Three-dimensional Computed Tomography Reconstruction Research Articles

Allometry of human calvaria bones during development from birth to 8 years of age shows a nonlinear growth pattern

Pediatric skulls change rapidly in size and shape during development, especially for children up to 8 years of age. This project was developed to address the gap in understanding of the three-dimensional growth parameters of the human skull during this period and the impact these growth patterns have on fontanelle closure and suture formation. This study offers novel data on the dynamic changes in the anatomy of the skull with the intention of providing better guidance for pediatric surgical care. Craniometric landmarks defined on three-dimensional computed tomography reconstructions were used to map skull development in children aged 0 to 8 years old. A total of 364 datasets were analyzed and statistically representative 3D skulls with anatomical craniometric features such as head shape, bone size, suture and fontanelle closure time were generated for 17 age groups spanning birth to 8 years of age to provide a comprehensive neuroanatomical understanding of how the pediatric skull changes over time. This study indicates that the cranial bones follow a non-linear growth pattern, with the occipital and frontal bones driving the directionality of fontanelle closure and delivers a 3D visualization of the developmental characteristics of the skull providing a landmark resource for understanding the growth dynamics of the human skull. While clinical measurements remain valid approaches for the planning of surgical interventions, these 3D models may provide a more accurate planning paradigm.

A Case of A Middle-Aged Woman with Cor Triatriatum Dexter and Sick Sinus Syndrome: Comprehensive Cardiovascular Evaluation

This case study discusses a 51-year-old woman with a complex cardiovascular condition, cor triatriatum dexter, complicated by sick sinus syndrome. The patient presented with a history of bradycardia, dizziness, and amaurosis, and was admitted to the emergency department due to numbness in her right limb. Diagnostic examinations, including computed tomography (CT) and cardiac color-ultrasound screening, revealed cor triatriatum dexter along with an enlarged left atrium and ventricle. Additional findings included the absence of the inferior vena cava and polysplenic syndrome. Based on these results, double-chamber pacemaker surgery was recommended, supported by cardiac and thoracic-abdominal CT angiography and three-dimensional vascular reconstruction. This case underscores the importance of comprehensive examinations in identifying associated cardiovascular abnormalities.

Effect of transbronchial or intravenous administration of indocyanine green on resection margins during near-infrared-guided segmentectomy: a review.

For early-stage non-small cell lung cancer, surgical resection remains the best treatment option. Currently, sublobar resection, including segmentectomy, is recommended in these cases, as it provides a better quality of life with the same oncological outcomes; however, is requires adequate resection margins. Accurate preoperative planning and proper identification of the intersegmental planes during thoracic surgery are crucial for ensuring precise surgical management and adequate resection margins. Three dimensional computed tomography reconstruction and near-infrared-guided intersegmental plane identification can greatly facilitate the surgical procedures. Three-dimensional computed tomography reconstruction can simulate both the resection and resection margins. Indocyanine green is one of the most frequently used and affordable fluorophores. There are two ways to identify the intersegmental planes using indocyanine green: intravenous and transbronchial administration. Intravenous application is simple; however, its effectiveness may be affected by underlying lung disease, and it requires the isolation of segmental structures before administration. Transbronchial use requires appropriate bronchoscopic skills and preoperative planning; however, it also allows for delineation deep in the parenchyma and can be used for complex segmentectomies. Both methods can be used to ensure adequate resection margins and, therefore, achieve the correct oncological radicality of the surgical procedure. Here, we summarise these applications and provide an overview of their different possibilities.

Three-dimensional computed tomography reconstruction of an elongated styloid process.

Three-dimensional computed tomography reconstruction of an elongated styloid process.

Three-dimensional computed tomography reconstruction of a calcified stylohyoid ligament.

Three-dimensional computed tomography reconstruction of a calcified stylohyoid ligament.

