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Objective:To explore the accuracy and clinical application value of a Multi-Agent Reinforcement Learning framework (MARL framework) in three-dimensional ultrasound to automatically locate the coronal plane of the uterus.Methods:A total of 144 female patients who underwent routine gynecological examinations in Luohu People′s Hospital during May 2020 were selected as the experimental subjects. The three-dimensional volume data of the uterus of all the experimental subjects were collected by using the Resona-8 high-end color Doppler ultrasound system. A sonographer with more than 5 years of clinical experience manually locate the coronal plane of the uterus in all collected data, and at the same time automatically locate the coronal plane of the uterus MARL framework. The coronal plane images of the uterus obtained by the two methods were saved, and the operation time of the two methods was recorded. The coronal plane uterine images obtained by the two methods were mixed together, and the images were scored 0-1 by two senior ultrasound experts in a double-blind manner. The average score greater than or equal to 0.6 points was considered qualified.Results:①In 144 volunteers, among the coronal planes of the uterus located by the two methods, 131 were qualified by the manual method, and 137 were qualified by the automatic method.There was no statistical difference between the manual and automatic coronal plane images of the uterus (χ 2=1.934, P=0.164) by the chi-square test. ②Using interquartile range analysis, the median and interquartile range of the image score of the automatic group was 0.80(0.75, 0.90), while the median and interquartile range of the image score of the manual group was 0.80(0.75, 0.90). The Wilcoxon signed rank test was used to analyze the quality of the coronal plane images obtained by manual and automatic methods, and the difference was not statistically significant ( Z=1.241, P=0.215). ③The paired t test was used to compare the time required to locate the coronal surface of the uterus, by manual method (63.65±10.182)s, by automatic method (3.25±0.294)s, the difference between the two methods was statistically significant ( t=19.52, P<0.001). Conclusions:The method based on MARL framework has a high correlation with the manual locating of the coronal plane of uterus in three-dimensional ultrasound, and greatly reduces the operation time. It can be effectively applied in clinical practice and lays a foundation for the automatic diagnosis of uterine related diseases.
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BACKGROUND: Pilon fractures usually happened during severe injury, associated with compression and comminution of metaphysis and soft tissue injury and primary articular cartilage damage in varying degrees The treatment is difficult and the prognosis is relatively poor. OBJECTIVE: To explore the clinical effect of application of meta-plate and mini-plate internal fixation for the treatment of anterior comminuted coronal plane Pilon fractures. METHODS: From January 2013 to June 2017, 17 patients of closed anterior comminuted coronal plane Pilon fractures were admitted in Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University. There were 7 males and 10 females, aged from 24 to 62 years, with an average age of 41.3 years. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. Preoperative CT scans and three-dimensional reconstruction confirmed that the main fracture line was in coronal plane and multiple fragments of distal tibial metaphysis were displaced obviously. According to Ruedi-Allgower classification, there were 3 cases of type and 14 cases of type III. Fracture fragments of articular surface were fixed with transverse metacarpophalangeal mini-plate and screws, and the distal tibial coronal fractures were fixed with anterior meta-plate. The ankle and hind foot score of the American Orthopaedic Foot and Ankle Society was used to evaluate the function after surgery. RESULTS AND CONCLUSION: (1) The 17 patients were followed up for 12 to 28 months. All incisions healed in the first stage without complications such as wound infection, skin necrosis, failure of internal fixation and neurovascular injury. Only one patient had redness on the edge of the incision after operation and healed after swelling reduction and dressing change. (2) Fractures healed within 3 to 6 months without delayed union or nonunion. (3) At the last follow-up, the American Orthopaedic Foot and Ankle Society ankle and hind foot score was excellent in 10 cases, good in 5 cases, and average in 2 cases. The excellent and good rate was 88%. (4) The application of transverse mini-plate and screws fixation can effectively support and fix the fracture fragments of articular surface. Combined with anterior meta-plate of distal tibia for the treatment of anterior comminuted coronal plane Pilon fractures can achieve good therapeutic effect, and strengthen biomechanical stability.
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Objective To investigate the clinical value of modified BI?RADS classification by using the coronal plane of automatic breast volume scaner. Methods The total of 201 BI?RADS 3~5 classification of breast masses were retrospectively analyzed. All masses underwent conventional ultrasound and ABVS examination. Using BI? RADS classification standard terms to describe various information of breast masses, and record the coronal image of the masses on the complete interface echo, convergence sign, angle, burr, which classified BI?RADS ultimately. Results The coronal plane of convergence sign, complete interface echo, angulation and burr were significantly different between benign and malignant tumors (P<0.0001). The sensitivity of ABVS convergent sign in diagnosing breast malignant tumors was 68.2%, specificity was 93.4% and accuracy was 82%. The conventional ultrasound combined with the coronal feature of ABVS modified by BI?RADS classification showed that 3 kinds of malignant rate reduced from 8.5%to 3.2%. The rate of malignant 4a decreased from 25.2%to 12.1%and the rate of malignant 5 increased from 94.2% to 98%. Conclusion The convergence sign of ABVS can be used as a significant independent predictor of breast malignant tumors;ultrasound combined with ABVS is helpful to improve the accuracy of ultrasound BI?RADS classification.
