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@#Objective To investigate the clinical effect of 3D computed tomography bronchial bronchography and angiography (3D-CTBA) and guidance of thoracoscopic anatomic pulmonary segmentectomy by Mimics software system. Methods A retrospective analysis was performed on patients who underwent thoracoscopic segmentectomy in the Department of Thoracic Surgery of Affiliated People's Hospital of Jiangsu University from June 2020 to December 2022. The patients who underwent preoperative 3D-CTBA using Materiaise's interactive medical image control system (Mimics) were selected as an observation group, and the patients who did not receive 3D-CTBA were selected as a control group. The relevant clinical indicators were compared between the two groups. Results A total of 59 patients were included, including 29 males and 30 females, aged 25-79 years. There were 37 patients in the observation group, and 22 patients in the control group. The operation time (163.0±48.7 min vs. 188.8±43.0 min, P=0.044), intraoperative blood loss [10.0 (10.0, 20.0) mL vs. 20.0 (20.0, 35.0) mL, P<0.001], and preoperative puncture localization rate (5.4% vs. 31.8%, P=0.019) in the observation group were better than those in the control group. There was no statistically significant difference in the thoracic tube placement time, thoracic fluid drainage volume, number of intraoperative closure nail bin, postoperative hospital stay, or postoperative air leakage incidence (P>0.05) between the two groups. Conclusion For patients who need to undergo anatomical pulmonary segmentectomy, using Mimics software to produce 3D-CTBA before surgery can help accurately identify pulmonary arteriovenous anatomy, reduce surgical time and intraoperative blood loss, help to determine the location of nodules and reduce invasive localization before surgery, and alleviate patients' pain, which is worthy of clinical promotion.
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Objective To investigate the accuracy and application value of the Tada formula in evalua-ting the meningioma volume based on 3D reconstruction technology.Methods The thin-slice magnetic reso-nance images of 297 patients with meningioma treated in the neurosurgery department of 940 Hospital of PLA Joint logistics Support Force from January 2014 to May 2022 were retrospectively analyzed.The meningioma volume was evaluated by the Tada formula method and three-dimensional reconstruction method respectively.The accuracy of the evaluation of meningeal tumor volume by the Tada formula was analyzed by grouping sta-tistics.Results In the whole sample and the concentrated sample,the obtained meningioma total volumes had no statistical difference between the two methods(P＞0.05),the Spearman correlation coefficients were 0.995 and 0.993 respectively,and the intragroup correlation coefficients(ICC)were 0.992 and 0.989,respec-tively.In the Bland-Altman plot,most of the data points were within the limit of uniformity.Compared with different groups,the Tada formula had a slightly lower accuracy in the volume assessment of meningiomas with higher degree of irregularity,and a better accuracy in the volume assessment of supratentorial meningio-mas than subtentorial meningiomas.Conclusion The Tada formula could accurately evaluate the volume of meningioma,and it could be used as a preliminary method to evaluate meningioma volume in clinic
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BACKGROUND:In recent years,with the development of 3D printing,surgical surgery has become personalized and accurate.3D printed guide template technique can realize preoperative planning and intraoperative navigation,making surgery more accurate.In clinical orthopedic surgery for moderate and severe stiff scoliosis,there is still a problem that the accuracy of screw placement is not high,resulting in screw loosening and even nerve complications.There are few studies on 3D printed guide template technique to guide screw placement in surgery for severe stiff scoliosis. OBJECTIVE:To evaluate the clinical effect of the 3D printed guide template technique combined with multiple posterior derotation in the treatment of severe rigid scoliosis. METHODS:The clinical data of six patients with severe scoliosis undergoing 3D printed guide template technique of pedicle screw combined with multiple posterior derotation were retrospectively analyzed.There were 3 males and 3 females,with a mean age of(18.17±3.49)years(range,15-23 years).The changes of parameters related to lateral bending were analyzed at postoperative 2 weeks and 18 months,and the results were obtained by statistical analysis. RESULTS AND CONCLUSION:(1)The operation time was 280-540 minutes(mean 340.83±102.20 minutes).The intraoperative blood loss was 1 000-4 000 mL(mean 2 000.00±1 073.70 mL).The fixed segments were 9-14 vertebral bodies(mean 11.83±1.72),and no screw loosening occurred during the operation.(2)All patients were followed up.At postoperative 2 weeks,the anteroposterior and lateral radiography of the whole spine showed that the cobb angle,the distance between the vertical line of C7 on the coronal plane and the median line of S1,the distance between the vertical line of C7 in the sagittal plane and the posterior edge of S1,apical vertebral translation,thoracic kyphosis,and lumbar lordosis were significantly corrected.The average correction rate of the cobb angle in the main curve was 62.22%.After 18 months of follow-up,there was no significant change in all parameters compared with 2 weeks after operation;the orthopedic effect was satisfactory,and there was no infection or internal fixation fracture.(3)There was one case of delayed wound healing;scar healing appeared after dressing change treatment;no neurological complications occurred.(4)The results show that the 3D print-guide template combined with multiple posterior rod derotation technique is safe and effective in the treatment of severe rigid scoliosis,and the correction effect is satisfactory.
