Prevalence of soft tissue calcifications in CBCT images from the oral and maxillofacial radiology service at UNAB, Viña del Mar, Chile / Prevalencia de calcificaciones en tejidos blandos en CBCT del servicio de radiología oral y maxilofacial de la UNAB sede Viña del Mar, Chile

Soft tissue calcifications can indicate the presence of more serious, potentially life-threatening pathologies. Therefore, their study can lead to an early diagnosis of those conditions that have not yet become clinically apparent. Main objective: To determine the prevalence of calcifications in soft tissues of the head and neck in cone beam computed tomography images obtained from the Oral and Maxillofacial Radiology Service at Universidad Andrés Bello (UNAB), Viña del Mar, Chile. Material and Methods: Retrospective, cross-sectional, quantitative study. A total of 288 images of cone beam computed tomography (CBCT) were used. Images were obtained at random from the database of the Oral and Maxillofacial Radiology Service at UNAB, Viña Del Mar, between 2014 and 2019. Results: A prevalence of 59.72% of soft tissue calcifications was obtained. The most prevalent were: tonsilloliths and calcified stylohyoid ligament, accounting for 30.65% and 45.56%, respectively. Conclusion: A high prevalence of soft tissue calcifications was found in a population that has not been studied previously; therefore, it is important that the dentist perform a detailed analysis of the cone beam computed tomography.

Introducción: Las calcificaciones en tejidos blandos pueden indicar patologías más graves, que incluso pueden comprometer la vida. Por lo tanto, investigarlas puede conducir a un diagnóstico temprano de aquellas que aún no se han manifestado clínicamente. Objetivo principal: determinar la prevalencia de calcificaciones en tejidos blandos de cabeza y cuello en tomografía computarizada de haz cónico del Servicio de Radiología Oral y Maxilofacial de la UNAB, Viña del Mar, Chile. Material y Métodos: Estudio retrospectivo, transversal, cuantitativo. Se utilizaron 288 volúmenes de tomografía computarizada de haz cónico (CBCT, por las iniciales en inglés de Cone Beam Computed Tomography), obtenidas al azar, de la base de datos del Servicio de Radiología Oral y Maxilofacial de la Universidad Andrés Bello (UNAB), Viña del Mar entre 2014 y 2019. Resultados: Se obtuvo una prevalencia de 59.72% de calcificaciones en tejidos blandos. Las más prevalentes fueron: tonsilolitos, con un 30,65% y ligamento estilohioídeo calcificado, con un 45,56%. Conclusión: Se encontró una alta prevalencia de calcificaciones en tejidos blandos en una población que no ha sido estudiada previamente, por ello es importante que el odontólogo realice un análisis detallado de la tomografía computarizada de haz cónico.

Volumetric computed tomography reconstruction, rapid prototyping and 3D printing of opossum head ( Didelphis albiventris ) / Reconstrucción volumétrica por tomografia computarizada, prototipado rápido e impresión 3D de cabeza de zarigüeya ( Didelphis albiventris )

Natural anatomical pieces of wild animals are rare and teachers seek alternatives in satisfactory quantity and quality to inform their students. This article aims to describe the use of multiplanar reconstructions and 3D volume rendering computed tomography (CT) images, rapid prototyping and 3D printing of opossum head to create a biomodel to veterinary education in descriptive anatomy of wild animals. A six-step method study was conducted to construct the biomodel: (1) selection of opossum head from museum; (2) CT scanning of bones structures in veterinary hospital; (3) DICOM visualization medical images in multiplanar reconstructions and 3D volume rendering; (4) .dicom file conversion to .stl; (5) 3D printing of opossum head by rapid prototyping; (6) comparison of 3D model printed with the original anatomical piece. The use of CT images with their different forms of reconstruction can provide a more comprehensive 3D view of opossum craniofacial region and allow a better understanding of head anatomy of this species. The 3D printed biomodel can be a viable alternative to original bone specimens when used in anatomy education. However, further studies must be continued to validate the method in Veterinary Medicine courses.

