Multiplanar Reconstruction Technique Research Articles

Application of multi-planar reconstruction technique in endovascular repair of aortic dissection

BACKGROUND Endovascular repair of aortic dissection is an effective method commonly used in the treatment of Stanford type B aortic dissection. Stent placement during the operation was one-time and could not be repeatedly adjusted during the operation. Therefore, it is of great significance for cardiovascular physicians to fully understand the branch status, position, angle, and other information regarding aortic arch dissection before surgery. AIM To provide more references for clinical cardiovascular physicians to develop treatment plans. METHODS Data from 153 patients who underwent endovascular repair of aortic dissection at our hospital between January 2021 and December 2022 were retrospectively collected. All patients underwent multi-slice spiral computed tomography angiography. Based on distinct post-image processing techniques, the patients were categorized into three groups: Multiplanar reconstruction (MPR) (n = 55), volume reconstruction (VR) (n = 46), and maximum intensity projection (MIP) (n = 52). The detection rate of aortic rupture, accuracy of the DeBakey classification, rotation, and tilt angles of the C-arm during the procedure, dispersion after stent release, and the incidence of late complications were recorded and compared. RESULTS The detection rates of interlayer rupture in the MPR and VR groups were significantly higher than that in the MIP group (P < 0.05). The detection rates of DeBakey subtypes I, II, and III in the MPR group were higher than those in the MIP group, and the detection rate of type III in the MPR group was significantly higher than that in the VR group (P < 0.05). There was no statistically significant difference in the detection rates of types I and II compared to the VR group (P > 0.05). The scatter rate of markers and the incidence of complications in the MPR group were significantly lower than those in the VR and MIP groups (P < 0.05). CONCLUSION The application of MPR in the endovascular repair of aortic dissection has improved the detection rate of dissection rupture, the accuracy of anatomical classification, and safety.

Comparison between Eustachian tube angle and length in chronic otitis media and contralateral ear

Background: Chronic suppurative otitis media (CSOM) is still a significant public health problem, especially in developing countries. Eustachian tube dysfunction is one of the factors that influence the occurrence of CSOM. The pathogenesis of acute and chronic otitis media is initiated by negative pressure in the middle ear. One theory of the event of CSOM is the continuum theory. The eustachian tube as one of the factors that influence the occurrence of CSOM has been proven from various studies comparing CSOM patients and the average population and CSOM with and without cholesteatoma. With the advanced technology, CT scan helps diagnose pathological conditions in the ear as a diagnostic tool and evaluation modality. CT scan imaging with a multiplanar reconstruction technique can provide a clear image of the anatomical shape of the Eustachian tube. Objective: This study aims to determine the relationship between the angle and length of the Eustachian tube in the ear with CSOM and the contralateral ear's angle and length. Method: An analytic study with a cross-sectional design involving 30 samples of CSOM patients with the contralateral ear. The measurement of the angle and length of the Eustachian tube using the multiplanar HRCT temporal reconstruction technique. Result: Statistical analysis with paired t-test showed that the Eustachian tube angle was significantly more horizontal in the CSOM ear than the contralateral ear (p<0.05). Eustachian tube length was shorter in CSOM than contralateral (p<0.05). Conclusion: The angle of the eustachian tube in the CSOM ear is smaller (more horizontal) and shorter than the contralateral ear.

The proximity of the middle hepatic vein to the hepatic hilus: a retrospective radiological study.

The middle hepatic vein (MHV) is an important landmark in anatomical hemihepatectomy. The proximity between the MHV and the hilar plate was suspected to be associated with tumor exposure during left hemihepatectomy for advanced perihilar cholangiocarcinoma and is reported to facilitate a dorsal approach to the MHV during laparoscopic hemihepatectomy. However, the precise distance between these locations is unknown. To investigate the "accurate and normal" distance between the MHV and the hilar plate, the present study focused on patients who presented without perihilar tumor. One hundred and sixty-eight consecutive patients who underwent pancreatoduodenectomy were included. Retrospective radiological measurement was performed using preoperative multi-detector row CT. The optimized CT slices perpendicular to the MHV were made using the multiplanar reconstruction technique. The shortest distance between the MHV and the hilar plate was measured on the left and right sides on the perpendicular slices. The diameters of the left and right hepatic ducts were also measured. The distance was 9.0mm (1.9-20.0mm) on the left side and 11.3mm (2.3-21.8) on the right side (p < 0.001). The distance on the left side was < 10mm in 60% of patients (n = 100). Only one-third of patients (n = 55) had a distance of ≥ 10mm on both sides. As the hepatic ducts became more dilated, the distance from the MHV to the hilar plate became shorter. The MHV was located in close proximity to the hepatic hilus, especially on the left side.