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BACKGROUND:One-hole split endoscope technique has been widely used in the treatment of lumbar degenerative diseases,but there is no relevant literature on the safety analysis of this technique in the treatment of upper lumbar disc herniation. OBJECTIVE:To observe the position relationship of nerve roots,intervertebral space and bone landmarks in the upper lumbar spine by three-dimensional lumbar CT reconstruction technology,and to provide a basis for the clinical operation of one-hole split endoscope surgery. METHODS:Twenty-six patients with upper lumbar disc herniation underwent a lumbar CT scan.Mimics 17.0 software was imported to measure the related imaging parameters of L1/2 to L3/4 segments:(1)Measurement of vertical distance:In coronal view,the distance(a)from the intersection point of the medial facet of the superior articular process and the superior endplate(N)to the apex of the articular process(S);in the coronal view,the distance(b)from the sagittal intersection(M)of N and the inferior endplate to the apex of the inferior articular process(X).(2)Measured horizontal distance:the distance(c)between the cross-section of N and the lower edge of the outlet nerve root(N2);distance(d)between the cross-section of N and the intersection point of neural tissue(N1);N1 to N2 distance(e);distance(f)between the cross-section of M and the lateral edge of the nerve tissue(M1);M to M cross-section and exit nerve root intersection(M2)distance(g);distance(h)from M1 to M2;distance(i)from M2 to N1;distance(j)from the posterior edge of the articular surface(R)to M2 in sagittal view of the superior articular process. RESULTS AND CONCLUSION:(1)With the decrease of the segment,the distances a and b gradually increased,and the distance j gradually decreased.There was no significant difference between L1/2 and L2/3 segments(P>0.05).(2)With the decrease of the segment,distance d first decreased and then increased;distance f gradually decreased;distances c,e,g,h and i gradually increased;and there was no significant difference between L2/3 and L3/4 segments(P>0.05).(3)Distance i was the shortest distance without pulling nerve roots in the natural state,and the area of the safety zone was between four points M1,M2,N1,and N2.The bone was removed to the upper and lower endplates by biting the bone downward and upward through S and X,respectively,to expose the intervertebral space,and the window of distance g to M2 could be opened outward to avoid injury of the outlet nerve roots.(4)In conclusion,the upper lumbar vertebrae have unique anatomical characteristics.Based on the relevant measurements of nerve roots,spinal dura and intervertebral space,the parameters of the one-hole split endoscope technique are more accurate and safe during operation.