Las piezas anatómicas naturales de animales salvajes son raras y los profesores buscan alternativas satisfactorias, en cantidad y calidad, para enseñar a sus alumnos. Este artículo tuvo como objetivo describir el uso de la reconstrucción volumétrica por tomografía computarizada, la creación rápida de prototipos y la impresión 3D de la cabeza de zarigüeya para obtener un biomodelo en anatomía descriptiva de animales salvajes para educación veterinaria. Se realizó un estudio en seis pasos para construir el biomodelo: (1) selección de cabeza de zarigüeya del museo; (2) tomografía computarizada de estructuras óseas en hospital veterinario; (3) visualización de las imágenes médicas en DICOM por reconstrucciones multiplanares y renderización de volumen 3D; (4) conversión de archivos .dicom a .stl; (5) impresión 3D de cabeza de zarigüeya mediante prototipado rápido; (6) comparación del modelo 3D impreso con la pieza anatómica original. El uso de imágenes de tomografía computarizada, con sus diferentes formas de reconstrucción, puede proporcionar una vista 3D más completa de la región craneofacial de zarigüeya y permitir una mejor comprensión de la anatomía de la cabeza de esta especie. El biomodelo 3D impreso puede ser una alternativa viable a las muestras óseas originales cuando se utiliza en la educación de la anatomía. Sin embargo, se deben continuar los estudios para validar el método en los cursos de Medicina Veterinaria.

The development of a free radiological anatomy software teaching tool / Desarrollo de un software libre de anatomia radiológica como una herramienta de enseñanza

SUMMARY: The purpose of this research was to develop a free radiological anatomy software for radiologic anatomy education to assist students and professionals in health science. The study was divided into two phases: image acquisition and software development. The first phase was to obtain plain radiographic images and computed tomographic (CT) scans of an anthropomorphic phantom of head and neck. In addition, plain radiographic images of an anthropomorphic phantom of the chest were obtained. The second phase was the development of the anatomy software as an ImageJ macro. The software was developed through the insertion of the radiologic anatomy landmarks into the images that were obtained and application of multiple choice questions. The software was then tested for usability by getting the professors to answer the multiple choice questions. The software presented radiologic anatomy from 1) Head projections: Waters view, Towne view, Caldwell view, Lateral view, Submentovertex, PA view; 2) Thoracic Spine projections: AP and Lateral View and 3) Chest: PA view, Lateral and Oblique. Tomographic imaging presented one hundred radiologic landmarks of head. In total, there were 354 questions. A final report containing the score of correct answers, as well as the user ID, Date and Time of the test were showed. The test were available in three languages (Spanish, English and Portuguese). A user-friendly and inexpensive software was developed and presented. Students and professionals from several countries are able to practice, repeatedly, the recognition of radiologic anatomical landmarks.

RESUMEN: El propósito de esta investigación fue desarrollar un software gratuito de anatomía radiológica para la educación de anatomía radiológica para ayudar a estudiantes y profesionales de ciencias de la salud. El estudio se dividió en dos fases: adquisición de imágenes y desarrollo de software. La primera fase consistió en obtener imágenes radiográficas simples y tomografías computarizadas (TC) de un fantasma antropomórfico de cabeza y cuello. Además, se obtuvieron imágenes radiográficas simples de un fantasma antropomórfico del tórax. La segunda fase fue el desarrollo del software de anatomía como una macro ImageJ. El software se desarrolló a través de la inserción de los puntos de referencia de la anatomía radiológica en las imágenes que se obtuvieron y la aplicación de preguntas de opción múltiple. Luego, se probó la usabilidad del software haciendo que los profesores respondieran las preguntas de opción múltiple. El software presentó la anatomía radiológica de 1) Proyecciones de la cabeza: vista de aguas, vista de Towne, vista de Caldwell, vista lateral, Submentovertex, vista de PA; 2) proyecciones de la columna torácica: vista AP y lateral y 3) Cofre: vista de PA, lateral y oblicua. Las imágenes tomográficas presentaron cien puntos de referencia radiológica de la cabeza. En total, hubo 354 preguntas. Se mostró un informe final con la puntuación de las respuestas correctas, así como la identificación del usuario, la fecha y la hora de la prueba. Las pruebas estaban disponibles en tres idiomas (español, inglés y portugués). Se desarrolló y presentó un software fácil de usar y de bajo costo. Estudiantes y profesionales de varios países pueden practicar, repetidamente, el reconocimiento de puntos de referencia anatómicos radiológicos.