The effect of age and sex on esophageal hiatal surface area among normal North American adults using multidetector computed tomography.

The size of the esophageal hiatus is clinically important for preserving the integrity of the lower esophageal sphincter mechanism. The purpose of this study was to systematically establish the mean hiatal surface area (HSA) for normal North American adults under physiologic conditions and assess the relationship between sex and age on HSA. Multi-Detector Computer Tomogram (MDCT) images of the esophageal hiatus in 119 healthy adult subjects (61 males and 58 females with an age range of 24-88years) were retrospectively analyzed using the multi-planar reconstruction (MPR) technique to directly measure their hiatal length (long axis), width (short axis) and surface area at end inspiration. The mean HSA for males was 2.88 cm2, with a standard deviation of 0.74 cm2. The mean HSA for females was 2.51 cm2, with a standard deviation of 0.68 cm2. There was a statistically significant difference in HSA between males and females (p = 0.0053); however, there was no statistically significant difference between the HSA among different age groups (p = 0.8439). Similarly, significant differences between males and females were demonstrated in both the length (p = 0.0263) and width (p = 0.0311) measurements, but there was no evidence of an association of these parameters with age. For the first time, the normal size of the hiatus at end inspiration has been established noninvasively for a population of healthy adults from MDCT images.

A new “practical" plane for Eustachian tube measurements and its application in predicting middle ear dysfunction in patient with acquired cholesteatomas

SettingThe Eustachian tube plays a vital role in middle ear physiology. There has been evidence that Eustachian tube (ET) and angle are correlated with middle ear function. The measurements of these Eustachian tube features are now made possible with computed tomography and multiplanar reconstruction techniques. However, there has not been a standardised protocol devised to these measurements in limited window cone-beam CT scans of temporal bones.ObjectiveThe primary object of the present study is to establish and validate a new landmark in closer proximity to the middle ear that is consistently captured, thereby allowing ET angle and length to be measured from the majority of cone-beam CT scans. Secondarily, the ET anatomies of patients with middle ear dysfunction manifesting as acquired cholesteatoma are analysed with this new method of measurement.MethodsThis study undertook a step-by-step method to first validate the methods of ET measurement with Reid’s standard plane, then identifying an alternative landmark, thus a new plane visible on limited window cone-beam CT scans of temporal bones and lastly, validating the application of this new plane in the measurements of ET angle and length. This new method of measurement was coined the Ku-Copson plane and was applied to 30 cochlear implant patients and 30 patients with acquired cholesteatomas. Their ET anatomies were analysed and compared.ResultsIt was found that the new Ku-Copson mandibular fossa plane was a reliable and accurate plane for the measurement of ET angle and length. Furthermore, it was found that patients with acquired cholesteatomas have statistically significant smaller ET angles and shorter ET lengths when compared with patients with cochlear implants, of normal middle ear function.ConclusionThe newly proposed method utilising the right mandibular fossa as an anatomical landmark for ET angles and lengths measurement appears to be viable. The close proximity of this landmark to the middle ear means that it is highly likely to be captured in most cone-beam CT scans of the petrous temporal bones. This enables the retrospective examination ET angles and lengths to be conducted on CB CT scans. This study reports statistically significant difference in ET anatomy in patients with middle ear dysfunction.