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BACKGROUND:With the application and development of 3D printing technology in medicine,orthopedic internal fixation surgery has become precise and individualized.The equal-scale fracture model obtained by 3D printing technology was simulated and planned before surgery,realizing the leap from traditional 2D images to more vivid and detailed three-dimensional objects.It allows the surgeon to understand the fracture type in advance and rehearse the reduction sequence,so as to realize the individualized implementation of fracture surgery,optimize the surgical process,bring better postoperative recovery and less surgical complications. OBJECTIVE:To compare clinical efficacy of three 3D printed models combined with computerized virtual repositioning technology to assist incision reduction bone plate internal fixation and traditional incision reduction bone plate internal fixation in the treatment of Robinson II B2 clavicle fracture. METHODS:Eighty patients with Robinson II B2 clavicle fracture were randomly divided into trial group(n=40)and control group(n=40).In the trial group,three kinds of 3D printing models(affected clavicle fracture model,computer simulation clavicle fracture reduction model,clavicle mirror model of healthy side)combined with computer virtual reduction technology were used for preoperative in vitro surgery rehearsal.Finally,3D printing was used for clavicle mirror model of healthy side to advance bending and select bone plates for internal fixation.In the control group,open reduction plate internal fixation was applied.The time from admission to surgery,intraoperative blood loss,operation time,frequency of fluoroscopy,number of bends of the bone plate,fracture healing time,complications,and visual analog scale score and Constant score before and after surgery were compared between the two groups. RESULTS AND CONCLUSION:The time from admission to operation in the trial group was greater than that in the control group(P<0.05).Operation time,intraoperative fluoroscopy frequency and bending times of the bone plate in the trial group were lower than those in the control group(P<0.05).The trial group had faster fracture healing and fewer complications(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).Constant score of the two groups had an increasing trend with time(F=613.50,P<0.001),but the difference between the groups was not statistically significant(F=0.08,P=0.78),and there was no interaction between the measurement times and the group assignment(F=0.27,P=0.66).The visual analog scale score decreased with time(F=1 149.55,P<0.001),but there was no significant difference between groups(F=0.02,P=0.88),and there was no interaction between the number of measurements and the group assignment(F=1.02,P=0.36).The results show that the use of 3D printed model combined with computer virtual reduction technology for preoperative rehearsal can shorten the operation time,reduce the number of intraoperative fluoroscopy frequency and the times of bone plate bending,and have the advantages of faster fracture healing,fewer complications,and similar functional recovery to the traditional incision reduction bone plate internal fixation.
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BACKGROUND:Ankylosing spondylitis is a progressive inflammation of spinal stiffness deformity caused by tissue ossification and fibrosis.The posture of ankylosing spondylitis patients is abnormal and their activities are limited that minor injuries can lead to thoracolumbar fractures.Traditional medical image observation limits doctors'preoperative decision planning and postoperative disease prevention for ankylosing spondylitis treatment. OBJECTIVE:Based on the spinal model of ankylosing spondylitis patients before and after posterior spinal cancellous ossification osteotomy("Y"osteotomy for short),to explore the biomechanical changes of"Y"osteotomy and fixation in the treatment of ankylosing spondylitis. METHODS:Based on the preoperative and postoperative CT images of an ankylosing spondylitis patient who went to the Second Affiliated Hospital of Inner Mongolia Medical University,a three-dimensional spine model(T11-S1)before and after"Y"osteotomy(L3 osteotomy)was reconstructed in Mimics 19.0 software.A 7.5 Nm torque was applied to the top of T11 vertebral body to simulate the movement of the spine under six conditions:flexion,extension,left bending,right bending,left rotation and right rotation.Finally,the range of motion of each vertebral body,the stress of each intervertebral disc,and the stress of the screw rod system were simulated. RESULTS AND CONCLUSION:(1)After"Y"type osteotomy and posterior fixation,the range of motion of all vertebrae in the spine decreased,and the loss rate of upper vertebrae was large(L1:77.95%).(2)The maximum stress of the spinal intervertebral disc before operation occurred at the L1-L2 segment(0.55 MPa),and the maximum stress of the spinal intervertebral disc after operation occurred at the T11-T12 segment(0.50 MPa),and the stress of intervertebral disc below T12 was far less than that before operation.(3)The maximum stress of the screw rod system(166.67 MPa)occurred in the upper and middle segments of the rod body and the root of the pedicle screw.(4)In conclusion,the"Y"type posterior fixation operation enhances the stability of the spine and reduces the range of motion of the spine.The vertebral body decompression of the fixed segment is great and the stress-shielding phenomenon of the lower vertebral body is significant.The stiffness of the rod body and the stress concentration area of the pedicle screw should be strengthened to avoid the fracture of the rod caused by stress fatigue.