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.

Sectioned images of a cat head to contribute to learning of its sectional anatomy / Imágenes seccionadas de una cabeza de gato para contribuir al conocimiento de su anatomía seccional

The sectional anatomy of a cat head is essential when interpreting CTs and MRIs of the region. In learning the sectional anatomy, sectioned images of a cat could be quite effective data. The main objective was to assist veterinary physicians who learn the sectional anatomy of a cat head by presenting high-quality sectioned images. A short-haired female cat was frozen and sectioned frontally using a cryomacrotome. Every sectioned surface in real body color was photographed with a digital camera. The frontal planes were stacked to produce dorsal and sagittal planes. High-quality sectioned images of a cat head allowed the identification of small, complicated structures. The notable structures were as follows: each bone of the cranium, structures of the brain, tympanic cavity (larger than human), oval window (larger than human), vestibular nerve, cochlear nerve, ear ossicles, six extraocular muscles, pupil (larger than human), retractor bulbi muscle (not found in human), optic nerve, olfactory bulb (considerably large), vomeronasal organ duct (not found in human), infraorbital gland (not found in human), masticatory muscles (larger than human), maxillary nerve (larger than human), and mandibular nerve. This pacesetting report describes the detailed head structures of a cat from the viewpoint of sectional anatomy. The sectioned images will be given to other interested researchers free of charge.

El conocimiento de la anatomía seccional de cabeza de gato es esencial para interpretar estudios por tomografía computada y resonancia magnética de la región. En el conocimiento de esta anatomía seccional, las imágenes seccionadas de un gato podrían aportar datos bastante efectivos. El objetivo principal consistió en ayudar a los médicos veterinarios para que aprendan la anatomía seccional de una cabeza de gato mediante la presentación de imágenes seccionadas de alta calidad. Una gata de pelo corto fue congelada y seccionada frontalmente usando un criomicrótomo. Cada sección, con el color real del cuerpo, fue fotografiada con una cámara digital. Los planos frontales se apilaron para producir planos dorsales y sagitales. Las imágenes seccionadas de alta calidad de una cabeza de gato permitieron la identificación de estructuras pequeñas y de dificil visualización. Las estructuras destacadas fueron las siguientes: cada hueso del cráneo, las estructuras del cerebro, la cavidad timpánica (más grande que en el humano), la ventana oval (más grande que en el humano), el nervio vestibular, el nervio coclear, los huesecillos del oído, seis músculos extraoculares, la pupila, el músculo retractor del ojo (no se encuentra en el ser humano), nervio óptico, bulbo olfatorio (considerablemente grande), conducto del órgano vomeronasal (no se encuentra en el ser humano), glándula infraorbitaria (no se encuentra en los humanos), músculos masticatorios (más grandes que en el humano), nervio maxilar (más grande que en el humano) y nervio mandibular. En este trabajo describimos detalladamente, desde el punto de vista de la anatomía seccional, las estructuras de la cabeza de un gato. Las imágenes seccionadas estarán a disponibles para otros investigadores en forma gratuita.

Using a smartphone as a tool to measure compensatory and anomalous head positions / Uso do smartphone como ferramenta para medir a posição compensatória e anômala da cabeça

ABSTRACT Purpose: To describe a new method for measuring anomalous head positions by using a cell phone. Methods: The photo rotation feature of the iPhone® PHOTOS application was used. With the patient seated on a chair, a horizontal stripe was fixed on the wall in the background and a sagittal stripe was fixed on the seat. Photographs were obtained in the following views: front view (photographs A and B; with the head tilted over one shoulder) and upper axial view (photographs C and D; viewing the forehead and nose) (A and C are without camera rotation, and B and D are with camera rotation). A blank sheet of paper with two straight lines making a 32-degree angle was also photographed. Thirty examiners were instructed to measure the rotation required to align the reference points with the orthogonal axes. In order to set benchmarks to be compared with the measurements obtained by the examiners, blue lines were digitally added to the front and upper view photographs. Results: In the photograph of the sheet of paper (p=0.380 and a=5%), the observed values did not differ statistically from the known value of 32 degrees. Mean measurements were as follows: front view photograph A, 22.8 ± 2.77; front view B, 21.4 ± 1.61; upper view C, 19.6 ± 2.36; and upper view D, 20.1 ± 2.33 degrees. The mean difference in measurements for the front view photograph A was -1.88 (95% CI -2.88 to -0.88), front view B was -0.37 (95% CI -0.97 to 0.17), upper view C was 1.43 (95% CI 0.55 to 2.24), and upper view D was 1.87 (95% CI 1.02 to 2.77). Conclusion: The method used in this study for measuring anomalous head position is reproducible, with maximum variations for AHPs of 2.88 degrees around the X-axis and 2.77 degrees around the Y-axis.

