Images In Plane Research Articles

Diagnostic Challenges in Right Iliac Fossa Mass Caused by a Fish Bone

Right iliac fossa (RIF) mass is a common condition seen by surgeons. Despite advances in diagnostic modalities, it remains a diagnostic and therapeutic challenge, hence many authors describe RIF mass as temple of surprises. We report a challenging case of a 35-year-old man whopresented with a tender RIF mass. Abdominal ultrasonography (USG) and computed tomography (CT) scan abdomen were done and he was treated nonsurgically. His symptoms recurred after one month and a CT scan abdomen was repeated which revealed a suspicious foreign body within the appendicular mass. Laparotomy was performed which showed a macerated appendix with a 4-cm long fish bone within. The role of diagnostic tools in managing RIF mass and the treatment modality of appendicular mass are discussed. In managing RIF mass, a surgeon must be aware of thevarious differential diagnoses, but common diagnosis should always be entertained. Multi-modal diagnostic tools must be considered, including serial imaging in different planes.
 Keywords: Appendicitis, Right iliac fossa mass, Fish bone

Digital plasmonic holography with iterative phase retrieval for sensing.

Propagating surface plasmon waves have been used for many applications including imaging and sensing. However, direct in-plane imaging of micro-objects with surface plasmon waves suffers from the lack of simple, two-dimensional lenses, mirrors, and other optical elements. In this paper, we apply lensless digital holographic techniques and leakage radiation microscopy to achieve in-plane surface imaging with propagating surface plasmon waves. As plasmons propagate in two-dimensions and scatter from various objects, a hologram is formed over the surface. Iterative phase retrieval techniques applied to this hologram remove twin image interference for high-resolution in-plane imaging and enable further applications in real-time plasmonic phase sensing.

Fluoroless intravascular ultrasound image-guided liver navigation in porcine models

BackgroundAn intravascular ultrasound catheter (IVUSc) was developed for intracardiac ultrasound to assess interventions with compelling results. However, intrahepatic vascular exploration was rarely tested and was always associated with X-ray techniques. The aim of this study was to demonstrate the feasibility to navigate through the whole liver using an IVUSc, providing high-quality images and making it unnecessary to use ionizing radiation.MethodsAn ex vivo pig visceral block and an in vivo pig model were used in this study. The IVUS equipment was composed of an US system, and of an 8 French lateral firing IVUSc capable of producing 90-degree sector images in the longitudinal plane. After accessing the intravascular space with the IVUSc into the models, predetermined anatomical landmarks were visualized from the inferior vena cava and hepatic veins and corroborated.ResultsIVUS navigation was achieved in both models successfully. The entire navigation protocol took 87 and 48 min respectively, and 100% (21/21) and 96.15% (25/26) of the landmarks were correctly identified with the IVUSc alone in the ex vivo and in vivo models respectively. IVUS allowed to clearly visualize the vasculature beyond third-order branches of the hepatic and portal veins.ConclusionsA complete IVUS liver navigation is feasible using the IVUSc alone, making it unnecessary to use ionizing radiation. This approach provides high-definition and real-time images of the complex liver structure and offers a great potential for future clinical applications during diagnostic and therapeutic interventions.

The Coronal Pulp Cavity Index an aid in age determination -A Cone Beam Computed Tomography Study

Background: The objective of the present study was to assess the accuracy of age estimation from TCI ofmandibular molars (except wisdom teeth) of both sides using CBCT images of known age and sex, so thatwe can apply this method to estimate age in both living individuals and skeletal material of unknown age.Methods: A cross sectional retrospective study was conducted on a total of 100 CBCT images of subjectswho were referred to the department for varied diagnostic purposes of known age and gender. All CBCTimages with a fully visible pulp cavity were selected. Two measurements were taken at two different levels.Height of the crown (CH) and height of the coronal pulp cavity (CPCH). Then tooth – coronal index (TCI)for each tooth was calculated as follows: TCI = CPCH X 100 / CH.Results: Comparison of TCI value between male and female showed no significant difference between thegender. Among the four mandibular molars (lower left and right1stand 2nd molars) 46 and 47 TCI correlateswell with age. TCI of 46 has significant prediction of age in female with an R value of 0.426. Inter observermeasurements showed a moderate to good agreement of the measures.Conclusions: TCI method of mandibular teeth was found to be a reliable method for age estimation and notgender determination. CBCT can be used in age determination for forensic purposes as it is non- invasiveand also makes it possible to reconstruct the images in different planes showing the anatomical and imagedstructures at different planes.

