar teeth: A cone-beam computed tomography study using two classification systems in a Japanese population

Background/purposeInadequate knowledge increases the risk of overlooking root canals and causing procedural errors that can lead to root canal treatment failure. This study aimed to analyze the root and root canal morphology in maxillary premolar teeth using two classification systems assessed by cone-beam computed tomography (CBCT) in a large Japanese population. Materials and methodsThis study evaluated 1443 maxillary teeth including 726 first and 717 s premolars, from 642 Japanese individuals aged 16–84 years. CBCT images were analyzed according to the Vertucci and Ahmed classification systems, focusing on the root and root canal morphology. Variations were analyzed based on gender and age using the chi-square test (P < 0.05). ResultsMaxillary first premolars were predominantly single-rooted (64.9%) and had two root canals (86.2%). Females exhibited a higher prevalence of single-rooted (71.0%) compared to males (49.8%) (P < 0.05). Additionally, single root canals occurred significantly more frequently in females (14.0%) than in males (7.5%) (P < 0.05). Maxillary second premolars mostly had a single root (97.8%) with a single root canal (72.1%). The frequency of second premolars with two root canals significantly increased with age (P < 0.001). The three-rooted configuration occurred in 1.2% and 0.3% of the first and second premolars, respectively. ConclusionMaxillary premolars in a Japanese population showed significant anatomical variations, highlighting the importance of understanding anatomical characteristics specific to age and gender. Ahmed's system provides a more comprehensive description of the morphological variations.

Prevalence of middle mesial canal in mandibular molars: A cross-sectional cone-beam computed tomography study.

The first tooth to erupt is the first mandibular molar, which is the tooth with the highest number of retreatments. Several factors are responsible for the failure of the endodontic success and one of the most important being the particular pulp anatomy of each tooth. To aim was determine the prevalence of the middle mesial (MM) canal in first mandibular molars and to study if there are predisposing factors to the presence of this canal by retrospectively analyzing cone-beam computed tomography (CBCT) images in vivo. CBCT images of 100 patients were selected. A total of 206 first mandibular molars were examined. The CBCTs were analysed using Careastream CS 3D imaging software. Findings of MM canals were recorded along the variables sex and left/right side. Prevalence was compared using the Chi-square test (P< 0.05) and Cramer's V was used to indicate the effect size between the variables. Of the 206 teeth analysed, the prevalence of MM canals was 33.11% (49 teeth). There was no statistically significant difference between sex and prevalence of the MM canal. There was a significant difference between sex and the distance between the mesial canals was found, being the most common range in women was 1-2 mm (35.8%) and 2-3 mm (51%) in men. The most common range of distance between the mesial canals where the MM canal was localized was 3-4 mm (50%), being statistically significant (p<0,05). This cross-sectional study showed a high prevalence of MM canals (33.11%) in first mandibular molars. The prevalence of the MM canal was significantly higher when the distance between mesiobucal and mesiolingual canals was 3-4mm. This knowledge let direct the clinicians in locating MM canal for improving endodontic prognosis. Key words:Cone-beam computed tomography, middle mesial canal, prevalence.

Exploring Variation in Root Canal Morphology of Maxillary Second Premolars: A Cone-Beam Computed Tomography Study in a Pakistani Subpopulation

A comprehensive knowledge of anatomy of roots and root canals was a key for successful treatment outcomes. Maxillary second premolars often display variability in root and canal numbers. Traditional 2-dimensional imaging techniques have limitations in exact diagnosis of dental anatomy, encouraging the practice of Cone Beam Computed Tomography (CBCT) for comprehensive three-dimensional imaging. Objective: To explore the variations in the number of roots and root canals in maxillary second premolars using CBCT. Methods: The current study was a retrospective study and conducted at the Radiology department of Fatima Memorial College of Dentistry, Lahore. A total of 143 CBCT scans with completely formed roots were included. Data were analyzed using Planmeca Romexis imaging software and statistical analysis was performed using SPSS version 23.0. Results: Among 143 individuals, the majority exhibited one root and one canal in maxillary second premolars. In terms of root number, 77% of the 2nd premolars had a single root and 23% had two roots. In relevance of root canals, 62.5% were found to have a single canal and 37.5% had two root canals. However, no any case was found having three roots and canals. Bilateral symmetry in root canal patterns was observed in most cases, with statistically significant differences between genders. Conclusions: The findings of this study may contribute to the understanding of variations in dental anatomy in Pakistani population and emphasize the importance of one’s treatment approaches for optimal patient care.