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BACKGROUND:The distribution of the necrotic area plays an important role in hip preservation treatment.At present,there are few studies on whether the difference in the three-dimensional spatial distribution of osteonecrosis of the femoral head affects the clinical outcome of fibular support. OBJECTIVE:To explore the relationship between the spatial distribution and clinical outcome at the sites of osteonecrosis of the femoral head and fibular support using CT three-dimensional reconstruction so as to provide a basis for optimizing the applicable conditions of fibular support and improving the hip preservation effect of fibular support. METHODS:Eighty patients with osteonecrosis of the femoral head who were treated with fibular support for hip preservation from January 2010 to January 2021 were selected as the study subjects according to the inclusion criteria.They were followed up for at least 2 years.According to the clinical outcome,the patients were divided into the successful hip preservation group(n=55)and the failure hip preservation group(n=25).3D reconstruction was performed according to the preoperative and postoperative CT images of the patients.According to the three-column theory,the femoral head was divided into outer nine areas,middle nine areas and inner nine areas(L1-9,C1-9,and M1-9)to explore the spatial distribution of necrotic area of the femoral head and fibular support area and its relationship with clinical outcome. RESULTS AND CONCLUSION:(1)Before operation,the necrotic area of the femoral head was mainly distributed in L1,L2,L4,L5,C1,C2,C4,and C5(the upper and middle part of the anterior part of the outer ninth area and the middle part of the middle ninth area).After operation,the fibular support area was mainly distributed in L5,L6,C5,and C6(the middle and lower part of the outer ninth area and the middle and lower part of the middle ninth area).(2)There were significant differences in the distribution of osteonecrosis of the femoral head between the successful hip preservation group and the failure hip preservation group in L8(the posterior middle part of the outer ninth area),C3(the anterior lower part of the middle ninth area),C6(the lower middle part of the middle part of the inner ninth area)and M2(the anterior middle part of the inner ninth area)(P<0.05).There was a significant difference in the distribution of fibular support in L5 and L6(middle and lower part of outer nine)(P<0.05).Among them,the L8 region could be used as an independent predictor of hip preservation failure in fibular support surgery.The area under the curve of the L8 single factor prediction model was 0.698[95%CI(0.575,0.822)];the sensitivity was 76%,and the specificity was 63.6%.(3)It turns out,when the necrotic area involves L8,C3,C6,and M2,especially L8,the failure of fibular support may increase,and when the fibular support involves L5 and L6,the effect of hip preservation is often not ideal.
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BACKGROUND:Digital three-dimensional reconstruction technology is gradually applied to orthopedic diseases with the advantages of visualization,accuracy and non-invasiveness,but there is less evidence-based support for its use in artificial hip hemiarthroplasty for intertrochanteric fractures of the femur in the elderly. OBJECTIVE:To investigate the application value and economic effects of digital three-dimensional reconstruction techniques in artificial hip hemiarthroplasty of intertrochanteric fractures of the femur in the elderly. METHODS:One hundred and thirty elderly patients with intertrochanteric femur fractures admitted to Zunyi First People's Hospital from January 2019 to December 2022 were selected and randomly divided into a control group(n=65)and an observation group(n=65).Artificial hip hemiarthroplasty was performed in both groups.The control group adopted the film template measurement method for manual preoperative planning while the observation group adopted a digital three-dimensional reconstruction technique.Preoperative planning and intraoperative actual application of prosthesis compliance rate,fibrinogen,D-dimer,bilateral femoral eccentric distance difference,bilateral lower limb length difference,Harris hip function score,visual analog scale score,excellent and good rate of hip function,complications,and hospitalization cost were observed in both groups. RESULTS AND CONCLUSION:(1)The proportion of acetabular side and femoral side prosthesis in grade 0(fully compliant)was higher in the observation group than that in the control group(P<0.05).(2)Fibrinogen and D-dimer levels in the observation group were lower than those in the control group 3 days after surgery(P<0.05).(3)The difference in bilateral femoral eccentric distance and the difference in bilateral lower limb length in the observation group were smaller than those in the control group immediately after surgery(P<0.05).The differences in Harris and visual analog scale scores were not significantly different between the two groups preoperatively,6 and 12 months postoperatively(P>0.05).There was no significant difference in excellent and good rate of hip function between the two groups 12 months postoperatively(P>0.05).(4)There was no significant difference in the complication rate between the two groups(P>0.05).The hospitalization cost of the observation group was higher than that of the control group(P<0.05).(5)It is indicated that digital three-dimensional reconstruction technology applied in artificial hip hemiarthroplasty of intertrochanteric femoral fracture in the elderly can not only accurately determine the prosthesis type before surgery,but also accurately reconstruct the bilateral lower limbs offline,but its hospitalization cost is high.