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Objectives: Miniscrews have been used in recent years for anchorage in orthodontic treatment. However, it is not clear whether the miniscrews are absolutely stationary or move when force is applied. This prospective clinical study was undertaken to evaluate the mobility of orthodontic miniscrews under orthodontic loading using computed tomography. Materials and Methods: Ten adult patients (7 females and 3 males with mean age of 19 years, 7 mm overjet) who required en masse retraction of upper and lower anterior teeth in first premolar extraction spaces were included in this study. After initial alignment of anterior teeth, the 0.019” ×0.025” stainless steel archwire were placed in preadjusted edgewise appliance. The miniscrews (diameter - 1.3 mm, length - 7 mm) were inserted in between second premolar and the first molar in the maxilla (zygomatic buttress) and in mandible on the buccal side as direct anchorage. Immediately after placement of miniscrews without waiting period, NiTi coil springs (force of 150 g in the maxilla and 100 g in the mandible) were placed for the retraction. Denta Scans were taken immediately before force application (T1) and 6 months later (T2). The mean changes obtained at T1 and T2 in Denta Scans (axial plane, coronal plane, paraxial plane) were evaluated to determine any movement of different parts of miniscrews using one-way ANOVA test and Student’s unpaired t-test. Results: On average, miniscrews were extruded and tipped forward significantly, by 1 mm at the screw head in the axial plane (Group III) and 0.728 mm in the coronal plane (Group IV). Tail of miniscrews showed average tipping of 0.567 mm in the axial plane (Group I) and 0.486 mm in the paraxial plane (Group V). Least average mobility was shown by screw body of 0.349 mm in the axial plane (Group II). Clinically, no significant mobility was observed. Conclusion: Miniscrews are a stable anchorage for orthodontic tooth movement but do not remain absolutely stationary like an endosseous implant throughout orthodontic loading although miniscrews might move according to placement site, orthodontic loading, and inflammation of peri-implant tissue. Waiting period between miniscrews placement and orthodontic loading does not significantly affect the miniscrew mobility so immediate loading can be recommended. To prevent hitting any vital organs because of miniscrew mobility, it is recommended that they can be placed in a nontooth-bearing area that has no foramen, major nerves, or blood vessel pathway, or in a tooth-bearing area allowing a 1.5 mm safety clearance between the miniscrew and dental root.
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Objective To investigate the volume of hippocampal formation in normal adult using coronal magnetic resonance imaging. Methods 3D-fSPGR sequence was used to depict the brain in 68 healthy adult. The volume of hippocampus was calculated by drawing the outline of 10 coronal hippocampal formation images acquired equally form posterior border of rostrum corpus callosum to anterior border of the splenium. Data were analysed using the SPSS 17.0 software. Results In the coronal plane images of normal adult brain, the absolute volume of left and right hippocampal formation were 2 319.63-2 610.73 mm3 and 2 447.52-2 749.50 mm3 respectively . The relative volume of left and right hippocampal formation were 2 319 . 87-2 602 . 47 mm 3 and 2 443.96-2 755.89 mm3. There were no correlation between hippocampal volume and age (r = 0.084, P = 0.549. Significant gender differences (t=2.500, P=0.029) were observed between absolute volume of right hippocampal formation in the youth group. There were significant differences in the absolute volume (t = -2.571, P = 0.022), relative volume (t = 2.600, P = 0.021) among the right and left hippocampal formation. Significant absolute volume differences (P = 0.038) were observed between the middle-aged group and the youth group among the hippocampal formation of women. Conclusion No significant differences were observed in age, gender among the hippocampal volume of normal adult, and there was a significant difference between the left and right hippocampal formation volume.
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PURPOSE: The aim of this study was to establish a measurement standard for the weight-bearing axial alignment of the lower extremities when performing a lower extremity reconstruction. MATERIALS AND METHODS: Among 274 patients (147 males and 127 females) in their 20s to 30s without any physical disabilities, and who had undergone weight-bearing full leg standing radiographs, 188 patients (100 males and 88 females) were examined this study. The data was analyzed further according to their age and gender using the radiographic value on the coronal and sagittal alignment of the lower extremities. RESULTS: The weight bearing ratio was 38.47+/-10.52% on the coronal plane and 36.11+/-7.88% on the sagittal plane. Both the mechanical axis and the the weight bearing axis were not identical due to their 0.68+/-0.89degrees difference on average. The most adjacent point of the femoral condyles to the tibial plateau on the sagittal plane was assigned to the center of the knee joint. The difference between the mechanical axis and weight bearing axis was 0.04degrees, which was not significant. CONCLUSION: There is a difference between the mechanical axis, which consists of both a line from the center of the femoral head to the center of knee joint and a line from the center of the knee joint to the center of ankle joint, and the weight bearing axis, which is linked directly from the center of the femoral head to the center of the ankle joint. Furthermore, the weight bearing axis passes through the anteromedial part in the knee joint. The center of the knee joint is defined as the most adjacent point of both femoral condyle to the tibial plateau on the sagittal plane.