Tortuosity of the left anterior descending artery is associated with hypertension and is not independently related to physical performance: A cardiac computed tomography study.

Coronary tortuosity (CorT) is frequently observed in invasive angiography, though its aetiology and clinical significance remain ambiguous. Prior research has indicated possible links between CorT and factors such as hypertension, age, and calcium scores in the left anterior descending (LAD) artery. The aim of this study was to examine and optimize the usage of coronary computed tomography angiography (CCTA) with vessel tracking to explore these associations. Observational sub-study of the single centre randomised controlled CATCH-trial. From the original study 600 participants, who underwent CCTA, 250 were randomly selected. Clinical data and patient risk factors were sourced from medical records and structured interviews. Tortuosity of the LAD was quantified by calculating the ratio of the actual vessel-length to the straight-line distance. The final study population comprised 194 patients (56 patients were excluded due to poor image quality or inability to perform adequate vessel tracking). After adjusting for confounding variables, tortuosity was significantly associated with hypertension (p < 0.001), female gender (p = 0.01), and increasing age (p = 0.045). No significant correlation was observed between CorT and calcium scores. Univariate analysis indicated that higher CorT levels were linked to lower metabolic equivalents of task (METs) in bicycle tests (p = 0.003); however, this relationship became nonsignificant (p = 0.97) upon adjustment for age, gender, and hypertension. Our findings suggest that increased CorT is most prevalent in patients with hypertension, advancing age, and female gender. Although higher tortuosity levels did not significantly impact METs during physical activity, further research is warranted to explore the underlying mechanisms of this relationship.

Morphometric Analysis of the Mandibular Canal and Its Anatomical Variants in a Chilean Subpopulation: Cone Beam Computed Tomography Study.

The inferior alveolar nerve (IAN), contained within the mandibular canal (MC), is a structure prone to damage in clinical and surgical procedures on the mandible. This study aimed to analyze the MC morphology and its anatomical variants in a Chilean subpopulation using cone beam computed tomography (CBCT). In total, 342 images from patients with the following parameters were observed: 120 kV, 9 mA, field of view 12 × 9 MC, and voxel size 0.12 mm. The average length of the MC recorded a mean value of 70.493 ± 4.987 mm on the right side and 70.805 ± 5.177 mm on the left side. The location of the mental foramen (MF) was most frequently found between the mandibular first and second premolar. The greatest bone thickness was found at the level of the basilar border of the 2MPM. The root closest to the MC was distal from the mandibular second molar. The lowest thickness was in the lingual area at 1MM. The prevalence of the anterior loop (AL) (61.5%) and the retromolar canal (RC) (17.5%) showed no significant differences between men and women. The results obtained showed that the morphology of the MC in the Chilean subpopulation can vary.

Vidian Canal in Chiari Type I Malformation: A Computed Tomography Study.

To evaluate the position and dimension of the Vidian canal (VC) in Chiari type I malformation (CIM). Radiologic views of 49 CIM (mean age: 23.58±15.62y, sex: 23 males/26 females) and 51 healthy subjects (mean age: 42.50±20.12y, sex: 21 males/30 females) were included in this computed tomography study. In comparison with controls, the VC angle and the distance of the round foramen to VC were greater in CIM, but VC length and the distances of the superior wall of the bony sphenoidal sinus, midsagittal plane, and vomerine crest to VC were smaller in CIM. Relative to the sphenoid bone, the position of VC in CIM was determined as type 1 (59.2%) >type 2 (28.6%) >type 3 (12.2%), whereas in controls as type 1 (54.9%) >type 3 (25.5%) >type 2 (19.6%). Relative to the medial pterygoid plate, the position of VC in CIM was determined as type A (63.3%) >type B (20.4%) >type C (16.3%), while in controls as type B (43.1%) >type A (40.2%) >type C (16.7%). VC size and position correlated with CIM. Compared with controls, CIM patients had more partially protruded VC into the bony sphenoidal sinus and more medially located VC according to the medial pterygoid plate.