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BACKGROUND:Due to the young age of children,the occipital condyle and foramen magnum are not fully developed,and they are prone to various diseases and injuries in the occipitocervical junction,which requires surgical treatment in severe cases.However,anatomical parameters for the development of the occipital condyle and foramen magnum in children are lacking. OBJECTIVE:To measure the morphological structure of the occipital condyle and foramen magnum by three-dimensional reconstruction technique,and to provide important anatomical parameters for occipitocervical junction lesions,related surgical procedures and forensic identification. METHODS:Imaging data of 389 cases of primitive children and adolescents involved in skull base undergoing spiral CT scanning(247 males and 142 females)aged 1-18 years were collected and divided into 1-3-year-old group,4-6-year-old group,7-9-year-old group,10-12-year-old group,13-15-year-old group,and 16-18-year-old group according to their age.Mimics 16.0 software was used to reconstruct the skull base and measure the length and width of the foramen magnum.A formula was used to calculate the area and index of the foramen magnum.We measured the length,width and height of the occipital condyle,the angle between the long axis and the sagittal axis of the occipital condyle(O-S angle),the included angle between the midpoint of the front and back edges of the foramen magnum and the connection between the back edge of occipital condyle and the intersection point of the foramen magnum(F-O angle),and the included angle between the midpoint of the front and back edges of the foramen magnum and the midpoint of the back wall of the sublingual neural tube(F-H angle).Gender,side and age differences were analyzed among the indicators. RESULTS AND CONCLUSION:(1)In foramen magnum measurement,there was no significant difference between sexes in the index of the foramen magnum(P>0.05),but there were significant differences in length,width and area of the foramen magnum(P<0.05).(2)The O-S angle,F-O angle and F-H angle of the occipitral condyle were not significantly different between genders(P>0.05),but length,width and height of the occipital condyle were significantly different between genders(P<0.05).(3)There were no significant differences in the length of the occipital condyle among different groups(P>0.05),but there were significant differences in the width and height of the occipital condyle,O-S angle,F-O angle and F-H angle among different groups(P<0.05).(4)Length,width and area of the foramen magnum,length,width and height of the occipital condyle showed a wavy increasing trend with the increase of age,while O-S,F-O and F-H angles showed a wavy decreasing trend with the increase of age,while the index of the foramen magnum showed no significant change.(5)In conclusion,there are gender and lateral differences in the morphological indexes of the foramen magnum and the occipital condyle in children.These differences can provide an important reference for clinical surgical approach selection and forensic examination.
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BACKGROUND:In recent years,cervical facet joints have been paid more and more attention to the pathogenesis and surgical treatment of cervical spondylosis,but there are few anatomical studies on adult lower cervical facet joints. OBJECTIVE:To measure three-dimensional parameters of the lower cervical facet to provide a basis for the design of the lower cervical transarticular facet screw guide. METHODS:From June 2021 to June 2022,100 cases receiving cervical spine CT examination in the Affiliated Hospital of Xuzhou Medical University were selected,with 50 males and 50 females,aged 20-50 years.After screening,each image showed no cervical spinal stenosis,cervical disc herniation,obvious bone hyperplasia,infection or tumor.The sagittal inclination angle of each segment of the cervical spine facet joint and the angle between the lower cervical spine facet joint surface and the transarticular facet joint screw at the C3-7 levels were measured after 3D reconstruction.According to the measurement results of statistical analysis,a lower cervical transarticular facet screw guide was designed using CAD software. RESULTS AND CONCLUSION:The inclination angle of the cervical facet joint surface on the sagittal plane was distributed in a U-shaped shape centered on C5,and the magnitude relationship was C7>C6>C3>C4>C5.The relationship between transarticular facet screw angles on the sagittal plane was:C6/7>C5/6>C4/5>C3/4,where the angle of C3/4,C4/5 and C5/6 was close to 90°,and the angle of C6/7 exceeded 100°.By measuring the sagittal inclination angle of the cervical facet joint and the angle of the transarticular facet screw,this study designed a guide that was perpendicular to the lower cervical facet joint surface in the sagittal plane.