Application of Multiplanar Volume Reconstruction Technique for the Assessment of Electrode Location and Analysis of the Correlation to Cochlear Programming and Performance in Common Cavity Deformity

Purpose: Owing to the characteristic anatomy, cochlear implantation (CI) for common cavity deformity (CCD) has resulted in varied outcomes and frequent facial and vestibular nerve stimulation. The current study analyzed the correlation among the distance between each electrode and cavity wall (abbreviation, D), programming parameters, and performances outcomes.Materials and Methods: The current, retrospective study included 25 patients (27 ears) with CCD underwent CI. The multiplanar volume reconstruction (MPVR) techniques were employed to reconstruct and evaluate the postoperative temporal bone CT. The D and maximum comfortable level (MCL) 6 months after CI, facial and vestibular nerve stimulation, and outcomes 1, 2, and 3 years after CI pertaining to the questionnaires were documented and analyzed.Results: The patients were divided into symptomatic (10, 37%) and asymptomatic (17, 63%) groups according to with or without facial and vestibular nerve stimulation. The MCL pertaining to the symptomatic group was significantly lower than asymptomatic group, but Categories of Auditory Performance (CAP) scores 1 year after surgery was better (p < 0.05). The subjects were divided into flat (12, 44.4%) and curved (15, 55.6%) groups based on the contour of MCL map. The MCL and D were lower and shorter in the curved group than the flat group, and CAP score 1 year after surgery and Speech Intelligibility Rating (SIR) 3 years after surgery were better (p < 0.05).Conclusion: Although abnormal reactions such as facial and vestibular nerve stimulation were observed to be more frequent, lower MCL and better outcomes were observed in relation to the shorter D.

Proximal femur anatomy-implant geometry discrepancies.

Objectives: Due to ongoing concern about femur anatomy-implant mismatches, this cross-sectional study aimed to create a geometric femur profile and used it to identify and quantify possible mismatches between femur anatomy and cephalomedullary nail dimensions. The work further aimed to assess whether patient demographics affect anatomy-implant coherence. Methods: One hundred skeletally mature complete femur computer tomography (CT) scans were collected and exported to software enabling landmark placement and measures with multiplanar reconstruction techniques. Results: Clinically relevant anatomy-implant discrepancies included the femur neck and shaft axis offset 6.1 ± 1.7 mm (95% CI [5.7–6.4]), femur radius of curvature 1.2 ± 0.3 m (95% CI [1.1–1.2]), femur anteversion 18.8 ± 9.2 (95% CI [16.9–20.6]). The implants reviewed in this study did not compensate for the femur neck and shaft axis offset and had a larger radius of curvature than the studied population. Clinically significant demographic geometry differences were not identified. Conclusion: There were discrepancies between femur anatomy and cephalomedullary nail implant design; however, no clinically significant femur feature inconsistency was identified among the demographic subgroups. Due to the identified anatomy-implant discrepancies, including the femur neck and shaft axis offset, we suggest that these measurements be considered for future implant design and surgical technique.

Computed Tomographic Assessment before Transcatheter Aortic and Mitral Valve Replacement

Transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR) are catheter-based interventional techniques for treating patients having high risk for surgical aortic or mitral valve replacement, respectively. While TAVR is a technique for treating severe aortic stenosis, TMVR is primarily used for treating mitral regurgitation. Echocardiography is the initial imaging modality used for a detailed assessment of the mitral and aortic valve lesions. Multidetector computed tomography (MDCT) is then used as a complementary tool to provide additional information essential for pre-procedure planning. High spatial resolution and good temporal resolution of MDCT along with multiplanar reconstruction technique permit a comprehensive assessment relevant for the multiple aspects of preprocedural planning. The current article outlines the MDCT acquisition protocols, reconstruction techniques, and assessment of various essential parameters for TAVR and TMVR.

Impact of Left Atrial Volume Index on Discrepancy in Mitral Valve Area Assessed by Two-Dimensional Planimetry and Three-Dimensional Multi-Planar Reconstruction Technique

Background: Mitral valve area (MVA) is technically measured using both two-dimensional (2D) planimetry and three dimensional multi planar reconstruction (3D-MPR) techniques; however, studies have always overestimated MVA using the former method. Objectives: This study aimed to assess the correlation between MVA assessed by 2D and 3D techniques and the impact of left atrial volume index (LAVI) on the discrepancy between MVA assessed by two echocardiography techniques. Methods: The data of 75 patients with moderate to severe mitral stenosis assessed by both 2D planimetry and 3D-MPR techniques were retrospectively reviewed. Clinical and echocardiographic variables were evaluated. Left atrial (LA) volume was determined using biplane area-length method. Results: The mean MVA assessed by the 2D and 3D techniques was 1.03±0.24 cm2 and 0.99±0.25 cm2 with a mean discrepancy of 0.04±0.15 cm2, respectively. A strong association was observed between the MVA values assessed by 2D planimetry and 3D-MPR methods (r coefficient = 0.817, P&lt;0.001) indicating a slight discrepancy between the two techniques in assessing MVA measure. The pointed discrepancy was affected by none of the baseline characteristics and LAVI value. There was an adverse association between LAVI value and MVA measured by both 2D planimetry (r coefficient = -0.291, P= 0.011) and 3D-MPR (r coefficient=-0.260, P=0.024). Conclusion: In contrast to the left atrial dimension, the discrepancy in MVA values assessed by 2D planimetry and 3D-MPR is not influenced by LAVI adjusted for baseline parameters.