Prevalence of pulmonary nodules detected incidentally on noncancer-related imaging: a review.

Pulmonary nodules are common incidental findings requiring surveillance. Follow-up recommendations vary depending on risk factors, size and solid or subsolid characteristics. This review aimed to evaluate the prevalence of clinically significant nodules detected on noncancer-dedicated imaging and the prevalence of part-solid and ground-glass nodules. We conducted a systematic search of literature and screened texts for eligibility. Clinically significant nodules were noncalcified nodules >4-6 mm. Prevalence estimates were calculated for all studies and risk of bias was assessed by one reviewer. Twenty-four studies were included, with a total of 30 887 participants, and 21 studies were cross-sectional in design. Twenty-two studies used computed tomography (CT) imaging with cardiac-related CT being the most frequent. Prevalence of significant nodules was highest in studies with large field of view of the chest and low size thresholds for reporting nodules. The prevalence of part-solid and ground-glass nodules was only described in two cardiac-related CT studies. The overall risk of bias was low in seven studies and moderate in 17 studies. While current literature frequently reports incidental nodules on cardiovascular-related CT, there is minimal reporting of subsolid characteristics. Unclear quantification of smoking history and heterogeneity of imaging protocol also limits reliable evaluation of nodule prevalence in nonscreening cohorts.

High Resolution Computed Tomography Study of the Length, Width & Angle of Eustachian Tube in Normal Ear and in Chronic Otitis Media.

Eustachian tube is complex and inaccessible structure. It connects nasopharynx to middle ear. It is composed of cartilaginous and bony segments. Eustachian tube helps in pressure regulation, protection and clearance of the middle ear. Dysfunctions of Eustachian tube are either due to anatomical obstruction or functional failure. Whether variation of length, width of bony canal, isthmus, length of the cartilaginous canal and angulation of the Eustachian tube to horizontal plane affects overall pressure regulation, protection and mucociliary clearance leads to the spread of the infection to the middle ear are highlighted. A comparative prospective study design of 20 adults of both gender of normal ear computerized tomography done for some other cause and 20 adults of both gender with chronic otitis media (tubo-tympanic pathology). After obtaining consent, clinical examination, all patients had got computerized tomography study of the temporal bone and were evaluated to study the variation of length, width of bony canal, isthmus, length of the cartilaginous canal and angulation of the Eustachian tube to horizontal plane. In our series cartilaginous Eustachian tube length is 26.72mm in normal ear and 26.17mm in diseased ear. Long and reduced diameter of bony segment is the anatomical cause in the tubotympanic pathology along with inflammation and loss of ciliary moment. Normal ear bony width is 2.36mm; isthmus 1.18mm are comparatively more than diseased ear (bony width 2.13 & isthumus1.04). Whereas bony length of normal ear is 11.21mm and diseased ear is 11.62mm. Decreased Eustachian tube pretympanic diameter and Reid -plane ET angle can be used to predict Eustachian tube dysfunction. Angle to horizontal plane in our series in normal ear 44.670 whereas in diseased ear 45.10. The Eustachian tube plays an important role in the development of the tubotympanic pathology of the ear. Pre-existing Eustachian tube anatomical variation appears to be risk factor in developing tubotympanic pathology.

Feasibility study of photon-counting CT for material identification based on YSO/SiPM detector: A proof of concept.

