Evaluation the scanning accuracy of Blue-Light laboratory scanners in complete edentulous Maxilla with multiple implants with titanium scan bodies / Evaluación de la precisión de escaneado de los escáneres de laboratorio de luz azul en maxilares desdentados completos con implantes múltiples con cuerpos de escaneado de titanio

Abstract To evaluate the accuracy of complete arch scanning with multiple implant titanium scan bodies using laboratory scanners. A master model of an edentulous maxillary arch with 6 implants was fabricated. Titanium scan bodies were inserted into the model. Three laboratory scanners were used: D2000 (3Shape), Vinyl High Resolution (Smart Optics), and inEos X5 (Dentsply Sirona). The master model was consecutively scanned ten times using dental laboratory scanners (LS) without detaching and repositioning the scan bodies. Linear and angular accuracy between adjacent implants was measured using inspection software (Control X, Geomagic). The accuracy of the complete arch scans was calculated. Implant regions were defined as; parallel (R1: #24-26 and #16-14), angled (R2: #22-24 and #14-12), angled to occlusal plane (R3: #12-22), and cross-arch (R4: #16-26). The effect of LS and implant region on accuracy was compared using two-Way ANOVA (α=0.05). Significant greater linear distortion was noted in R4 (61.2±17.9µm) compared to R1 (23.4±15.5µm) and R2 (26±17.7µm) (p<0.01). Greater linear distortions were noted in R4 with D2000 (0.07±0.016 degrees) and Vinyl High Resolution (0.067±0.02 degrees) than inEos X5 (0.032±0.021 degrees) (p>0.05). Greater mean linear precisions were noted in R1 (9±8µm) and R3 (9.3±8.3µm) than R4 (12.6±10.3µm) (p<0.05). The highest linear precision was noted in D2000 (7.2±7.6µm) (p<0.05). The angular precision of D2000 (0.02±0.015 degrees) was the highest (p<0.01). The angular precisión of R4 (0.036±0.018 degrees) was the lowest (p<0.01). This study revealed that the trueness was affected by the implant region and the precision was affected by both LS and implant region.

Resumen Evaluar la precisión del escaneado de la arcada completa con cuerpos de escaneado de titanio de múltiples implantes utilizando escáneres de laboratorio. Se fabricó un modelo maestro de una arcada maxilar edéntula con 6 implantes. Se insertaron cuerpos de escaneo de titanio en el modelo. Se utilizaron tres escáneres de laboratorio: D2000 (3Shape), Vinyl High Resolution (Smart Optics) e inEos X5 (Dentsply Sirona). El modelo maestro se escaneó consecutivamente diez veces usando escáneres de laboratorio dental (LS) sin separar y reposicionar los cuerpos de escaneo. La precisión lineal y angular entre implantes adyacentes se midió utilizando un software de inspección (Control X, Geomagic). Se calculó la precisión de los escaneos completos del arco. Las regiones del implante se definieron como; paralelo (R1: #24-26 y #16-14), angulado (R2: #22-24 y #14-12), angulado al plano oclusal (R3: #12-22) y cruzado (R4: #16-26). El efecto de LS y la región del implante en la precisión se comparó mediante ANOVA de dos vías (α=0,05). Se observó una distorsión lineal significativamente mayor en R4 (61,2±17,9µm) en comparación con R1 (23,4±15,5µm) y R2 (26 ±17,7µm) (p<0,01). Se observaron mayores distorsiones lineales en R4 con D2000 (0,07±0,016 grados) y vinilo de alta resolución (0,067±0,02 grados) que en inEos X5 (0,032±0,021 grados) (p>0,05). Se observaron precisiones lineales medias mayores en R1 (9±8µm) y R3 (9,3±8,3µm) que en R4 (12,6±10,3µm) (p<0,05). La mayor precisión lineal se observó en D2000 (7,2±7,6 µm) (p<0,05). La precisión angular de D2000 (0,02±0,015 grados) fue la más alta (p<0,01). La precisión angular de R4 (0,036±0,018 grados) fue la más baja (p<0,01). Este estudio reveló que la veracidad se vio afectada por la región del implante y la precisión se vio afectada tanto por LS como por la región del implante.

Impact of dentists and equipment in the performing dental imaging examinations: a longitudinal analysis

Abstract: In this study, we aimed to identify factors associated with performing dental imaging examinations in public health services. Brazilian data at the municipal level (n = 5,564) in two time periods, P0 (2005-2007) and P1 (2014-2016), were collated from health information systems. The increase in the municipal rates of intraoral and extraoral radiographic imaging procedures was the outcome. Changes in the use of clinical procedures and the rates of dentists and equipment were the main predictors. Multiple logistic regression analysis was performed to estimate the adjusted odds ratio (OR). Approximately 35.3% of the Brazilian municipalities increased the dental radiography equipment rate, 9.9% increased the fan-beam computed tomography (CT) equipment rate, and 5.9% increased the magnetic resonance imaging (MRI) equipment rate. In addition, 31.8% increased the periapical/interproximal radiography rate, 10.5% increased the CT rate, and 4.4% increased the MRI rate. Increases in the dental radiography, CT, and MRI rates were associated with higher chances of periapical/interproximal images (OR = 1.90, p < 0.01), face and neck images (OR =1 5.3, p < 0.01), and MR images (OR = 18.1, p < 0.01), respectively. Municipalities that increased the rates of endodontists increased the rates of periapical/interproximal (OR = 2.50, p < 0.01) and occlusal (OR = 1.60, p < 0.01) imaging procedures, and those that increased the rates of radiologists also increased the rates of occlusal (OR = 2.00, p < 0.01) and panoramic (OR = 1.70, p < 0.01) imaging procedures. The implementation of a secondary dental care center, Centro de Especialidades Odontológicas (CEO) was associated with an increase in the chances of performing periapical/interproximal and panoramic radiographic procedures in 1.5 and occlusal radiographic examinations in 2.0. The rates of dentists, equipment, specialized dental centers, and specific dental procedures were associated with the increased use of imaging procedures in dentistry in the Brazilian public health system.