Posterior Tibial Slope and a New Morphometric Method With Multiplanar Reconstruction Technique in a Turkish Sample.

Aim: The posterior tibial slope (PTS) is important in planning many orthopedic procedures. The aim of the study is to outline a PTS measurement method using multiplanar reconstruction (MPR) in knee computed tomography (CT) images.Methods: MPR reconstruction was performed on pre-captured CT angio images of 124 patients. A standard tibial axis was created. Then, using reference points, the PTS was measured separately for the medial PTS (MPTS) and lateral PTS (LPTS). To identify an intra- and interobserver error, the technical error of measurement (TEM), relative TEM (rTEM), and coefficient of reliability (R) of the measurement were analyzed.Results: The study enrolled 124 patients (88 males, 36 females) from 18 to 92 years old. The average MPTS 8.63 ± 2.7° and LPTS 7.77 ± 3.1° were significantly different (p < 0.05). However, there was no difference between the sexes (p = 0.52 for MPTS; p = 0.9 for LPTS). The R for intraobserver reliability was 0.942 for the MPTS and 0.943 for the LPTS, and that for interobserver reliability was 0.815 and 0.806, respectively.Conclusions: PTS measurement from CT images appears advantageous as it eliminates measurement limitations due to tibial rotation and has high intra- and interobserver consistency.

Computed tomography comparison study of two Axis-based C1 transpedicular screw trajectory designs

BACKGROUND CONTEXTTo our knowledge, there is no comparison study of two different Axis-based C1 transpedicular screw trajectory (TST) designs. PURPOSETo compare two different Axis-based C1 TST designs. STUDY DESIGNThe computed tomography (CT) morphologic analysis of the two different C1 Axis-based TST designs. METHODSFirstly, the design of Axis C/M and related measurements were made on a work station by using neck computed tomography angiography (CTA) data of 62 patients. The central axes (Axis M and Axis C) of C1 TST were designed by multiplanar reconstruction (MPR) technique. Based on Axis M and Axis C, the following parameters were measured: (A, A’), distance between the insertion point (IP) and the midline. (B, B’), distance between IP and the inferior aspect of C1 posterior arch. (C, C’), distance between IP and the C1 anterior cortex of the lateral mass along Axis M/C. (D, D’), insertion angle (IA) based on Axis M/C. (E, E’), the narrowest width of the inner medullary cavity (IMC) along Axis M/C. RESULTThe C1 TST can be designed by MPR technique based on CT volume scan. The design of Axis C trajectory was easier to Axis M trajectory. A, A’ were 20.7±1.6mm and 20.6±1.9mm. Both B, B’ were 2.0±0.6mm. C, C’ were 27.2±2.1mm and 27.5±2.1mm. D, D’ were 9.9±5.0°and 10.4±7.7°. E, E’ were 5.0±1.3mm and 5.4±1.4mm. Among 62 patients (124 sides), Axis C can be achieved by medial inclination, perpendicular, lateral inclination method in 81.5%, 13.7%, 4.8% sides, respectively; Axis M can be achieved by medial inclination, perpendicular, lateral inclination method in 90.3%, 8.9%, 0.8% sides, respectively. CONCLUSIONAxis C can be a reliable trajectory for C1 transpedicular screw insertion as long as there is no displaced fracture in the C1 pedicle and lateral mass. Because of the individual differences, the ideal C1 TST can be achieved by medial inclination, perpendicular or even lateral inclination method, although its inclination direction is medial in the majority of patients.

