Tomography Scan Research Articles

Association of Atrial Fibrillation with Age, Gender, Hypertension, and Diabetes Mellitus in Cases of Ischemic Stroke

Objective: To determine the frequency of atrial fibrillation in patients presenting with ischemic stroke and explore association of atrial fibrillation with age, gender, diabetes mellitus, and hypertension. Study Design: Cross-sectional analytical study Place and Duration of Study: Department of Internal Medicine, Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Sep 2018. Methodology: All patients diagnosed with ischemic strokes as per the World Health Organization guidelines presenting to the department were included. Information was gathered regarding age, gender, hypertension, and diabetes mellitus and electrocardiogram was recorded for each patient within 24 hours of presentation to check for atrial fibrillation. Computed tomographic scans of the sampled individuals were evaluated to exclude patients with intracerebral bleed, sub-arachnoid hemorrhage or brain tumors. Results: Ninety-five patients (mean age: 46.8±15.5 years) with ischemic stroke were included. Sixty (63.2%) patients were male and 35(36.8%) were female. Atrial fibrillation was present in 35(36.8%) patients. It was significantly more common in patients with diabetes and patients with hypertension (p=0.001 and p=0.004 respectively). No significant association of atrial fibrillation with gender or age of the patient was observed (p=0.086 and p=0.057 respectively) Conclusion: Atrial fibrillation was quite high in our sampled patients with ischemic stroke. The frequency was more common in patients with diabetes and patients with hypertension.

Method Development: Characterization of the Structure of the Thymic Epithelial Cell Network Utilizing Fluorescent Whole Slide Scanning and 3D SEM Array Tomography.

Method Development: Characterization of the Structure of the Thymic Epithelial Cell Network Utilizing Fluorescent Whole Slide Scanning and 3D SEM Array Tomography.

Effect of septal extension graft on nasal tip support: A finite element analysis

Septal extension graft (SEG) is an effective method to control the projection, rotation, and shape of the nasal tip. However, the structural mechanics of SEG have not yet been adequately determined. The purpose of this study was to examine the effect of SEG parameters on nasal tip support using finite element analysis. A multicomponent nasal model was constructed from a computed tomographic scan. A control model without graft and a total of 15 models with different SEGs were created, regarding the direction, length, width, and piece of SEG. The nasal tip compression was simulated to analyze the von Mises stress, reaction force, and strain energy of the tip structure. The SEG increased the max stress, reaction force, and strain energy of the nasal tip compared to the normal control. The SEG perpendicular to the nasal dorsum resulted in the highest maximum stress, reaction force, and strain energy for the same size of SEG. With the length increasing from 15×8×1mm to 25×8×1mm, the reaction force remained relatively stable, but the stress on the graft reduced significantly. Adding the width and pieces of the SEG increased the reaction force and strain energy of the tip. The placement of SEG can strengthen the nasal tip support. The direction, length, width, and piece of SEG have an impact on the mechanics. Diagnostic, III.

The Feasibility of Multiple Fixation Points in C2.

Analysis using three-dimensional simulation software for spinal screw placement and computed tomographic scan images. To assess the feasibility of achieving multiple (three or four) screw fixation points in C2 vertebra by using a combination of pedicle and laminar screws. Secure C2 fixation using multiple screws is required or beneficial in some unique cases. However, to the best of our knowledge, there have been no reports analyzing the feasibility of multiple screw fixation in C2. We used 1.0-mm interval computed tomographic scan images of 100 patients (50 men and 50 women) and screw trajectory simulation software. The diameter of all screws was set at 3.5 mm, considering its common usage in real surgery. The anatomical feasibility of placing both pedicle and laminar screws on the same side was evaluated. For all feasible sides, the three-dimensional distance between the screw entry points was measured. In 85% of cases, both pedicle and laminar screws could be placed on both sides, allowing for the insertion of 4 screws. In 11% of cases, 2 screws could be placed on one side, while only 1 screw was feasible on the other side, resulting in the placement of 3 screws. In all 181 sides where both types of screws could be inserted, the distance between their entry points exceeded 16.1 mm, which was sufficient to prevent the collision between the screw heads. C2 vertebra can accommodate three (11%) or four (85%) screws in 96% of cases.