Iterative intelligent algorithm-based on CT three-dimensional reconstruction in endoscopic thyroidectomy and perioperative comprehensive nursing

This research was aimed to explore the application of computed tomography (CT) 3D reconstruction technology based on iterative intelligent algorithm in endoscopic thyroidectomy (ET) and perioperative comprehensive nursing. A total of 140 patients with thyroid mass receiving ET were randomly divided into controls (conventional ultrasound combined with perioperative routine nursing) and experimental group (CT 3D reconstruction based on iterative intelligent algorithm combined with perioperative comprehensive nursing), 70 cases in each group. The iterative intelligent algorithm used in this article is an image processing algorithm based on deep learning. Its goal is to generate more accurate and clear 3D reconstructed images by learning and optimizing the original CT images for multiple iterations. The detailed process of the algorithm is as follows: Data preprocessing, Feature extraction and representation, Iterative optimization, 3D reconstruction image generation. Finally, after multiple iterations of optimization, the algorithm will generate high-quality 3D reconstruction images, which can clearly show the anatomical structure of the thyroid mass and the surrounding tissue of the lesion. In order to evaluate the effectiveness of the algorithm, this article recorded the maximum vertical diameter, maximum left and right diameter, and maximum anteroposterior diameter of thyroid masses measured by the two imaging methods and solid specimens. In addition, the postoperative pain of patients was evaluated by visual analogue scale (VAS), and the incidence of complications and nursing satisfaction were counted.

A novel classification of lateral malleolus morphological characteristics based on three-dimensional computed tomography reconstruction

BackgroundThe study was to establish a novel classification of the morphological characteristics of fibula anterior-inferior margin (FAIM), which was reported in few studies. MethodsThe 501 images with three-dimensional computed tomography (3D CT) reconstruction were reviewed retrospectively. The width, height, thickness, long axis, short axis, and lateral malleolus angle were measured. ResultsThe FAIM was divided into Angular, Flat, and Arc. The Flat has no distinct fibular obscure tubercles (FOT). The short axis of Angular and Arc were more significant than the Flat (P < 0. 05). The height of left was larger than the right, but short axis was less than it (P < 0.05). The height and short axis of males were larger than the females (P < 0.05). ConclusionsA novel classification (the Angular, Flat and Arc) of FAIM was identified based on lateral malleolus morphology, and it suggested that not all have obvious FOT. Level of EvidenceLevel Ⅲ, retrospective study.

Unveiling the distinctive ossification patterns of diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis using computed tomography three-dimensional reconstruction.

To quantitatively analyze the morphological characteristics of osteophytes in DISH and syndesmophytes in AS, and summarize different ossification patterns to help identify the two diseases. Associated factors for new bone formation would be investigated. Fifty patients with DISH and 50 age-, sex-, CT examination site- matched patients with AS were enrolled. Radiographic and clinical data were reviewed. Osteophytes (syndesmophytes) in front of each vertebral body and the corresponding intervertebral disc space were defined as vertebral osteophytes unit (VOU). The volume, angle and location (contralateral, ipsilateral, bilateral) of osteophytes in each VOU were measured and compared between DISH and AS groups. In each VOU, the volume and angle of osteophytes in DISH were significantly larger. The best osteophytes volume and angle cutoff value in predicting DISH was 0.59 cm3 and 40.15°. Contralateral, bilateral, ipsilateral osteophytes were recorded in 59.32%, 36.38%, 4.3% of assessed VOUs in patients with DISH and 64.78%, 29.31%, 5.91% in AS (p‹0.001), respectively. As to ipsilateral osteophytes, the volume was inversely correlated with the center of the vertebral body to the center of the descending aorta (DISH: r = -0.45, p= 0.01; AS: r = -0.83, p‹0.001). Advanced age, disease duration, smoking and overweight contribute to the progression of osteophytes and syndesmophytes. Morphological features of osteophytes are helpful to distinguish DISH with AS. Aortic pulsations inhibit or hinder new bone formation in both DISH and AS. Maintaining normal BMI could postpone osteophytes formation.

