ABSTRACT
Background: The sphenoid sinus shows multitude of variations in pneumatization, size and pattern of septations leading to differences in its segmentation. Pre-operative knowledge of their attachment especially to posterolateral bony walls covering vital structures is of utmost importance for a safe trans-sphenoidal approach for various surgical procedures involving skull base. Non-contrast computed tomography (NCCT) with its ability to provide multiplanar reformations (MPR) with sharp algorithms is now a reference standard for visualization of these intra-sphenoid sinus septations preoperatively. The objective of this study was to determine the number and attachment of intra-sphenoid sinus septations in a Kashmiri population sample.Methods: NCCT head images of 591 patients in the age range of 16 to 75 years were analyzed retrospectively. Individuals with age less than 16 years, previous surgery involving skull base/sphenoid sinus, trauma causing hem sinus/fractures around skull base or having space occupying lesions around skull base/sphenoid sinus were excluded from the study. On the CT workstation multi-planar coronal, sagittal and axial reconstructions were performed and subsequently examined.Results: The age range was 16 to 75 years with mean age of 43.56 years of which 453 (76.6%) were males and 138 (23.4%) were females. Single intra-sphenoid septation was the most common anatomic variant in present study (79.7%) being complete in 71.7% and partial or incomplete in 8% of the examined subjects. Double septa were found in 11% inpresent study and more than 2 septae in 3.4%. After sellar attachment (51%) the next most common site of attachment was to the carotid canal (29.5%) (23% to left ICA and 6.5% to the right ICA).Conclusions: Intricate knowledge about sphenoid sinus, its pneumatization and anatomical variations in intra-sphenoid sinus septations and its relationship with the surrounding vital structures is of utmost importance before performing any endoscopic/open surgery involving skull base via trans-sphenoidal approach. The present study shows that a significant percentage of septal attachment to the carotid canal makes main sphenoidal septum as not so reliable landmark for endoscopic procedures as used to be in the pre-imaging era. Thus, preoperative CT is mandatory to avoid injuries to para-sellar neurovascular and glandular structures.
ABSTRACT
Background:Radiological determination of gender relies predominantly on the skeletal radiology and assumes importance in mass natural disasters, bomb explosions, exhumations and warfare where skeletal fragmentation is common. Varied literature is present regarding the role of foramen magnum in establishing gender identification.The objective of the study wasto establish normative values of cross-sectional area of foramen magnum in both genders using NCCT and try to ascertain any significant difference in cross-sectional area in the two genders which may help in gender identification.Methods:NCCT head images of 378 subjects were analysed in individuals beyond the age of skeletal immaturity. Free ROI technique using electronic calliper tool was used. The cross-sectional area of foramen magnum was automatically obtained after tracing its whole inner circumference.Results:Mean cross-sectional area of foramen magnum in females was 806.79±106.58 mm2and was 878.33±98.42 mm2in males. Although the cross-sectional area in males was greater than females no statistically significant difference was found. The correlation coefficient was found to be weaker (R=0.0413). Conclusions: No statistically significant difference was found between the two genders. The correlation coefficient was also weak to draw any inference about the gender of the skull on CT imaging. Further studies are needed to include other parameters like the sagittal and transverse diameters of foramen magnum in a larger sample to show importance of foramen magnum, if any, in helping gender identification of skeletal remains
ABSTRACT
Objective To explore the evaluation of contrast enhanced CT with multi -direction adjusting multi -planar reformation(MPR)on the stomach wall invasion of advanced gastric cancer.Methods 105 cases of advanced gastric cancer proved by pathology after surgery were checked by contrast enhanced CT before surgery.All the images were reconstructed by multi -direction adjusting MPR to show perfectly the lesions of gastric cancer,T stage diagnosed by CT were compared with the T stage diagnosed by pathology.Results T1,T2,T3,T4 stage diag-nosed by pathology were 9 cases,23 cases,46 cases and 27 cases respectively,the accuracy of multi -direction adjus-ting MPR in diagnosing T1,T2,T3,T4 stage were 98.1%,93.3%,86.7%,91.4% respectively.Conclusion Con-trast enhanced CT with multi -direction adjusting MPR can improve the accuracy in diagnosing the T stage of ad-vanced gastric cancer,which can be used to evaluate the staging of advanced gastric cancer.