Horn Width Research Articles

Evaluation of the Accuracy of 4 Conventional Freehand Frontal Ventriculostomy Methods in the Chinese Population.

In conventional freehand frontal ventriculostomy, the Kocher point is the entry point, the external auditory canal is the sagittal target, and the coronal targets include the ipsilateral medial canthus (IMC), the midpoint between the bilateral external auditory meatus (MAM), the contralateral medial canthus (CMC), and the region perpendicular to the skull (P). The aim of this study was to calculate puncture accuracy of the 4 conventional methods to guide clinical selection. Patient data from thin-slice computed tomography scans were imported, and a 3-dimensional model was reconstructed using software to simulate puncture. The accuracy and puncture depth of the 4 freehand frontal ventriculostomy methods were analyzed. From January 1, 2022, to December 30, 2023, 520 patients were screened and 206 were enrolled; 137 (66.5%) participants were males, and 69 (33.5%) were females. The median age of the patients was 64 years (IQR 53-73). The maximal frontal horn width was 21.7-53.7 mm (IQR 34.4-40.0), and the intercanthal distance was 26.0-43.2 mm (IQR 30.7-34.9). Simulating bilateral ventricular puncture, for the IMC trajectory, the puncture accuracy was 13.3% (55/412) [95% CI 10.4-17.0] and the puncture depth was 41.8 ± 4.6 mm. For the MAM trajectory, the puncture accuracy was 74.5% (307/412) [95% CI 70.1-78.5] and the puncture depth was 43.6 ± 4.3 mm. For the P trajectory, the puncture accuracy was 90.5% (373/412) [95% CI 87.3-93.0] and the puncture depth was 49.4 ± 5.9 mm. For the CMC trajectory, the puncture accuracy was 100.0% (412/412) [95% CI 99.1-100.0] and the puncture depth was 47.2 ± 5.2 mm. Compared with the MAM trajectory, the CMC and P trajectories were more reliable in frontal ventriculostomy, but the P trajectory may enter the contralateral ventricle. The IMC trajectory is not recommended unless the frontal horn is wider than 45 mm or the Kocher point is moved inward.

Rigorous Wiener–Hopf analysis of a horn radiator with thick walls

The radiation from a two-dimensional horn radiator with thick walls is studied rigorously when illuminated with a dominant TEM mode. The method consisting of the mode matching method and the Fourier transform technique together gives rise to a scalar modified Wiener–Hopf equation of the third kind (MWHE-3). The formulation includes branch-cut integrals, which are evaluated approximately, and an infinite number of unknown constants that satisfy an infinite system of linear equations that can be treated numerically. The effects of the wall thickness of a horn radiator, as well as the horn width and length, on the radiation from the horn are also presented in comparison with similar structures that are available in the literature.

Clinical and radiographic outcomes after subduro-peritoneal shunt insertion in adults

BackgroundSubdural collections consist amongst others of cerebrospinal, inflammatory, haemorrhagic or infective fluid. While these accumulations can be treated with conservative or surgical measures, such as burr hole evacuation or craniotomy, clinicians may resort to implantation of a subduro-peritoneal shunt, due to their high recurrence rates. While this treatment option is widely used in the pediatric population, its efficacy and safety in adults is scarcely reported. MethodsThis project is a retrospective case series of 25 adult patients, who underwent subduro-peritoneal shunt (SDPS) implantation between December 2008 and June 2021. The indications included symptomatic subdural collections following trauma, tumor resection or bone flap reimplantation. In general, adjustable valves were used. All patients received a pre- and postoperative computed tomography (CT) scan. We evaluated patients’ postoperative clinical outcomes as well as radiographic criteria, including midline shift, frontal horn width and collection volume. Additionally, we analyzed shunt-related complications. ResultsImpaired consciousness was the commonest presenting symptom. We report a significant reduction in volume and width of the subdural collection after SDP shunt implantation. Furthermore, the midline shift decreased significantly. While 60 % (N=15) of the patients improved clinically, only 12 % (N=3) deteriorated. Complications comprised infection in 12 % (N=3) of patients and valve dysfunction in 1 patient. ConclusionsOur study shows that SDPS in adults is an effective treatment to eliminate or reduce subdural collections, that improves clinical outcomes in the majority of patients. Hence, it should be utilised more widely in this patient population. However, further studies are necessary to validate the treatment and identify eligible patients.