Three-Dimensional Computed Tomography Reconstructions May Detect Pincer Lesions With Higher Sensitivity Than Radiographs in Patients With Femoroacetabular Impingement Syndrome

To assess the diagnostic capability of radiographs (XRs) to detect pincer lesions compared with 3-dimensional (3D) computed tomography scans in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). We performed a retrospective review of all patients who underwent hip arthroscopy for FAIS between September 1, 2020, and October 2, 2022. Preoperative imaging was reviewed. Pincer lesions were defined as a lateral center-edge angle greater than 40°; a Tönnis angle greater than 0°; the presence of the ischial spine, crossover, or posterior wall sign; and the presence of overcoverage greater than 80%. Under "select criteria," patients were classified as having a pincer lesion on XRs and 3D computed tomography reconstructions (CTRs) based on the lateral center-edge angle or Tönnis angle alone, whereas "all criteria" added the presence of the crossover sign and coverage percentage. Statistical analysis was performed to determine the diagnostic accuracy of XRs compared with 3D CTRs. A total of 69 patients met the inclusion criteria. There were 21 male patients (30.4%) and 48 female patients (69.6%). The mean age was 33 ± 13.5 years. χ2 Analysis for select criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ2 Analysis for all criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ2 Analysis further showed that when using XRs, a pincer lesion was more likely to be detected under all criteria than under select criteria. Likewise, when using 3D CTR, a pincer lesion was more likely to be detected under all criteria than under select criteria. In this study, we found that 3D CTR detected pincer lesions in patients undergoing hip arthroscopy for FAIS with significantly higher sensitivity than XRs alone. Level III, retrospective cohort study.

CT measurements of the proximal femoral medullary cavity in healthy adults: a cross-sectional study

Objective: To analyse the proximal femoral morphology on three-dimensional reconstructed imagery to explore the factors influencing the relevant parameters. Method: The cross-sectional study was conducted at Peking University Third Hospital in northern China from January 2019 to August 2020, and comprised healthy adults who underwent computed tomography scanning. Three-dimensional computed tomography reconstruction of the proximal femoral medullary cavity was performed using Mimics 22. The anatomical parameters related to total hip arthroplasty were measured to examine the relationship among gender, age and femoral length. Data was analysed using SPSS 20. Results: Of the 63 adults, meaning 126 hips, 21(33.3%) were males, meaning 42(33.3%) hips, and 42(66.6%) were females, meaning 84(66.6%) hips. The overall mean age was 51.5±23.1 years (range: 23-68 years). The inflection point of the medullary cavity curved at 5-10mm distal to the lesser trochanteric line. Most horizontal plane parameters significantly differed between men and women (p&lt;0.05), with the mean medullary cavity being wider in men than women. There was a significant difference between the genders in the sagittal anterior-posterior diameter of the canal flare index (p&lt;0.05). Age was negatively correlated with the coronal medial-lateral diameter and coronal lateral diameter of canal flare index. In the coronal and sagittal planes, there was a positive correlation between the metaphysis and diaphysis, and the coronal and sagittal planes were positively correlated with the orthogonal plane. Conclusions: Femoral morphology could be influenced by gender and age. Morphological changes of the proximal femoral medullary cavity were not present in a single plane, but were affected by multiple planes. When the diameter of one plane became larger, its orthogonal plane concomitantly increased. Key Words: Proximal femoral, Morphology, CT measurement, Correlation.

Melon and rostral muscle morphology of Gervais' beaked whale (Mesoplodon europaeus): Alternating patterns of bilateral asymmetry.

Toothed whales utilize specialized nasal structures such as the lipid-rich melon to produce sound and propagate it into the aquatic environment. Very little nasal morphology of mesoplodont beaked whales has been described in the literature, and the anatomy of the melon and associated musculature of Gervais' beaked whale (Mesoplodon europaeus) remains undescribed. Heads of three (n = 3) Gervais' beaked whales were examined in detail via dissection as well as computed tomography (CT) and magnetic resonance imaging (MRI). Two additional Gervais' beaked whale individuals (n = 2) were studied via archived CT and MRI scans. Representative transverse dissection sections of the melon were processed for polarized light imaging to verify the presence of tendons inserting into the melon tissue. Three-dimensional (3D) CT reconstructions of the melon, rostral muscles, and associated structures were performed to assess morphology and spatial relationships. In all individuals, the melon's main body demonstrated a bilaterally asymmetrical, curvilinear geometry. This curvilinear shape was defined by a pattern of alternating asymmetry in the medial rostral muscles that projected into the melon's tissue. In transverse polarized light imaging, a network of tendons originating from these asymmetrical rostral muscle projections was observed permeating the melon's lipid tissue. This curvilinear melon morphology and associated asymmetrical musculature suggest a means of lengthening the lipid pathway within a relatively short dimensional footprint. In addition, the species-specific arrangement of muscular projections suggests complex fine-tuning of the melon's geometry during echolocation. Further studies may lend additional insight into the function of this unusual melon morphology.