The value of unenhanced computed tomography in differentiating brain tumors from non-neoplastic lesions / 中华神经科杂志

Objective:To investigate the additional value of unenhanced computed tomography (CT) in the differential diagnosis of brain tumors and non-neoplastic lesions.Methods:A total of 237 cases [140 males and 97 females; (49±16) years old; including 48 cases of low-grade glioma, 134 cases of high-grade glioma, 38 cases of primary central nervous system lymphoma, 9 cases of medulloblastoma, 5 cases of germinoma, and 3 cases of central neurocytoma] of brain tumors (diffuse gliomas and non-glial tumors) diagnosed by biopsy or surgery and pathology in the Affiliated Hospital of Qingdao University from September 2016 to October 2020 were collected retrospectively. Sixty-six cases [46 males and 20 females; (42±13) years old; including 12 cases of abscesses, 5 cases of infarcts, 33 cases of demyelinating lesions, 11 cases of autoimmune encephalitis, and 5 cases of central nervous system vasculitis] of brain non-neoplastic lesions were confirmed by biopsy or clinic. All patients underwent routine magnetic resonance imaging (MRI) scan and unenhanced CT before the treatment. The images were reviewed by two neuroradiologists together blind to the final diagnosis with and without CT images respectively. The diagnostic results and reliability scores were recorded, and the accuracy of the two evaluations was compared.Results:CT hyperattenuation exhibited a higher specificity (95%) than conventional MRI scan (86%), and a lower diagnostic sensitivity (34% vs 86%). Compared to MRI alone, the combined modality of MRI and unenhanced CT significantly improved diagnostic accuracy (94% vs 86%). Additionally, the CT attenuation ratio of non-neoplastic lesions was significantly lower than that of neoplastic lesions [0.69 (0.61,0.78) and 1.14 (1.00,1.25), W=2 123, P<0.05]. The CT attenuation ratio in the non-glial origin tumor group was significantly higher than that in the diffuse glioma group [1.28 (1.18,1.41) and 1.13 (0.97,1.21), W=1 858, P<0.05]. There was no significant difference in grade Ⅲ and Ⅳ groups of diffuse glioma [1.11 (0.99,1.20) vs 1.16 (1.09,1.24), P>0.05 (Nemenyi test)]. However, both were significantly higher than that of grade Ⅱgroup of diffuse glioma [0.89 (0.76,1.07), P<0.05 (Nemenyi test)]. No significant difference was observed between astrocytic tumors and oligodendroglial tumors at the same grade. Conclusions:Hyperattenuation on unenhanced CT is highly specific for the diagnosis of brain tumors. Unenhanced CT plus MRI is more accurate for distinguishing the two entities in hypoattenuation lesion on unenhanced CT.

COPD identification using maximum intensity projection of lung field CT images and deep convolution neural network / 中华健康管理学杂志

Objective:To propose a model using the maximum intensity projection (MIP) of lung field computed tomography (CT) images and deep convolution neural network (CNN) and explore its value in identifying chronic obstructive pulmonary disease (COPD).Methods:A total of 201 subjects were selected from the Second Hospital of Dalian Medical University from January 2010 to May 2021. All subjects were included according to the inclusion criteria and were divided into COPD group (101 cases) and healthy controls group (100 cases). Each patient underwent a high-resolution CT scan of the chest and pulmonary function test. First, the lung field was extracted from CT images and the intrapulmonary MIP images were acquired. Second, with these MIP images as input, the model for identifying COPD was constructed based on a modified residual network (ResNet). Finally, the influence of the number of residual blocks on the performance of the models was investigated. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the identification efficiency.Results:The accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of ResNet26 was 76.1%, 76.2%, 76.0%, 76.2%, and 76.0%, respectively; and the AUC of the test was 0.855 (95% CI: 0.799-0.901). The accuracy, sensitivity, specificity, PPV, NPV of ResNet50 was 77.6%, 76.2%, 79.0%, 78.6%, and 76.7%, respectively; and the AUC of the test was 0.854 (95% CI: 0.797-0.900). The accuracy, sensitivity, specificity, PPV, NPV of ResNet26d was 82.1%, 83.2%, 81.0%, 81.6%, and 82.7%, respectively; and the AUC of the test was 0.885 (95% CI: 0.830-0.926). Conclusions:The COPD identification model via MIP images from CT images within the lung and deep CNN is successfully constructed and achieves accurate COPD identification. And it can provide an effective tool for COPD screening.

