Analysis of Wrist Morphology Through Hamate and Lunate Bone Variations in Anatolian Population Using Plain Radiography / Análisis de la Morfología de la Articulación Radiocarpiana a Través de las Variaciones de los Huesos Hamato y Semilunar en la Población de Anatolia Mediante Radiografía Simple

SUMMARY: The present study aimed to evaluate wrist (lunate) anatomy in terms of the incidence of lunatum morphology on plain-radiographs among the Anatolian (Turkey) population, accompanied by demographic analysis. We obtained all the patients' data regarding demographical features, diagnosis, and posteroanterior (PA) X-ray imaging. Two radiograph-reviewers repeated the analysis twice, one month later, blinded to their findings before the previous review. The lunatum structure was determined as Type-1 (n:293) and Type-2 (n:207) for each radiograph. Most of the 500 wrists' radiographs [n:293 (58.6 %)] were type-I lunate. The mean age was 36.7±13.3 (range:18-90) years. Sex distribution was as follows: 185 (63.1 %) males to 108 (36.9 %) females. Type-2 lunate was seen in 207 participants (41.4 %). The mean age for type-2 was 41.6±15.2 (18-88) years. 142 (68.6 %) participants were male sex, while 65 (31.4 %) were females. The mean age of subjects with type-I showed a difference with type-II (p=0.007). There was no relationship in terms of sex (p=0.206) between the groups. In the Anatolian region, type-1 lunate was dominant compared to type-2. The incidence rate of lunate type in Anatolian population was similar to the Arab population.

El presente estudio tuvo como objetivo evaluar la anatomía de la articulación radiocarpiana en términos de la incidencia de la morfología del hueso semilunar en radiografías simples entre la población de Anatolia (Turquía), acompañado de un análisis demográfico. Obtuvimos todos los datos de los pacientes con respecto a las características demográficas, el diagnóstico y las imágenes de rayos X posteroanteriores (PA). Dos revisores de radiografías repitieron el análisis dos veces, un mes después, sin conocer sus hallazgos antes de la revisión anterior. La estructura del lunatum se determinó como Tipo-1 (n:293) y Tipo-2 (n:207) para cada radiografía. La mayoría de las 500 radiografías de muñecas [n:293 (58,6 %)] fueron semilunar tipo I. La edad media fue de 36,7±13,3 (rango: 18-90) años. La distribución por sexos fue la siguiente: 185 (63,1 %) hombres y 108 (36,9 %) mujeres. El semilunar tipo 2 se observó en 207 participantes (41,4 %). La edad media para el tipo 2 fue de 41,6±15,2 (18-88) años. 142 (68,6 %) participantes eran del sexo masculino, mientras que 65 (31,4 %) eran del sexo femenino. La edad media de los sujetos con tipo I mostró una diferencia con el tipo II (p = 0,007). No hubo relación en cuanto al sexo (p=0,206) entre los grupos. En la región de Anatolia, el semilunar tipo 1 era dominante en comparación con el tipo 2. La tasa de incidencia del tipo semilunar en la población de Anatolia fue similar a la de la población árabe.

Verma-Naumoff syndrome: a case report / Síndrome de Verma-Naumoff: a propósito de un caso

In skeletal dysplasias, there are short rib polydactyly syndromes, which traditionally differentiate into four lethal types. This report describes a case of Type III, which presented characteristics of Types I and II. A 38-year-old woman presented fetal growth restriction at 17 weeks and 6 days, decreased amniotic fluid, enlarged and hyperechogenic kidneys, and long bones below the 3rd percentile. Three weeks later, she developed anhydramnia. The couple did not consent to the performance of an invasive test for genetic diagnosis and chose to maintain the pregnancy. At 33 weeks, due to premature labor and interactivity, a cesarean section was performed, giving birth to a female baby, who died due to respiratory failure there were no vocal cords and no trachea visible at laryngoscopy. On physical examination, he had the phenotypic characteristics of the syndrome. An X-ray showed short ribs and severe pulmonary hypoplasia. After birth, the parents chose not to carry out a genetic study or an anatomical examination. Researchers have suggested that there is an intersection of the anatomical changes of the types. This case report supports this theory.

En las displasias esqueléticas, existen síndromes de polidactilia de costillas cortas, que tradicionalmente se diferencian en cuatro tipos letales. Este reporte describe un caso del tipo III, que presentó características de los tipos I y II. Mujer de 38 años con restricción del crecimiento fetal a las 17 semanas y 6 días, líquido amniótico disminuido, riñones agrandados e hiperecogénicos y huesos largos por debajo del percentil 3. Tres semanas después, desarrolló anhidramnia. La pareja no consintió en la realización de una prueba invasiva de diagnóstico genético y optó por mantener el embarazo. A las 33 semanas, debido al parto prematuro y la interactividad, se realizó una cesárea, dando a luz a un bebé, que murió debido a una insuficiencia respiratoria: no había cuerdas vocales ni tráquea visible en la laringoscopia. Al examen físico presentaba las características fenotípicas del síndrome. Una radiografía mostró costillas cortas e hipoplasia pulmonar severa. Después del nacimiento, los padres optaron por no realizar un estudio genético ni un examen anatómico. Los investigadores han sugerido que existe una intersección de los cambios anatómicos de los tipos. Este reporte de caso apoya esta teoría.