Morphometric Assessment of Bi-caudate Index Using Computerized Tomographic Scan from Sokoto North-Western Nigeria

Aim: To determine the bi-caudate index (BCI) of Nigerians using computerized tomography from Sokoto North-Western Nigeria.
 Study Design: Retrospective cross- sectional.
 Place and Duration of Study: Department of Anatomy Usmanu Danfodiyo University Sokoto and Department of Radiology Usmanu Danfodiyo University Teaching Hospital Sokoto, between January, 2020 and January, 2022.
 Methodology: CT scans of 186 apparently healthy normal individuals of age group 1 to 70 years were taken and the subjects were categorized into age intervals of 10 years; males and females taken separately. The linear measurements of caudate and brain were taken directly from the screen. The Bi Caudate Index were calculated. The mean values in each group were compared with age and sex, using appropriate statistical tests.
 Results: The least BCI in male was 6.0mm and was seen in the age group 1-10 years while in female the least BCI was 5.0mm, seen in the age group 1-10. The largest BCI in male was 21mm, observed in the age group 61-70years, while the largest BCI in female 19.0mm, seen in the age group 61-70 years.
 Conclusion: Bi Caudate Index shows positive correlation with age.

Sagittal Alignment in Total Knee Arthroplasty: Are There Any Discrepancies Between Robotic-Assisted and Manual Axis Orientation?

Sagittal alignment determines the extension and flexion of knee prostheses in total knee arthroplasty (TKA). The definition of the sagittal axes may be different between the Mako TKA system (Stryker) and the conventional manual intramedullary approach. Whether there is any discrepancy between the 2 approaches has not been well studied. We retrospectively analyzed 60 full-length computed tomographic (CT) scans of the lower extremities of 54 patients. The femur and tibia were modeled by using Mimics (Materialise). The Mako mechanical axes were determined according to the Mako TKA Surgical Guide. The manual intramedullary axes were determined according to the central axis of the tibial proximal and femoral distal medullary cavities. The femoral, tibial, and combined angular discrepancies were measured in the sagittal plane. On the femoral side, the Mako mechanical axis was more likely to be located in an extended position relative to the manual intramedullary axis (56 of 60 knees). The median angular discrepancy was 2.46° (interquartile range [IQR], 1.56° to 3.43° [range, -1.06° to 5.24°]). On the tibial side, the Mako mechanical axis was likely to be located in a flexed position relative to the manual intramedullary axis (57 of 60 knees). The median angular discrepancy was 2.40° (IQR, 1.87° to 2.84° [range, -0.79° to 4.20°]). The angular discrepancy of the femoral-tibial sagittal angle was 4.63° (IQR, 3.71° to 5.64° [range, 1.20° to 9.02°]). Compared with manual TKA, the Mako system is more likely to result in a decreased posterior tibial slope and extension of the femoral prosthesis. It may also influence the evaluation of lower-extremity extension and flexion. When using the Mako system, special attention should be given to these discrepancies. Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

Evaluation of Dental Enamel Thickness in Maxillary Teeth of Alouatta guariba clamitans, Alouatta caraya, and Sapajus nigritus by Cone Beam Computed Tomography.

Tooth enamel thickness is widely studied in primates and is important in differentiating taxa and in interpreting diet and feeding behavior. The objective of this study was to measure enamel thickness and discuss whether the results can be associated with different feeding patterns. Thirty-four syncraniums of Alouatta guariba clamitans, Alouatta caraya, and Sapajus nigritus were subjected to cone beam computed tomographic (CBCT) scans, and the dental enamel was measured in different regions of the crown using the multiplanar reconstruction tool. The differences observed indicate that for many variables and teeth, A. guariba clamitans showed significantly higher values compared to the other 2 species, with the exception of the cuspid region. Although the A. guariba clamitans is a folivorous species, it showed thicker enamel for most of the variables. CBCT was efficient in performing the measurements, allowing analysis of the syncraniums.