Manejo multimodal de aneurisma cirsoideo. Reporte de un caso y revisión de la literatura

Scalp arteriovenous malformations (AVMs), commonly known as cirsoid aneurysms, are complex collections of arteries and veins that communicate directly. It has been postulated that AVMs occur both through the activation of inactive fistulous lesions and through the formation of new fistulous vascular channels through the canalization of injured vessels. Depending on their size and complexity, a variety of strategies can be used to treat them. The case of a 53-year-old male is presented who came for evaluation due to an increase in the volume of a pulsating lesion that extended from the right parietotemporal region accompanied by holocraneal headache and tinnitus. A cerebral angiotomography was performed in which a lesion composed of ectatic serpentine images, with a right extracranial location, subsequently diagnostic cerebral angiography was performed demonstrating a right frontoparietal fistulous and plexiform arteriovenous shunt fed by afferents from the right superficial temporal, posterior auricular, occipital and middle meningeal arteries, with drainage through a varicose and ectatic vein towards the external jugular vein. An endovascular embolization of the arteriovenous shunt was performed via the femoral route in two stages, achieving a “pressure cooker” construction to perform the injection of embolizing fluid and have a subtotal embolization of 93%, with this it was possible to perform a microsurgical resection with a right fronto-parietal-temporal approach resecting the deepest part, leaving the scalp with embolized vessels without resecting. To close the surgical wound, a simple flap rotation was performed to cover the skin defect derived from its resection. The patient underwent post-resection cerebral panangiography, identifying the absence of arteriovenous shunt. Depending on the extent and anatomical complexity of the malformation, clinical manifestations may vary. More than 80% of AVMs will be present at birth and the rest may develop after head trauma or surgical interventions. Appropriate therapeutic intervention is needed through selective angiography, during which endovascular embolization of the major feeding vessels can be performed before open surgical intervention. Volume-based three-dimensional computed tomography reconstructions can be used for further planning. Surgical reduction of post-embolization arterial supply will reduce intraoperative hemorrhage, facilitating total surgical resection. Removal can result in large, full-thickness skin defects that may be difficult to reconstruct without compromising functional and cosmetic results. Keywords: Cirsoid aneurysm; multimodal management; treatment; endovascular; giant

Intraobserver and Interobserver Reliability of the Computed Tomography-Based Classifications Used in Posterior Malleolar Fractures: The Haraguchi and Bartoníček-Rammelt Classifications.

Three main computed tomography (CT)-based classification systems have been defined and used for posterior malleolar fractures. The intraobserver and interobserver reliability of two of these systems has never been investigated. The aim of this study was to investigate the intraobserver and interobserver reliability of the Haraguchi (HC) and Bartoníček-Rammelt (BRC) classifications. Axial and sagittal CT sections and three-dimensional reconstruction images of 60 fractures were evaluated twice by six observers at a 6-week interval. Cohen κ values for intraobserver reliability and Fleiss κ values for interobserver reliability were calculated. The interobserver reliability of the HC was fair in both assessments (Fleiss κ: 0.263 and 0.249 for the first and second evaluations, respectively). The interobserver reliability of the BRC was moderate in both evaluations (Fleiss κ: 0.535 and 0.447, respectively). The intraobserver reliability values (Cohen κ) of the HC were determined to be between 0.532 and 0.927 for the six observers. These values indicated moderate agreement for one observer, substantial for four, and very good for one. Intraobserver reliability values for the BRC were determined to be between Cohen κ of 0.626 and 0.884. Based on these values, the BRC's intraobserver reliability indicated substantial agreement for two observers and very good for four observers. Intraobserver and interobserver reliability values of the BRC were higher than those of the HC.

Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: 3-Year Follow-Up Study.

