Imaging-anatomic Measurements of Carotid Artery Bifurcation

ABSTRACT Objective: To have anatomic measurements of carotid artery bifurcation (CAB) with 64-spiral computed tomography angiography (64-SCTA), and provide anatomic basis for related research. Methods: Imaging data of 92 subjects (45 males, 47 females, the age range 20-82 years and mean age 48.4 ± 6.1 years) without pathology of CAB, who underwent 64-SCTA in head and neck from June 1, 2008 to June 30, 2010, were selected from the Picture Archiving and Communication Systems in Zhongshan Hospital of Xiamen University, Fujian, China. On the 3D images, the angle and size of CAB were measured, and the statistical comparisons of measurements were made between the bilateral, sex and age groups. Results: The measurements of CAB were divided into young (≤ 40 years) and older (> 40 years) groups: bifurcation angle is 36.206° ± 10.210° and 49.343° ± 16.489°, respectively; the inner diameter of common carotid artery (CCA) is 6.820 ± 0.635 and 6.845 ± 0.838 mm, respectively; the proximal inner diameter of internal carotid artery (ICA) is 7.143 ± 0.992 and 7.476 ± 1.630 mm, of the enlargement is 7.568 ± 1.069 and 8.554 ± 1.733 mm, of the distal is 4.897 ± 0.508 and 5.123 ± 0.699 mm, respectively; the inner diameter of external carotid artery (ECA) is 4.324 ± 0.580 and 4.104 ± 0.638 mm, respectively. There were statistically significant differences in all the measurements between male and female groups, in the bifurcation angle, inner diameters of ICA and ECA between young and older groups, and in the bifurcation angle between the left and right (p < 0.05). Conclusion: A 64-SCTA with 3D image post-processing technique can clearly observe and show the CAB. All CAB measurements will provide the objective basis for applied anatomy, imaging diagnosis and surgery treatment.

Percutaneous Magic screw Fixation for acetabular posterior column fracture: An imaging anatomical study / 解剖学报

Objective To investigate the entry point, direction and fixation range of Magic screw for acetabular posterior column fracture. Methods The 3D models of 100 pelvis were reconstructed by Mimics 19. 0 software based on CT data, and the virtual magic screw were placed in acetabular posterior column, then the screw' s entry point were determined, and the direction, length, diameter and safe range were measured respectively. Acetabular posterior column with magic screw was osteotomy modeling by Mimics 19.0 and imported the Geomagic Wrap 2017 software, after that anatomical parameters of the screw path were measured. Results The entry point of Magic screw on bone surface was located at (33. 37±5. 53) mm of the anterior inferior iliac spine moving posteriorly, and ( 13. 40±3. 70) mm of the apex of the upper margin of acetabular moving celphalad in male, which were (33. 97±5. 46) mm and (9. 01±3. 86)mm in female. The posterior inclination angle, interior inclination angle of magic screw and the angle between screw and iliac wing were (57.40±6.57)°, (52. 09±5. 65)° and (15. 21 ±3.42)° in male, which were (55. 64±8. 01)°, ( 51. 55±5. 58)° and (9. 85±3. 68)°in female. The maximum diameter of male screw was (6. 97±0. 98) mm, which was (6. 39±0. 85) mm in female. The length of male screw was (76. 73±9. 20) mm, which was (63. 64±8. 37) mm in female. The safe range of posterior inclination and interior inclination of were ( 7. 19 ± 3. 30)° and (9. 41 ±3. 95)° in male screw with 5.5 mm diameter, which were (8. 37±2. 82)° and ( 10. 32±3. 93)° in female screw with 5. 2 mm diameter. In the direction of the screw, the length range of the posterior column which is fixed by screw was (56. 87±7. 60) mm, and the proportion of fractures fixed with screws which were located on the top of the acetabular was 20/50 in male, which were (41. 71±7. 97) mm and 8/50 in female. Conclusion Percutaneous Magic screw is a minimally invasive treatment for acetabular posterior column fracture, which is difficult to operate. The screw can fix the fracture which is located at the middle and upper part of the acetabular posterior column.