Accuracy of Intraoral Scanners and Conventional pressions in Full-Arches: A Systematic Review

ABSTRACT: The aim of this study was to evaluate intraoral scanners accuracy in full-arches, comparing them with conventional impressions. A scientific research performed in MEDLINE, EBSCOhost, and SciELO databases was conducted to analyze articles published between 2015 and 2020. Clinical and in vitro studies that evaluated accuracy (precision and trueness) from intraoral scanners and conventional impressions in full-arches were included. Two tests were applied to evaluate the methodological bias from the studies. Out of the 191 articles found, seven of them were selected for a qualitative analysis. In clinical studies,intraoral scanners CEREC Omnicam and 3Shape TRIOS Colorhad the highest precision compared to conventional irreversible hydrocolloid impressions. In in vitro studies, conventional polyvinyl siloxane impressions showed the highest accuracy, followed by intraoral scanners Cadent iTero and CEREC Omnicam, while irreversible hydrocolloid impressions showed the lowest accuracy. Digital intraoral impression systems do not show superior accuracycompared to highly accurate conventional impression techniques. However, they provide excellent clinical results and both methods are clinically accepted.

RESUMEN: El objetivo de este estudio fue evaluar la exactitud de escáneres intraorales en impresiones digitales de arco completo en comparación con las impresiones convencionales. Se realizó una revisión sistemática en las bases de datos MEDLINE, EBSCOhost y SciELO para analizar artículos publicados entre los años 2015 y 2020. Se incluyeron estudios clínicos e in vitro que evaluaran exactitud (precisión y/o veracidad) de escáneres intraorales impresiones convencionales en arcos completos. Dos pautas se aplicaron para evaluar el riesgo de sesgo de los estudios. De 191 artículos encontrados, 7 fueron seleccionados para un análisis cualitativo. En los estudios clínicos, los escáneres intraorales CEREC Omnicam y 3Shape TRIOS Color presentaron la mayor precisiónen comparación con las impresiones convencionales de hidrocoloide irreversible. En los estudios in vitro, las impresiones de polivinil siloxano presentaron la mayor exactitud seguido por los escáneres intraorales CadentiTero y CEREC Omnicam, mientras quelas impresiones de hidrocoloide irreversible presentaron la menor exactitud. Los sistemas de impresión digital intraoral no mostraron tener una exactitud superior comparados con las técnicas de impresión convencional de gran exactitud. Sin embargo, proveen excelentes resultados clínicos y ambos métodos son clínicamente aceptables.

Hemorragia adrenal bilateral en paciente recuperado de neumonía COVID-19 Grave: caso Radiológico / Bilateral adrenal hemorrhage after severe COVID-19 infection: report of one case

We report a 47-year-old male with a severe disease caused by COVID-19, who required mechanical ventilation for 18 ays. During the hospital stay he received dexamethasone and anticoagulation with heparin. After discharge a new chest CT scan showed homogeneous hypo vascular enlargement of both adrenal glands, not present in the initial imaging studies. It was interpreted as a subacute bilateral adrenal hemorrhage. The patient remained stable and without any complaint.

Preoperative computed tomography-guided localization of lung nodules with needle placement: a series of cases / Marcação pré-operatória de nódulo pulmonar com fio-guia orientado por tomografia computadorizada: uma série de casos

ABSTRACT Objective: to report the preoperative localization of pulmonary nodules with the placement of a guidewire oriented by Computed Tomography. Methods: the nodules were marked using a needle in the shape of a hook or another in the shape of a Q, guided by tomography. The choice of the location for the marking was the shortest distance from the chest wall to the nodule. The marking procedure was performed under local anesthesia and a tomographic control was obtained immediately at the end. Patients were referred to the operating room. Surgical resection occurred less than two hours after the needle placement. Results: between February 2017 and October 2019, 22 patients aged 43 to 82 years (mean 62.1) were included. The nodules had diameters that varied from 4 to 30 mm and the distance between the nodules and the pleural surface varied from 2 to 43 mm. The location and resection of the nodules were successfully performed in all cases. The guidewire was displaced in five cases. Five patients presented pneumothorax, with the space between the visceral and parietal pleura varying from 2 to 19 mm. In nine patients, an intraparenchymal hematoma of 6 to 35 mm in length was observed without signs, symptoms, or hemodynamic and ventilatory repercussions. The histopathological study was conclusive in all patients. Conclusions: the localization of pulmonary nodules through guidewires proved to be safe, reliable, and feasible in this series of cases. There was no need for surgical intervention to treat complications.

RESUMO Objetivo: relatar a marcação pré-operatória de nódulos pulmonares com o posicionamento de um fio-guia orientado por Tomografia Computadorizada. Métodos: os nódulos foram marcados utilizando-se agulha em formato de anzol ou outra em formato de Q, orientada por tomografia. A escolha do local para a realização da marcação foi o de menor distância da parede torácica até à lesão. O procedimento de marcação foi realizado sob anestesia local e controle tomográfico foi obtido imediatamente ao término da marcação. Os pacientes foram encaminhados ao centro cirúrgico. A ressecção cirúrgica ocorreu em tempo inferior a duas horas após a marcação. Resultados: entre fevereiro de 2017 e outubro de 2019, 22 pacientes, com faixa etária entre 43 e 82 anos (média 62,1) foram incluídos. Os nódulos apresentavam diâmetros que variaram de 4 a 30mm e, a distância entre os nódulos e a superfície pleural variou de 2 a 43mm. A localização e a resseção dos nódulos foram realizadas com sucesso em todos os casos. Houve deslocamento do fio-guia em cinco casos. Cinco pacientes apresentaram pneumotóraces, com o espaço entre as pleuras visceral e parietal variando de 2 a 19mm. Em nove pacientes, foi observado hematoma intraparenquimatoso com 6 a 35mm de extensão sem sinais, sintomas ou repercussão hemodinâmica e ventilatória. O estudo histopatológico foi conclusivo em todos os pacientes. Conclusões: a marcação de nódulos pulmonares por meio de fios marcadores se mostrou segura, confiável e factível nesta série de casos. Não houve necessidade de intervenção para o tratamento de complicações associadas ao método.