Maternal birth trauma: how imaging can (and should) change clinical practice.

Maternal birth trauma: how imaging can (and should) change clinical practice.

Investigating the Axonal Magnetic Fields Corresponding to Delta and Theta Waves in the Human Brain Using Direct Detection MRI

This study showed an alternative and non-invasive method for measuring brainwaves using Magnetic Resonance Imaging (MRI) with a gradient echo - echo planar imaging (GE-EPI) sequence. An attempt was made to measure the axonal magnetic fields of delta and theta waves using direct detection with MRI. Time-varying brainwaves produce an axonal current which may induce a magnetic field according to the Biot-Savart law. The MR scanner can detect inhomogeneous magnetic fields caused by weak currents generated in a subject that interact with the main magnetic field, $B_{o}$ , of the scanner. Fifteen healthy volunteers were scanned with closed eyes in a dark imaging room. The GE-EPI sequence was used to acquire 1500 time frame images in an axial plane on a 3.0 T Philips scanner. A Butterworth bandstop filter was applied to filter out physiological signals before the detection of brainwave signals. Fast Fourier Transform (FFT) was used to produce frequency spectra where the brainwave frequencies could be detected. Our study measured an axonal magnetic field of 1.5 ± 0.2 nT for the delta waves and 1.5 ± 0.3 nT for the theta waves. Delta waves were found in the range 1.5–4.0 Hz and theta waves in the range 4.0–6.5 Hz. The waves were found on both sides of the occipital lobe, temporal lobe, and hippocampus. We detected more theta waves (2.1% of the brain slice with 5 mm thickness) than delta waves (1.5% of the brain slice with 5 mm thickness). PLCC for the % $\vert \Delta S/S_{eq}\vert $ between the delta and theta waves was 0.7584 at $p =0.001$ significance level and 95% confidence level. We also applied Short Time Fourier Transform (STFT) with epoch lengths of 3.85 s, 7.7 s, and 30.8 s. But the appearance of brainwave signals was not as clear as using FFT over the entire imaging duration.

Usando a tomografia computadorizada 3D na descrição anatômica do olho e do órgão vestibulococlear de arara-canindé (Ara ararauna Linnaeus, 1758) e tucano (Ramphastos toco Statius Muller, 1776)

The aim of this study was to evaluate the use of Computed Tomography to study the anatomy of the eye and the vestibulocochlear organ of the wild birds. For this purpose, formaldehyde-embalmed specimens of a toucan and of a blue-and-yellow macaw were submitted to a whole-body scan by a 64 slice-Multidetector CT yielding 0,7mm-thick transversally oriented images. These were reconstructed by specific software that produced additional images in dorsal, transversal, and sagittal planes, as well as three-dimensional images, which were obtained by two techniques: Maximum Intensity Projection and Volume Rendering. Our study found that the eye bulbs in the orbit occupy a proportionally large space in the skull, highlighting the important role that vision plays in these animals. CT provided gross anatomic information about the size and shape of the eye, such as lenses and scleral rings of these birds. Regarding the vestibulocochlear organ, CT was less likely to identify the inner ear structures, especially the ones of the membranous labyrinth. The bony semicircular canals were clearly seen and in the middle ear, thecolumellawas identified. Our results demonstrate that the vestibulocochlear organ of birds is less complex than that of mammals, although, as expected, the semicircular canals are very well developed, being adapted to the accurate balance present in these animals.CT can be used as a good technique to evaluate eye and ear structures on these birds, and can be useful to study them in vivofor pathological conditions or for comparisons between different species.

Testing the X-ray computed microtomography on microfossil identification: An example from Sergipe-Alagoas Basin, Brazil