RESUMO Objetivo: Descrever novo método de medida da posição anômala da cabeça (PAC) usando celular. Métodos: Foi utilizado o recurso de rotação de fotografias do aplicativo fotos do iPhone®. Com paciente em uma cadeira, foram fixadas duas faixas, uma horizontal, na parede ao fundo e outra sagital sobre o assento. Fotografias: frontal (1 A e 1 B), com a cabeça inclinada sobre um ombro, e superior (1 C e 1 D), visualizando testa e nariz. Também fotografada uma folha sulfite com duas retas desenhadas formando um ângulo de 32º. Trinta examinadores foram orientados a mensurar a rotação necessária para alinhar os pontos de referência com os eixos ortogonais. Para estabelecer medidas de referência a serem comparadas com aquelas obtidas pelos examinadores, foram acrescentadas digitalmente linhas azuis nas fotos frontal e superior. Resultados: Na foto da folha de papel (p=0,380 e a=5%), os valores observados não diferem estatisticamente do valor conhecido de 32º. Média das medidas: foto frontal 1A, 22,8 ± 2,77, frontal 1B, 21,4 ± 1,61, superior 1C, 19,6 ± 2,36 e superior 1D, 20,1±2,33. A média das diferenças das medidas na foto frontal 1A foi de -1,88 (IC 95% -2,88 a -0,88), frontal 1B de -0,37 (IC 95% -0,97 a 0,17), superior 1C de 1,43 (IC 95% 0,55 a 2,24) e superior 1D foi 1,87 (IC 95% 1,02 a 2,77). Conclusões: O método utilizado neste estudo para medida da posição anômala da cabeça é reprodutível e apresenta variação máxima de 2,88º nas posições anômalas da cabeça ao redor do eixo X e 2,77º do Y.

Browsing software of the head sectioned images for the android mobile device / Software de navegación para el dispositivo móvil android de imágenes seccionadas de cabeza

SUMMARY: The purpose of this research was to enable anyone to learn the sectional anatomy of the head anywhere, anytime by presenting software to browse sectioned images on a Google Android mobile device. Among the 2,343 sectioned images at 0.1 mm intervals, 234 sectioned images at 1 mm intervals were chosen. The corresponding 234 segmented images containing 236 head structures were selected. The software of the mobile version was programmed and debugged in the Java programming language. The folders of the sectioned images and segmented images and the txt file of the segmentation data were arranged in the source code of the software. The software was distributed free of charge at the homepage (neuroanatomy.kr) and Google Play Store. After installing the software, the sectioned images and corresponding segmented images could be browsed by touching and swiping the screen. In the medical category of the Google Play Store, the software earned a good reputation. The software of the Android mobile version was usable regardless of the time and place. The software is under the authors' non-commercial policy. Other investigators may modify the mobile software to browse their own images. The mobile version of the software will aid medical students and doctors in learning sectional anatomy.

RESUMEN: El propósito de esta investigación fue permitir que toda persona aprendiera la anatomía de secciones de la cabeza, en cualquier lugar y en cualquier momento, a través de un software para examinar imágenes seccionadas en un dispositivo móvil Android de Google. De las 2.343 imágenes seccionadas a intervalos de 0,1 mm, se seleccionaron 234 imágenes seccionadas a intervalos de 1 mm. Se seleccionaron las 234 imágenes segmentadas que contenían 236 estructuras de cabeza. El software de la versión móvil fue programado y depurado en el lenguaje de programación Java. Las carpetas de las imágenes seccionadas y las imágenes segmentadas y el archivo .txt de los datos de segmentación se organizaron en el código fuente del software. El software se distribuyó gratuitamente en la página principal (neuroanatomy.kr) y Google Play Store. Después de instalar el software, las imágenes seccionadas y las imágenes segmentadas correspondientes se pueden navegar tocando y deslizando la pantalla. En la categoría médica de Google Play Store, el software obtuvo buena recepción. El software de la versión móvil de Android fue utilizado independientemente de la hora y el lugar. El software está bajo la política no comercial de los autores. Otros investigadores pueden modificar el software móvil para navegar por sus propias imágenes. La versión móvil del software ayudará a los estudiantes de medicina y los médicos en el aprendizaje de la anatomía seccional.