Current photon-counting computed tomography (CT) systems utilize semiconductor detectors, such as cadmium telluride (CdTe), cadmium zinc telluride (CZT), and silicon (Si), which convert x-ray photons directly into charge pulses. An alternative approach is indirect detection, which involves Yttrium Orthosilicate (YSO) scintillators coupled with silicon photomultipliers (SiPMs). This presents an attractive and cost-effective option due to its low cost, high detection efficiency, low dark count rate, and high sensor gain. This study aims to establish a comprehensive quantitative imaging framework for three-energy-bin proof-of-concept photon-counting CT based on YSO/SiPM detectors developed in our group using multi-voltage threshold (MVT) digitizers and assess the feasibility of this spectral CT for material identification. We developed a proof-of-concept YSO/SiPM-based benchtop spectral CT system and established a pipeline for three-energy-bin photon-counting CT projection-domain processing. The empirical A-table method was employed for basis material decomposition, and the quantitative imaging performance of the spectral CT system was assessed. This evaluation included the synthesis errors of virtual monoenergetic images, electron density images, effective atomic number images, and linear attenuation coefficient curves. The validity of employing A-table methods for material identification in three-energy-bin spectral CT was confirmed through both simulations and experimental studies. In both noise-free and noisy simulations, the thickness estimation experiments and quantitative imaging results demonstrated high accuracy. In the thickness estimation experiment using the practical spectral CT system, the mean absolute error for the estimated thickness of the decomposed Al basis material was 0.014±0.010mm, with a mean relative error of 0.66%±0.42%. Similarly, for the decomposed polymethyl methacrylate (PMMA) basis material, the mean absolute error in thickness estimation was 0.064±0.058mm, with a mean relative error of 0.70%±0.38%. Additionally, employing the equivalent thickness of the basis material allowed for accurate synthesis of 70keV virtual monoenergetic images (relative error 1.85%±1.26%), electron density (relative error 1.81%±0.97%), and effective atomic number (relative error 2.64%±1.26%) of the tested materials. In addition, the average synthesis error of the linear attenuation coefficient curves in the energy range from 40 to 150keV was 1.89%±1.07%. Both simulation and experimental results demonstrate the accurate generation of 70keV virtual monoenergetic images, electron density, and effective atomic number images using the A-table method. Quantitative imaging results indicate that the YSO/SiPM-based photon-counting detector is capable of accurately reconstructing virtual monoenergetic images, electron density images, effective atomic number images, and linear attenuation coefficient curves, thereby achieving precise material identification.

Incidence and Mortality Life-Attributable Risks for Patients Subjected to Recurrent CT Examinations and Cumulative Effective Dose Exceeding 100 mSv.

Computed tomography (CT) multi-detector array has been heavily utilized over the past decade. While transforming an individual's diagnosis, the risk of developing pathogenesis as a result remains a concern. The main aim of this institutional cumulative effective dose (CED) review is to highlight the number of adult individuals with a record of CED ≥ 100 mSv over a time span of 5 years. Further, we aim to roughly estimate both incidence and mortality life-attributable risks (LARs) for the shortlisted individuals. CT studies performed over one year, in one dedicated trauma and emergency facility, were retrospectively retrieved and analyzed. Individuals with historical radiological CED ≥ 100 mSv were short-listed. LARs were defined and established based on organ, age and gender. Out of the 4406 CT studies reviewed, 22 individuals were found with CED ≥ 100 mSv. CED varied amongst the short-listed individuals, with the highest CED registered being 223.0 mSv, for a 57-year-old male, cumulated over an average study interval of 46.3 days. The highest median mortality risk was for females, 214 per 100,000 registered for the age group 51-60 years. While certain clinical indications and diseases require close follow-up using radiological examinations, the benefit-to-risk ratio should be carefully considered, particularly when CT is requested.

Exploring the atlantic part of the vertebral artery in the South Indian population and its implications in spine surgery.