Anatomical parameters of the rectus capitis posterior major and obliqus capitis inferior muscles based on an oblique sagittal magnetic resonance scan method / Parámetros anatómicos de los músculos recto posterior mayor de la cabeza y oblicuo mayor de la cabeza basados en un método oblicuo sagital de exploración por resonancia magnética

The deep suboccipital muscles has been shown to connect the spinal dura mater via dense connective tissue termed the myodural bridge (MDB). The MDB has both physiological and clinical implications. Data on morphological and imaging anatomical parameters of the deep suboccipital muscles are scare. In this study, T2-weighted images of rectus capitis posterior major (RCPma) and obliqus capitis inferior (OCI) of 109 healthy adults were obtained by 0-degree sagittal and 30-degree oblique sagittal continuous MRI scanning of the head and neck of the subjects. Sectional area parameters of the RCPma and the OCI were measured. The 0-degree sagittal section was measured with 5 mm bias from the median sagittal plane, the sectional area of the RCPma was 186.34± 55.02 mm2 on the left, and 202.35± 59.76 mm2 on the right. The sectional area of OCI was 221.72± 68.99 mm2 on the left, and 224.92± 61.34 mm2 on the right; At the section with 30-degree bias from the oblique sagittal plane, the sectional area of RCPma was 183.30± 42.24 mm2 in males, and 133.05± 26.44 mm2 in females. The sectional area of OCI was 254.81± 46.20 mm2 in males, and 167.42± 27.85 mm2 in females. Significant sex difference exists in the sectional areas of the RCPma and OCI, the values of the male subjects were predominantly larger (P < 0.05), however there were no age- related significant difference. The sectional area of RCPma is bilateral asymmetric, the RCPma on the right side is larger than that of the left side (P < 0.05), but the OCI is bilaterally symmetric (P >0.05). The MRI image features, imaging anatomical data and sexual dimorphism of the RCPma and the OCI are presented in this study. This imaging anatomical data will be useful for functional and clinical studies on the RCPma, OCI, and the MDB.

Se ha demostrado que los músculos suboccipitales profundos conectan la duramadre espinal a través del tejido conectivo denso denominado puente miodural (PMD). El PMD tiene implicaciones tanto fisiológicas como clínicas. Los datos sobre los parámetros anatómicos y morfológicos y de imagen de los músculos suboccipitales profundos son alarmantes. En este estudio, se obtuvieron imágenes ponderadas en T2 del músculo recto posterior mayor (RCPma) y del músculo oblicuo mayor de la cabeza (OCI) de 109 adultos sanos, mediante una exploración de la cabeza y el cuello sagital de 0 grados y sagital oblicua de 30 grados. Se midieron los parámetros de área seccional del RCPma y el OCI. La sección sagital de 0 grados se midió con un sesgo de 5 mm desde el plano mediano, el área de la sección de la RCPma fue 186,34 ± 55,02 mm2 a la izquierda y 202,35 ± 59,76 mm2 a la derecha. El área seccional de OCI fue 221.72 ± 68.99 mm2 a la izquierda y 224.92 ± 61.34 mm2 a la derecha. En la sección de 30 grados desde el plano sagital oblicuo, el área de la sección de RCPma fue de 183.30 ± 42.24 mm2 en los hombres, y 133.05 ± 26.44 mm2 en las mujeres. El área seccional de OCI fue de 254.81 ± 46.20 mm2 en varones y 167.42 ± 27.85 mm2 en mujeres. Existe una diferencia significativa según el sexo en las áreas seccionales de la RCPma y la OCI, los valores de los sujetos masculinos fueron predominantemente mayores (P <0.05). Sin embargo, no hubo diferencia significativa relacionada con la edad. El área de la sección de RCPma es bilateral asimétrica, la RCPma en el lado derecho es más grande que la del lado izquierdo (P <0.05), pero el OCI es bilateralmente simétrico (P> 0.05). Las características de la imagen de resonancia magnética, los datos anatómicos de imágenes y el dimorfismo sexual de la RCPma y la OCI se presentan en este estudio. Estos datos anatómicos de imágenes serán útiles para estudios funcionales y clínicos en RCPma, OCI y PMD.

Anatomical parameters of the rectus capitis posterior minor muscle based on a new magnetic resonance scan method / Parámetros anatómicos del músculo recto posterior menor de la cabeza basado en un nuevo método de escaner con resonancia magnética