Intraoral scanners: A narrative review

Objectives: Accurate impressions are essential in fabricating dental restorations and fixed dental prostheses. During the last decade, digital impression systems have improved substantially. The objective of this narrative review is to discuss the recent research on intraoral scanners with regards to it's technology, accuracy and applications for fabrication of dental restorations and fixed dental prostheses. Materials and methods: A search strategy was performed in MEDLINE/PubMed, Scopus and Google Scholar with keywords - intraoral scanners, accuracy, applications, dentistry. Results: 395 articles were retrieved. After hand search a total of 415 articles were identified. Ultimately, 30 articles were selected and summarized and discussed as they met the selection criteria. Conclusion: Within the scope of this review, reported literature showed that digital intra-oral impressions have presented an achievement in the dental market as they reduce time required and simplify the clinical procedures with better communication with the technician and the patient. The current intraoral scanners (IOS) are sufficiently accurate for capturing impressions for fabrication of prosthetic restorations (inlays/onlays, copings and frameworks, single crowns and fixed partial dentures) on both natural teeth and implants; in addition, they can be used for smile design, and to fabricate posts and cores, removable partial prostheses, obturators, orthodontic aligners and custom made devices. The use of IOS in long-span restorations with natural teeth or implants is still a challenge.

Influence of trueness for local finish lines of a full crown preparation on that of complete finish line / 北京大学学报(医学版)

OBJECTIVE@#To investigate the factors affecting the trueness of finish lines of full crown preparations in digital impressions.@*METHODS@#A full crown preparation of the right maxillary molar was prepared on the standard resin dentition model, the trueness of the finish lines, the full crown preparation in the whole dentition and the isolated full crown preparation were measured respectively. Detection of scanning trueness of the finish lines of the full crown preparation in the whole dentition: (1) Using Imetric scanner to scan the full crown preparation, obtaining STL (Stereo lithographic) format data as the reference true value; (2) Using CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner to scan the full crown preparation, obtaining all the STL format data, import Geomagic Studio 2013 software, extraction of images and data of the complete finish lines or local finish lines (mesial, distal, buccal, lingual) of the full crown preparation, then using the data to 3D Compare Analysis with the reference true value, outputting RMS (root mean square) values which could evaluate the scanning trueness, the lower RMS value was, the lower the trueness was. The detection of scanning trueness of the finish lines of the isolated full crown preparation: (1) the anterior and posterior adjacent teeth of the preparation were removed to establish the model of the isolated full crown preparation; (2) CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner were used to scan the isolated preparations, and each group was repeated 6 times. Data collection and analysis were the same as the first part, that is, detection of scanning trueness of finish lines of the full crown preparation in the whole dentition.@*RESULTS@#In the whole dentition, (1) the RMS value [(44±7) μm] of CEREC Omnicam oral scanner scanning complete finish lines was greater than that of 3Shape TRIOS oral scanner [(35±6) μm](P < 0.05). (2) the RMS values of the mesial [(45±9) μm], buccal [(38±3) μm] and lingual [(40±3) μm] finish lines in CEREC Omnicam oral scanner scanning were all lower than that in distal [(63±7) μm](P < 0.05), and the RMS values in mesial were higher than that in buccal and lingual (P>0.05). The RMS values of 3Shape TRIOS oral scanner scanning mesial and distal finish lines were significantly higher than those of the buccal and lingual side (P>0.05), in which:(45±8) μm in mesial, (50±10) μm in the distal, (33±8) μm in the buccal and (33±6) μm in the lingual side. The RMS value of CEREC Omnicam oral scanner scanning distal finish line was greater than that of 3Shape TRIOS oral scanner (P < 0.05). Without adjacent teeth, (1) the RMS values of the complete finish lines of CEREC Omnicam oral scanner and 3 Shape TRIOS oral scanner were significantly reduced (P < 0.05), including CEREC Omnicam oral scanner (34±3) μm and 3 Shape TRIOS oral scanner (26±4) μm; (2) the RMS values of the buccal and lingual finish lines of CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner showed no significant changes (P>0.05), among which, CEREC Omnicam oral scanner buccal (44±7) μm, lingual (43±3) μm, 3Shape TRIOS oral scanner buccal (29±5) μm, lingual (40±7) μm. The RMS values of CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner were significantly reduced and there was no significant difference between them (P>0.05). CEREC Omnicam oral scanner (32±8) μm and 3Shape TRIOS oral scanner (32±6) μm. The RMS values of the distal finish lines of CEREC Omnicam oral scanner and 3 Shape TRIOS oral scanner also decreased significantly (P < 0.05), and CEREC Omnicam oral scanner (38±3) μm decreased more significantly, similar to 3Shape TRIOS oral scanner (36±1) μm, P>0.05.@*CONCLUSION@#When adjacent teeth exist in the full crown preparation, the mesial and distal parts of the finish line will be blocked by adjacent teeth, which will affect the trueness of the local finish line, and ultimately reduce the trueness of the complete finish line.