Micro‐CT‐assisted determination of the shattering and non‐shattering phenotypes of charred rice spikelet bases from archaeological sites: a new methodological approach

AbstractThe selection of a non‐shattering phenotype is a pivotal change in the process of rice domestication. However, current research is heavily restricted by the preservation conditions of macro‐plant remains in early and middle Neolithic sites, as very limited well‐preserved rice spikelet bases could be retrieved. We present a non‐destructive method based on micro‐computed tomographic (CT) scanning, which could provide detailed visualization of the internal structures of charred spikelet bases and efficiently discriminate the shattering and non‐shattering phenotypes of rice spikelet bases according to the abundance of fusiform echinate phytoliths. It could be widely applied in different contexts, especially those poorly preserved specimens and tempers in pottery sherds, greatly improving our knowledge of rice domestication.

Axillary Lymph Node in Extra-Ocular Retinoblastoma - Benign or Malignant?

A 1-year-old male child presented with whitish discoloration of pupil of the left eye and swelling over the left axilla. A contrast-enhanced magnetic resonance imaging of the brain and orbits performed revealed left eye extra-ocular retinoblastoma. 18F-fluorodeoxyglucose positron emission tomography/computed tomography scan was done in this child as a part of baseline staging of retinoblastoma in an ongoing research project. The scan revealed left eye extra-ocular retinoblastoma along with calcified left axillary level I lymph node.

Artificial Intelligence Assisted Fabrication of 3D, 4D and 5D Printed Formulations or Devices for Drug Delivery.

5D & 4D printings are an advanced version of 3D printing class and are one of the most revolutionary and powerful fabrication methods used for preparing innovative structures and solid substances using precise additive manufacturing technology. It captures the imagination of one with its potential to produce flexible designing and fabrication of innovative products with high complexity and speed. This technology with the assistance of AI (Artificial Intelligence) facilitates real-time sensing, adapting to change, and predicting the state of printing. 3D printing works by employing advanced materials utilizing a computer aided design with tomography scan under AI control which deposits printing material in accordance with the nature of a file usually in STL format, but it requires time for printing. This shortcoming can be overcome by 4D printing where smart materials are incorporated with time as 4th dimension. This technique has self-repair and self-assembly properties that will save around 80% of time. Some printed materials are made sensitive to temperature, humidity, light, and other parameters so that they can respond to stimulus, but it's one limitation of not being able to print complex shapes having curved surfaces can be overcome by utilising 5D printing where additive manufacturing is done by rotation of extruder head and rotation of print bed to print in 5 different axes. This review evaluates the prospective of these techniques with AI interference in medicine and pharmacy, with its effective and efficient production for the required design precision.

Twisted Right Ovarian Teratoma Mimicking Ruptured Inflamed Appendix in a Young Woman

Abstract A 27-year-old female was referred to our health facility with a working diagnosis of a ruptured appendix on account of sudden onset of severe right iliac fossa and pelvic pain. Abdominal ultrasound scan, plain abdominal radiograph, and abdominal computed tomographic scans done in our health facility revealed a fairly rounded poorly vascularized right ovarian mass containing a tooth, fat, and Rokitansky nodule. A radiological diagnosis of matured poorly vascularized right ovarian teratoma with possible torsion was made. She had laparotomy with excision of the right ovarian mass, and the histology of the excised specimen confirmed the diagnosis of matured right ovarian teratoma. She responded well postoperatively, and subsequent follow-up assessment was satisfactory.

