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Objective:To discuss the application of virtual endoscopy in the diagnosis of adenoid hypertrophy and the morphologic classification of adenoid. Methods:The clinical data of 97 children with adenoid hypertrophy admitted to Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University General Hospital from July 2022 to December 2022 were collected. The virtual endoscopic reconstruction of the nasopharynx was performed by cone beam computed tomography. The results of virtual endoscopic adenoid size measurement were compared with the results of nasopharyngeal CT median sagittal position and nasopharyngeal endoscopy. Virtual endoscopic classification of adenoid based on the size of the adenoids and their relationship with the torus tubarius. Results:The t-test results of the size of adenoids measured by virtual endoscopy and nasopharyngeal CT were t=1.699 and P=0.093, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.921 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal CT was highly consistent. The t-test results of the size of adenoids measured virtual endoscopy and nasopharyngeal endoscopy were t=1.543 and P=0.15, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.900 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal endoscopy was highly consistent. Among the 97 children, the morphological classification results of adenoids were 48 cases of overall hypertrophy type, 47 cases of central bulge type, and 2 cases of flat thickening type. Conclusion:The diagnosis of adenoid hypertrophy by virtual endoscopy has high accuracy, which not only avoids the invasive operation of traditional nasopharyngeal endoscopy, but also can observe the adenoid condition and its relationship with the torus tubarius from multiple angles. And, the morphological classification of adenoids using virtual endoscopy has guiding significance for perioperative preparation.
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Child , Humans , Adenoids/surgery , Nasopharynx/diagnostic imaging , Adenoidectomy , Endoscopy/methods , Hypertrophy/surgeryABSTRACT
Objective To explore the clinical efficacy and application value of CT virtual endoscopy (CTVE) in endoscopic resection of pituitary via transsphenoidal approach. Methods From January 2015 to December 2017, 21 patients with pituitary adenomas undergoing endoscopic transsphenoidal approach surgery were selected. All the patients were performed CT scan with GE64 spiral CT before operation, then reconstructed by CTVE. The preoperative CTVE simulated images and the observed images in the operation were compared, and the consistency of the 2 images was analyzed. Results CTVE simulated images and the observed images in the operation showed good consistency in the ratings of sphenoid sinus opening, optic canal protuberance, internal carotid artery protuberance and optic canal internal carotid recess (O-C recess) ( Kappa ＝ 0.774, 0.912, 0.959 and 0.958); and general consistency in the ratings of septum of sphenoid sinus, sellar floor and ramp recess ( Kappa＝0.479, 0.691 and 0.721). Conclusions CTVE technology can accurately simulate the reconstruction of the important anatomical structure of the saddle area before operation, which helps to design the operation plan and improve the curative effect and safety of the operation; this technique also helps to learn and master the endoscope technology.
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Bronchoscopy has been an important tool for clinicians. Based on the traditional training, this research tries to introduce microteaching combined with simulated bronchoscope, strengthens the chest CT reading training, standardizes operation practices, which significantly improve the operation speed, flex-ibility and accuracy, shorten the training cycle of the novices. This medical teaching method are effective to contribute the novices to master the operation skill of bronchoscopy.
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Objective To explore the diagnostic value of capsule endoscopy and small bowel CT virtual endoscopy( CTVE) in identifying of small intestinal diseases. Methods Fifty?five cases patients of suspected small intestinal diseases who were treated by Capsule endoscopy and small bowel CTVE examination in the Affili?ated Hospital of North China University of Science&Technology and Kailuan Majiagou Mine Hospital from Janu?ary 2009 to December 2015 were chosen. The detection rate and diagnostic accuracy of small bowel disease were compared between the two methods. Results There was no significant difference in the detection rate of CTVE and capsule endoscopy( 80. 7% vs. 89. 5%,P=0. 719) . There was significant difference in the accuracy of CTVE and capsule endoscopy in the diagnosis of small intestinal non space occupying lesions ( 60. 7% vs. 89. 3%, P=0. 040) . The correct rate of diagnosis of small bowel lesions was 93. 1% in CTVE,and 51. 7% in capsule en?doscopy,there was statistically significant difference between the two ways( P=0. 032) . Conclusion Capsule endoscopy and CTVE are both non invasive tests,the operation is simple,safe,and the patients are easy to ac?cept,and they are both helpful in the diagnosis of small bowel diseases. Capsule endoscopy has an advantage in the diagnosis of small bowel lesions,while CTVE is superior to capsule endoscopy in terms of small bowel occup?ying lesions. Combined use of the two ways can improve the diagnostic rate of small bowel disease.