Comparison of computed tomography angiography and digital subtraction angiography in hepatic artery anatomical variation / 中华普通外科杂志

Objective To compare computed tomography angiography (CTA) and digital subtraction angiography (DSA) in identifying anatomical variation of hepatic artery.Methods A retrospective analysis was made on 220 patients who underwent both CTA and DSA in our hospital.The volume rendering (VR) reconstruction of CTA images was performed.The image quality and the recognition of hepatic artery anatomic variation between CTA and DSA were compared.Results There was a significant difference in the image quality of hepatic artery between the two imaging methods (x2 =88.016,P =0.000),DSA was superior to CTA.There was no significant difference in the accuracy of hepatic artery anatomical identification between CTA and DSA (x2 =0.252,P =0.615).This study has found five other types of hepatic artery anatomical variation besides Micheles types.Conclusion The anatomical variation of hepatic artery is complex,and there are many other variations besides Micheles types.CTA,as a noninvasive method,can provide sufficient information for hepatic artery anatomy.

Imaging study of second sacral alar-iliac screw placement in adult degenerative scoliosis / 中华骨科杂志

Objective@#To discuss the imagingcharacteristics of S2AI screw trajectory in ADS patients.@*Methods@#Forty patients with degenerative scoliosis were scanned with Simens Sliding 40-slice spiral CT scanner. Three-dimensional scanning and reconstruction were performed in these patients with the scanning range including thoracolumbar spine, lumbar spine, lumbosacral region, pelvis and bilateral hip joints. The base of the lateral sacral crest on the midline between the lower edge of S1 dorsal foramina and the upper edge of S2 dorsal foramina was the starting point. The placement plane of S2AI screw trajectory was determined from the starting point to the lower margin of anterior inferior iliac spine. A 10mm diameter screw was the design template. A circle with a diameter of 5 mm as the center of the lowest point of the ilium inner cortex was made, and a tangent line from the starting point to the outer diameter of the circle (the inner part of the ilium) was selected as the axis of the screw trajectory. The lateral angle and the length of the axis of the screw trajectory and iliac width were measured in transverse plane. The caudal angle, the distance from the axis of the screw trajectory to iliosciatic notch, and the caudal angle, the distance from the axis of the screw trajectory to the upper edge of the acetabulum were measured in sagittal plane. These parameters were recorded and analyzed.@*Results@#The trajectory length of S2AI screw in ADS patients was 12.00±0.99 cm, the lateral angle was 41.24°±3.92°, the caudal angle was 27.73°±6.45°, and the distance from the axis of the screw trajectory to iliosciatic notch was 1.05±0.81 cm, the distance from the axis of the screw trajectory to the upper edge of the acetabulum was 1.85 ± 0.33 cm, and the iliac width was 2.12±1.65 cm. The trajectory length, lateral angle, caudal angle, distance from the axis of the screw trajectory to iliosciatic notch, distance from the axis of the screw trajectory to the upper edge of the acetabulum and iliac width of S2AI screw was respectively 12.40±0.83 cm, 39.47°±1.76°, 28.00°±6.39°, 1.08±0.32 cm, 1.76±0.34 cm, 2.26±0.25 cm in male patients, and was respectively 11.75±1.01 cm, 42.30°±4.48°, 27.56°±6.61°, 1.21±1.00 cm, 1.90±0.32 cm, 2.04±0.18 cm in female patients. The screw length and lateral angle had statistically difference between male and female patients(P<0.05). Compared with non-ADS patients in previous studies, female patients with ADS had significant differences in increased lateral angle and decreased caudal angle of S2AI screw.@*Conclusion@#There is ideal trajectory of S2AI screws in ADS patients. There was no significant difference of the length of S2AI screws between ADS patients and non-ADS population. Different direction was noticed in the placement of S2AI screws, especially in female patients. Increased lateral angle and decreased caudal angle would be obtained in the procedure of placing S2AI screws in female ADS patients during operation.

Accuracy of mandibular measurements of sexual dimorphism using stabilizer equipment

Abstract The objective of this investigation was to compare the accuracy of mandibular measurements using a stabilizer (MS) with gold standard computed tomography (GS) images. Sixty mandibles were studied. Werth TomoScope HV Compact® was used to obtain CT images (GS), and the MS was also used. Analysis of the CT scans was performed using the VG Studio Max software® (Volume Graphics GmbH, Heidelberg, Germany), and MS was used after the proper positioning of the mandible. Descriptive and paired t test measures were used, and a ROC curve was calculated, as well as sensibility and specificity. MedCalc and STATA 13.0® were used (95% level of significance). Bicondylar breadth, bicoronoid breadth and minimum ramus breadth reached the highest concordance correlation coefficients at 0.99 (0.99-1.00), 0.99 (0.99–1.00) and 1.00 (0.99–1.00), respectively. Comparing observers with GS, the lowest accuracy was noted for the maximum mandibular length [0.59 (0.45–0.69), 0.64 (0.51–0.74)], the breadth of the right (0.14 (0.04–0.23), 0.14 (0.004–0.24)) and left mandibular body [0.14 (0.03–0.24), 0.16 (0.05-0.26)], and the right [0.58 (0.45–0.69), 0.63 (0.51–0.73) and left (0.59 (0.45–0.70), 0.59 (0.46–0.69)] mandibular angle. Various measurements exhibited good sensibility for males using MS: maximum mandibular length (78.12), bicondylar breadth (78.12), left mandibular notch breadth (84.37), and the left height of the mandibular body at the mental foramen (75.00). High specificity in discriminating females was observed for the left maximal ramus height (85.19), mandibular length (85.71), bicoronoid breadth (96.43), right height of the mandibular body at the mental foramen (82.19), bimental breadth (78.57), breadth right (92.86) and left (96.43) mandibular body, minimum ramus breadth (89.29), and left mandibular angle (85.71). MS was able to discriminate sexual dimorphism.