Nomograms and Reference Ranges for Intra-Cranial Ventricular Dimensions in Indian Neonates.

To establish normal reference values for commonly used ventricular indices - Anterior Horn Width (AHW), Ventricular Index (VI) and Thalamo-Occipital Distance (TOD)-against common variables including gestational age, birth weight and head circumference in Indian newborns. This was a cross-sectional study. Cranial ultrasound was performed between post-natal days 3 to 7. Anterior fontanelle was taken as the acoustic window. Data were analyzed to determine correlation, coefficient of determination (R2), regression equations and plotted against gestational age (GA). Total 2200 newborns were included in the study.The study observed that there is an increase in VI, AHWand TODwith an increase in gestational age (p-value < 0.001) and birth weight (p-value < 0.001). No significant correlation of gender and singleton or multiple gestation-with the intraventricular dimensions was observed (p-value > 0.05). All the three ventricular parameters were found to have a significantly lower mean value in the normal vaginal delivery group as compared to the LSCS group. There was a good correlation between ventricular indices of the left and right side. Nomograms of AHW, TOD, and VI were prepared with respect to gestational age. Intracranial ventricular size dimensions vary significantly with increasing gestational age and birth weight. The new nomograms for various ventricular indices of Indian neonates can assist in objectively assessing ventricular sizes.

Morphology of Barchan Dunes on Earth and Mars: Classification and Scale‐Invariance

AbstractMorphological characteristics were measured for barchan dunes on Earth (2,686 dunes in 30 barchan fields) and Mars (720 dunes in 10 barchan fields) using satellite images. The data were used to (a) develop a new barchan classification system; (b) compare characteristics of barchans on Earth and Mars; and (c) assess whether barchans, in bulk, display allometric or scale‐invariant characteristics. Dimensional metrics were obtained for the width and length of barchan bodies, the width and length of barchans including the horns, and the length of each horn. Dimensionless metrics were derived for the ratios of the body width to the width between the tips of the horns (width ratio), the length of the entire barchan to the length of the body (length ratio), and the length of the longer horn to the shorter horn (symmetry ratio). The width, length, and symmetry ratios were used to classify barchans into eight types and compare the characteristics of their distributions on the two planets. From this analysis, it was established that, statistically, barchans on Earth are distinctive from those on Mars based on the morphometrics, with terrestrial barchans being, on average, of smaller size and more often symmetrical, while Martian barchans more often have convergent horns that are short relative to the central dune body and are more often asymmetrical. The analysis further reveals that barchan planform morphology can be considered scale‐invariant, and we argue that body width is the most appropriate measure representing barchan size.

Development of a nomogram for fetal Evans Index.

This study aims to investigate the fetal Evans Index and establish a nomogram for fetuses without any additional fetal anomalies detected during the prenatal period. We conducted our research at Ankara City Hospital, including 894 patients who were admitted and evaluated between gestational weeks 16-40. These patients had no fetal anomalies detected in subsequent gestational weeks. Descriptive data, such as age, gravidity, parity, and body mass index (BMI), were recorded. Gestational week and Evans Index (mean, median, standard deviation, minimum, maximum, and percentile) were also documented. The Evans index was calculated as the ratio between the maximal width of the frontal horns and the maximal width of the inner diameter of the cranium. We evaluated 894 fetuses in pregnant women had no fetal anomalies detected throughout the pregnancy. The evaluation took place at different gestational weeks, and a nomogram for the Evans Index was created. It is relevant for clinicians and researchers to be aware of the range of fetal Evans Index values across different gestational weeks as a prognostic criterion.