To investigate long-term changes in femoral anteversion angle (FAA) in children with intoeing gait and to identify factors that affect FAA changes. We retrospectively analyzed three-dimensional computed tomography data from 2006 to 2022 of children with intoeing gait with ≥3 years of follow-up without active treatment. The study examined the mean changes in FAA, the effects of sex, age, and initial FAA on FAA change, and mean FAAs by age. Changes in FAA severity up to eight years of age were also observed and analyzed by sex. A total of 126 lower limbs of 63 children (30 males, 33 females) with intoeing gait were included, with a mean age of 5.11±1.05 years and a mean follow-up period of 43.59±7.74 months. The initial FAA was 41.42°±8.29° and the follow-up FAA was 33.25°±9.19°, indicating a significant decrease (p<0.001). Significant correlations were observed between age and changes in FAA, as well as between initial FAA and changes in FAA (r=0.248, p=0.005; r=-0.333, p<0.001). At age 8 years, only 22 limbs were classified as having mild FAA severity. During the follow-up period, children with intoeing gait had a significant decreased in FAA. No significant difference in FAA change was found between sex, but younger children and those with greater initial FAA were more likely to have decreased FAA. However, most children retained moderate to severe severity of increased FAA. Further studies are required to validate these findings.

Uniportal video-assisted thoracoscopic combined subsegmentectomy: a case report of left S3b + S4b

: Anatomical complex segmentectomy has become increasingly important in oncological lung resection, particularly for small ground-glass nodules of primary lung cancers. Resection of a lung nodule located between the left upper division and the lingual segment is technically challenging. Delicate surgical planning is crucial to ensure adequate surgical margin while preserving maximum pulmonary function. A combined subsegmentectomy can be a feasible choice but is challenging to perform under uniportal approach due to limited working space and insufficient exposure of target segmental bronchi and pulmonary arteries. The purpose of this article is to introduce the technique we use to overcome these challenges. Herein, we report a case with two ground-glass nodules in the left upper lobe, one 0.6-cm adjacent to the V3b and one 0.4-cm beneath the S4b surface. Instead of extended upper division trisegmentectomy or extended lingulectomy, a uniportal video-assisted thoracoscopic S3b + S4b combined subsegmentectomy was planned and performed. Three-dimensional computed tomography reconstruction was performed preoperatively to reveal the branching pattern of the associated sub-segmental bronchi and pulmonary vessels. Inflation-deflation method was applied to identify intersegmental planes, and both lesions were removed successfully. We describe our “open the side door” technique for performing subsegmentectomy in this patient. This technique is helpful when performing a complex subsegmentectomy.

Morphological classification and clinical significance of medial malleolus based on computed tomography three-dimensional reconstruction.

Internal malleolus fractures and postoperative functional limitations are serious complications of deltoid ligament repair, reconstruction, while studies on conducting beak. Anatomical structure classification of medial malleolus at home and abroad is reported rarely. Hence, this morphological study is mainly designed to investigate the anatomical morphological classification and clinical significance of medial malleolus based on computed tomography (CT) three-dimensional reconstruction. From October 2018 to January 2021, 373 patients who underwent CT examination of malleolus medialis joint in the Jiang'an Hospital of Traditional Chinese Medicine were observed. The medial malleolus was observed and classified; then, geometric parameters were measured according to different medial malleolus types. According to the results of 373 cases, medial malleolus can be divided into four types: omega type (66%), radical sign type (16%), inverted triangle type (14%), and wave type (4%). There are four main shapes: omega, inverted triangle, radical sign, and wave in the medial malleolus of all normal ankles. The measurement of medial malleolus parameters according to medial malleolus in different shapes was of importance to guide smooth operation of medial malleolus fixation and deltoid ligament reconstruction and epidemiological.

Detailed observation of anatomical location and pattern in Hangman’s fracture based on computed tomography three-dimensional reconstruction