Application Value of Multi-Slice Spiral CT Multiplanar Reconstruction Technique in the Diagnosis and Clinicopathological Analysis of Gastrointestinal Lymphoma

Objective: The purpose was to explore the value of multi-slice spiral CT (MSCT) multiplanar reconstruction technique in the diagnosis and clinicopathological analysis of gastrointestinal lymphoma (GIL). Methods: 82 GIL patients treated in our hospital from February 2018 to February 2019 were selected as the experimental group of this study, and 82 patients with other gastrointestinal tumors diagnosed by pathology during the same period were selected as the control group. Both groups of patients were scanned by MSCT and analyzed by multiplanar reconstruction technique to compare the diagnostic results and clinicopathological indexes of the two groups. Results: The diagnostic accuracy of MSCT multiplanar reconstruction scanning was higher, with no statistical difference from that of pathological examination results (P > 0.05). Compared with the control group, the objective image noise of the experimental group was lower while the signal-to-noise ratio (SNR) was higher, with significant differences between the two groups (P < 0.05). There were statistically significant differences in the CT reconstruction parameters of different tumor types and different clinical stages in the experimental group (P < 0.05). Conclusion: MSCT multiplanar reconstruction technique is effective in diagnosing GIL, and the CT reconstruction parameters have important guiding value for the differentiation of tumor tissue types and clinical stages. The technique enables the doctors to fully grasp the clinical manifestations of the disease and select appropriate therapeutic regimens, improving the diagnostic accuracy and prognostic effect of the disease, which is worthy of wide application and promotion in clinic.

Application of CT Image Based on Three-Dimensional Image Segmentation Algorithm in Diagnosis of Osteoarthritis

Objective: To investigate the application of multi-slice spiral CT in degenerative changes of lumbar facet joints using the LOG algorithm. Methods: The CT findings of 100 cases of degenerative vertebral facet joint disease were reviewed and analyzed in this paper. Results: The main CT manifestations of facet disease are osteophyte formation, articular hyperplasia and hypertrophy, osteosclerosis, narrowing of joint space, articular surface destruction, joint capsule calcification, joint gas accumulation, joint subluxation, and lateral recesses and vertebrae. Signs such as narrow mesopores. Conclusion: The multi-slice spiral CT (MSCT) and multi-planar reconstruction (MPR) techniques are analyzed by the LOG operator algorithm. It is found that the two techniques can fully display the anatomical structure and pathological changes of the vertebral facet joints, and are useful for the diagnosis of facet joint disease. Provide enough imaging evidence.

Application of three-dimensional fast gradient echo sequence in observation of craniocervical junctional ligament.

To explore the value of three-dimensional fast gradient echo sequence (3D-GRE) in observation of the craniocervical junctional ligament. A total of 21 healthy volunteers underwent 3D-GRE imaging. The imaging data was imported into the post-processing workstation. The structures of the ligaments in the craniocervical junctional area were observed and evaluated by multiplanar reconstruction technique. The features of ligaments in the craniocervical junction were shown clearly for all the 21 cases of volunteers. The scan time was 267-294 s. After the treatment with the three-dimensional reconstruction technique, the signal characteristics and the running structure of the transverse ligament, the alar ligament, the serrated ligament and the lamina could be effectively displayed. The 3D-GRE can evaluate the three-dimensional data of craniocervical junctional ligament in a short period of time. Post-processing reconstruction technique can clearly evaluate the structure characteristics of each ligament, which can lay a foundation for further application in craniocerebral trauma patients.

Deep Learning Approach Applied to Prediction of Bone Age Based on Computed Tomography Orthopedic Image Processing

Objective: Deep learning and neural network models are new research directions in the field of machine learning and artificial intelligence. Deep learning has made breakthroughs in image recognition and speech recognition applications, and has also shown unique advantages in face recognition and information retrieval, and has been widely used. Methods: Thin-layer computed tomography (CT) scan and multiplanar reconstruction (MPR) and volume reconstruction (VR) techniques were used to perform CT thin-slice scan and volume of the bilateral clavicle sternum at 548 number of l5~25 years old. Reproduction (volume rendering, VR) and three-dimensional image recombination, measuring and calculating the longest diameter of the sternal end of the bilateral clavicle, the longest diameter of the metaphysis and its length ratio, the area of the epiphysis, the area of the metaphysis and its area ratio, etc. We establish a mathematical model of bone age inference, and then substitute 50 training samples into the mathematical model to test the accuracy of the model. Results: There was a statistically significant difference between the male and female sex ratios in the same age group (P &lt; 0.05). The established mathematical model shows that the developmental law of the sternal skeletal bone is highly correlated with the biological age. The accuracy of all models is 70.5% (±1.0 years old) and 82.5% (±1.5 years). Skeletal X-ray images show different gradation changes in black and white, with black-and-white contrast and hierarchical image features. Based on the advantages of deep learning in image recognition, we combine it with bone age assessment research to build a forensic bone age automation. Conclusions: This paper harnesses the basic concepts of deep learning and its network structure, and expounds the research progress of deep learning in image recognition in different research fields at home and abroad in recent years, as well as the advantages and application prospects of deep learning in bone age assessment.