Micropaleontology is crucial branch of Earth Sciences, with a pivotal role in the success of the oil and gas industry over the decades. This sector of paleontology is based on the taxonomical description of microfossils, which encompass fossils with size variation from 0.001 mm to 1 m. Normally these microorganisms have a high rate on preservation, thus they are widely accepted as reliable evidence to infer about paleodepositional settings and paleoclimate change. Furthermore, microfossils are critical to understanding the evolution through time, being many of them recognized as index fossil and providing useful biozones to correlation. Since 1950, microfossils have been taxonomically described mainly by stereomicroscopes. However, as the technology progress, traditional ways to study these organisms are challenged and improved by nondestructive three-dimensional imaging techniques, as X-ray tomographic microscopy (SRXTM), three-dimensional X-ray microscopy (3D-XRM), the X-ray computed microtomography (microCT) and X-ray computed nanotomography (nanoCT). Recently, one of the most compelling research areas in micropaleontology is the desire to automatize and enhance the details of systematic classification. Thereby, an increasing number of researches have applied the high-resolution X-ray analysis aiming to improve the morphological, taxonomic and taphonomic examination. Most of them have detailed the enhancement provided by the technique when compared with the standard microscopes, and raised questions about the traditional characters used on the microfossil systematic taxonomy. Nevertheless, even with the surpassing detail on microfossil characterization, the application of microCT has been hampered by the costs and sometimes by the needs of specific computer skill. Thus, this research has evaluated the use of microCT as the technique to classify a random bulk of microfossil (comprising foraminifers, ostracods, radiolarians, gastropods and echinoderms) with no further software treatment. No standard microscope analysis was performed. Despite chemical composition of microfossils, most of the specimens morphology, especially internal structures, have been easily acquired and analyzed. 96% of the microfossils of the dataset were identified at least on genus level. Irrespective of the deepness of detail, when considering the overall taxonomic identification, the microCT seems to be effective as the standard microscope. Nonetheless, when problematic specimens are evaluated, the microCT seems to be a more reliable and practical tool than other methods as Scanning Electron Microscopy. Thus, the technique can be used solo or as a complementary method to the stereomicroscope. Additionally, the high-resolution has the potential to lead to the expected automatized micropaleontology, since they can provide numerous images in several planes. This may create a strong database necessary to machine learning and computer identification.

Developmental anomalies of the superior vena cava and its tributaries: What the radiologist needs to know?

Deviations from the normal process of embryogenesis can result in various developmental anomalies of the superior vena cava (SVC). While these anomalies are often asymptomatic, they assume clinical importance during interventions such as central venous catheterisations and pacemaker implantations and during cardiothoracic surgeries while instituting cardiopulmonary bypass and for creation of cavo-pulmonary connections. Role of imaging in identifying these anomalies is indispensable. Cross-sectional imaging techniques like CT venography and magnetic resonance (MR) venography allow direct visualisation and consequently increased detection of anomalies. CT venography plays an important role in detection of SVC anomalies as it is readily available, has excellent spatial resolution, short acquisition times and potential for reconstruction of images in multiple planes. This pictorial review focuses on the developmental anomalies of the SVC and its tributaries highlighting their embryological basis, imaging appearances on CT venography and potential clinical implications, where relevant.

Evaluation of Whole-Body MRI (WB-MRI) in Smoldering Multiple Myeloma (SMM)