Identification of hyoid bone morphometry in terms of gender in the Turkish population

Objectives: This study aimed to investigate differences in the morphology of the hyoid bone between genders. Methods: This retrospective cross-sectional study analyzed patient records from the Akdeniz University Faculty of Medicine, Department of Radiology. The study included 51 male and female patients, aged 19 to 29, who underwent neck CT scans between January 1, 2015, and January 1, 2016. Measurements taken included the length (BL) and width (BH) of the hyoid bone corpus, length of the greater horns (CL), lower end width of the greater horns (CWI), upper end width of the greater horns (CWS), lower end length of the greater horns (CHI), upper end length of the greater horns (CHS), and the distance between the right and left upper edges of the greater horns (WCS). Results: The values for CL, CWI, CHI, BL, BH, and WCS were significantly higher in males compared to females (p&lt;0.05). However, no statistically significant difference was found between genders for CWS and CHS (p&gt;0.05). Conclusion: This study provides valuable insights that could contribute to the fields of anatomy, forensic medicine, and anthropology.

High-level feature-guided attention optimized neural network for neonatal lateral ventricular dilatation prediction.

Periventricular-intraventricular hemorrhage can lead to posthemorrhagic ventricular dilatation or even posthemorrhagic hydrocephalus if not detected promptly. Sequential cranial ultrasound scans are typically used for their diagnoses. Nonetheless, manual image audit has numerous disadvantages. This study aimed to develop a predictive model utilizing modified inception (MI) and high-level feature-guided attention (HFA) modules for predicting neonatal lateral ventricular dilation via ultrasound images. The MI modules reduced input data sizes and dimensions, while the HFA modules effectively delved into semantic information through supervision from high-level feature images to low-level feature images. The process facilitated the accurate identification of dilated lateral ventricles. A total of 710 neonates, corresponding to 1420 lateral ventricles, were recruited in this study. Each lateral ventricle was captured in two images, one on the parasagittal plane and the other on the coronal plane. The combination of anterior horn width, ventricular index, thalamo-occipital distance, and ventricular height served as the gold standard. A lateral ventricle would be considered dilatated if any of these four indices exceeded its upper reference value. These lateral ventricles were randomly split into training and testing sets at a 7:3 ratio. We evaluated the validity of our proposed approach and its competitors across the coronal plane, parasagittal plane, and overall performance. We also determined the impact of subjects' baseline characteristics on the overall performance of the proposed approach. Additionally, ablation analyses were conducted to ensure the efficacy of the proposed approach. Our proposed approach achieved the largest Youden index (0.65, 95% CI: 0.58-0.72), DOR (27.11, 95% CI: 15.89-46.26), area under curves (AUC) of receiver operating characteristic curve (ROC) (0.84, 95% CI: 0.80-0.88), and AUC of precision-recall curve (PRC) (0.81, 95% CI: 0.74-0.86) in the overall performance assessment and ablation analyses. Moreover, it boasted the biggest Cramer's V values on the coronal (Cramer's V=0.488, p<0.001) and parasagittal (Cramer's V=0.713, p<0.001) planes individually. Factors such as left side, male sex, singleton birth, and vaginal delivery were positively correlated with higher performance regarding the proposed algorithm, except for the gestational age. This work provides a novel attention optimized algorithm for rapid and accurate ventricular dilatation predictions. It surpasses the traditional algorithms in terms of validity whether concerning the coronal plane, parasagittal plane, or overall performance. The overall performance of algorithms will be influenced by the baseline characteristics of populations.

Predictors of Hydrocephalus Risk After Stereotactic Radiosurgery for Vestibular Schwannomas: Utility of the Evans Index.

Hydrocephalus after Gamma Knife® stereotactic radiosurgery (SRS) for vestibular schwannomas is a rare but manageable occurrence. Most series report post-SRS communicating hydrocephalus in about 1% of patients, thought to be related to a release of proteinaceous substances into the cerebrospinal fluid. While larger tumor size and older patient age have been associated with post-SRS hydrocephalus, the influence of baseline ventricular anatomy on hydrocephalus risk remains poorly defined. A single-institution retrospective cohort study examining patients who developed symptomatic communicating hydrocephalus after undergoing Gamma Knife® SRS for unilateral vestibular schwannomas from 2011 to 2021 was performed. Patients with prior hydrocephalus and cerebrospinal fluid diversion or prior surgical resection were excluded. Baseline tumor volume, third ventricle width, and Evans Index (EI)-maximum width of the frontal horns of the lateral ventricles/maximum internal diameter of the skull-were measured on axial postcontrast T1-weighted magnetic resonance imaging. A total of 378 patients met the inclusion criteria; 14 patients (3.7%) developed symptomatic communicating hydrocephalus and 10 patients (2.6%) underwent shunt placement and 4 patients (1.1%) were observed with milder symptoms. The median age of patients who developed hydrocephalus was 69 years (IQR, 67-72) and for patients younger than age 65 years, the risk was 1%. For tumor volumes <1 cm3, the risk of requiring shunting was 1.2%. The odds of developing symptomatic hydrocephalus were 5.0 and 7.7 times higher in association with a baseline EI > 0.28 (P = .024) and tumor volume >3 cm3 (P = .007), respectively, in multivariate analysis. Fourth ventricle distortion on pre-SRS imaging was significantly associated with hydrocephalus incidence (P < .001). Patients with vestibular schwannoma with higher baseline EI, larger tumor volumes, and fourth ventricle deformation are at increased odds of developing post-SRS hydrocephalus. These patients should be counseled regarding risk of hydrocephalus and carefully monitored after SRS.