A descriptive, quantitative cross-sectional study of the atlantic part (V3) of the vertebral artery (VA). This study aimed to bridge the research gap in the morphometry of the V3 segment of the VA in the South Indian population. The microsurgical anatomy of this segment of the VA has been explored in various populations, and a thorough understanding of the anatomy and course of the VA, particularly the V3 segment, is essential to prevent iatrogenic complications. Several computed tomography studies but a few cadaveric studies have explored the V3 segment of the VA in the South Indian population. This study examined 40 VAs from 20 embalmed cadavers that were obtained from the voluntary donation program, and Institutional Ethical Clearance was obtained before the study. The length, diameter, and angle of the vertical, horizontal, and exit parts of the V3 segment of the VA were documented after its exposure. The mean lengths of the right and left VAs on each part were nearly similar, except for the mean length of the horizontal part (right: 38.937 mm, left: 40.237 mm) and total length of the V3 segment (right: 66.870 mm, left: 70.350 mm). These morphometric parameters are essential to spine surgeons who intend to operate on a small part (vertical, horizontal, or exit part) of the V3 segment of the VA. The mean values of the parameters obtained in this study give average measurements or safe limits to surgeons for safe surgical procedures such as the occipital condyle screw technique and C1 laminectomy.

Machine Learning Algorithms for Sex Classification by Using Variables of Orbital Structures: A Computed Tomography Study

Machine Learning Algorithms for Sex Classification by Using Variables of Orbital Structures: A Computed Tomography Study

Posterior Tibial Slope Measurements of the Medial and Lateral Plateaus Vary Widely Between Magnetic Resonance Imaging and Computed Tomography

This study aims to compare posterior tibial slope (PTS) measurements of the medial tibial plateau (MTP) and lateral tibial plateau (LTP) on magnetic resonance imaging (MRI) versus computed tomography (CT) to determine the agreement of measurement between imaging modalities. Patients aged 15-65 years with concurrent MRI and CT imaging were initially included. Knees with significant arthrosis (Kellgren-Lawrence grade >2), proximal tibia fracture, or artifact obscuring visualization were excluded. Two independent raters measured PTS of the MTP and LTP on paired MRI and CT. Interrater and intrarater reliability were assessed using the intraclass correlation coefficient (ICC). Intermethod agreement was assessed using ICC and Bland-Altman analyses. An acceptable Bland-Altman limit of agreement (LOA) was set at ±2°, requiring 95% of measurement differences between imaging modalities to fall between ±2° for an acceptable level of agreement. 46 knees in 45 patients met final inclusion criteria. Interrater reliability was good for MRI (ICC 0.78-0.83) and moderate-to-good for CT (ICC 0.64-0.80) studies. Intrarater reliability was moderate-to-excellent (ICC 0.64-0.94). Intermethod agreement between MRI and CT was poor at the MTP (ICC 0.34-0.42) and moderate at the LTP (ICC 0.59-0.70). Bland-Altman analysis demonstrated high variability of PTS measurements between MRI and CT: 0.16° (95% LOA -6.10-6.41°) for MTP for Rater 1; 0.22° (95% LOA -5.01-5.45°) for LTP for Rater 1; -0.95° (95% LOA -7.22-5.33°) for MTP for Rater 2; -0.99° (95% LOA -6.48-4.85°) for LTP for Rater 2, with only 47.83 to 60.87% of measurement differences falling within the predetermined acceptable LOA of ±2°. Although the interrater and intrarater reliability was moderate-to-excellent, the degree of agreement between PTS measurements on MRI and CT was highly variable at both medial and lateral plateaus. Although some variability may have been due to the study's limitations, PTS measurements at individual plateaus may not be interchangeable between MRI and CT. Level III, retrospective cohort study.

Variations of the Lingula and Mandibular Ramus in the Context of Sagittal Split Ramus Osteotomy: A Cone Beam Computed Tomography Study Supporting an Ethnic-Centric Approach to Orthognathic Surgery.