Dosis de radiación por radiografías y factores asociados en neonatos de la Unidad de Recién Nacidos del Hospital Universitario San Ignacio, Bogotá, Colombia / X-ray radiation dose and associated factors in neonates from the newborn unit of Hospital Universitario San Ignacio, Bogotá, Colombia

Introducción. Las radiografías continúan usándose ampliamente, subestimando los riesgos. Esto sucede, especialmente, en las unidades de cuidado neonatal, lo que implica que los neonatos reciben una dosis de radiación ionizante mayor que los adultos. Objetivo. Cuantificar las dosis de radiación recibidas al tomar radiografías y evaluar los posibles factores asociados con el aumento de la dosis. Materiales y métodos. Se llevó a cabo un estudio observacional de 160 neonatos de la Unidad de Recién Nacidos del Hospital Universitario San Ignacio, Bogotá, Colombia. Se consideró como variable dependiente la dosis de entrada en piel por cada radiografía. Se hizo la caracterización de los pacientes, seguida de un análisis multivariado con regresión lineal múltiple para identificar factores asociados. Resultados. Se analizaron 160 pacientes y 492 radiografías en total. Entre los hallazgos más frecuentes, se encuentran: pacientes de sexo masculino (n=87; 54,4 %), nacimiento por cesárea (n=122; 76,3 %) e indicación de toma de radiografías por dificultad respiratoria (n=123; 24,9 %). El 1,8 % (n=9) de los pacientes no tenían una indicación para la toma de la radiografía. La radiografía más frecuente fue la de tórax (n=322; 65,4 %). La mayoría de las radiografías se tomaron con el equipo computarizado (n=352; 71,5 %) y no con el digital (n=140, 28,4 %). La mediana de la dosis de entrada en piel con el equipo computarizado fue de 0,112 mGy (0,022; 0,134 mGy) y, con el equipo digital, de 0,020 mGy (0,019, 0,022 mGy). Conclusiones. Se cuantificaron las dosis de radiación absorbida en neonatos, general y específica, con el equipo computarizado y el digital. Se identificaron mayores dosis con el equipo computarizado. Se reconoció la interacción entre el equipo computarizado con menores edades gestacionales corregidas como principal factor para el aumento de la dosis. Además, se reconoció la relación entre el equipo computarizado y una menor edad gestacional corregida, como principal factor para una mayor dosis.

Introduction. Radiographs are still widely used, underestimating the risks. This situation is frequent in neonatal care units, generating radiation doses than in adults. Objective. To quantify the received radiation doses when performing radiographs on neonates and the possible factors associated with higher doses. Materials and methods. We performed an observational study of 160 neonates from the newborn unit of the Hospital Universitario San Ignacio, Bogotá, Colombia. We considered the input dose of each radiograph as the dependent variable. Patients were characterized and a multivariate analysis with multiple linear regression was performed to identify associated factors. Results. We analyzed 160 newborns and 492 radiographs. The most frequent findings were male patients (n=87, 54.4%), cesarean delivery (n=122, 76.3%), and radiograph indication for respiratory distress (n=123, 24.9%). One-point eight percent of the patients (n=9) did not have radiograph indication. The most frequently taken radiograph was chest (322, 65.4%). Most radiographs were taken with a computerized equipment (n=352, 71.5%), compared to a digital one (n=140, 28.4%). The median input dose with computerized equipment was 0.112 mGy (0.022, 0.134 mGy), and with the digital equipment was 0.020 mGy (0.019, 0.022 mGy). Conclusions. The general and specific absorbed radiation doses were measured in neonates with a computerized and a digital equipment. We identified higher doses with the computerized equipment. In addition, it was recognized the correlation between computerized radiography equipment with lower corrected gestational ages as the main factor for dose increase.