The past findings confirm that the Rectus Capitis Posterior minor (RCPmi) is connected to the cervical spinal dura mater via the Myodural Bridge (MDB) through the posterior antlanto-occipital interspace. It is hypothesized to perform some functions. Furthermore, some clinical studies found that the pathology of RCPmi might be related to chronic headaches. But few studies were related to the morphological parameters of the RCPmi. It would be conducive to performing clinical researches on the RCPmi and MDB. To explore the optimal section for measuring the RCPmi by MRI and provide imaging anatomy parameters of the RCPmi for clinical research. The RCPmi was measured in the dissection of 10 formalin-fixed cadaver specimens. The morphological parameters of the RCPmi were obtained. Based on these parameters, T2-weighted images of the RCPmi were collected from 109 healthy adults by using the MRIs with different oblique sagittal scanning angles. The parameters of length and area of the RCPmi on the scanning sections were measured using MRI workstation and Mimics software. The length of RCPmi reached a maximum at 30 degrees scanning leaned from the posterior median line through the dens of the axis in oblique sagittal section. At this scanning section, the length of RCPmi was 21.2 ± 2.6 mm in males and 19.3 ± 2.4 mm in females and the area of RCPmi was 91.9 ± 27.2 mm2 in males and 73.3 ± 22 mm2 in females. These parameters of RCPmi were present with significant gender differences (P < 0.05) but was not age related. Thirty degrees leaned from the median line was suggested to be the optimum scanning angle to display the RCPmi in oblique sagittal section. The reference values of length and area of the RCPmi were established for studies of hypertrophy or amyotrophy of the RCPmi.

Hallazgos previos confirman que el músculo rector posterior menor de la cabeza (mRPMC) está conectado a la duramadre cervical por medio del puente miodural (PMD) a través del espacio intermedio antlanto-occipital posterior. Se plantea la hipótesis de su capacidad para realizar algunas funciones. Además, estudios clínicos encontraron que la patología del mRPMC podría estar relacionada con dolores de cabeza crónicos. Sin embargo, pocos estudios se relacionaron con los parámetros morfológicos del mRPMC. Se buscará realizar investigaciones clínicas sobre el mRPMC y el PMD, además de explorar la sección óptima que permita medir el mRPMC por resonancia magnética (RM) y que permita obtener la imagen adecuada para la identificación de los parámetros anatómicos del mRPMC en la investigación clínica. Se midió el mRPMC durante la disección de 10 especímenes, correspondientes a cadáveres fijados con formalina. Se obtuvieron los parámetros morfológicos del mRPMC. Basándose en estos parámetros, se estudiaron imágenes ponderadas en T2 del mRPMC de 109 adultos sanos, utilizando las resonancias magnéticas con diferentes ángulos de exploración sagital oblicua. Los parámetros de longitud y área del mRPMC en las secciones de exploración se midieron utilizando la estación de trabajo del equipo de RM y el software Mimics. La longitud del mRPMC alcanzó un máximo de 30 grados de exploración, inclinado desde la línea mediana posterior, a través del eje en la sección sagital oblicua. En esta sección la longitud del mRPMC fue 21,2 ± 2,6 mm en los hombres y 19,3 ± 2,4 mm en las mujeres, y el área del mRPMC fue 91,9 ± 27,2 mm2 en los hombres y 73,3 ± 22 mm2 en las mujeres. Se observaron diferencias significativas de sexo en estos parámetros del mRPMC (P <0,05) sin embargo estos no estaban relacionados con la edad. Se sugirieron 30 grados inclinados a partir de la línea mediana como el ángulo óptimo de exploración para mostrar el mRPMC en la sección sagital oblicua. Los valores de referencia de longitud y área del mRPMC se establecieron para estudios de hipertrofia o amiotrofia del mRPMC.

Cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex:a comparative study from imaging anatomical prospective / 实用医学杂志

Objective To studythe cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex and their correlations with abdominal adipose tissue thickness and age. Methods The vertical distances,cephalocaudal relationship and other related anatomic parameters of aortic bifurcation relative to umbilicus and iliac crest vertex in 108 patientswere measured by consecutive abdominal CT scanning. The correlations of the acquired data with abdominal adipose tissue thickness and age were analyzed using Pearson correlation coefficient. Results Umbilicus was located at cephalad to aortic bifurcation in 67 patients(62.0%), caudal in 34(31.4%)andthe same level in 7(6.5%),with the vertical distance of(4.53 ± 17.51)mm to the aortic bifurcation. No statistically significant relationship was found between abdominal adipose tissue thickness(P>0.05) or age(P>0.05). Iliac crest vertex relative to aortic bifurcationwas located at cephalad,caudal and the same level in 31,71 and 6 patients,taking up 28.7%,65.7%and 5.6%,respectively. Its vertical distance to the bifurcation was(-6.34 ± 14.49)mm,nonrelated with abdominal adipose tissue thickness(P>0.05),but positively correlated with age(P<0.01). The difference in the cephalocaudal relationship of aortic bifurcation relative to umbilicus and iliac crest vertex was statistically significant(P<0.01). Conclusion Compared with iliac crest vertex,umbilicus is an important landmark of locating abdominal aortic terminal occlusion position in vitro because it mostly lies cephalad to aortic bifurcation in the front of the body,not easy to vary with abdominal adipose tissue thickness and age.