ObjectiveTo observe the precise anatomical location and pattern of the fracture lines in Hangman’s fracture.MethodsThree-dimensional computed CT images of 210 patients with Hangman’s fracture were collected. According to the involvement of anatomical structures, the injuries were classified into facet joint injury and pure bony injury. The C2 ring was also divided into: anterior, middle, and posterior elements. The anatomical structures involvement and fracture patterns were observed.ResultTotal 520 anatomical structures injuries were involved in 210 patients Hangman’s fractures, including 298 facet joints injuries (57.3%) and 222 bony injuries (42.7%). The most common facet joints injury was superior articular facet injury of C2, and the most common pure bony injury was pediculoisthmic component fracture. The injuries of anterior element (60.6%) were more common than that of middle (20.4%) or posterior (19.0%) element. One injury in anterior element on one side and another injury located in the anterior, middle or posterior element other side was the most common fracture pattern. Injury of middle element on one side with another injury located in the middle or posterior element could be also observed.ConclusionIn Hangman’s fractures, fracture lines could occur in any part of C2 ring. Facet joints injuries were more common than pure bony injuries, and the injuries of anterior element were also more common than that of middle or posterior element. The high prevalence of facet joints injuries means that most of Hangman’s fractures may be involved with intra-articular injuries.

Delayed atlantoaxial rotatory dislocation in a child with Crohn's disease: illustrative case.

Atlantoaxial rotatory dislocation (AARD) in children may be caused by neck trauma or an upper respiratory tract infection. Here the authors describe the very rare association between inflammatory bowel disease and AARD in a child. A 7-year-old girl presented with an 11-month history of torticollis that occurred spontaneously without a trauma context. Her history revealed a recent diagnosis of Crohn's disease. Physical exam of the cervical spine revealed a "cock-robin" posture. Neck radiography and three-dimensional computed tomography reconstruction established the diagnosis of AARD. Given the duration of the symptoms and failure of previous conservative treatments, the patient was taken to the operating room and underwent open reduction through posterior approach with a C1-2 fusion according to the Harms technique. The torticollis resolved with no recurrence at the last follow-up and minimal restriction of rotation. This is the third report to describe the very rare association between inflammatory bowel disease and AARD but at a very early age, the youngest in the literature. One should be aware of such association as early diagnosis may prevent aggressive surgical management.

Anatomical Description of Loggerhead Turtle (Caretta caretta) and Green Iguana (Iguana iguana) Skull by Three-Dimensional Computed Tomography Reconstruction and Maximum Intensity Projection Images.

The growing interest in reptiles has posed a challenge to veterinary clinicians due to the lack of a standardized system to perform anatomical studies similar to those used for dogs and cats. In this paper, we have attempted to describe, employing computed tomography and subsequent three-dimensional reconstructions, the normal anatomical features that comprise the skulls of two species of reptiles: the loggerhead turtle (Caretta caretta) and the green iguana (Iguana iguana). Computed tomography (CT) and subsequent image processing allowed the identification of the bony structures that comprise the head of these species. As a result, and based on previous articles, we propose the most significant anatomical differences and similarities between these species.

The morphological classification and clinical significance of atlas vertebral artery sulcus based on computed tomography three-dimensional reconstruction

ObjectiveThe purpose of this study was to research the morphological classification and clinical significance of vertebral artery sulcus on atlas based on CT three-dimensional reconstruction.MethodsThree-dimensional reconstruction images of 300 adult atlases were collected. A total of 600 atlas vertebral artery sulci were selected in this study. The parameters required for placement of C1 pedicle screw, including depth of grinding drilling (ao), width (cd), length ab), height (H), lateral wall thickness (L1), inner wall thickness (L2), medial angle (∠α), and the cephalad angle to the transverse plane of atlas pedicle (∠β), were measured.ResultsCT three-dimensional reconstruction images showed that there were five types of atlas vertebral artery sulci: no process type (n = 494 cases, 82.33%), upper process type (n = 29, 4.83%), lower process type (n = 25, 4.17%), double process type (n = 19, 3.17%), and posterior ring type (33, 5.50%). One-way ANOVA tests showed that the five groups differed significantly in the parameter of ao, L2, H, ∠α and ∠β. One-way ANOVA with the LSD post hoc tests showed that the parameter ao of the group of no process type was less than that of the group of upper or lower process type (P < 0.05), and ao of the group of lower process or posterior ring type was less than that of the group of the upper type (P < 0.05). The parameter of ao of the male group was larger than that of the female group.ConclusionNo process type of the atlas vertebral artery sulcus was the most common, and the medial angle and cephalad angle of the atlas pedicle in this type were the smallest. When pedicle screws are inserted, the above two angles should not be too large. Male's ao was larger than that of female's. All these findings should be considered to avoid the deviation of the nail track.