Integrating Clinical and Neuroimaging Markers to Predict the Onset of Posthemorrhagic Ventricular Dilatation in Preterm Neonates

BackgroundPosthemorrhagic ventricular dilatation (PHVD) is a major complication of intraventricular hemorrhage (IVH); it is associated with high risks of cerebral palsy and cognitive deficits compared with infants without PHVD. This study aims to explore the early perinatal risk factors-associated with the risk of progressive PHVD. MethodsNeonates ≤29 weeks gestational age (GA) with Grade II-III IVH and periventricular hemorrhagic infarct (PVHI) between 2015 and 2021 were retrospectively reviewed. All cranial ultrasounds done within 14 days postnatal age (PNA) were assessed for grade of IVH, anterior horn width (AHW), ventricular index (VI), and thalamo-occipital index (TOD). The outcome was defined as death of any cause or VI and/or AHW and/or TOD ≥ moderate-risk zone based on an ultrasound done beyond two weeks PNA. ResultsA total of 146 infants with a mean GA of 26 ± 1.8 weeks, birth weight 900 ± 234 g were included, 46% were females. The primary outcome occurred in 56 (39%) infants; among them 17 (30%) and 11 (20%) needed ventricular reservoir and shunt insertion, respectively. The risk factors present within 14 days PNA that significantly increased the odds of developing PHVD were hemodynamically significant patent ductus arteriosus (odds ratio [OR] 6.1, 95% confidence interval [CI] 1.9 to 22), culture-proven sepsis (OR 5.4, 95% CI 1.8 to 18), Grade III IVH (OR 4.6, 95% CI 1.1 to 22), PVHI (OR 3.0, 95% CI 0.9 to 10), and VI (OR 2.1, 95% CI 1.6 to 2.9). ConclusionsClinical predictors such as significant ductus arteriosus and bacterial septicemia, along with risk levels of AHW and VI measured with early cranial ultrasounds, are potential predictors of subsequent onset of PHVD.

Prediction of post-hemorrhagic ventricular dilatation trajectory using a growth mixture model in preterm infants.

Early intervention for post-hemorrhagic ventricular dilatation (PHVD), guided by ventricular size measurements from cranial ultrasound (cUS), is associated with improved neurodevelopmental outcomes in preterm infants but benefits must be balanced against intervention risks. Anterior horn width (AHW) and ventricular index (VI) were measured from cUS for preterm infants (<29 weeks) with intraventricular hemorrhage admitted from 2010-2018. PHVD was defined as AHW > 6 mm or VI >97th percentile for postmenstrual age. Individual ventricular size trajectories were plotted, and a growth mixture model (GMM) used to identify latent trajectory classes and compare these to predetermined outcome of neurosurgical intervention. Measurements were obtained from 1543 cUS in 249 infants, of whom 39 had PHVD without and 17 PHVD with neurosurgical intervention based on signs of raised intracranial pressure. The GMM predicted trajectory identified: 93.3% of infants without PHVD, 88.2% and 30.8% of infants with PHVD with and without intervention using AHW; 100% of infants without PHVD, 52.9% and 59.0% of infants with PHVD with and without intervention using VI. The AHW GMM identified a significant proportion of infants with severe PHVD. Model refinement offers a promising approach for identifying differences in PHVD trajectory at an early stage to guide management. It is difficult to distinguish the trajectory of PHVD in the early stage of development, in particular PHVD that spontaneously arrests from slowly progressive PHVD which eventually requires intervention. We report the first modeling-based evaluation of PHVD trajectory for the prediction of short-term outcome of PHVD progression and neurosurgical intervention. With additional clinical validation and optimization to increase accuracy, predictive modeling has the potential to identify important differences in PHVD trajectory at an early stage in the clinical course, allowing for more individualized data-driven risk-benefit assessments to guide decisions on early intervention.