To investigate the ethnic variations concerning the lingula and ramus of the mandible, with particular emphasis on sagittal split ramus osteotomy (SSRO) in orthognathic surgery. This study examined Cone beam computed tomography (CBCT) scans from the Kenyan and Malay populations. Lingula morphology was classified into four categories. Morphometric measurements included lingula size, height above the occlusal plane, distance to the second mandibular molar, and distance from its apex to all four mandible borders. Regarding the ramus of the mandible, the thickness of each cortical plate, trabecular bone, and overall thickness were determined at two points. Furthermore, points of fusion of cortical plates were determined in both the vertical and horizontal planes. Among Kenyans, the triangular shape was most common (46.5%, n = 80 sides), while truncated was most common among Malays (34.4%, n = 57 sides). The overall mean size of lingula differed significantly between Kenyan (7.37 ± 2.19 mm) and Malay (4.14 ± 2.50 mm) populations (p<0.001). The lingula was more located postero-superiorly in Kenyans compared to Malays (p < 0.001). The mean distance from the distal aspect of the second mandibular molar to the lingula was 38.37 ± 4.98 mm among Kenyans, in contrast to 31.95 ± 0.03 mm among Malays (p < 0.001). The Malays exhibited a thicker mandible with a larger trabecular distance (5.99 ± 1.41 mm and 3.41 ± 1.29 mm, respectively) than Kenyans (5.28 ± 1.39 mm and 1.98 ± 0.98 mm, respectively) (p < 0.001). The points of fusion of the cortical plates differed significantly between Kenyans and Malays. This study focuses on two ethnic groups, Kenyans and Malays, and brings to lightthe ethnic-based differences in the position of the lingula and the dimensions of the mandibular ramus, both of which are essentialconsiderations in orthognathic surgery. Preoperative consideration of such variations is warranted, potentially mitigating iatrogenic injuries and enhancing successful patient outcomes.

Variations in the alveolar bone morphology in maxillary molar area: a retrospective CBCT study

BackgroundThis study quantitatively analyzed the anatomic structure of the alveolar bone in the maxillary molar region at three potential locations for Temporary Anchorage Device (TAD) placement. Additionally, the study compared the variability in this region across different age groups, sagittal skeletal patterns, vertical facial types, and sexes.MethodsIn this retrospective cone-beam computed tomography study, the buccal alveolar bone was analyzed in the posterior molar area of 200 patients, the measurement items include buccal alveolar bone height, alveolar bone thickness, interradicular distance, and maxillary retromolar space.ResultsBuccal alveolar height was greatest in the U56 region. The interradicular space was largest in the U56 region and increased from the alveolar crest to the sinus floor. Buccal alveolar bone thickness was highest in the U67 region and generally increased from the alveolar crest to the sinus floor. The maxillary retromolar space gradually increased from the alveolar crest to the root apex.ConclusionsTADs are safest when placed in the buccal area between the maxillary second premolar and the first molar, particularly at the 9 mm plane. The U67 region is the optimal safe zone for TAD placement for maxillary dentition distalization. TADs placement in adolescents can be challenging. Maxillary third molar extraction can be considered for maxillary dentition distalization.

Prevalence of Middle Mesial Canal in Mandibular First Permanent Molars in a Persian Population: An In Vivo Cone-Beam Computed Tomography Study.

This study aimed to identify the prevalence of the middle mesial canal (MMC) in mandibular first permanent molars in a Persian subpopulation sample using cone-beam computed tomography (CBCT). The secondary aim was to correlate the incidence of MMC with variables such as gender, age, and the presence of an additional distal canal. A total of 390 mandibular first molars from 314 CBCT images were retrospectively evaluated. The presence of the MMC was recorded while considering related factors such as additional distal canal and demographic information of the patients (age and gender). Fisher's exact tests and independent-samples t-test were used for the statistical comparisons with a significance level of 0.05. Among 390 mandibular first molars, 34 teeth contained an MMC (8.7%). The number of teeth with the MMC in women was equal to that of men. There was no significant difference between the two genders in the prevalence of the MMC (p > 0.05). The prevalence of patients' MMC had no significant relationship with their age (p > 0.05). However, there was a significant association between the presence of the MMC and an additional distal canal (p < 0.05). The incidence of an additional distal canal in teeth with a diagnosed MMC was statistically significant. The prevalence of the MMC in mandibular first molars in the study population was low; however, accurate knowledge of root canal morphology in terms of the presence of an additional root canal in these teeth should be considered.