Cephalometric Characteristics in Chilean Latino Population with Normal Occlusion and Harmonic Profiles in Permanent Dentition. A Retrospective Study / Características Cefalométricas en Población Latina Chilena con Oclusión Normal y Perfiles Armónicos en Dentición Permanente. Un Estudio Retrospectivo

SUMMARY: Malocclusion is usually treated based on clinical decisions complemented with a cephalometric analysis, allowing the comparison of an individual with standard reference norms. Cephalometric standards have mostly been obtained from Caucasian population, but may not be appropriate for other ethnic groups, becoming a clinically relevant problem in multicultural and multiracial societies. The present study aimed to establish cephalometric norms for Chilean-Latino population, using a representative sample of class I individuals in permanent dentition. A sample of 72 cephalometric x-rays of class I growing individuals (47 women and 25 men) between 10 and 20 years of age with class I occlusion and harmonic profile was obtained from the records of the Universidad de los Andes taken between 2012 and 2019, including 1164 individuals. The radiographs were classified according to their cervical vertebral maturation status, and cephalometrically analyzed, obtaining vertical and sagittal parameters in soft and hard tissues, which were compared with Caucasian cephalometric norms. The statistical analysis was performed using descriptive and inferential statistics (T-test, ANOVA and Bonferroni tests). Cephalometric norms were obtained for hard and soft tissues. Upon comparison with Caucasian norms, the subjects included in the sample present a tendency towards a convex profile, significant incisal proclination, dental protrusion, labial biprotrusion and an acute nasolabial angle. There are cephalometric differences between the Caucasian cephalometric norms and those observed Chilean Latino population, displaying differences at a hard and soft tissue level that should be taken into account for clinical decision making in Orthodontics.

La maloclusión generalmente se trata con base en decisiones clínicas complementadas con un análisis cefalométrico, lo que permite la comparación de un individuo con normas de referencia estándar. Los estándares cefalométricos se han obtenido en su mayoría de población caucásica, pero pueden no ser apropiados para otros grupos étnicos, convirtiéndose en un problema clínicamente relevante en sociedades multiculturales y multirraciales. El presente estudio tuvo como objetivo establecer normas cefalométricas para población chileno-latina, utilizando una muestra representativa de individuos clase I en dentición permanente. Se obtuvo una muestra de 72 radiografías cefalométricas de individuos en crecimiento clase I (47 mujeres y 25 hombres) entre 10 y 20 años de edad con oclusión clase I y perfil armónico de los registros de la Universidad de los Andes tomados entre 2012 y 2019, incluidas 1164 personas. Las radiografías se clasificaron según su estado de maduración vertebral cervical, y se analizaron cefalométricamente, obteniendo parámetros verticales y sagitales en tejidos blandos y duros, que se compararon con normas cefalométricas caucásicas. El análisis estadístico se realizó mediante estadística descriptiva e inferencial (T-test, ANOVA y pruebas de Bonferroni). Se obtuvieron normas cefalométricas para tejidos duros y blandos. En comparación con las normas caucásicas, los sujetos incluidos en la muestra presentan una tendencia hacia un perfil convexo, proinclinación incisal significativa, protrusión dental, biprotrusión labial y un ángulo nasolabial agudo. Existen diferencias entre las normas cefalométricas caucásicas y las observadas en población latina chilena, mostrando diferencias a nivel de tejidos duros y blandos que se deben considerar para la toma de decisiones clínicas en Ortodoncia.

Rotura traumática simultánea y bilateral del tendón del cuádriceps en un paciente fisicoculturista: informe de caso y revisión de la literatura / Simultaneous bilateral traumatic quadriceps tendon rupture in a bodybuilding patient: case report and literature review

La rotura traumática, simultánea y bilateral del tendón cuadricipital es una lesión infrecuente, generalmente asociada a otras enfermedades sistémicas tales como insuficiencia renal o trastornos endocrinos. Presentamos el caso de un varón sano y atleta de 38 años que sufrió esta lesión mientras realizaba una sentadilla en el gimnasio. (AU)

The traumatic bilateral and simultaneous quadriceps tendon rupture is a rare injury, usually associated with other systemic diseases such as renal insufficiency or endocrine disorders. We present the case of a 38-year-old healthy male athlete who sustained this injury while performing a squat at the gym. (AU)

Reproducibility of Digital Planning in Cementless Total Hip Arthroplasty Among Experienced and Novice Surgeons / Reprodutibilidade do planejamento digital na artroplastia total do quadril sem cimento entre cirurgiões experientes e iniciantes

Abstract Objective The present study aims to assess the reproducibility of digital planning for cementless total hip arthroplasty (THA) among surgeons with different levels of experience. In addition, it attempts to determine the degree of planning reliability based on a contralateral THA or on a spherical marker positioned at the greater trochanter for calibration. Methods Two evaluators with different experience levels (A1 and A2) performed independently the retrospective digital surgical planning of 64 cementless THAs. Next, we compared the planning with the implants used in the surgery. The reproducibility was excellent when planning and implants were identical; proper in case of a single-unit variation; and inappropriate if there was variation in two or more units. The present analysis also determined the calibration accuracy between the contralateral THA and the spherical marker at the greater trochanter level. Results The present study demonstrated greater success when the most experienced evaluator performed the planning and greater accuracy for the contralateral THA. When splitting the analysis per parameter (contralateral THA or spherical marker), there was a statistical difference only for the planning of A1 and the implants used in the surgery. This difference occurred in the excellent category, with 67.3% for contralateral THA compared with 30.6% for a spherical marker (p < 0.001), and in the inappropriate category, with 7.1% for contralateral THA compared with 30.6% for a spherical marker (p < 0.001). Conclusions Digital planning is more accurate when performed by an experienced evaluator. The contralateral prosthesis head was a better reference than a marker on the greater trochanter.