Lipofibromatosis accompanied by several congenital anomalies, report of a rare case.

Lipofibromatosis is a rare tumor of infancy, which has been reported about 10 years ago, and since then very few reports have been published. This tumor has been reported in association with congenital anomalies such as macrosyndactyly, but there is no report of multiple congenital anomalies with lipofibromatosis in the English literature as far as our knowledge goes. Herein, we report a case of this tumor associated with syndactyly, bilateral complete cleft lip and palate, trigonocephaly, and atrial septal defect.

Cytohistological features of rhinoscleroma.

Rhinoscleroma, also known as Mikulicz disease, is a chronic progressive disease caused by Klebsiella rhinoscleromatis. The disease is uncommon in Delhi. There are no cytological references of this disease. We describe the cytological features which should alert the pathologist to rule out this entity, which needs to be treated early. Immunohistochemistry on histopathological material is a useful adjunct to the diagnosis.

Embryonal rhabdomyosarcoma of the adult soft palate.

Embryonal rhabdomyosarcoma is the most common soft tissue sarcoma in children. We report a rare case of embryonal rhabdomyosarcoma of the soft palate in a 32-year-old Caucasian female. Detailed histology of the tumor is described. Positive staining with desmin, myogenin and myoD1 confirmed the tumor to be embryonal rhabdomyosarcoma. A genetic association between rhabdomyosarcoma, polycystic ovary syndrome and the FEM1A gene on the human chromosome is speculated upon.

Nocardial brain abscess in an immunocompetent host.

Nocardial infection of the central nervous system is rare and usually manifests as brain abscess. Here we describe an elderly gentleman who presented with signs and symptoms of an intracranial mass lesion localising to the frontal lobe. Clinical examination and CT scan suggested neoplasia as the probable diagnosis. A biloculated abscess was seen at surgery. Aspiration of the contents and examination of pus revealed Nocardia asteroides . Treatment included total excision and prolonged antibiotic therapy which resulted in an excellent outcome.

Basidiobolomycosis: a rare case report.

We report a rare case of basidiobolomycosis seen in an 11-year-old girl from North-Eastern part of India. She presented with complaints of bilateral nasal block and nasal discharge for seven-eight months. CT scan of sinuses revealed polypoidal mass in all the sinuses with extradural extension. The tissue biopsy examined histopathologically and microbiologically, revealed Basidiobolus ranarum.

Use of three dimensional ultrasound for nuchal translucency measurement in early pregnancy

To evaluate the role of three dimensional ultrasound in Nuchal translucency measurement in the first trimester. Prospective cross sectional study. Forty eight women pregnant in their first trimester were subjected to conventional and there dimensional ultrasound examination by two sonographers at a time using Vulson 730 machine. Scanning was saved and re-evaluated for nuchal translucency measurement. There was a good agreement between two and three dimensional altrasound. There was a positive correlation between nuchal thickness [NT] and crown rump length [CRI] [p<0.01]. There were negligible clinical differences in measurements of NT and CRL between the different observers. Only two cases had NT = 6 mm and both aborted. Nuchal translucency measurement is feasible, safe and accurate. This technique is potentially useful in fetuses that are not in all optimal position for standard 2D nuchal translucency measurement

A rare presentation of invasive rhino-orbital mucormycosis in an immunocompetent young girl: a case report.

A 18 year young, healthy, immunocompetent girl presented with proptosis of left eye, referred to eye OPD, suspected clinico-radiologically as malignancy. This presentation with suspicion of malignancy resulted into extensive surgical debridement with removal of left eye, which was diagnosed as mucormycosis on histopathological examination. Her eye could have been saved if the mucormycosis was highly suspected initially, because of the good general health and immunocompetency led to misdirected thought.