Usefulness of Blood Cultures and Radiologic Imaging Studies in the Management of Patients with Community-Acquired Acute Pyelonephritis

BACKGROUND: The objective of this study was to examine the usefulness of blood cultures and radiologic imaging studies for developing therapeutic strategies in community-acquired acute pyelonephritis (CA-APN) patients. MATERIALS AND METHODS: We prospectively collected the clinical data of CA-APN patients who visited 11 hospitals from March 2010 to February 2011. RESULTS: Positive urine and blood cultures were obtained in 69.3% (568/820) and 42.7% (277/648), respectively, of a total of 827 CA-APN patients. Blood culture identified the urinary pathogen in 60 of 645 (9.3%) patients for whom both urine and blood cultures were performed; the organisms isolated from urine were inconsistent with those from blood in 11 and only blood cultures were positive in 49 patients. Final clinical failure was more common in the bacteremic patients than the non-bacteremic ones (8.0% vs. 2.7%, P = 0.003), as was hospital mortality (3.6% vs. 0.3%, P = 0.003). Likewise, durations of hospitalization and fever were significantly longer. Bacteremia was independent risk factor for mortality (OR 9.290, 1.145-75.392, P = 0.037). With regard to radiologic studies, the detection rate of APN was 84.4% (445/527) by abdominal computed tomography and 40% (72/180) by abdominal ultrasonography. Eighty-one of 683 patients (11.9%) were found to have renal abscess, perinephric abscess, urolithiasis, hydronephorosis/hydroureter or emphysematous cystitis, which could potentially impact on clinical management. Patients with Pitt score ≥ 1, flank pain or azotemia were significantly more likely to have such structural abnormalities. CONCLUSION: Blood cultures are clinically useful for diagnosis of CA-APN, and bacteremia is predictive factor for hospital mortality. Early radiologic imaging studies should be considered for CA-APN patients with Pitt scores ≥1, flank pain or azotemia.

Comparação entre medidas digitais obtidas por CBCT e por escaneamento de modelo ortodôntico / Comparison of digital measurements obtained by scanning and CBCT of orthodontic plaster models

O modelo ortodôntico é um dos principais auxiliares no diagnóstico da má-oclusão e na elaboração do plano de tratamento ortodôntico, pois nele é possível realizar análise de modelos checando-se possíveis discrepâncias entre diâmetro dos dentes e espaço presente na arcada, distâncias transversais, além da análise do tipo de má-oclusão, sendo fundamental na Ortodontia. Com o avanço da tecnologia, hoje é possível obter modelos digitais por meio de escaneamento ou tomografia computadorizada de feixe cônico (CBCT), sendo a forma digital uma nova alternativa de análise de tais modelos. Este estudo propôs comparar as imagens de modelos digitais obtidos de imagens de CBCT de modelos de gesso com os medidos por escaneamento. Foram digitalizados 15 modelos de gesso por CBCT com o tomógrafo i-CAT, e por escaneamento digital com o scanner XCAD; em seguida, foram medidos digitalmente utilizando o programa Geomagic Studio. Foram calculados os coeficientes de correlação intraclasse com intervalos de 95% de confiança para cada medida, para avaliar o erro aleatório. Apesar da concordância estatística baixa, houve uma pequena diferença numérica entre os métodos, demonstrando resultados semelhantes clinicamente.

As digital approach is a new option to analyze orthodontic models, this study aims to compare images from digital models obtained by CBCT of plaster dental models with those obtained by scanning methods. 15 plaster models were digitalized by CBCT using the i-CAT scanner and, also, by digital scanning, on the XCAD scanner. Soon after, they were digitally measured and read into the Geomagic Studio software. The intraclass correlation coefficients with 95% confidence intervals were calculated for each measurement to evaluate the random error. The statistical agreement between the 3D scanning and the CBCT methods is poor for the evaluated measurements, as all the intraclass correlation values were close to zero. The 95% confidence intervals pass through zero. The only exception is for the intercuspid width with CCI of 0.656. The highest absolute error between the mean values is the sum of the mesiodistal width of teeth (0.3 mm) and the smallest is the intercuspid width (0.01 mm). The mesiodistal width of teeth is higher for measurements obtained by CBCT than those obtained by 3D scanner, as most of the models presented higher values for measurements obtained by CBCT models. Despite the low statistical correlation, there was a small numeric difference between the methods, demonstrating clinically similar results.