Resumo Objetivo Avaliar a reprodutibilidade do planejamento digital da artroplastia total de quadril (ATQ) sem cimento entre cirurgiões com diferentes níveis de experiência e o grau de confiabilidade no planejamento baseado na ATQ contralateral com o método de marcador esférico posicionado ao nível do trocanter maior. Método Dois avaliadores com níveis de experiência diferentes (A1 e A2) realizaram de forma independente o planejamento digital operatório retrospectivo de 64 ATQs sem cimento. O planejamento foi comparado com os implantes utilizados na cirurgia, sendo classificados como: excelentes, quando idênticos; adequados, quando houve variação de uma unidade; e inadequados, quando ocorreu variação de duas ou mais unidades. Na presente análise, também foi avaliada a acurácia do parâmetro de calibragem entre a ATQ contralateral comparada com o marcador esférico ao nível do trocanter maior. Resultados O estudo demonstrou maior êxito no planejamento quando realizado pelo avaliador mais experiente, com maior acurácia na ATQ contralateral. Ao fragmentar a análise de acordo com o parâmetro utilizado (ATQ contralateral ou marcador esférico), houve diferença estatística apenas na comparação do planejamento do avaliador A1 com os implantes utilizados na cirurgia. Esta diferença ocorreu na classificação excelente com 67,3% em ATQ contralateral como parâmetro contra 30,6% com marcador esférico (p < 0,001) e inadequado de 7,1% contra 30,6%, respectivamente (p < 0,001). Conclusões A acurácia do planejamento digital é mais precisa quando realizada por um avaliador experiente e a utilização da cabeça de prótese contralateral como referência se mostrou superior à utilização de um marcador no trocanter maior.

Bone density and implant stability with advanced platelet-rich fibrin in immediately loaded- implant assisted mandibular overdentures / Densidade óssea e estabilidade dos implantes com fibrina rica em plaquetas avançada em overdentures mandibulares com carga imediata

ABSTRACT Objective: The aim of this study is to determine the effect of Advanced Platelet-Rich Fibrin on bone density and implant stability in immediately loaded- implant-assisted mandibular overdentures (Split-mouth study). Material and Methods: Ten completely edentulous patients received two implants in the mandibular canine region and locator attachments were used to retain immediately loaded- implant mandibular overdentures. Each patient served in two Groups, one Group for each side. One side of the mandible received an implant with topical application of Advanced Platelet-Rich Fibrin in the implant osteotomy site (Group I) and the other site received an implant without application of Advanced platelet-rich fibrin (Group II). Each patient was examined clinically for implant stability using Osstell Mentor device and radiographically by ultra-low dose CT scan to measure bone density around the implant at baseline, three, six months, and one year. Results: There were no statistically significant differences (P>.05) in bone density and implant stability among the studied Groups during one year follow-up period. Conclusion : Advanced Platelet-Rich Fibrin has no effect on bone density and implant stability in immediately loaded implant-assisted mandibular overdenture.(AU)

RESUMO Objetivo: O objetivo deste estudo é determinar o efeito da Fibrina Rica em Plaquetas Avançada na densidade óssea e estabilidade dos implantes em Overdentures mandibulares com carga imediata (estudo de boca dividida). Material e Métodos: Dez pacientes edêntulos foram submetidos à instalação de dois implantes mandibulares na região dos caninos e pilares locator foram utilizados como sistema de retenção para as overdentures mandibulares com carga imediata. Cada paciente participou nos dois grupos, sendo um grupo para cada lado. Um lado da mandíbula recebeu implante com aplicação tópica de Fibrina Rica em Plaquetas Avançada no local do sítio cirúrgico do implante (Grupo I) e o outro local recebeu implante sem aplicação de Fibrina Rica em Plaquetas Avançada (Grupo II). Cada paciente foi examinado clinicamente quanto à estabilidade do implante usando o dispositivo Osstell Mentor e radiograficamente por tomografia computadorizada de ultrabaixa dose para medir a densidade óssea ao redor do implante no início do estudo, três, seis meses e um ano. Resultados: Não houve diferenças estatisticamente significativas (P>0,05) na densidade óssea e na estabilidade do implante entre os grupos estudados durante o período de acompanhamento de um ano. Conclusão: A Fibrina Rica em Plaquetas Avançada não tem efeito na densidade óssea e na estabilidade de implantes em Overdentures mandibulares com carga imediata (AU)