Introduction Whole-body magnetic resonance imaging (WB-MRI), including multiplanar multisequence technique with diffusion weighted images, is a novel imaging technique being evaluated for patients with multiple myeloma (MM). WB-MRI is ideal for this population due to its high sensitivity for bone marrow signal changes and full anatomic coverage from vertex to mid-thighs. It is well established that patients with unequivocal focal lesions on MRI have worse outcomes. Currently the IMWG recommends that all patients with smoldering multiple myeloma (SMM) undergo WB-MRI (or whole spine MRI if WB-MRI is not available) to rule out two or more focal lesions which would classify the patient as having symptomatic myeloma requiring treatment. There is a clear benefit of using MRI for the detection of early focal myeloma lesions however less is known about findings in the SMM population. Detection of subtle findings such as one small focal lesion or heterogeneous bone marrow in WB-MRI has unknown clinical significance that needs to be further evaluated. This study aimed to evaluate the sensitivity of WB-MRI compared to other highly sensitive functional imaging modalities in patients with SMM both at baseline and after treatment. Methods Imaging of patients with WB-MRI performed at the National Institutes of Health Clinical Center Myeloma Program were reviewed and compared to whole spine MRI and 18F-FDG PET/CT completed at the same timepoint. The majority of patients were being evaluated for enrollment on clinical trials. Patients had undergone a WB-MRI with a 3-Tesla system either as a baseline study, after completion of induction treatment, or during follow up determined by the time DWI became available at our institution. The imaging protocol included sagittalT1 weighted (W) and Short tau inversion recovery (STIR) for spine and coronal, axial T1W and axial T2 TSE pulse sequences. The functional component included diffusion weighted imaging in the axial plane (b=0 and 900sec/mm2). Radiological interpretation was performed by two readers using myeloma response assessment and diagnosis system (My-RADS) {Messiou, 2019 #340}. WB-MRIs were categorized as positive if focal lesions or diffuse/heterogenous pattern of bone marrow infiltration were present. Similarly, 18F-FDG PET/CTs and whole spine MRIs were classified as positive if focal lesions or diffuse/heterogenous pattern of bone marrow were present. Results A total of 34 patients with SMM and 5 patients with relapsed refractory multiple myeloma (RRMM) had sequential WB-MRI and 18F-FDG PET/CT. Figure 1 summarizes the radiological data of the SMM population. Eleven of these patients had PET/CT, whole spine MRI, and WB-MRI at baseline. Twenty-five patients had PET/CT and WB-MRI completed after at least 8 cycles of treatment. Thirteen patients had consistently negative imaging at baseline, 7 of which also had negative imaging after treatment, while 2 patients were found to have new lesions seen on WB-MRI after treatment. Six patients had resolution of positive imaging seen at baseline after treatment. Among the 17 patients with a positive WB-MRI, 12 (71%; 95% CI 47% - 87%) had a negative correlating PET/CT. Among 5 patients with positive PET/CT at the same time point as a WB-MRI, only 1 (20%; 95% CI 2% - 64%) correlated to a negative WB-MRI. Figure 2 depicts findings from patients with RRMM for comparison. All imaging modalities showed multiple focal findings in all 5 patients. Conclusions This study depicts the high sensitivity of WB-MRI in the SMM population. Such a high sensitivity is especially needed in SMM and early myeloma when disease burden is lower and the decision for treatment is being considered. In comparison to the RRMM population where all three imaging modalities easily detect multiple focal lesions, WB-MRI tends to identify myeloma involvement in the SMM patients more than the other imaging techniques. This suggests the importance of utilizing WB-MRI when diagnosing SMM. In the SMM population, the prognostic significance of lesions that are discrepant between MRI and FDG PET/CT is not yet known. Further follow up is needed to evaluate any difference in hard endpoints such as progression free survival between patients with positive findings described by WB-MRI. Disclosures No relevant conflicts of interest to declare.

Lower Baseline Apparent Diffusion Coefficient Values are Associated with Worse Survival in Locally Advanced Pancreatic Cancer

It is challenging to obtain adequate pathologic tissue to personalize therapy for locally advanced pancreatic cancer (LAPC) patients. Noninvasive diffusion MRI (dMRI) has the potential to characterize underlying tumor biology and treatment responsiveness. Our prior work found a strong, significant association between pretreatment apparent diffusion coefficient (ADC) values and pancreatic tumor cell destruction in patients with resectable pancreatic cancer undergoing preoperative chemoradiation (chemoRT). The goal of the current study was to prospectively investigate the relationship between dMRI characteristics and outcomes after chemoRT in LAPC patients. Locally advanced pancreatic cancer patients were prospectively enrolled onto an IRB-approved clinical trial, investigating dMRI characteristics before and during chemoRT. High quality dMRI images in the tumor plane were obtained and two radiation oncologists delineated each tumor on T1-weighted MRI and dMRI images. Baseline and mid-radiation (mid-RT) ADC values were compared with time to local failure (TTLF), time to distant failure (TTDF), progression free survival (PFS), and overall survival (OS). Pre- and post-radiation CA-19-9 lab values were also obtained and compared with clinical outcomes. Univariable Cox proportional hazard models were used for statistical analysis. A total of 23 dMRI scans were obtained in 9 patients (6 male, 3 female) who received gemcitabine-based chemoRT. For the overall cohort, the median age was 64 years (range 52-73), median PFS was 18 months, and median OS was 25.3 months from diagnosis. Baseline dMRIs were obtained a median of 25 days (range 1 – 35) prior to radiation. We found a significant association between lower baseline ADC values and all clinical outcomes. Lower mean baseline tumor ADC values were associated with lower OS, lower PFS, shorter TTLF, and shorter TTDF (see Table 1). In comparison, there were no significant relationships between CA-19-9 lab values or mid-RT ADC values with any clinical outcomes. Lower baseline tumor ADC values were found to significantly correlate with clinical outcomes including worse survival in LAPC patients. These findings are concordant with prior studies showing poor pathological responses in resectable pancreatic cancer patients with lower baseline ADC values. Further research is needed in a larger cohort of patients to study how this noninvasive biomarker may help with clinical decision-making and treatment planning.Abstract 3443; TableCox Proportional Hazards Model of Mean Pancreatic Tumor ADCTimepointEndpointHazard Ratio95% CIp-valueBaselineOS0.650.4 – 1.00.0496BaselinePFS0.540.3 – 0.90.01BaselineTTLF0.180.04 – 0.80.02BaselineTTDF0.540.3 – 0.90.03Mid-RTOS1.130.8 – 1.60.51Mid-RTPFS1.080.8 – 1.50.65Mid-RTTTLF00 – Inf0.99Mid-RTTTDF0.650.4 – 1.10.13 Open table in a new tab