Craniopharyngiomas : Radiological Differentiation of Two Types

OBJECTIVE: To determine imaging features that may separate adamantinomatous and papillary variants of craniopharyngiomas given that tumors with adamantinomatous signature features are associated with higher recurrence rates, morbidity, and mortality. We specifically reviewed calcification on CT, T1 bright signal intensity, and cystic change on T2 weighted images for differentiating these two types. METHODS: We retrospectively reviewed the MRI and CT studies in 38 consecutive patients with pathologically proven craniopharyngiomas between January 2004 and February 2014 for the presence of calcification on CT scans, bright signal intensity on T1 weighted images, and cystic change on T2 weighted images. RESULTS: Of the 38 craniopharyngiomas, 30 were adamantinomatous type and 8 were papillary type. On CT scans, calcification was present in 25 of 38 tumors. All calcified tumors were adamantinomatous type. Twenty four of 38 tumors had bright signal intensity on T1 weighted images. Of these 24 tumors, 22 (91.7%) were adamantinomatous and 2 were papillary type. Cystic change on T2 weighted images was noted in 37 of 38 tumors; only 1 tumor with papillary type did not show cystic change. CONCLUSION: T1 bright signal intensity and calcification on CT scans uniformly favor the adamantinomatous type over papillary type of craniopharyngioma in children. However, these findings are more variable in adults where calcification and T1 bright signal intensity occur in 70.6% and 58.8% respectively of adult adamantinomatous types of craniopharyngiomas.

Evaluation of Semi-automatic Segmentation Methods for Persistent Ground Glass Nodules on Thin-Section CT Scans / 대한의료정보학회지

OBJECTIVES: This work was a comparative study that aimed to find a proper method for accurately segmenting persistent ground glass nodules (GGN) in thin-section computed tomography (CT) images after detecting them. METHODS: To do this, we first applied five types of semi-automatic segmentation methods (i.e., level-set-based active contour model, localized region-based active contour model, seeded region growing, K-means clustering, and fuzzy C-means clustering) to preprocessed GGN images, respectively. Then, to measure the similarities, we calculated the Dice coefficient of the segmented area using each semiautomatic method with the result of the manually segmented area by two radiologists. RESULTS: Comparison experiments were performed using 40 persistent GGNs. In our experiment, the mean Dice coefficient for each semiautomatic segmentation tool with manually segmented area was 0.808 for the level-set-based active contour model, 0.8001 for the localized region-based active contour model, 0.629 for seeded region growing, 0.7953 for K-means clustering, and 0.7999 for fuzzy C-means clustering, respectively. CONCLUSIONS: The level-set-based active contour model algorithm showed the best performance, which was most similar to the result of manual segmentation by two radiologists. From the differentiation between the normal parenchyma and the nodule, it was also the most efficient. Effective segmentation methods will be essential for the development of computer-aided diagnosis systems for more accurate early diagnosis and prognosis of lung cancer in thin-section CT images.

Clinical Utility of Angiographic CT with a Flat-detector Angiographic System during Endovascular Procedure

OBJECTIVE: We evaluated the feasibility of angiographic computed tomography (ACT) for visualizing stent material in patients who underwent intracranial or extracranial stent placement to treat atherosclerotic lesions or stent assisted coil embolization. MATERIALS AND METHODS: We performed intrarterial and intravenous ACT on biplane angiography system equipped with flat panel detectors (Axiom Arits dBA; Siemens Medical Solutions, Forchheim, Germany). Vistipaque 320 was injected for contrast medium, total 150 mL at flow rate of 5 mL/s through artery and 77 mL at flow rate of 3.5 mL/s through vein. RESULTS: ACT is a new imaging modality that provides a clear visualization of stent strut. CONCLUSION: Therefore this new application has potential to become the noninvasive option for follow-up after endovascular surgery using stents.

Accuracy and precision of integumental linear dimensions in a three-dimensional facial imaging system / 대한치과교정학회지

OBJECTIVE: A recently developed facial scanning method uses three-dimensional (3D) surface imaging with a light-emitting diode. Such scanning enables surface data to be captured in high-resolution color and at relatively fast speeds. The purpose of this study was to evaluate the accuracy and precision of 3D images obtained using the Morpheus 3D(R) scanner (Morpheus Co., Seoul, Korea). METHODS: The sample comprised 30 subjects aged 24-34 years (mean 29.0 +/- 2.5 years). To test the correlation between direct and 3D image measurements, 21 landmarks were labeled on the face of each subject. Sixteen direct measurements were obtained twice using digital calipers; the same measurements were then made on two sets of 3D facial images. The mean values of measurements obtained from both methods were compared. To investigate the precision, a comparison was made between two sets of measurements taken with each method. RESULTS: When comparing the variables from both methods, five of the 16 possible anthropometric variables were found to be significantly different. However, in 12 of the 16 cases, the mean difference was under 1 mm. The average value of the differences for all variables was 0.75 mm. Precision was high in both methods, with error magnitudes under 0.5 mm. CONCLUSIONS: 3D scanning images have high levels of precision and fairly good congruence with traditional anthropometry methods, with mean differences of less than 1 mm. 3D surface imaging using the Morpheus 3D(R) scanner is therefore a clinically acceptable method of recording facial integumental data.