Systemic scleroderma: imaging findings of diagnosis and clinical management of temporomandibular joint disorders / Esclerodermia sistêmica: diagnóstico por achados imaginológicos e manejo clínico das disfunções temporomandibulares

Scleroderma, an autoimmune disease, directly affects the production of collagen in the connective tissue. In its systemic form, the disease causes oral manifestations such as: limited mouth opening, xerostomia, periodontal disease, thickening of the periodontal ligament and bone resorption of the mandible. This case report aims to draw attention to the difficulties encountered in providing dental care to patients with scleroderma and also to highlight the imaging findings, with emphasis on the temporomandibular joints, which are of interest to dentists about the disease. In the present case, the patient presented bilateral condylar erosion, in addition to disc displacement without reduction. Due to the systemic condition of the patient, it was decided to make an individualized occlusal splint. The limitation of mouth opening is a limiting factor for the manufacture of prostheses and plates, which is why partial prostheses are indicated and are easily removed by the patient. The decisions taken have a great impact on the health and quality of life of patients in these conditions, so there is a need for multidisciplinary involvement in order to arrive at the best treatment plan. After five years of using the stabilizing plate overnight, the patient reports greater comfort and muscle relaxation upon waking up (AU)

Esclerodermia, uma doença autoimune, afeta diretamente a produção de colágeno do tecido conjuntivo. Na forma sistêmica, a doença causa manifestações bucais, como: limitação de abertura bucal, xerostomia, doença periodontal, espessamento do ligamento periodontal e reabsorção da mandíbula. Este relato de caso tem por objetivo chamar atenção para as dificuldades encontradas ao promover atendimento odontológico para pacientes com esclerodermia e também destacar os achados imaginológicos, com ênfase na articulação temporomandibular, que são da doença e de interessa ao cirurgião-dentista. No presente caso, a paciente apresentava erosão condilar bilateral, com deslocamento de disco sem redução. Devido à condição sistêmica da paciente, foi decidido confeccionar uma placa oclusal individualizada. A limitação de abertura bucal é um fator limitante para confecção de próteses e placas, por isso próteses parciais são indicadas, além de serem de fácil remoção pelo paciente. As decisões tomadas tem grande impacto na saúde e qualidade de vida de pacientes nessas condições, deste modo é necessário uma equipe multidisciplinar envolvidas para chegar no melhor plano de tratamento. Após cinco anos fazendo uso da placa estabilizadora durante a noite, a paciente relata maior conforto e relaxamento muscular ao acordar (AU)

Clinical photographic and radiological correlation in patients with scoliosis / Correlação clínica fotográfica e radiológica em pacientes com escoliose / Correlación clínica fotográfica y radiológica em pacientes com escoliosis

ABSTRACT Objective: The study correlates angular radiographic measurements and measurements from photographs of the trunk of patients with adolescent idiopathic scoliosis. Methods: a cross-sectional study of 10 patients with adolescent idiopathic scoliosis and indication for surgical treatment in follow-up in the spine sector of HCRFMRP-USP. They were evaluated through measurements taken from clinical photographs of the patient's torso and angles on panoramic radiographs of the spine. Results: only the correlation between the axilla angle (AHA) and the proximal thoracic curve and main thoracic curve was observed in the sample studied. No correlation was observed between the other compared variables. The study was carried out in a sample with a small number of patients, whose objective was to carry out a pilot study to explore this topic. Conclusion: the analysis of deformities should consider the aesthetic aspect and radiographic evaluation; however, in this study, no statistical correlation was observed between these parameters. Level of Evidence IV; Case Series Study.

RESUMO: Objetivo: O estudo correlaciona as mensurações radiográficas angulares e as mensurações oriundas das fotografias do tronco de pacientes com escoliose idiopática do adolescente. Métodos: estudo transversal de 10 pacientes com escoliose idiopática do adolescente e com indicação de tratamento cirúrgico, em seguimento no setor de coluna vertebral do HCRFMRP-USP. Foram avaliados por meio de mensurações das fotografias clínicas do tronco dos pacientes e mensurações dos ângulos nas radiografias panorâmicas da coluna. Resultados: na amostra estudada foi observada somente a correlação entre o ângulo axila (AHA) e a curva torácica proximal e curva torácica principal. Não foi observado correlação entre as demais variáveis comparadas. O estudo foi realizado em amostra com pequeno número de pacientes, cujo objetivo era a realização de estudo piloto para explorar esse tópico. Conclusão: a análise das deformidades deve considerar o aspecto estético e avaliação radiográfica, porem neste estudo não foi observado correlação estatística entre estes parâmetros. Nível de Evidência IV; Estudo de Série de Casos.