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BACKGROUND:Reconstruction of the medial patellofemoral ligament is the primary and basic treatment for patellofemoral dislocation.Generally,autologous or allogeneic tendons are used to fix the patellofemoral podogram area and the femoral insertion,respectively.There are various fixation methods.Patellar lateral insertion fixation methods are relatively diverse,mainly traditional transosseous fixation and recent anchoring methods,including single tunnel,double-tunnel transosseous fixation,and two-wire anchor fixation.However,which fixation method is more effective in reducing patellofemoral joint stress and is more biomechanical has not been determined. OBJECTIVE:To observe the mechanical effects of patellofemoral joint and medial patellofemoral ligament reconstruction with transosseous and wire anchor fixation. METHODS:A three-dimensional finite element model of the knee joint was constructed.The medial patellofemoral ligament was reconstructed by a single tunnel through the bony canal or two wire anchors at the medial edge of the patella.The femoral side was fixed by extrusion nails to the medial epicondyle of the femur and the midpoint of the adductor tubercle.We observed the effects of the two fixation methods on patellofemoral joint and medial patellofemoral ligament loading during knee flexion at 0°,30°,60°,90°,and 120°. RESULTS AND CONCLUSION:(1)The stress on the patellofemoral joint was large when the knee was at flexion of 0-60°,peaked at 30°,and gradually decreased at 90° and 120°.The two fixation methods had little difference in the stress on the patellofemoral joint.(2)The stress on the medial patellofemoral ligament peaked at 30° and decreased significantly at 60°,and the load on the medial patellofemoral ligament was significantly greater at all angles with anchor fixation than with bony canal fixation.(3)The results showed that there was no significant difference in patellofemoral joint loading between the two fixation methods,but the stress on the medial patellofemoral ligament in anchoring was significantly greater than that in transosseous fixation.
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BACKGROUND:Acromion morphology is the most important external factor of degenerative rotator cuff tear,and studies on acromion morphology and acromion coverage have been continuing. OBJECTIVE:To investigate the coverage of acromion on rotator cuff tissue in three-dimensional space,measure coronal and sagittal parameters,and explore the relationship of acromial overhang,acromioglenoid angle and acromial coverage angle with degenerative full-thickness rotator cuff tears. METHODS:A total of 56 patients diagnosed with full-thickness rotator cuff tears by shoulder arthroscopic surgery or MRI in the Affiliated Hospital of Xuzhou Medical University from January 2022 to June 2023 were retrospectively collected as the tear group,while 48 patients with non-rotator cuff tear were included as the control group.Clinical data and chest CT data of the patients of the two groups were collected,and the shoulder blades of the patients were reconstructed using Mimics software.Acromial overhang,acromioglenoid angle and acromial coverage angle were measured in 3-matic software.The differences between the measurement parameters were compared between the two groups.Binary Logistic regression analysis and receiver operating characteristic curve analysis were performed to evaluate the ability of the measurement parameters to predict rotator cuff tear.It is generally believed that the parameter had good diagnostic value when the area under the receiver operating characteristic curve was greater than 0.8. RESULTS AND CONCLUSION:(1)The mean acromial overhang in patients with rotator cuff tears was greater than that in controls(P<0.001).The mean acromial coverage angle was also greater in patients with rotator cuff tears than in controls(P<0.001).There was no significant difference in the acromioglenoid angle between the two groups(P>0.05).(2)Binary Logistic regression analysis showed that acromial overhang and acromial coverage angle were both risk factors for rotator cuff tear(P<0.05).(3)Receiver operating characteristic curve analysis indicated that the areas under the curve of acromial overhang and acromial coverage angle were 0.725 and 0.865,respectively,and the optimal cutoff values were 36.15 mm and 60.65°.(4)The results showed that the acromial overhang and acromial coverage angle were greater in patients with rotator cuff tears than in patients without rotator cuff tears.Both were associated with degenerative full-thickness rotator cuff tears,and they could be used to predict rotator cuff tears,and the acromial coverage angle was more effective in predicting rotator cuff tears.