Radiomics of intrathrombus and perithrombus regions for Post-EVT intracranial hemorrhage risk Prediction: A multicenter CT study

ObjectivesThis study aimed to assess the predictive performance of radiomics derived from computed tomography (CT) images of thrombus regions in predicting the risk of intracranial hemorrhage (ICH) following endovascular thrombectomy (EVT). Materials and MethodsThis retrospective multicenter study included 336 patients who underwent admission CT and EVT for acute anterior-circulation large vessel occlusion between December 2018 and December 2023. Follow-up imaging was performed 24 h post-procedure to evaluate the occurrence of ICH. 230 patients from centers A and B were randomly allocated into training and test groups in a 7:3 ratio, while the remaining 106 patients from center C comprised the validation cohort. Radiologists manually segmenting the thrombus on CT images, and the perithrombus region was defined by expanding the initial region of interest (ROI). A total of 428 radiomics features were extracted from both intrathrombus and perithrombus regions on CT images. The Mann–Whitney U test was used for feature selection, and least absolute shrinkage and selection operator (LASSO) regression was employed for model development, followed by validation using a 5-fold cross-validation approach. Model performance was assessed using the area under the curve (AUC) of the receiver operating characteristic (ROC). ResultsAmong the eligible patients, 128 (38.1 %) experienced ICH after EVT. The combined model exhibited superior performance in the training cohort (AUC: 0.913, 95 % CI: 0.861–0.965), test cohort (AUC: 0.868, 95 % CI: 0.775–0.962), and validation cohort (AUC: 0.850, 95 % CI: 0.768–0.912). Notably, in the validation group, both the perithrombus and combined models demonstrated higher predictive accuracy compared to the intrathrombus model (0.837 vs. 0.684, p = 0.02; AUC: 0.850 vs. 0.684, p = 0.01). ConclusionsRadiomics features derived from the perithrombus region significantly enhance the prediction of ICH after EVT, providing valuable insights for optimizing post-procedural clinical decisions. Clinical relevance statementThis study highlights the importance of radiomics extracted from intrathrombus and perithrombus region in predicting intracranial hemorrhagefollowing endovascular thrombectomy, which can aid in improving patient outcomes.

Hindfoot Alignment in Flexible Cavovarus Deformity Under Orthostatic and Coleman Block Test Positions: A Weightbearing Computed Tomography Study.

Flexible cavovarus deformity is prevalent and the Coleman block test is frequently used to assess the first ray plantarflexion malpositioning in the overall deformity as well as the flexibility of the hindfoot. The objective was to assess and compare the weightbearing computed tomography (WBCT) 3-dimensional (3D) changes in clinical and bone alignment in flexible cavovarus deformity patients when performing the Coleman block test when compared to normal standing position and to controls. Twenty patients (40 feet) with flexible cavovarus deformity and 20 volunteer controls (40 feet) with normal foot alignment underwent WBCT imaging of the foot and ankle. Cavovarus patients were assessed in normal orthostatic and Coleman block test positions. Foot and ankle offset (FAO), hindfoot alignment angle (HAA), talocalcaneal angle (TCA), subtalar vertical angle (SVA) and talonavicular coverage angle (TNCA) and a CT-simulated soft tissue envelope image, WBCT clinical hindfoot alignment angle (WBCT-CHAA), were evaluated by 2 readers. Measurements were compared between cavovarus nonstressed and stressed positions and to controls. P values of .05 or less were considered significant. The intra- and interobserver intraclass correlation coefficient were good or excellent for all WBCT measurements. Cavovarus patients demonstrated significant correction of WBCT-CHAA (9.7 ± 0.4 degrees), FAO (2.6 ± 0.4%), and TNCA (8.8 ± 1.8 degrees) when performing the Coleman block test (all P values <.0001). However, WBCT-CHAA and FAO measurements were still residually deformed and significantly different from controls (P values of .001 and <.0001, respectively). TNCA values corrected to values similar to healthy controls (P = .29). No differences were observed in cavovarus patients during Coleman block test for the coronal measures: HAA, TCA, and SVA measurements. In this study, we observed improvement in the overall 3D WBCT alignment (FAO), axial plane adduction deformity (TNCA), as well as CT simulated clinical hindfoot alignment (WBCT-CHAA) in flexible cavovarus deformity patients when performing a Coleman block test. However, we did not find improvement in measures of coronal alignment of the hindfoot, indicating continued varus positioning of the hindfoot in these patients.