Application value of 16-slice spiral CT multi-planar reconstruction, surface occlusion display and other image post-processing techniques in the diagnosis of peripheral lung cancer

Objective To explore the application value of 16-slice spiral CT multi-planar reconstruction(MPR), surface occlusion display and other image post-processing techniques in the diagnosis of peripheral lung cancer. Methods From April 2017 to April 2019, a total of 98 patients with peripheral lung cancer admitted to the Affiliated Hospital of Hangzhou Normal University and the First People's Hospital of Jiashan County were selected.The detection rates of various signs of MPR, surface occlusion display and other image post-processing techniques in the diagnosis of peripheral lung cancer were analyzed and compared. Results MPR in the diagnosis of peripheral lung cancer, the lobulated sign was 94.9%(93/98), the vascular bundle sign was 85.7%(84/98), the fine and short burr was 93.9%(92/98). The detection rate of vascular bundle sign and fine burr sign was higher than that of thin layer scan (χ2=5.351, 5.023, 5.777, all P 0.05). The surface occlusion in the diagnosis of peripheral lung cancer, showed 90.8%(89/98) lobulated sign and 74.5%(73/98) pleural indentation.The detection rates of lobulated sign and pleural sag were higher than those of thin layer scanning (χ2=5.450, 6.002, all P 0.05). Conclusion In the diagnosis of various signs of peripheral lung cancer, the detection rate of 16-slice spiral CT MPR technique is high and worthy of application. Key words: Tomography, spiral computed; Lung neoplasms; Image processing, computer-assisted; Multi-plane reconstruction technology; Surface occlusion display

Diagnostic Potential of Panoramic Radiography and CBCT in Detecting Implant-Related Ex Vivo Injuries of the Inferior Alveolar Canal Border.

The aim of this ex vivo study was to compare the diagnostic performances of panoramic radiography and cone beam computerized tomography (CBCT) in detecting implant-related injuries of the inferior alveolar canal. Monocortical bone windows were created in 60 fresh sheep hemimandibles, the inferior alveolar canals were revealed and 120 dental implants were inserted. Three types of injuries, described as pilot drill damage (PDRILL), collapsing of the superior border of the canal (COLL), penetration of the implant tip into the canal (PENET) and one control group, were simulated. Standard (PANO) and dentition mode panoramic (PANO-DENT) images as well as CBCT data presented as multiplanar reconstruction (MPR) and cross-sectional (CROSS) views were evaluated by 6 observers who had also expressed their level of confidence to their final diagnosis. Intra- and interobserver agreement scores were rated good. The area under the curve (AUC) values and the confidence scores for CROSS and multiplanar reformation (MPR) views were both significantly higher than those of PANO and PANO-DENT (P < .05 for each) in PDRILL group. In COLL group, observers showed less confidence to PANO and PANO-DENT compared to CROSS and MPR techniques (P < .05 for each). No other significant differences were found. Within the limits of this experimental study, it can be suggested that the standard and dentition modes of panoramic radiography can be as effective as CBCT in the detection of penetrating and collapsing injuries, but multiplanar and cross-sectional views of the CBCT are more accurate than panoramic radiography in the detection of pilot drill injuries in sheep mandible.

Loop characteristics andaudio-vestibular symptoms or hemifacial spasm: is there a correlation? A multiplanar MRI study.