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@#Objective To investigate the accuracy of 18F-FDG positron emission tomography/computed tomography (PET/CT) combined with CT three-dimensional reconstruction (CT-3D) in the differential diagnosis of benign and malignant pulmonary nodules. Methods The clinical data of patients who underwent pulmonary nodule surgery in the Department of Thoracic Surgery, Northern Jiangsu People's Hospital from July 2020 to August 2021 were retrospectively analyzed. The preoperative 18F-FDG PET/CT and chest enhanced CT-3D and other imaging data were extracted. The parameters with diagnostic significance were screened by the area under the receiver operating characteristic (ROC) curve (AUC). Three prediction models, including PET/CT prediction model (MOD PET), CT-3D prediction model (MOD CT-3D), and PET/CT combined CT-3D prediction model (MOD combination), were established through binary logistic regression, and the diagnostic performance of the models were validated by ROC curve. Results A total of 125 patients were enrolled, including 57 males and 68 females, with an average age of 61.16±8.57 years. There were 46 patients with benign nodules, and 79 patients with malignant nodules. A total of 2 PET/CT parameters and 5 CT-3D parameters were extracted. Two PET/CT parameters, SUVmax≥1.5 (AUC=0.688) and abnormal uptake of hilar/mediastinal lymph node metabolism (AUC=0.671), were included in the regression model. Among the CT-3D parameters, CT value histogram peaks (AUC=0.694) and CT-3D morphology (AUC=0.652) were included in the regression model. Finally, the AUC of the MOD PET was verified to be 0.738 [95%CI (0.651, 0.824)], the sensitivity was 74.7%, and the specificity was 60.9%; the AUC of the MOD CT-3D was 0.762 [95%CI (0.677, 0.848)], the sensitivity was 51.9%, and the specificity was 87.0%; the AUC of the MOD combination was 0.857 [95%CI (0.789, 0.925)], the sensitivity was 77.2%, the specificity was 82.6%, and the differences were statistically significant (P<0.001). Conclusion 18F-FDG PET/CT combined with CT-3D can improve the diagnostic performance of pulmonary nodules, and its specificity and sensitivity are better than those of single imaging diagnosis method. The combined prediction model is of great significance for the selection of surgical timing and surgical methods for pulmonary nodules, and provides a theoretical basis for the application of artificial intelligence in the pulmonary nodule diagnosis.
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@#Oral and maxillofacial tumors are common oral and maxillofacial surgery-related diseases. Digital surgical technology, represented by virtual surgical design and surgical navigation, is the main auxiliary means of the surgical diagnosis and treatment of oral and maxillofacial tumors. However, the existing digital technology still has some problems and room for improvement in terms of 3D visualization imaging and intraoperative hand-eye coordination. At present, the application of 3D visualization technology represented by mixed-reality technology has been rapidly developing in the medical field. It assists in realizing the real-time stereoscopic presentation of medical images by superimposing 3D virtual images onto the real surgical environment. Mixed-reality technology has been gradually applied to the diagnosis and treatment of oral and maxillofacial tumors. Preoperatively, mixed-reality technology can be used to construct a 3D model of the tumor and its surrounding vital structures based on imaging data, at which point the medical team can personalize the preoperative assessment and design the surgical plan in the mixed-reality environment. Intraoperatively, the combination of mixed-reality technology and surgical navigation technology can be used to display the 3D virtual model in real time in the actual environment of the operation area, overcoming the hand-eye coordination problem associated with using navigation technology alone and further improving the accuracy and safety of oral and maxillofacial tumor surgery. The combination of mixed-reality technology and internet medical technology can provide a high-quality teaching platform to promote the development of regional oral and maxillofacial surgery practices. The limitations of mixed-reality technology include image occlusion, lack of accuracy when used alone, and long alignment times. In this review, the application of mixed-reality technology to the diagnosis and treatment of oral and maxillofacial tumors will be summarized and assessed by combining information from domestic and international literature reports with the practical clinical experience of the author group.
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The finite element method(FEM)is a widely employed mathematical technique in mechanical research that divides an object into discrete and interacting finite elements. Medically, finite element analysis(FEA)enables the simulation of biomechanical experiments that are challenging to conduct. Orbital surgery poses significant challenges to ophthalmologists due to its inherent difficulty and steep learning curve. FEM enables the simulation and analysis of the mechanical properties of orbital tissue, offering a novel approach for diagnosing and treating orbital-related diseases. With technological advancements, FEM has significantly matured in the diagnosis and treatment of orbital diseases, becoming a popular area of research in orbital biomechanics. This paper reviewed the latest advancements in orbital FEM, encompassing the development of orbital FEA models, simulation of orbital structure, and its application in orbital-related diseases. Additionally, the limitations of FEM and future research directions are also discussed. As a digital tool for auxiliary diagnosis and treatment, orbital FEA will progressively unlock its potential for diagnosing and treating orbital diseases alongside technological advancements.