Dislocations in chemical vapor deposition diamond layer detected by confocal Raman imaging

Dislocations in a homoepitaxial diamond film grown by chemical vapor deposition (CVD) were characterized by confocal Raman imaging. The diamond film was grown on a high-pressure high-temperature (HPHT) substrate using an oxygen-adding condition to minimize dislocation formation during diamond growth. The dislocation densities in the CVD thin film and substrate were found to be 3 × 104 and 2 × 104 cm−2, respectively, from large-area Raman imaging. The spatial variation of stress around dislocations in CVD diamond was analyzed three-dimensionally using in-plane images of peak positions of diamond first-order lines taken at different depths from the diamond film surface. The variational directions of the stresses depended on the types of dislocation: ⟨110⟩ variational direction corresponds to edge [001] dislocation, whereas the ⟨100⟩ variational direction corresponds to 45° mixed [001] dislocation. Most dislocations passed through the CVD thin film from the substrate. Some dislocations were newly generated at the CVD layer–substrate interface. The dislocations in CVD diamond propagate along the [001] direction of diamond crystal with the same Burgers vector in the HPHT substrate.

Lateral articulation of the Spanish trill /r/

The Spanish trill /r/ represents a rich area for language acquisition research because of its particular articulatory requirements and its tendency toward variation. Lateral bracing has been documented during production of the canonical apical trill. Some articulatory studies suggest alternate lateral articulations of the Spanish trill, with lateral bracing on one side and vibration on the other, which are not distinguishable from central trills from the acoustic signal [Rivera-Campos and Boyce, “Describing alternative articulations of the Spanish trill /r/ by ultrasound technology,” JASA 133(5)]. With the aim of replicating these findings, the present study uses ultrasound imaging in midsagittal and coronal planes to characterize tongue position and movement during different phonetic variants of /r/ produced by seven speakers (four L2 Spanish learners and three native Spanish speakers). The study will shed light on the frequency of the central and lateral strategies in native Spanish speakers and L2 learners, whether the presence of frication or failure of trilling is connected to the lateral strategy, and will contribute to the general understanding of covert articulatory variants.

English

BACKGROUND Magnetic resonance imaging is known to demonstrate the perianal anatomy accurately. MR Fistulography with saline as contrast agent has been described to facilitate the detection of fistula tracks. We wanted to study the diagnostic accuracy, sensitivity, specificity, positive and negative predictive values of magnetic resonance fistulography using saline as a contrast agent using surgical findings as a reference standard. METHODS Fifty-nine clinically diagnosed cases of perianal fistulae who were sent for preoperative MR imaging of the perianal fistulae were included in the study. MR imaging after instillation of saline was obtained in these patients through a cannula inserted into the external opening. T2 and STIR images in axial and coronal planes were studied. Diagnostic indices were calculated using surgical findings as reference standard. RESULTS MR imaging with saline instillation demonstrated a sensitivity of 97.92 % in the detection of primary tracks. The sensitivity in determination of internal opening, secondary tracks, abscesses and horseshoe tracks were 98.04 %, 95.24 %, 100 % and 100 % respectively. MRI had 100 % specificity in detection of primary tracks, internal opening, secondary tracks, abscesses and horseshoe tracks before and after instillation of saline. The sensitivity was found to be more in participants who did not have active perianal discharge at the time of MR examination. CONCLUSIONS MRI with instillation of saline into the fistulous track is highly accurate for the presurgical evaluation of perianal fistula with respect to accurate depiction of primary track, secondary track, abscess and horseshoe extensions. It can serve as a cheaper alternative to MR examination using I.V. Gadolinium based contrast agents or MR Fistulography using Gadolinium agents. KEYWORDS Magnetic Resonance Imaging (MRI), Perianal Fistula, Saline, Pre-Operative Assessment, Fistulography, Horseshoe, Internal Opening, Secondary Tracks