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Adult , Humans , Male , Ankle Joint , Axis, Cervical Vertebra , Head , Knee Joint , Leg , Lower Extremity , Weight-BearingABSTRACT
PURPOSE: We evaluated the correlation of the anatomic parameters of the acromion those represent on the magnetic resonance image (MRI) of impingement syndrome. MATERIALS AND METHODS: From June, 2004 to December, 2005, 71 cases were surgically proven to be impingement syndrome, and the anterior acromial hooking angle, the lateral acromial hooking angle (AAHA and LAHA) and the acromial hooking index (AHI: the sum of the AAHA and LAHA) were compared to 16 control cases. At the same period, 55 cases were surgically proven to be partial or full thickness rotator cuff tear, and age, gender and twelve anatomic parameters, including the acromial type, the acromial angle, the anterior covering, the acromial slope, the AAHA, the lateral acromial angle, the acromial torsional angle, the lateral acromial angulation, the LAHA, the lateral covering, the acromiohumeral distance and the AHI were assessed. RESULTS: The AAHA and AHI were increased as impingement syndrome proceeded. The acromial type and acromial angle, and the AAHA, LAHA and AHI showed significant differences between the controls and the rotator cuff tear patients on univariant analysis. On multivariant analysis, gender was most strongly correlated with rotator cuff tear. Age, AAHA and the acromial angle showed similar correlation, respectively. CONCLUSION: The coronal acromial shape is correlated with rotator cuff tear, and it is important to correct the lateral acromial shape when performing acromioplasty.
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Humans , Acromion , Magnetic Resonance Spectroscopy , Rotator CuffABSTRACT
PURPOSE: The purpose of this study is to find out the normal distal tibial articular surface angle in coronal plane in Koreans. This would be helpful as the basic data for ankle reconstruction after trauma or deformity correction. MATERIALS AND METHODS: Weight bearing anteroposterior radiographs of 123 normal ankles were reviewed. A line parallel to the shaft of the tibia was made. Another line was drawn parallel to the articular surface of the distal tibia. The superolateral angle that subtended by these two lines was measured. RESULTS: There were 72 males and 51 females. The mean age overall was 35.7 years old. The mean age for males was 31.9 (28~36) years old. The mean age for females was 41.1 (37~45) years old. The mean distal tibial articular surface angle was 90.8 degrees. The mean distal tibial articular surface angle for males was 91.5 degrees and for females 89.9 degrees. CONCLUSION: The mean distal tibial articular surface angle in coronal plane for Koreans is 90.8 degrees. We can avoid the error of the varization at the ankle alignment when the correction was performed vertical or minimal valgus to tibia tuberosity axis in Korean people.
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Female , Humans , Male , Ankle , Axis, Cervical Vertebra , Congenital Abnormalities , Tibia , Weight-BearingABSTRACT
When we establish treatment planning of facial asymmetry, we must predict each asymmetrical element that will be changed upon coronal, axial, sagittal plane. At the visual point, prediction of the change of coronal plane is most important. It is important difference between Rt. and Lt. mandibular angle belonging to posterior coronal plane, as well as anterior coronal plane, such as upper and lower incisor, or midline of chin point. Several methods for control bulk of mandibular angle are additional angle shaving after osteotomy, grinding contact area between proximal and distal segment for decrease the volume, or bone graft for increase the volume. But, at the point of bimaxillary surgery, transverse position of posterior maxilla is an important factor for control it. So, we would report transverse movement of posterior maxilla for decrease asymmetry on the posterior coronal plane of face, that is, asymmetry of mandibular angular portion.
Subject(s)
Chin , Facial Asymmetry , Incisor , Maxilla , Orthognathic Surgery , Osteotomy , TransplantsABSTRACT
Objective To provide sectional anatomic data for the coronal imaging diagnosis and surgical treatment of the diseases of the liver.Methods The course,distribution of left,middle,and right hepatic veins and their important tributaries as well as the relationship with the hepatic portal veins were investigated using serial coronal sections of the trunk of 30 adult cadavers,coronal MR images of abdomen of 10 adult healthy volunteers and three-dimensional MSCT image of intrahepatic ducts of 5 healthy adults.Results The draining form of left hepatic vein can be divided into 4 types according to the external shape character of left lateral lobe.All veins of the ventral area of segment Ⅷ opened into the middle hepatic vein.All veins of the dorsal area of segment Ⅷ joined the right hepatic vein.However,the veins(V8i) situated between the ventral and dorsal areas of segment Ⅷ can be divided into 3 types on the draining form.Right hepatic vein usually appears on the section through or behind the inferior vena cava with 4 types on the coronal plane.Conclusions Coronal section has obvious advantage to show the course of hepatic veins in the longitudinal direction.Segment Ⅷ can be divided into dorsal and ventral subsegments according to V8i,This method of subsegmental division may contribute to the development of new and safer surgical procedures of the liver.