RESUMEN: Objetivo: El estudio correlaciona medidas radiográficas angulares y medidas de fotografías del tronco de pacientes con escoliosis idiopática del adolescente. Métodos: estudio transversal de 10 pacientes con escoliosis idiopática del adolescente y con indicación de tratamiento quirúrgico, en seguimiento en el sector de columna del HCRFMRP-USP. Se evaluaron mediante medidas tomadas de fotografías clínicas del torso de los pacientes y medidas de ángulos en radiografías panorámicas de la columna vertebral. Resultados: en la muestra estudiada solo se observó la correlación entre el ángulo axilar (AHA) y la curva torácica proximal y torácica principal. No se observó correlación entre las otras variables comparadas. El estudio se realizó en una muestra con un número reducido de pacientes, cuyo objetivo fue realizar un estudio piloto para explorar este tema. Conclusión: el análisis de las deformidades debe considerar el aspecto estético y la evaluación radiográfica, sin embargo, en este estudio no se observó correlación estadística entre estos parámetros. Nivel de Evidencia IV; Estudio de Serie de Casos.

Radiographic findings in the coxofemoral joint of Australian Cattle Dogs / Achados radiográficos em articulação coxofemoral de cães da raça Australian Cattle Dog

Australian Cattle Dogs (ACD) are medium-sized animals widely used in fieldwork for managing cattle and sheep. There needs to be more information about the conditions these dogs can develop despite being well-characterized animals since the beginning of the 20th century. Hip dysplasia (HD) is a developmental abnormality between the femoral head and the acetabular fossa, which can be debilitating. However, the available literature has no studies on the prevalence of this condition in dogs of this breed. This study aimed to evaluate radiographs of ACD qualitatively and quantitatively. For this purpose, 49 dogs considered healthy without clinical signs of HD were radiographically assessed, and the animals were classified as dysplastic (D) and non-dysplastic (ND). A frequency of 46.9% of dysplastic dogs was observed, with males being more affected. The cortical index (CI) and angle of inclination (AI) could not differentiate D from ND animals; only the Norberg angle (NA) was effective in this differentiation. No correlation was observed between AI, CI, and AN.(AU)

Os cães da raça Autralian Cattle Dog (ACD) são animais de porte médio, muito utilizados no trabalho de campo para manejo de gado e ovelha. Apesar de serem animais bem caracterizados desde o início do século XX, há poucas informações sobre afecções que esses cães podem desenvolver. A displasia coxofemoral (DCF) é uma anormalidade do desenvolvimento entre a cabeça do fêmur e a fossa acetabular podendo ser debilitante. Contudo, não há estudos, na literatura disponível, sobre a prevalência desta afecção em cães dessa raça. O objetivo deste trabalho foi avaliar qualitativamente e quantitativamente radiografias de cães da raça ACD. Para tanto, foram avaliados radiograficamente 49 cães considerados hígidos e sem sinais clínicos de DCF. Os animais foram classificados em displásicos (D) e não displásicos (ND). Observou-se a frequência de 46,9% de cães displásicos, sendo os machos mais acometidos. O índice cortical (IC) e o ângulo de inclinação (AI) não foram capazes de diferenciar os animais D dos ND, apenas o ângulo de Norberg (AN) foi eficaz nessa diferenciação. Não houve correlação entre AI, IC e AN.(AU)

Research Progress in Diagnostic Reference Levels in Interventional Radiology / 中国医学科学院学报

During interventional procedures,subjects are exposed to direct and scattered X-rays.Establishing diagnostic reference levels is an ideal way to optimize the radiation dose and reduce radiation hazard.In recent years,diagnostic reference levels in interventional radiology have been established in different countries.However,because of the too many indicators for characterizing the radiation dose,the indicators used to establish diagnostic reference levels vary in different countries.The research achievements in this field remain to be reviewed.We carried out a retrospective analysis of the definition,establishment method,application,and main factors influencing the dose difference of the diagnostic reference level,aiming to provide a basis for establishing the diagnostic reference level for interventional procedures in China.

Clinical and imaging features of eight cases of Ewing sarcoma of the jaw / 华西口腔医学杂志

OBJECTIVES@#This study investigate the clinical and imaging features of Ewing sarcoma (ES) of the jaw.@*METHODS@#Eight cases of pathologically diagnosed ES of the jaw from January 2010 to June 2022 were included in the study. Clinical and radiological features were retrospectively analyzed.@*RESULTS@#Among the eight cases, the mean age at onset was 29.4 years, and the male to female ratio was 7∶1. The predilecting site was the posterior part of mandible, accounting for 75% of the cases. The lesions often exhibited early numbness of the lower lip and lymphadenopathy. The main radiographic manifestation of mandibular lesions was ill-defined radiolucency, mixed with fibrous or brush-like tumor matrix, and soft tissue mass. The maxillary ES lesions mainly presented as lytic bone destruction accompanied by adjacent soft tissue mass. Periosteal ossification was rarely seen.@*CONCLUSIONS@#The clinical and imaging characteristics of ES in the jaw are helpful for its diagnosis.