External evaluation of a deep learning-based approach for automated brain volumetry in patients with huntington’s disease

A crucial step in the clinical adaptation of an AI-based tool is an external, independent validation. The aim of this study was to investigate brain atrophy in patients with confirmed, progressed Huntington's disease using a certified software for automated volumetry and to compare the results with the manual measurement methods used in clinical practice as well as volume calculations of the caudate nuclei based on manual segmentations. Twenty-two patients were included retrospectively, consisting of eleven patients with Huntington's disease and caudate nucleus atrophy and an age- and sex-matched control group. To quantify caudate head atrophy, the frontal horn width to intercaudate distance ratio and the intercaudate distance to inner table width ratio were obtained. The software mdbrain was used for automated volumetry. Manually measured ratios and automatically measured volumes of the groups were compared using two-sample t-tests. Pearson correlation analyses were performed. The relative difference between automatically and manually determined volumes of the caudate nuclei was calculated. Both ratios were significantly different between the groups. The automatically and manually determined volumes of the caudate nuclei showed a high level of agreement with a mean relative discrepancy of − 2.3 ± 5.5%. The Huntington's disease group showed significantly lower volumes in a variety of supratentorial brain structures. The highest degree of atrophy was shown for the caudate nucleus, putamen, and pallidum (all p < .0001). The caudate nucleus volume and the ratios were found to be strongly correlated in both groups. In conclusion, in patients with progressed Huntington's disease, it was shown that the automatically determined caudate nucleus volume correlates strongly with measured ratios commonly used in clinical practice. Both methods allowed clear differentiation between groups in this collective. The software additionally allows radiologists to more objectively assess the involvement of a variety of brain structures that are less accessible to standard semiquantitative methods.

Morphometric Analysis and Interrelationship of Seven Indonesian Hornbill Species (Aves, Bucerotidae) Utilizing Principal Component and Cluster Analyses

In this comprehensive study, we examined 15 distinct morphometric characteristics within seven Indonesian hornbill species. Precise measurements of these morphometric traits were obtained using 0.1 mm calipers and a 1000 mm measuring tape. Our analysis encompassed a total of 85 individuals representing seven hornbill species: Anthracoceros albirostris (18 individuals), A. malayanus (4 individuals), Aceros cassidix (3 individuals), Rhyticeros plicatus (7 individuals), R. undulatus (36 individuals), Buceros bicornis (1 individual), and B. rhinoceros (16 individuals). To elucidate the morphometric ratio data, we employed a robust analytical approach involving the Principal Component Analysis (PCA), Discriminant Analysis, and Cluster Analysis. Our findings underscored a clear separation between hornbill genera, primarily attributed to a combination of PC1 (pertaining to body length) and PC3 (associated with beak morphology). Key morphometric traits that delineated these genera on PC1 included tail length, beak length, horn length, total length, and wing length. Meanwhile, on PC3 (characterizing beak morphology), the distinguishing features encompassed beak width, horn width, and tarsus length. Additionally, our analysis unveiled the characteristics that distinguish species within the genera Anthracoceros and Rhyticeros to be a composite of tail length and head length. This discerning morphometric data facilitated the clustering of seven hornbill species into two distinct groups: Group I comprised A. albirostris and A. malayanus, while Group II included R. plicatus, R. undulatus, A. cassidix, B. rhinoceros, and B. bicornis. Notably, these groups exhibited a 31.93% degree of similarity. This dataset holds immense potential for facilitating genetic classification and comparative studies of Indonesian hornbills.