Hallazgos tomográficos en pacientes con tumores orbitarios / Tomographic Findings in Patients with Orbital Tumors in Holguin

Introducción: los tumores de la órbita son infrecuentes, pueden originarse en las paredes o en el contenido de la órbita o desde las cavidades próximas. Las técnicas de imagen y sobre todo la tomografía axial computarizada, son una herramienta indispensable en el conocimiento de las enfermedades oftalmológicas. Objetivo: describir los hallazgos tomográficos en pacientes con tumores orbitarios. Métodos: se realizó un estudio de serie de casos a pacientes con tumores de órbita procedentes de la Consulta Provincial de Oftalmología del Hospital Vladimir Ilich Lenin en el período comprendido de enero 2009-enero 2010 en estrecha relación con los Servicios de Imagenología y Anatomía Patológica. El Universo quedó constituido por 17 pacientes, previo consentimiento informado, con diagnóstico clínico de tumores de órbita atendidos en la Consulta de Oftalmología y que no reportaron alergia al contraste. Resultados: existió un predominio del grupo de edad de 51 a 60 años con cinco casos para el 29,4 %. Prevaleció como signo al examen físico, el exoftalmos y la proptosis constituyó el hallazgo tomográfico más frecuente (76,4 %). La localización extraconal de los procesos orbitarios fue la predominante (9 pacientes con el 52,9 %), así como, las lesiones heterogéneas (14 casos para el 82,3 %). Conclusiones: La tomografía axial computarizada constituyó el método imagenológico de elección en todos los pacientes con sospecha clínica de tumores orbitarios pues permitió identificar la localización, presencia de proptosis y estructura de las lesiones tumorales.

Introduction: orbital tumors are rare and can arise in the walls or in the content of the orbit or from the closest cavities. Imaging techniques and especially computed tomography is an indispensable tool in understanding ophthalmic diseases. Objective: describe the tomography findings in patients with orbital tumors. Methods: a descriptive and prospective study was carried out comprising a series of cases of patients from the provincial doctor´s ophthalmology office at Vladimir Ilich Lenin Hospital, who presented orbit tumor during the period from January 2009 to January 2010, in conjunction with the radiology and pathological anatomy services. The sample was made up of 17 patients seen at the ophthalmology consultation, all of who had been diagnosed with orbital tumors and who were not allergic to the contrast. Results: the age group between 51 to 60 years old predominated over the rest of the patients (5 cases to 29.4 %). Exophthalmus was the prevailing sign upon physical examination and protosis was the most frequent tomography finding (13 patients to 76.4 %). The extraconal location of the orbital processes prevailed (9 patients to 52.9 %), as well as heterogeneous lesions that (14 cases to 82.3 %). Conclusion: CT Scan (computed Tomography) constitutes the imaging method of choice in all patients who are clinically suspected to present orbital tumors because it allows to identify the location, proptosis presence and the structure of the tumoral lesions.

Björk-Jarabak cephalometric analysis on CBCT synthesized cephalograms with different dentofacial sagittal skeletal patterns

OBJECTIVE: The objective of this study was to evaluate the Björk and Jabarak cephalometric analysis generated from cone-beam computed tomography (CBCT) synthesized lateral cephalograms in adults with different sagittal skeletal patterns. METHODS: The sample consisted of 46 CBCT synthesized cephalograms obtained from patients between 16 and 40 years old. A Björk and Jarabak cephalometric analysis among different sagittal skeletal classes was performed. Analysis of variance (ANOVA), multiple range test of Tukey, Kruskal-Wallis test, and independent t-test were used as appropriate. RESULTS: In comparison to the standard values: Skeletal Class III had increased gonial and superior gonial angles (P < 0.001). This trend was also evident when sex was considered. For Class I males, the sella angle was decreased (P = 0.041), articular angle increased (P = 0.027) and gonial angle decreased (P = 0.002); whereas for Class III males, the gonial angle was increased (P = 0.012). For Class I females, the articular angle was increased (P = 0.029) and the gonial angle decreased (P = 0.004). Björk's sum and Björk and Jabarak polygon sum showed no significant differences. The facial biotype presented in the three sagittal classes was mainly hypodivergent and neutral. CONCLUSIONS: In this sample, skeletal Class III malocclusion was strongly differentiated from the other sagittal classes, specifically in the mandible, as calculated through Björk and Jarabak analysis. .

OBJETIVO: o objetivo deste estudo foi avaliar a análise cefalométrica de Björk-Jarabak realizada com base em telerradiografias sintetizadas a partir de tomografia computadorizada de feixe cônico (TCFC) em adultos com diferentes padrões esqueléticos sagitais. MÉTODOS: a amostra foi composta de 46 telerradiografias sintetizadas a partir de TCFC obtidas de pacientes entre 16 e 40 anos de idade. A análise cefalométrica de Björk-Jarabak foi conduzida entre as diferentes classes esqueléticas sagitais. Análise de variância (ANOVA), teste de Tukey, de Kruskal-Wallis e teste t independente também foram realizados. RESULTADOS: em comparação a valores padrão, a má oclusão de Classe III esquelética apresentava ângulos goníacos aumentados (p < 0,001). Essa tendência também foi evidente quando o sexo dos pacientes foi considerado. Pacientes Classe I do sexo masculino tiveram o ângulo sela diminuído (p = 0,041), o ângulo articular aumentado (p = 0,027) e o ângulo goníaco também diminuído (p = 0,002). Já os pacientes Classe III tiveram o ângulo goníaco aumentado (p = 0,012). Pacientes Classe I do sexo feminino tiveram o ângulo articular aumentado (p = 0,029) e o ângulo goníaco diminuído (p = 0,004). A soma de Björk e a soma dos polígonos de Björk-Jarabak não revelaram diferenças significativas. O biótipo facial presente nas três classes sagitais foi hipodivergente e neutro. CONCLUSÕES: na amostra do presente estudo, a má oclusão esquelética de Classe III foi fortemente diferenciada de outras classes sagitais, ...