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Multidetector CT (MDCT) gastrography has been regarded as a promising technique for the preoperative imaging of gastric cancer. It has the ability to produce various three-dimensional (3D) images. Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging. In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies. In this article, we discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin.
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Humans , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Neoplasm Staging , Stomach Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
Objective To investigate the diagnostic value of CT virtual endoscopy on the small intestine (CTVE)technology for intestinal diseases. Methods Forty-nine cases with suspected small bowel disease were tested by CTVE from December 2010 to February 2014. They also were performed. Results Of 49 patients, operation or electronic endoscopy showed that 9 cases were benign tumors,29 cases with malignant tumors,3 cases with intestinal polyps,4 cases with intestinal inflammation,2 cases with bowel dysfunction and 2 cases with normal intestinal. CTVE test showed that 11 cases were with benign tumors,29 cases with malignant tumors,2 cases with intestinal inflammation,1 case with intestinal polyps,4 cases with intestinal dysfunction and 2 cases with normal small intestine. Better consistency between the two diagnosis was seen(Kappa = 0. 70). The accurate rate of diagnosis was 85. 71%(42 / 49). The correct rate of CTVE diagnosis of space occupying lesions was 90. 24%(37 / 41). The correct rate of non occupied lesions was 50. 00%(3 / 6). Conclusion CTVE technology has the advantages of simple operation,safe,painless,and clinical diagnosis of small bowel disease rate is higher especially for small bowel accounted disease. It is worthy of clinical application.
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Objective To assess the diagnostic value of capsule endoscopy (CE) and CT virtual endoscopy (CTVE) for small intestinal diseases.Methods The data of 31 patients with suspected small bowel diseases who were examined by both CTVE and CE were collected.The diagnostic rates of CE and CTVE was compared by paired data McNemar test,using the diagnosis confirmed by surgery or follow-up as the golden standard.Results The confirmed diagnosis of 31 patients were small intestinal tumor in 16,nontumorous lesion in 10 and no abnormal lesion in 5.CE identified positive findings in 24 patients,including 14 cases of tumorous lesion (with mis-location in 2 and failure in definite diagnosis in 7) and 10 cases of non-tumorous lesion.CTVE identified positive findings in 17 patients,including 14 cases of tumorous lesion (with mis-location in 1 and failure in definite diagnosis in 4) and 3 cases of non-tumorous lesion.The combination of CE and CTVE could identified positive findings in 26 patients,including 16 tumorous and 10 nontumorous lesions.The diagnostic rates of CE and CTVE for tumorous lesions were both 87.5％ (14/16).The overall diagnostic rate of combined CE and CTVE was 83.9％ (26/31),which was significantly higher than that of CTVE alone (54.8％,17/31) but similar to that of CE alone (77.4％,24/31).Conclusion Both CE and CTVE are effective in diagnosis of small intestinal lesions and the combined use of 2 methods can increase diagnosis yield.