Ultrasound-Guided Out-of-Plane Versus In-Plane Radial Artery Cannulation in Adult Cardiac Surgical Patients

The primary objective was to compare the rate of first-pass radial arterial cannulation using out-of-plane ultrasound guidance with in-plane imaging. The secondary endpoints were a comparison of the number of times the cannula was redirected, the number of attempts, the number of skin punctures, the incidence of hematoma, the time to completion of the cannulation procedure, and the number of failed attempts between the 2 ultrasound imaging techniques. A prospective, randomized, observational study. A tertiary cardiac care center. Adult patients undergoing elective cardiac surgery. Radial artery cannulation with ultrasound guidance. Eighty-four adult patients scheduled for elective cardiac surgery were randomly assigned to the out-of-plane ultrasound group (group I, n = 42) or the in-plane ultrasound group (group II, n = 42) for left radial artery cannulation. A linear ultrasound probe was used to identify the radial artery. In each approach, the number of times first-pass success was achieved, the number of times the cannula was redirected, the number of skin punctures, the incidence of hematomas, and the number of failed attempts were recorded. The first-pass success rate was greater in the in-plane ultrasound group and was statistically significant (p = 0.007). In the out-of-plane ultrasound group, a larger number of patients needed redirection of the cannula (p = 0.002). The number of patients in whom the skin needed to be punctured more than once was greater in the out-of-plane ultrasound group compared with the in-plane ultrasound group (p = 0.002). The incidence of hematoma formation and time to completion of the technique were similar in both groups (p = 0.241 and p = 0.792, respectively). In-plane ultrasound guidance appeared to be superior for achieving a higher first-pass success rate more often with minimal redirections and skin punctures compared with out-of-plane ultrasound guidance.

Validity and reliability of smartphone-based Goniometer-Pro app for measuring the thoracic kyphosis

Background contextIt is important to precisely measure thoracic kyphosis while examining the patients and studying effectiveness of therapeutic treatments. PurposeThe present study evaluates validity as well as intra- and inter-rater reliability of health-related Goniometer-Pro android app in measuring thoracic kyphosis. MethodsA total number of 31 subjects were examined to validate using markers and measures of the proposed method to mark the spinous process, palpation, and radiologic imaging in the sagittal plane to obtain the thoracic curvature using Cobb method. Moreover, 40 subjects were examined for reliability by applying an evaluator at three occasions with an interval of one week (intra-rater) and three different evaluators at the same place and day (inter-rater). ResultsFindings indicated that there was no significant difference between Cobb angle and the angle from the proposed method in thoracic curvature (p > 0.5). However, significant correlation was observed for the thoracic (r = 0.81, P = 0.000) with an ICC of 0.89. Intra- and inter-rater measurements were significantly correlated. ConclusionOur proposed method using Goniometer-Pro android app is highly reliable and accurate in determining thoracic curvature values.

Anatomical variations of the main septum of the sphenoidal sinus and its importance during transsphenoidal approaches to the sella turcica

BackgroundThere are numerous variations reported regarding anatomy of the sphenoidal sinuses that include e.g. their pneumatisation, septation and relation to neurovascular structures. The following study aimed to examine the height of the MS in the sphenoidal sinuses, as well as its type (bony, membranous or mixed) and its course amongst the adult Polish population. Materials and methodsA retrospective analysis of 296 computed tomography (CT) images (147 females, 149 males) of the paranasal sinuses was conducted. Images in axial, coronal, and sagittal planes were visualised and analysed. ResultsThe average height of the MS was 2.1 ± 0.41 cm for the entire research group. Completely bony MS was found in 32.77% of the patients, partially membranous in 63.85%, and solely membranous in 3.38% of the patients. The course of the MS that changed from the anterior to the posterior section of the sinuses predominated (83.78%). The MS had the shape of the letter ‘C’ in 22.29% of the cases (C-shaped in 11.82% and inverted ‘C’ in 10.47%). The rarest was the MS resembling letter ‘S’, which only appeared in 11.48% of the patients (S-shaped in 5.74% and inverted ‘S’ in 5.74%). Only 16.22% of the patients had the MS that shifted neither its course nor its shape. ConclusionsThe MS might be an intraoperative marker of the midline, providing surgeons with good spatial orientation. Notwithstanding, the MS changed its course in the majority of the studied here patients, hence more careful transsphenoidal approach is needed to avoid iatrogenic neurovascular injuries.