Research status and outlook of deep learning in oral and maxillofacial medical imaging / 中华口腔医学杂志

Artificial intelligence, represented by deep learning, has received increasing attention in the field of oral and maxillofacial medical imaging, which has been widely studied in image analysis and image quality improvement. This narrative review provides an insight into the following applications of deep learning in oral and maxillofacial imaging: detection, recognition and segmentation of teeth and other anatomical structures, detection and diagnosis of oral and maxillofacial diseases, and forensic personal identification. In addition, the limitations of the studies and the directions for future development are summarized.

Research on multi-class orthodontic image recognition system based on deep learning network model / 中华口腔医学杂志

Objective: To develop a multi-classification orthodontic image recognition system using the SqueezeNet deep learning model for automatic classification of orthodontic image data. Methods: A total of 35 000 clinical orthodontic images were collected in the Department of Orthodontics, Capital Medical University School of Stomatology, from October to November 2020 and June to July 2021. The images were from 490 orthodontic patients with a male-to-female ratio of 49∶51 and the age range of 4 to 45 years. After data cleaning based on inclusion and exclusion criteria, the final image dataset included 17 453 face images (frontal, smiling, 90° right, 90° left, 45° right, and 45° left), 8 026 intraoral images [frontal occlusion, right occlusion, left occlusion, upper occlusal view (original and flipped), lower occlusal view (original and flipped) and coverage of occlusal relationship], 4 115 X-ray images [lateral skull X-ray from the left side, lateral skull X-ray from the right side, frontal skull X-ray, cone-beam CT (CBCT), and wrist bone X-ray] and 684 other non-orthodontic images. A labeling team composed of orthodontic doctoral students, associate professors, and professors used image labeling tools to classify the orthodontic images into 20 categories, including 6 face image categories, 8 intraoral image categories, 5 X-ray image categories, and other images. The data for each label were randomly divided into training, validation, and testing sets in an 8∶1∶1 ratio using the random function in the Python programming language. The improved SqueezeNet deep learning model was used for training, and 13 000 natural images from the ImageNet open-source dataset were used as additional non-orthodontic images for algorithm optimization of anomaly data processing. A multi-classification orthodontic image recognition system based on deep learning models was constructed. The accuracy of the orthodontic image classification was evaluated using precision, recall, F1 score, and confusion matrix based on the prediction results of the test set. The reliability of the model's image classification judgment logic was verified using the gradient-weighted class activation mapping (Grad-CAM) method to generate heat maps. Results: After data cleaning and labeling, a total of 30 278 orthodontic images were included in the dataset. The test set classification results showed that the precision, recall, and F1 scores of most classification labels were 100%, with only 5 misclassified images out of 3 047, resulting in a system accuracy of 99.84%(3 042/3 047). The precision of anomaly data processing was 100% (10 500/10 500). The heat map showed that the judgment basis of the SqueezeNet deep learning model in the image classification process was basically consistent with that of humans. Conclusions: This study developed a multi-classification orthodontic image recognition system for automatic classification of 20 types of orthodontic images based on the improved SqueezeNet deep learning model. The system exhibitted good accuracy in orthodontic image classification.

Digital X-ray Machine Carestream DRX-NOVA Fault Maintenance / 中国医疗器械杂志

OBJECTIVE@#To analyze the malfunction and maintenance process of Carestream digital X-ray machine DRX-NOVA for reference.@*METHODS@#The fault of Carestream digital X-ray machine DRX-NOVA in 2011-2021 was summarized, the fault types were classified, and the maintenance process was summarized.@*RESULTS@#Fault types can be divided into three categories, each of which has its own characteristics and specific solutions.@*CONCLUSIONS@#It is necessary to master the principle of equipment to repair all kinds of equipment failures. Repair the machine should be careful, comprehensive consideration of the cause of the failure. To correctly understand and analyze the operation of the machine under normal conditions, we can accurately analyze the cause of failure, so that we can really solve the problem.

Retrospective analysis of BI-RADS 4 and 5 lesions additionally detected by breast MRI / 中华外科杂志