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Objective To evaluate 64-MSCT virtual endoscopy in the examination method,displaying ability and clinical application of colon lesions.Methods Compared the results of 49 cases of patients examined with 64-MSCT with that got from Coloscopy,and statistical analysis was conducted.Results A total of 19 cases of adenocarcinoma and 2 cases of colonic diverticula as well as 44 cases of adenomatous polyp were detected.The display rate of polyps was 100％ in which was larger than 10mm,73％ in which was range of 5 ～ 10mm in size and 50％ in which was smaller than 5mm.Conclusion As an relatively noninvasive examination method,64-MSCT virtual endoscopy is concordant with onventional colonoscopy in the aspect of detectable rate and revealing the lesion morphologic and can be used as an important examination measure in the diagnosis for colonic diseases.
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ObjectiveTo investigate the diagnostic value of multi-slice spiral CT (MSCT) 3D reconstruction and virtual endoscope technology on ear temporal diseases.MethodsOne hundred and forty patients suspected with ear temporal diseases were examined with MSCT,and all the scanned images were 3D reconstructed and processed by virtual endoscopy.ResultsIn 140 patients,97 cases were detected with ear temporal disease,including 58 cases with acute and chronic otitis media,20 cases with artificially cochlear placement evaluation,2 cases with concha and middle ear malformations and 17 cases with temporal bone injury.MSCT 3D reconstruction and virtual endoscope technology could clearly show the location,scope and form of the lesions and structure relationships with nearby tissues.ConclusionsMSCT 3D reconstruction and virtual endoscope technology have important value on diagnosing ear temporal diseases.
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ObjectiveTo explore the value of CT virtual endoscopy in the treatment strategies in low rectal cancer surgery.MethodsFifty- seven cases of rectal cancer in Jining First Hospital were collected,preoperative rectum CT virtual endoscopy,detailed records of patients with rectal invasion and the circumstances surrounding lymph nodes were investigated.Differences were compared in patients after routine pathological examination.And the distance of the tumor from the anal margin was compared with the preoperative rectum on rectal examination and rectal CT virtual endoscopy.ResultsPreoperative rectum CT virtual endoscopy had no significant difference in evaluation of metastases of the surrounding lymph nodes.Compared with postoperative pathological examination( x2 =2.5,P ＞ 0.05 ),while had significant difference in evaluation in perirectal infiltration( x2 =4.44,P ＜ 0.05 ).Rectal examination and rectum CT virtual endoscopy had no significant difference judgement of the tumor from the anal margin ( P ＞ 0.05 ).ConclusionsCT virtual endoscopy has a great significance in the preoperative evaluation of rectal cancer surgical treatment strategies,which should be further studied.
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Objective To investigate the technique and method of MSCT in examination of laryngeal. Methods MSCT data of 28 patients with laryngeal carcinoma confirmed pathologically were analyzed retrospectively. Images quality was evaluated and the results obtained with various windows and CT virtual larynscopy were compared. Results All images had good quality,20 cases(69% ) could be displayed with conventional soft tissue windows,24 cases(81% ) could be demonstrated with lung windows,and 27 cases(93% ) could be demonstrated with CT virtual larynscopy. Conclusion The multislice CT could effectively demonstrate laryngeal carcinoma, and could be applied routinely in examination of laryngeal carcinoma.
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Both heterotaxia and intraluminal duodenal diverticulum (IDD) are uncommon congenital anomalies. Heterotaxia is a group of situs anomalies and IDD is a type of duodenal atresia. Heterotaxia is commonly associated with intraabdominal abnormalities causing intestinal obstruction, but heterotaxia with IDD is extremely rare. Herein we report a case of 21-year-old female who presented with symptoms of duodenal obstruction due to IDD associated with heterotaxia. This is the second case found as a result of a search through PubMed. We first used 3-dimentional virtual computed tomograph endoscopy for making the diagnosis and the treatment plan of this patient.