We investigated if loop characteristics correlatewith audio-vestibularsymptoms or hemifacial spasmin patients with a vascular loop in the root entry zone (VII and VIII) and in the internal auditory canal. A retrospective, multicenter study analyzed 2622 consecutive magnetic resonance imaging (MRI) scans of the cerebellopontine angle of patients with asymmetric audio-vestibular symptom or hemifacial spasm; patients' symptoms were confirmed by clinical tests. MRIs displaying vascular loops visible in the axial view were analyzed using multiplanar reconstruction. We evaluated (1) depth of penetration of the loop into the internal auditory canal (IAC); (2) largest diameter of the vessel; (3) nerve(s) involved in the vascular impingement, position of the loop relative to such nerve(s) and number of contacts between vessel and nerve(s); (4) length of such contact. The loop metrics described above were correlated with the patients' audio-vestibular symptoms and hemifacial spasm. Three hundred ninety-nine patients displayed a loop visible in the MRI axial view and out of them only 118 displayed a direct contact between loop and nerve. The cochlear nerve was involved in a contact in 57.7%. Loops in direct nerve contact had a calibre > 0.85mm, were located in the middle portion of the IAC, and correlated with vertigo (p = 0.002), tinnitus (p = 0.003), and hemifacial spasm (p < 0.001). Asymmetric sensorineural hearing loss (SNHL) correlated with number of contacts (p < 0.001) and length of contact (p < 0.05). The contact was asymptomatic in 41.5% of patients. Loop characteristics may help predict whether a vascular impingement is responsible for a symptom and guide the physician to select the best treatment. • A vascular loop in the internal auditory canal was observed in 18-20% of the patients in this study; whether a loop can be responsible for a compressive syndrome is still unclear in particular referred to thevestibulocochlearnerve. • Compression by a loop on the facial nerve causes hemifacial spasm; compression by a loop on the cochlear or vestibular nerve may cause audio-vestibular symptoms. • In patients with a loop, the loop calibre, the loop position, and the number of loop-nerve(s) assessed via the multiplanar MRI reconstruction technique may help assess whether the patient will manifest audio-vestibular symptoms or hemifacial spasm.

Pulmonary MALT Lymphoma has variable features on CT

Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is the most common primary pulmonary lymphoma. There are limited studies on imaging features of pulmonary MALT lymphoma. We present the computed tomography (CT) manifestations of pulmonary MALT lymphoma and the correlation between CT manifestations and clinical characteristics. Patients (n = 53) with histologically confirmed pulmonary MALT lymphoma who underwent chest CT scanning were retrospectively analyzed. Evaluated findings included distribution of pulmonary lesions, morphological pattern of appearance, contrast enhancement features, size, presence of thoracic lymphadenopathy, and secondary associated features. Pulmonary MALT lymphoma was observed in multiple (79%) and bilateral (66%) disease with random distribution (≥70%) of pulmonary lesions. The most frequent morphological pattern was consolidation (n = 33, 62%), followed by nodule (n = 23, 43%) and mass (n = 11, 21%). Common associated features were air bronchograms and bronchiectasis, especially cystic bronchiectasis and angiogram sign. Asymptomatic patients had less consolidation and bronchiectasis than did symptomatic patients. Cystic bronchiectasis was only observed in the symptomatic group. In conclusion, pulmonary MALT lymphoma manifests as diverse patterns on CT scans. Consolidation combined with cystic bronchiectasis was a characteristic late sign, which may assist in differential diagnosis. High-resolution CT images and multiplanar reconstruction techniques are helpful for accurately determining imaging manifestations.

Anatomy of the Surrounding Tissue of the Eustachian Tube in Patulous Eustachian Tube: 3 Tesla Magnetic Resonance Imaging Approach.

To clarify the possible pathological conditions of cartilaginous portion of the Eustachian tube (ET) and its surrounding tissues. Retrospective review. Twenty-five normal subjects (control group) and 25 patients with patulous ET (patulous group). We reconstructed cross-sectional 3 Tesla magnetic resonance (MR) images using the multiplanar reconstruction (MPR) technique. Cross-section area widths that were measured included the following: 1) inferior head of lateral pterygoid muscle (PM); 2) pterygoid venous plexus (PVP); 3) medial soft tissues of ET, including ET cartilage; and 4) maximum cross-sectional area of high intensity surrounding the medial ET lumen. A statistically significant difference was found in the thickness of the inferior head of the lateral PM between male and female; it was thicker in the male participants. Ostmann's fatty tissue (OF) was significantly smaller in the patulous ET group. Smaller size of the surrounding tissues of the ET, viz., the OF, may contribute to the pathogenesis of patulous ET.