Objectives: To establish a newly-designed scoring system for breast imaging-reporting and data system (BI-RADS) 4 and 5 breast lesions only visible on MRI, and to examine their clinical pathway of biopsy. Methods: The BI-RADS 4 and 5 breast lesions only visible on MRI but not suspected on mammograms or ultrasound between June 2007 and December 2021 at Beijing Hospital were evaluated retrospectively. A total of 209 lesions from 184 patients were finally included. All patients were female, aged (50±11) years (range: 27 to 76 years). All lesions were confirmed by pathology and divided into malignancy and non-malignancy. The lesions were divided into mass and non-mass type using BI-RADS. The receiver operator characteristic (ROC) curve was used to evaluate the diagnostic performance of the new scoring system. Four types of pathology-obtaining pathway were used: biopsy guided by second-look ultrasound, local excision guided by lesion position information on MRI, intraductal lesion excision guided by methylene blue stain and mastectomy. The data between mass and non-mass lesions were compared by Mann-Whitney U test, χ2 test or Fisher exact test,respectively. Results: There were 124 malignant and 85 non-malignant lesions, while 100 mass and 109 non-mass lessions. The sizes between mass and non-mass lesions showed significant difference(M(IQR)) (7.0 (3.0) mm vs. 25.0 (25.0) mm, U=568.000, P<0.01) and their BI-RADS diagnostic accuracy had no significant difference (53.0% (53/100) vs. 65.1% (71/109), χ2=3.184, P=0.074). The areas under ROC curve of the new scoring system for evaluating mass and non-mass were 0.841 and 0.802, respectively. When taking Score 3 as threshold, it can potentially avoid 14.0% (14/100) and 4.6% (5/109) of biopsies in mass and non-mass, respectively. As to pathway of obtaining pathology, second-look ultrasound succeeded more easily in mass than non-mass (41.0% (41/100) vs.26.6% (29/109), χ2=4.851, P=0.028). More MRI-guided local excisions were performed in non-mass than mass (52.3% (57/109) vs. 34.0% (34/100), χ2=7.100, P=0.008). Conclusions: For suspicious breast lesions detected by MRI but not suspected on X-ray or ultrasound, the new scoring system can further increase diagnostic accuracy. The second-look ultrasound plays an important role for obtaining pathology, especially for mass-type lesion.

The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers / 中华肿瘤杂志

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

Development and Application of Medical Imaging Analysis Platform Based on Radiomics and Machine Learning Technologies / 中国医疗器械杂志

OBJECTIVE@#In order to solve the technical problems, clinical researchers face the process of medical imaging analysis such as data labeling, feature extraction and algorithm selection, a medical imaging oriented multi-disease research platform based on radiomics and machine learning technology was designed and constructed.@*METHODS@#Five aspects including data acquisition, data management, data analysis, modeling and data management were considered. This platform provides comprehensive functions such as data retrieve and data annotation, image feature extraction and dimension reduction, machine learning model running, results validation, visual analysis and automatic generation of analysis reports, thus an integrated solution for the whole process of radiomics analysis has been generated.@*RESULTS@#Clinical researchers can use this platform for the whole process of radiomics and machine learning analysis for medical images, and quickly produce research results.@*CONCLUSIONS@#This platform greatly shortens the time for medical image analysis research, decreasing the work difficulty of clinical researchers, as well as significantly promoting their working efficiency.

Establishment and evaluation of rabbit model of closed tibial fracture / 中国骨伤

OBJECTIVE@#To explore the effect of a modified three-point bending fracture device for establishing a rabbit model of closed tibial fracture.@*METHODS@#The model of closed tibial fracture was established in 40 6-month-old male New Zealand white rabbits with a body weight of 2.5 to 3.0 kg, and the model was verified at 6 weeks after operation. Five rabbits underwent pre modeling without temporary external fixation before modeling, and then were fractured with a modified three-point bending fracture device;35 rabbits underwent formal modeling. Before modeling, needles were inserted, and splints were fixed externally, and then the fracture was performed with a modified three-point bending fracture device. The fracture model and healing process were evaluated by imaging and histopathology at 2 hours, 4 weeks, and 6 weeks after operation.@*RESULTS@#Two hours after modeling, the prefabricated module showed oblique fracture in varying degrees and the broken end shifted significantly;Except for 1 comminuted fracture, 2 curved butterfly fractures and 2 without obvious fracture line, the rest were simple transverse and oblique fractures without obvious displacement in formal modeling group. According to the judgment criteria, the success rate of the model was 85.71%. Four weeks after modeling, the fixed needle and splint of the experimental rabbits were in good position, the fracture alignment was good, the fracture line was blurred, many continuous callus growths could be seen around the fracture end, and the callus density was high. Six weeks after modeling, many thick new bone trabeculae at the fracture, marginal osteoblasts attached, and a small number of macrophages were seen under the microscope. The intramembrane osteogenesis area was in the preparation bone stage, the medullary cavity at the fracture had been partially reopened, the callus was in the absorption plastic stage, and many osteoclasts were visible. The X-ray showed that the fracture line almost disappeared, part of the medullary cavity had been opened, the external callus was reduced around, the callus was in the plastic stage, and the bone cortex was continuous. It suggests that the fracture model showed secondary healing.@*CONCLUSION@#The improved three-point bending fracture device can establish a stable rabbit model of closed tibial fracture, and the operation is simple, which meets the requirements of closed fracture model in basic research related to fracture healing.