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Female , Humans , Young Adult , Diverticulum , Duodenal Obstruction , Endoscopy , Intestinal ObstructionABSTRACT
Objective To research the visualization of congenital heart disease by three-dimensional echocardiographic(3DE) virtual endoscopy(VE) system. Methods Datasets.from 10 healthy children and 22 patients with congenital heart disease were collected (10 patients with atrial septal defects, 6 patients with ventricular septal defects and 6 patients with tetralogy of Fallot). 3DE heart models were reconstructed by virtual reality computing techniques and visualization in scientific computing techniques. The VE system was programmed under the C++ 6.0 language condition,the visualization toolkit (VTK) platform was employed to carry out the graphics and visualization utilities. The virtual eye can move along the navigation paths in the heart by manual camera movements. Results The VE can provide special information in aspects of intracardiac anatomy, The visible heart models show precisely complex anatomy structure and spatial relationships. 3DE intracardiac endoscopic imaging can thus be visualized and navigated successfully by the VE system. Conclusions 3DE VE is a new system for the visualization of congenital heart disease.
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Objective To determine the diagnostic value of double-phase enhancement and virtual endoscopy with multi-slice spiral CT (MSCT) on clinical staging of preoperative bladder cancer.Methods Seventy-five patients with bladder cancer diagnosed by fibercystoscope or operation. All of them were examined by double-phase enhancement and virtual endoscopy with MSCT. The images were analyzed and clinical staging were obtained. The findings of MSCT (71 cases)were compared with the post-operative histopathological results. Results There were 94 lesions to be found. The staging of MSCT: T1 26 cases,T2, 27 cases, T2b 13 cases, T3 12 cases, T4 16 cases. Histopathological results: pT1 28 cases, pT2a 24 cases, pT2b 14 cases, pT3 12 cases, pT4 16 cases. The sensitivity of preoperative staging on bladder cancer was 89.4 % (84/94) by double-phase enhancement of MSCT;the sensitivity of virtual endoscopy was 96.6% (84/87)for polyploidy tumors and 90. 9 % (10/11) for sessile lesions. When double-phase enhancement and virtual images were evaluated together, the sensitivity rate increased to 94.5%. When the tumors were confined within the bladder wall (≤T2b), the diagnostic accuracy of double-phase enhancement and virtual images was 91.2% (51/56). When the tumors had invaded the tissues and organs beyond the bladder wall (≥T3), the accuracy was 100% (28/28). Conclusion Double-phase enhancement and virtual endoscopy of MSCT is of great value in clinical staging of bladder cancer.
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@#Objective To evaluate the value of CT virtual endoscopy(CTVE)for microsurgery of pituitary microadenomas via transsphenoidal approach.Methods In 18 patients with pituitary micmadenomas underwent microsurgery via transsphenoidal approach,the presurgical CT data was transfered to work station,the anatomies of the sphenoid sinus were then reconstructed by CTVE.The CTVE images were used to make the preoperative planning and indentify sphenoid sinus, sellar floor,and the position of the tumor during surgery.The CTVE images and the views from intraoperative microscope were compared. Results CTVE could display the anotomoties of sphenoid sinus in a three-dimentional mode.The display rates of superfical antomies such as sphenoid septa,sellar floor,carotid prominence,optic prominence and opticocarotid recess were 344.4%,100%,41.7%,36.1%and 58.3%respectively and the visual fields of these anatomic landmarks were larger than the views from the intraoperative microscope. CTVE could depcit the anatomies of the enhanced carotid ateries and pituitary tissue and some optic canals underlying the sellae by transparent function or heighten the threshold.The sites of the tumor could be marked correctly on CTVE images.CTVE could simulate the operative approach and some operating procedures properatively. Conclusion CTVE can display the anatomies of sphenoid sinus in a three-dimensional mode. In transsphenoidal treatment of pituitary microadenoma,CTVE can help to make preoperative planning,locate the intraoperative structures and make a precise bone window during surgery.