Ultrasonic 3D reconstruction and measurement of lacrimal sac in normal adult Chinese population / Reconstrucción 3D con ultrasonido y mediciones del saco lagrimal en una población china de adultos normales

To apply the ultrasonic 3D reconstruction method to measure the anatomic image data of lacrimal sac in the normal adult Chinese population, providing imaging anatomical basis for the clinical diagnosis and treatment of lacrimal duct diseases. 80 volunteers without lacrimal duct diseases were enrolled. The GE Voluson E8 ultrasonic diagnostic apparatus was used, with gynecological intracavitary probe (frequency: 5 ~ 12MHz) for the examination and measurement. Each datum was repeated three times for the average value. Among the 80 eyes, the lacrimal sacs of 74 eyes exhibited the clear imaging, with the imaging rate as 92.5 %. the vertical diameter of lacrimal sac cavity (LSC): 13.3±2.2 mm; anteroposterior diameter: 6.0±1.1 mm; trans diameter: 4.9±0.9 mm; the vertical distance from the sac cavity top to the skin surface: 6.3±0.12 mm, the vertical distance from the sac cavity bottom to the skin surface: 6.5±0.11 mm; the distance from the angular artery to the medial canthus: 7.8±0.05 mm; the vertical distance from the angular artery to the skin surface: 7.7±0.08 mm. The lacrimal sac and angular artery in the adults could be shown clearly in ultrasonic 3D reconstruction, the accumulated anatomical parameters could provide the instructive meanings towards the clinical diagnosis and treatment of lacrimal diseases.

El objetivo de este estudio consistió en aplicar el método de reconstrucción 3D de ultrasonidos para medir los datos de las imágenes anatómicas del saco lagrimal en una población china adulta normal, proporcionando imágenes con base anatómica para el diagnóstico clínico y el tratamiento de las enfermedades de los conductos lagrimales. La muestra consistió en 80 voluntarios sin enfermedades de los conductos lagrimales. Se utilizó el aparato de ultrasonido GE Voluson E8, con una sonda intracavitaria ginecológica (frecuencia: 5 ~ 12 MHz) para realizar el examen y la medición. Cada dato se repitió tres veces para obtener el valor medio. De los 80 ojos, los sacos lagrimales de 74 ojos mostraron una imagen clara, siendo la tasa de formación de imágenes del 92,5 %. Se realizaron mediciones: diámetro vertical de la cavidad del saco lagrimal (LSC): 13,3 ± 2,2 mm; diámetro anteroposterior: 6,0 ± 1,1 mm; diámetro transversal: 4,9 ± 0,9 mm; distancia vertical desde la porción superior de la cavidad del saco lagrimal hasta la superficie de la piel: 6,3 ± 0,12 mm, distancia vertical desde el fondo de la cavidad del saco lagrimal hasta la superficie de la piel: 6,5 ± 0,11 mm; distancia desde la arteria angular al canto medial: 7,8 ± 0,05 mm; distancia vertical desde la arteria angular a la superficie de la piel: 7,7 ± 0,08 mm. El saco lagrimal y la arteria angular en los adultos se podría demostrar claramente en la reconstrucción 3D con ultrasonido. Los parámetros anatómicos acumulados podrían ser de significativo valor para un certero diagnóstico clínico y tratamiento de enfermedades de los sacos lagrimales.

Does the existing traditional undergraduate Anatomy curriculum satisfy the senior medical students.

Interns at the end of their clinical year and medical students at the end of their final year were asked to evaluate the anatomy curriculum they had experienced in their undergraduate preclinical years. Most of the respondents found that the gross anatomy taught to them was adequate but the vast majority expressed that clinical anatomy, imaging anatomy and surface and living anatomy were inadequate. Both interns and medical students ranked anatomy courses and integrated clinical topics as the keystone for their clinical training and felt the need of a clinically oriented anatomy curriculum, case studies and participation of clinical faculty members in teaching during the pre-clinical years. Retrospective evaluations at the end of internships and the undergraduate years are helpful “evidence” to be considered when reforming the anatomy curriculum, and in particular when developing a clinical core course in anatomy. The results of such surveys should be taken into consideration when discussing modifications to the anatomy curriculum.