Radiological Evaluation of Huntington’s Disease: A Case Report

Huntington’s Disease (HD) is a rare neurodegenerative condition inherited in an autosomal dominant pattern, where Gamma Amino Butyric Acid-ergic (GABAergic) neurons in the basal ganglia progressively deteriorate. Symptoms include subcortical dementia, behavioural changes, midlife psychosis, and involuntary choreoathetosis movements. Imaging techniques like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) show shrinkage of the caudate nucleus and putamen, alongside enlarged lateral ventricles. Diagnosis is confirmed through molecular analysis identifying the hallmark amplified Cytosine Adenine Guanine (CAG) triplet. The case report describes a 57-year-old female diagnosed with HD, presenting symptoms of accidental falls caused by involuntary jerky movements, along with behavioural changes and cognitive decline over three years. Initial Non Contrast Computed Tomography (NCCT) of the brain revealed bilateral basal ganglia and diffuse cerebral atrophy. Quantitative analysis indicated a decreased frontal horn width to intercaudate distance (FH/CC) ratio of 1.24 and an increased Intercaudate distance to inner table width (CC/IT) ratio of 0.30. Multivoxel Magnetic Resonance Spectroscopy (MRS) showed reduced N-Acetyl Alanine (NAA) and creatine (Cr) levels with an NAA/Cr ratio of 0.84. Magnetic Resonance Tractography and Diffusion Tensor Imaging (DTI) revealed elevated Fractional Anisotropy (FA) and diffusivity in the basal ganglia, and reduced FA with increased diffusivity in white matter tracts. Genetic analysis by Polymerase Chain Reaction (PCR) confirmed HD. Newer MRI like DTI allows early identification of disease and better assessment of disease progression and response to therapy. A multidisciplinary approach involving neurologists, psychiatrists, and other healthcare professionals is essential. Genetic counseling and psychosocial support are crucial for patients and their families. Early and accurate identification of HD is vital for timely interventions and improved symptom control.

The associations between common neuroimaging parameters of Progressive Supranuclear Palsy in magnetic resonance imaging and non-specific inflammatory factors - pilot study.

Progressive Supranuclear Palsy is an atypical parkinsonism based on tauopathic pathology. Growing interest is associated with the pathomechanism of this disease. Among theories analyzing this issue can be mentioned the one highlighting the significance of inflammation. In this study authors examined 14 patients with PSP-Richardson syndrome (PSP-RS) and 13 healthy volunteers using laboratory testing based on the analysis of interleukins 1 and 6 (IL-1 and IL-6), tau in the cerebrospinal fluid (CSF) and non-specific parameters of peripheral inflammation in the serum (IL-1, IL-6, neutrophils, lymphocytes, monocytes, platelets and the ratios based on the factors). All of the patients underwent neuroimaging using magnetic resonance imaging using 3 Tesla. The serum levels of IL-1 were positively correlated with the area of the mesencephalon, suggesting that higher levels of IL-1 are not linked with atrophic changes in this region, whereas serum levels IL-6 was positively correlated with frontal horn width and negatively correlated with superior cerebellar area. Additionally IL-6 in the serum was found to be correlated with neutrophil-to-high density lipoprotein ratio. The observations were not confirmed in the analysis of the levels of interleukins in the CSF. To the best of our knowledge this work is one of the first analyzing this issue. The outcome of the work shows that the role of interleukins associated with microglial activation may possibly differ in the context of neurodegenerative changes, moreover the role of peripheral inflammation in PSP requires further analysis.

The Role of the Evans Index and the Maximal Width of the Frontal Horns of the Lateral Ventricles in the Diagnostic Imaging of Progressive Supranuclear Palsy and Multiple-System Atrophy.

Progressive Supranuclear Palsy and Multiple-System Atrophy are entities within the spectrum of atypical parkinsonism. The role of imaging methods in the diagnosis and differentiation between PSP and MSA is limited and Magnetic Resonance Imaging (MRI) is currently used as a reference modality. In this study, the authors examined a group of patients with atypical parkinsonism using a 1.5 T MRI system and aimed to find simple and repeatable measurements that may be useful to distinguish between these diseases. The results of the study indicate that the maximal width of the frontal horns of the lateral ventricles and Evans' Index may, to some extent, be useful as basic and simple measurements in the diagnostic imaging of patients with atypical parkinsonism.

Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Posthemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial

To study the potential role of ventricular volume (VV) estimation in the management of posthemorrhagic ventricular dilatation related to the need for ventriculoperitoneal (VP)-shunt insertion and 2-year neurodevelopmental outcome in infants born preterm. We included 59 patients from the Early vs Late Ventricular Intervention Study from 4 participating centers. VV was manually segmented in 209 3-dimensional ultrasound scans and estimated from 2-dimensional ultrasound linear measurements in a total of 1226 ultrasounds. We studied the association of both linear measurements and VV to the need for VP shunt and 2-year neurodevelopmental outcome in the overall cohort and in the 29 infants who needed insertion of a reservoir. We used general estimating equations to account for repeated measures per individual. Maximum pre-reservoir VV (β coefficient=0.185, P=.0001) and gestational age at birth (β =-0.338; P=.0001) were related to the need for VP shunt. The estimated optimal single VV measurement cut point of 17cm3 correctly classified 79.31% with an area under the curve of 0.76 (CI 95% 0.74-0.79). Maximum VV (β=0.027; P=.012) together with VP shunt insertion (β =3.773; P=.007) and gestational age (β =-0.273; P=.0001) were related to cognitive outcome at 2years. Maximum ventricular index and anterior horn width before reservoir insertion were independently associated with the need of VP shunt and the proposed threshold groups in the Early vs Late Ventricular Intervention Study trial were associated with long-term outcome. Pre-reservoir VV measurements were associated with the need for VP-shunt insertion and 2-year cognitive outcome among infants born preterm with posthemorrhagic ventricular dilatation. ISRCTN43171322.

Novel metrics to characterize temporal lobe of very preterm infants on term-equivalent brain MRI.

Preterm birth adversely impacts brain development and contributes to neurodevelopmental impairment; the temporal lobe may be particularly vulnerable to the impact of very preterm (VP) birth. Yet, no prior magnetic resonance imaging (MRI) scoring system incorporated a method to quantify temporal lobe size in VP infants. We developed and applied three metrics (temporal lobe length, extra-axial space, and temporal horn width) to quantify temporal lobe structure on term-equivalent brain MRIs obtained from 74 VP and 16 term infants. We compared metrics between VP and term infants and explored associations of each metric with perinatal risk factors. All metrics had excellent reliability (intra-class correlation coefficient 0.62-0.98). VP infants had lower mean temporal lobe length (76.8 mm versus 79.2 mm, p = 0.02); however, the difference attenuated after correction for postmenstrual age. VP infants had larger temporal horn widths compared with term infants (2.6 mm versus 1.8 mm, p < 0.001). Temporal lobe length was positively associated with gestational age, birth weight, and male sex, and negatively associated with the duration of parenteral nutrition. The proposed metrics are reliable and sensitive in distinguishing differences in temporal lobe development between VP and full-term infants. We developed a novel method for quantifying temporal lobe size among very preterm infants at term equivalent using simple metrics performed on brain MRI. Temporal lobe metrics were reliable, correlated with brain volume from volumetric analysis, and were sensitive in identifying differences in temporal lobe development among preterm compared with term infants, specifically larger temporal horn size in preterm infants. This temporal lobe metric system will enable future work to delineate the perinatal and postnatal factors that impact temporal lobe growth, and better understand the relationship between temporal lobe disturbance and neurodevelopment in very preterm infants.

Biometrical and histological study of reproductive organs of indigenous cattle in Bangladesh