Is cerebral spinal fluid flow associated with body mass index and head circumference in healthy children? A phase contrast magnetic resonance imaging study

BackgroundThe aim of this study was to investigate the relationship between age, gender, body mass index (BMI), and head circumference (HC) and cerebral spinal fluid (CSF) flow dynamics in the pediatric population. The prospective study included a total of 137 participants, 75 boys and 62 girls, ranging in age from 2 to 204 months. Quantitative evaluation of CSF flow was made by using phase contrast magnetic resonance imaging (PC-MRI) in the axial plane at the level of the aqueductus cerebri. Flow dynamics were recorded as peak and mean velocity (cm/s); cranial, caudal, and net volume (ml); and aqueductus cerebri area (mm2). Correlation between baseline descriptive parameters, including age, gender, BMI, and HC, and the aforementioned CSF flow dynamics were investigated.ResultsThe net volume was significantly lower in girls (p = 0.002). There was no association between age and aqueduct area, mean velocity, and cranial volume. The peak velocity was remarkably higher in children (p = 0.03), whereas cranial and net volume were found to be lower in infants (p = 0.04 and p = 0.03, respectively). Notably, cases with HC below normal values had lower cranial, caudal, and net volume and aqueductus cerebri area (p = 0.01, p = 0.03, p = 0.03, and p = 0.04, respectively). There was no association between BMI and indicators of CSF flow dynamics in PC-MRI.ConclusionBMI and HC may be associated with CSF flow dynamics in children. A smaller HC is accompanied by a lower forward flow volume, reverse flow volume, net volume, and aqueductal diameter. These points should be remembered during the design of further trials on determinants of CSF flow in children.

A pictorial review of lung torsion using 3D CT cinematic rendering.

Lung torsion is the abnormal rotation of a lobe or lung around its bronchovascular pedicle. It most commonly occurs in the setting of pulmonary resection, though it has also been described after large-volume thoracentesis and video-assisted thoracic surgery, as well as spontaneously. Resulting ischemia can lead to infarction, making this an emergent diagnosis. As findings are often nonspecific, a high index of suspicion is required, especially in the postsurgical setting. 2D CT angiography findings are subtle and include direct signs of pedicle rotation on CT as well as indirect findings including loss of normal parenchymal enhancement, atelectasis of torsed lobe/lung, and abnormal fissure position. These direct and indirect findings are often appreciated on different window presets and upon review of images in multiple planes, with need to collate the information subsequently. 3D cinematic rendering (CR) using multi-planar light sources can readily highlight spatial relationships of vasculature in the chest and may be able to assist in the confident diagnosis of this sometimes subtle but life-threatening pathology. We have provided the first characterization of common lung torsion findings on 3D CR.

Quasi-simultaneous multi-focus imaging using a lock-in pixel image sensor and TAG lens.

In this paper, a quasi-simultaneous multi-focus imaging technique named simulfocus imaging is reported. This technique was developed for measuring an entire object distributed in the depth direction beyond the depth of field (DOF) with high resolution in a single shot. Simulfocus imaging can acquire multiple focal planes in one shot by synchronizing a tunable acoustic gradient index (TAG) lens and a lock-in pixel image sensor. The TAG lens is a tunable-focus lens whose focal position can be changed at a high speed of several tens to several hundreds of kilohertz. The lock-in pixel image sensor is a special image sensor that can execute multiple exposures at an arbitrary timing during a single shooting. The sensor includes a number of photoelectron storage units in each pixel, and the units where the photoelectrons generated by each exposure are stored can be freely selected. Since an image can be acquired for a single storage unit, and the lock-in pixel image sensor has a number of storage units, the lock-in pixel image sensor can acquire multiple images in one shot. By assigning a specific exposure timing to each unit and synchronizing the exposure timing with the focus fluctuation of the TAG lens, it is possible to simultaneously acquire images in different focal planes. To evaluate the system, we conducted experiments to show the effectiveness of simulfocus imaging in microscope and telescope configurations. From the experimental results, it was confirmed that simulfocus was effective in both configurations.