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Objective To compare the different effect of two gastric tube insertion methods in pa-dents undergoing computed tomographic virtual endoscopy. Methods 56 patients undergoing computed tomographic virtual endoscopy were randomly divided into group A and B according to gastric tube insertion methods, group A inserted gastric tube to descending duodenum by gastroscope, group B inserted by Jag precursor via nose. One- time success rate and the incidence rate of side effect were compared between the two groups. X2 test was adopted. Results One- time success rate of group A and B was 33.3%, 82.9% respectively, with obvious statistic difference. The incidence rate of side effect of group A was higher than that of group B. Conclusions Inserting gastric tube to descending duodenum by Jag precursor via nose is convenient, time- saving, causing less pain and resulting in higher success rate.
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3D visualized reconstruction of human hollow structures from noninvasive medical imaging data is very important to medical diagnosis of the inner surface of hollow structures,medical education and surgical planning.However,due to the particular structures and characteristics of hollows,how to exactly and intuitively visualize the 3D structure and shape of the inner surface of a hollow structure is still a difficult issue in the field of medical visualization.A review of recent development of visualization techniques for human hollow structures is given in this article.Techniques including virtual endoscopy,virtual flattening,virtual cutting and color mapping ale described and compared.The advantages and disadvantages of each technology are pointed out.The future development of visualization techniques for hollow structures is also discussed.
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Objective To develop a virtual endoscopy system which can be integrated into PACS.Methods Key techniques on virtual endoscopy were researched and we implemented a virtual endoscopy system with the help of the Visualization Toolkit VTK.Results The Virtual endoscopy system was integrated into PACS and the post-processing function of PACS was advanced.Conclusion As a novel medical image post-processing technology,virtual endoscopy provides a completely non-invaded inspection,so it has broad application prospects in the computer-aided medical teaching,surgical navigation,surgical planning and clinical diagnosis.
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Objective To evaluate spiral CT scanning and CT virtual endoscopy(CTVE) in the clinical diagnosis of gastric carcinoma.Methods Spiral CT scan was performed in 28 patients with pathologically-proved gastric cancer . The CT scan parameters were : collimating width 5 mm , Pitch 1 . The volumetric data were acquired using a spiral CT scanner and transferred to computer workstation . CTVE was performed by navigator smooth function . The results were compared with the findings of fiberoptic endoscopy and/or surgery .Results Spiral CT scan could demonstrate the location ,size,extension of lesions and the relation with organs around .In 28 patients,CT findings included omentum involvement(n=7),pancreatic ivolvement (n=4),hepatic involvement (n=3),lymph node metastasis(n=3). CTVE could clearly demonstrate the three-dimensional image of normal wall stomach and the lesions , size and extension of lesions . The appearances of the inner lesions and normal wall of stomach on CTVE were similar to those on fiberoptic endoscopy and/or surgery . The accuracy in detecting lesion by CTVE was 92.8% in 28 patients . Conclusion CTVE combination with spiral CT scan is of great value in clinical diagnosis of gastric carcinoma .
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Objective To discuss the clinical values of virtual endoscopy (VE) using multislice computed tomography (MSCT) in diagnosis of the aorta and iliac artery diseases.Methods MSCT angiography in 36 cases suspected of the aorta and iliac artery diseases and 40 cases underwent abdominal examination were performed, then all CT virtual endoscopy (CTVE) were obtained at the vessel with suspected lesions on work-station, and the relations between the quality of images and scanning parameters were observed.Results All internal and dual-cavity were seen in 10 cases of aortic dissection; enlarged cavity of aneurysm were showed in 16 aortic aneurysms. Calcification plaques were displayed in 48 cases. One endograft and one postoperative aorta were seen the morphology and the location of stenosis. One case of iliac artery obstruction was displayed obstructive cavity on the image of CT virtual endoscopy.Conclusion The quality of CT virtual endoscopy is related to the scanning technique,scanning parameters, motion aritiact. CT vitrtual endoscopy is the important complementary to maximum intensity projection, multiplannar reformation, surface shadow display, and axial images, and has high value in the diagnosis, treatment, and follow-up of the aortic diseases