Calcified post-tuberculosis nodule at an unusual site

Abstract Calcification is one of the post-treatment sequelae of pulmonary tuberculosis (TB) and an isolated calcified pulmonary nodule representing granuloma in a lung fissure is rarely detected. We report the case of pulmonary nodule with calcification within the minor fissure of the right lung in a treated case of smear-positive pulmonary TB. As an incidental finding, a solitary post-tuberculous calcified granuloma may not have clinical significance but has to be differentiated from relapse of TB and other pathologic conditions particularly neoplasms. A computed tomographic scan of the chest is very useful for the detection and detailed evaluation of a pulmonary nodule such as its size, margins, doubling time, pattern of calcification and presence of cavitation and can help to identify whether the pulmonary nodule is benign or malignant.

Prevalence of Pre-Existing Lingual Cortex Perforation Prior to Extraction of Mandibular Third Molars

The research aims to determine the relationship between the mandibular third molars and the nearby lingual cortical bone as well as to determine the frequency of lingual cortex perforation.The analysis was carried out by “CBCTs (cone beam computed tomographic scans)” of 18-65 years old patients. Lingual cortex fenestration at both root tips was observed. Almost three-quarters of radiographs showed the majority of the lingual area on the upper portion of a root (51.2% and 52.8%). The most lingual region and the area surrounding the root tip were both 1.25 mm thick. Mandibular third molars and perforated across both base levels were shown to be significantly related (P value.001). More than 50% of patients had lingual cortical perforation brought on by mandible third-molar teeth. The likelihood of lingual cortical rupture following extraction of the mandibular third molars is a sign of a prior problem rather than surgery.

Determinants of Treatment Toxicity in Patients with Soft Tissue Sarcomas

Soft tissue sarcomas are rare malignant tumors. Traditionally, treatment is guided by patient and tumor characteristics. Data on the influence of patient characteristics, particularly nutritional status, on clinical outcomes are scarce. Body composition and its changes during treatment play an essential role in predicting toxicity, clinical outcomes, and mortality. This analysis aimed to investigate the relationship between treatment toxicity and body composition. Patients diagnosed with sarcoma who underwent first-line palliative chemotherapy between October 2017 and January 2020 were included. Baseline and follow-up computed tomographic scans at the third lumbar vertebra, available from diagnostic purposes, were analyzed using SliceOmatic software. Treatment toxicity was defined as a composite score of the Common Terminology Criteria for Adverse Events. Nutritional Risk Screening (NRS) 2002 score, psoas muscle thickness to height ratio, and comorbidity showed a significant association with overall toxicity, while skeletal muscle index and age showed a strong trend. In summary, the NRS 2002 tool must be routinely implemented in inpatient and outpatient settings for cancer patients, and nutritional therapy needs to become a fixed component of multimodal cancer treatment. Furthermore, validated standardized procedures for the quantification of muscle mass are needed to individualize and optimize cancer treatment.

A Novel Flexible Fixation Method for Syndesmotic Injury.

This study aims to evaluate the results and the safety of a novel fixation method we developed for syndesmosis injuries that we call the "embrace" technique. Between March 2018 and October 2020, a total of 67 patients with ankle fractures and syndesmotic injuries underwent syndesmosis fixation with the embrace technique at our institute. Plain radiographs and computed tomographic (CT) scans were obtained preoperatively. Postoperative radiographic assessment included anteroposterior (AP) and lateral radiographs and CT scans of both ankles. Additionally, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score, Olerud-Molander Ankle Score, and visual analog scale (VAS) score were used for postoperative assessment. The mean age was 27.6 ± 10.9 (range, 14-56) years. The mean follow-up time was 30.3 ± 6.2 (range, 24-48) months. There were no malreductions indicated by any CT parameter except fibular rotation in a postoperative comparison between 2 sides. We found significant preoperative-postoperative changes in anterior difference, posterior difference, and fibular rotation but no significant preoperative-postoperative difference in fibular translation. There was no significant postoperative difference between the affected-side and normal-side measurements of any parameter. Complications included delayed wound healing, lateral pain because of wire knot irritation (11.9%), and medial fiber wire irritation (7.5%). The mean AOFAS, Olerud-Molander, and VAS scores at the last follow-up were 94.4 ± 6.8 (range, 84-100), 95.4 ± 6.1 (range, 80-100), and 0.68 ± 1.0 (range, 0-3) points, respectively. In our cohort, this novel technique proved to be an effective method for syndesmosis fixation in patients with ankle fractures associated with very good radiologic and patient-reported outcomes. Level IV, case series.