Modifications of the articular eminence inclination in association with the loss of occlusal support in the molar area. A cone-beam computed tomography study.

The articular eminence (AE) is part of the temporal component of the temporomandibular joint (TMJ). The inclination of the AE (AEI) has an important role in TMJ biodynamics, influencing the path of movement of the disc-condyle complex. Although AEI values might change due to tooth loss, little is known about what effect could have the loss of occlusal support in the molar area on AE morphology. AEI was measured on cone-beam computed tomography (CBCT) images of 41 patients (82 TMJs) with or without occlusal support in the molar region. The patients included in this study were divided into four groups: (1) patients with maintained occlusal support in the molar areas on both sides (right and left side) (MM); (2) patients with loss of occlusal support in the molar areas on both sides (right and left side) (LL); (3) patients with loss of occlusal support in the molar area only on the right side, but with maintained occlusal support on the left molar area (LM); (4) patients with loss of occlusal support in the molar area only on the left side, but with maintained occlusal support in the right molar area (ML). AEI values were higher in the TMJs on the side with maintained occlusal support in the molar area (M) than the AEI values measured in TMJs from the side with loss of occlusal support in the molar area (L). AEI values on the right side were higher in the MM patients in comparison to the AEI values on the right side of LL patients. The loss of occlusal support in the molar areas changes the mandibular biodynamics, which might be reflected in the morphological changes at the AE level, where it might cause flattening of the articular slope predominantly on the right side.

The impact of lipoprotein(a) level on cardiac pathologies in diabetes: a cardiac CT study.

We aimed to explore the imaging profile of coronary atherosclerosis, perivascular inflammation, myocardial perfusion, and interstitial fibrosis in diabetes stratified by lipoprotein(a) [Lp(a)] levels. In this prospective study, we enrolled diabetic patients who had undergone computed tomography (CT) angiography, stress CT-myocardial perfusion imaging, and late iodine enhancement in 20 months. Then, we categorized them into elevated and normal groups based on an Lp(a) cutoff level of 30 mg/dL. All imaging data, including coronary atherosclerosis parameters, pericoronary adipose tissue (PCAT) density, stress myocardial blood flow (MBF), and extracellular volume (ECV), were collected for further analysis. In total, 207 participants (mean age: 59.1 ± 12.0 years, 111 males) were included in this study. Patients with elevated Lp(a) level had more pronounced percent atheroma volume (2.55% (1.01-9.01%) versus 1.30% (0-4.95%), p = 0.010), and demonstrated a higher incidence of positive remodeling, spotty calcification, and high-risk plaque (HRP) than those with normal Lp(a) levels (75.6% versus 54.8%, p = 0.015; 26.8% versus 9.6%, p = 0.003; 51.2% versus 30.1%, p = 0.011, respectively). Results of the multivariate analysis revealed that after adjusting for all clinical characteristics, elevated Lp(a) levels were an independent parameter associated with HRP (odds ratio = 2.608; 95% confidence interval: 1.254-5.423, p = 0.010). However, no significant difference was found between the two groups in terms of PCAT density, stress MBF, and ECV. Elevated Lp(a) levels are associated with extensive coronary atherosclerosis and HRP development. However, they are not related to perivascular inflammation, decreased myocardial perfusion, and interstitial fibrosis in diabetes. Elevated lipoprotein(a) levels are associated with extensive coronary atherosclerosis and a high incidence of HRPs. However, they are not related to perivascular inflammation, decreased myocardial perfusion, and interstitial fibrosis in diabetes. Diabetes is a known risk factor that accelerates cardiovascular disease progression. Diabetics with elevated lipoprotein(a) (Lp(a)) levels had a higher percent atheroma volume and positive remodeling, spotty calcification, and HRPs. Patients with diabetes should be screened for elevated Lp(a) using CCTA for comprehensive evaluation of atherosclerotic characteristics.