Reproductive anatomy is vital for successful reproductive management and has significance for application of assisted reproductive biotechnology. This study was carried out to characterize biometrically and histologically reproductive organs of 50 slaughtered female cattle (&lt;3 years; n=25, 3 to ≤5 years; n=25). The measurements (length, weight and width) of the right segment of the studied reproductive organs were greater compared to the left segment. No significant difference (p&gt;0.05) was observed between left and right ovary length, width and weight within and between age groups. The length of ovaries were 1.92±0.19 cm and 1.95±0.04 cm at &lt;3 years; 2.16±0.21 cm and 2.17±0.19 cm at 3 to ≤5 years; width were 1.09±0.14 cm and 1.17±0.10 cm at &lt;3 years and 1.31±0.10 cm and 1.46±0.11 cm at 3 to ≤5 years and the weight were 1.77±0.41 gm and 2.20±0.57 gm at &lt;3 years; 1.79±0.45 gm and 2.54±0.14 gm at 3 to ≤5 years in the left and right ovaries, respectively. Oviduct length, width and weight did not differ significantly (p&gt;0.05) between the left and right oviducts within and between the age groups. Oviduct length (16.36±0.78 and 17.58±0.97 cm), width (0.21±0.02 and 0.26±0.33 cm) and weight (0.72±0.03 and 0.81±0.11 gm) was found for the right oviduct at &lt;3 years and 3 to ≤5 years and for left oviduct length, width and weight were 16.20±0.65 and 16.64±0.86 cm; 0.19±0.02 and 0.23±0.03 cm; and 0.69±0.04 and 0.79±0.13 gm, at &lt;3 years and 3 to ≤5 years, respectively. However, uterine horn length differed significantly (p&lt;0.05) between age groups in the left (16.18±1.18 vs 27.45±2.98 cm) and the right horn of the uterus (17.45±1.40 cm vs 28.35±2.88 cm). On the other hand, uterine horn width and weight were not differed significantly between the left and right segments within and between the age groups. Uterus body length and weight were significantly (p&lt;0.05) higher at 3 to ≤5 years compared to &lt;3 years old cow. The average weight, length and width of uterine body were 44.40±7.33 gm vs 21.49±5.91 gm; 7.89±0.61 cm vs 5.87±0.43 cm; 3.46±0.27 cm vs 2.76±0.34 cm at &lt;3 years and 3 to ≤5 years, respectively The whole uterus weight was also differed significantly (p&lt;0.05) at &lt;3 years (47.18±14.92 gm) and 3 to ≤5 years (86.07±11.98 gm). Histological studies showed ideal characteristics of cattle oviduct and uterus. In nutshell, the right ovary was larger in length, wider in diameter, and heavier in weight as compared to left one in indigenous cattle of Bangladesh. Bangladesh Journal of Animal Science 51 (4): 169-177

Comparison of fetal and neonatal sonographic measurements of ventricular size in second- and third-trimester fetuses with or without ventriculomegaly: cross-sectional three-dimensional ultrasound study.

To assess, in a population comprising normal fetuses and fetuses with primary or post-hemorrhagic ventriculomegaly, the reproducibility of measurement of neonatal ultrasound indices in the fetus and to compare the performance of various cut-offs of these parameters to diagnose ventriculomegaly and classify its severity. This was a retrospective cross-sectional study including 182 singleton fetuses assessed by transvaginal neurosonography. The sample populations included 116 normal fetuses and 66 fetuses with primary (n = 56) or post-hemorrhagic (n = 10) ventriculomegaly. In all cases, the atrial width (AW) was measured according to standard protocols and the findings were compared with four sonographic indices developed in the neonate: the anterior horn width (AHW), the ventricular index (VI), the thalamo-occipital distance (TOD) and the fronto-occipital horn ratio (FOHR). Reproducibility of measurements was assessed using the intraclass correlation coefficient (ICC) and diagnostic accuracy of the neonatal indices was assessed against AW using areas under the receiver-operating-characteristics curves (AUC). The intra- and interoperator reproducibility of measurement of AW and the neonatal measurements was excellent, with ICCs > 0.99 for all measures. The association in the fetus of all four variables developed in the neonate with the degree of ventriculomegaly as defined by the AW was strong for severe ventriculomegaly (AW > 15.0 mm; all AUC > 0.95), whereas the separation of cases with mild ventriculomegaly (AW, 10.0-15.0 mm) from those with normal AW (< 10.0 mm) was less effective. When applied in the fetus, all four indices of ventriculomegaly developed in neonates (AHW, VI, TOD, FOHR) were associated strongly with fetal AW when the AW measurement indicated severe fetal ventriculomegaly. However, for mild ventriculomegaly, the association was weaker, probably due to the fact that, in the fetus, mild ventriculomegaly is not caused by obstruction of the ventricular system. Considering the similar performance of the four neonatal variables and the technical issues involved in determination of TOD and FOHR in the fetus, use of VI and AHW is preferred. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.