Demonstrating the empirical effect of population specificity of anthropological standards in a contemporary Australian population

The ability to differentiate individuals based on their biological sex is essential for the creation of an accurate anthropological assessment; it is therefore crucial that the standards that facilitate this are likewise accurate. Given the relative paucity of population-specific anthropological standards formulated specifically for application in the contemporary Australian population, forensic anthropological assessments have historically relied on the application of established methods developed using population geographically and/or temporally disparate. The aim of the present paper is, therefore, to assess the accuracy and reliability of established cranial sex estimation methods, developed from geographically distinct populations, as applied to the contemporary Australian population. Comparison between the original stated accuracy and sex bias values (where applicable) and those achieved after application to the Australian population provides insight into the importance of having anthropological standards optimised for application in specific jurisdictions. The sample analysed comprised computed tomographic (CT) cranial scans of 771 (385 female and 386 male) individuals collected from five Australian states/territories. Cranial CT scans were visualised as three-dimensional volume-rendered reconstructions using OsiriX®. On each cranium, 76 cranial landmarks were acquired, and 36 linear inter-landmark measurements were calculated using MorphDB. A total of 35 predictive models taken from Giles and Elliot (1963), Iscan et al. (1995), Ogawa et al. (2013), Steyn and İşcan (1998) and Kranioti et al. (2008) were tested. Application to the Australian population resulted in an average decrease in accuracy of 21.2%, with an associated sex bias range between − 64.0 and 99.7% (average sex bias value of 29.6%), relative to the original studies. The present investigation has highlighted the inherent inaccuracies of applying models derived from geographically and/or temporally disparate populations. It is, therefore, imperative that statistical models developed from a population consistent with the decedent be used for the estimation of sex in forensic casework.

Prospective study of integrating post-radiotherapy [18F] fluorodeoxyglucose-positron emission tomography/computed tomography scan and plasma Epstein-Barr virus DNA in surveillance of locoregionally advanced nasopharyngeal carcinoma.

6072 Background: To evaluate the role of [18F] fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) scan at 12-weeks after the end of Radiotherapy (RT) integrated with plasma EBV DNA in surveillance and standardized implementation of locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Methods: This prospective study was conducted in patients with stage III-IVa LA-NPC. FDG-PET/CT examination and plasma Epstein-Barr virus (EBV) DNA measurements was performed pretreatment and at 12-weeks after the end RT. The primary study endpoint was the negative predictive value (NPV) and other supporting diagnostic test characteristics of 12-weeks FDG-PET/CT for the surveillance of residual locoregional disease and new distant metastasis. Results: From June 2018 to December 2019, 506 eligible patients were enrolled and entered follow-up (median,45 months). At 12 weeks after the end of RT, there were 22 (4.3%) patients have residual locoregional disease, 30 (5.9%) patients developed distant metastasis and 6 (1.2%) patients presented both residual locoregional disease and distant metastasis. The NPV of 12-weeks FDG-PET/CT for overall residual diseases and distant metastasis was 96.3% (95% confidence interval [CI], 94.0%-97.8%) with sensitivity of 72.4% (95%CI, 58.9%-83.0%), specificity of 93.3% (95%CI, 90.5%-95.4%), positive predictive value (PPV) of 58.3% (95%CI, 46.1%-69.6%) and accuracy of 90.9% (95%CI, 88.4%-93.4%). In EBV DNA-based risk subgroups, the NPV of 12-weeks PDG-PET/CT was 96.8% (95%CI, 94.5%-98.2%) in patients with undetectable 12-weeks plasma EBV DNA and 87.0% (95%CI, 65.3%-96.5%) in patients with detectable 12-weeks plasma EBV DNA. Conclusions: 12-weeks PDG-PET/CT was reliable in the surveillance of LA-NPC and could help optimize the follow-up strategy and provide implications for timely and effective therapeutic regimen, especially for patients in different EBV DNA-based risk groups. Clinical trial information: NCT03601390 .

Tubarial Salivary Gland – The New Member of Nasopharynx

Tubarial Salivary Gland – The New Member of Nasopharynx

Direct Anatomic Registration in Computer-Assisted Total Hip Arthroplasty Improves Accuracy of Acetabular Cup Alignment.

Computer-assisted total hip arthroplasty using direct anatomic registration (DAR) with acetabular center axis software is an alternative method to the indirect anterior pelvic plane method. The software maps the center of hip rotation and orientation of the native acetabulum in 3 dimensions. This study aimed to evaluate the accuracy of acetabular cup alignment using DAR navigation combined with a mechanical guide device (MGD). This prospective nonrandomized controlled study included 106 patients who underwent primary cementless total hip arthroplasty through the posterolateral approach. Fifty-four patients in the study group underwent DAR combined with MGD, whereas 52 patients underwent MGD only for acetabular cup positioning. Plain radiographs of both hips and computerized tomographic scans were obtained 2 months postoperatively for the evaluation of acetabular cup inclination and anteversion, respectively. The acetabular cup alignment in the study group was within the Lewinnek safe zone more than that in the control group (81.5% vs 59.6%, P < .05). The study group had a mean inclination angle of 43.88° (standard deviation [SD] 5.38) and anteversion angle of 12.82° (SD 5.99), whereas the control group had 41.10° (SD 6.79) and 12.82° (SD 9.53), respectively. There were no significant differences in estimated blood loss, length of stay, and Harris hip scores at preoperative and 3 and 6 months postoperatively, except for the operative time, which was longer in the study group (P < .01). There was 1 posterior hip dislocation in each group. DAR navigation combined with MGD provides better accuracy for acetabular cup positioning within the Lewinnek safe zone compared with the conventional technique.

Comparison of Cranial Ultrasound and Computed Tomographic Scan Finding in Infants with Post Meningitis Complications

Objective: To compare the findings of cranial ultrasound and computed tomographic (CT) scans in infants with post-meningitis complications. Methodology: A prospective analysis of 124 consecutive term infants was conducted in the department of radiology at the Pakistan Institute of Medical Sciences, Islamabad from August 2021 to April 2022. Transfontanelle ultrasonography was performed with a two-dimensional Sonoace 1500 ultrasound scanner (Medison Inc, South Korea 1995) equipped with a 6.5 megahertz (MHz) curvilinear small head probe. Sagittal and coronal sections were scanned using standard techniques. We included all 124 confirm cases of meningitis came to our hospital in the period through consecutive non probability sampling, which fulfilled the required sample size to test the objective in our population. Results: The average age of the infants was 4 months, with 71 (57.3%) males and 53 (42.7%) were females. Ultrasonography results were confirmed by CT scans in all patients. The diagnostic accuracy of ultrasonography was found to be 32.14%. Seizures disorders were the most common complication observed in the study population. Conclusion: Using transfontanelle ultrasound, it is possible to diagnose lesions inside the infant's brain. Transfontanelle ultrasound scans are most often requested for hydrocephalus detection and for abnormal findings. Infants with post-meningitic complications commonly suffer seizures. In post meningitic complications, ultrasound can still be used as an early non-invasive diagnostic modality despite its low diagnostic accuracy. Improved collaboration between radiologists and pediatricians can lead to better outcomes and reduced mortality and morbidity in neonates and infants.