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Objective To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three⁃dimensional finite element model of the C
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Nasal drug delivery efficiency is highly dependent on the position in which the drug is deposited in the nasal cavity. However, no reliable method is currently available to assess its impact on delivery performance. In this study, a biomimetic nasal model based on three-dimensional (3D) reconstruction and three-dimensional printing (3DP) technology was developed for visualizing the deposition of drug powders in the nasal cavity. The results showed significant differences in cavity area and volume and powder distribution in the anterior part of the biomimetic nasal model of Chinese males and females. The nasal cavity model was modified with dimethicone and validated to be suitable for the deposition test. The experimental device produced the most satisfactory results with five spray times. Furthermore, particle sizes and spray angles were found to significantly affect the experimental device's performance and alter drug distribution, respectively. Additionally, mometasone furoate (MF) nasal spray (NS) distribution patterns were investigated in a goat nasal cavity model and three male goat noses, confirming the in vitro and in vivo correlation. In conclusion, the developed human nasal structure biomimetic device has the potential to be a valuable tool for assessing nasal drug delivery system deposition and distribution.
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A system for achieving two-dimensional(2D)visualization and three-dimensional(3D)reconstruction of lung images using CT data is designed.After DICOM image processing,and lung nodule segmentation and labeling,the multi-view and multi-resolution 3D display of lung parenchyma and nodules is realized using techniques such as resampling of CT sequences,3D reconstruction based on surface rendering,and morphological processing.Finally,the interactive interface is designed for implementing the functions of image enhancement,2D visualization,nodule delineation,3D reconstructions of lung parenchyma and nodules,rotation,zooming and switching the viewpoint.Experimental results show that the system provides clear and accurate 2D image visualization and lesion delineation,while reconstructing nodules in the generated 3D images completely and smoothly.Compared with the existing similar medical processing software,the developed system substantially improves the reconstruction and visualization efficiencies,enabling doctors to observe 3D images more quickly and accurately,and assisting in disease diagnosis and surgical planning.
RESUMO
Objective:To explore the diagnostic value of three-dimensional(3D)reconstruction of cone beam computed tomography(CBCT)and nine zone method of alveolar bone for ambush teeth of anterior maxilla.Methods:From January 2022 to January 2023,a total of 80 patients with ambush teeth of anterior maxilla were selected from the Stomatology Department of the Third Medical Center of Chinese PLA General Hospital.All patients sought medical attention due to uneven or missing dental alignment.A total of 88 ambush teeth of anterior maxilla were treated.After alveolar bone was conducted by nine zone method,the ambush teeth were found by nine zone method combined with temporomandibular bone CBCT.The number of ambush teeth of anterior maxilla at the outer-upper,outer-middle,outer-lower,middle-upper,middle-middle,middle-lower,inner-upper,inner-middle and inner-lower at the second tooth root of dental crown,as well as the position of the ambush teeth,dental crown positioning and root curvature,were counted by using statistical method.The diagnostic accuracies of two examination methods for the position of ambush teeth,dental crown positioning and root curvature were compared.The comparison of the rates between the nine zone method of alveolar bone and the research results of CBCT was analyzed by using chi square test and other methods.Results:In the 88 ambush teeth,the dental crowns and roots of 50 teeth were at the same side of adjacent teeth,and these of 5 teeth were at between adjacent teeth,and these of 33 teeth were at the different side of adjacent teeth.The most of dental crowns and roots of ambush teeth located in two regions,which were respectively inner-middle and outer-upper regions(23.86%and 19.32%)of maxilla.The diagnostic results of 88 ambush teeth were consistent with the results of intraoperative findings,with a diagnostic accuracy of 100%.The accuracies of the nine zone classification method of alveolar bone in the positions of ambush teeth and dental crown were significantly higher than those of CBCT,and the differences were statistically significant(x2=4.020,1.340,4.460,4.570,0.900,0.930,0.030,0.040,0.200,P<0.05),respectively.Conclusion:CBCT has the advantages of clearness,intuitiveness,accuracy and convenience in the localization of ambush teeth of the anterior maxilla.The nine zone method of alveolar bone has a significance of precise localization for the treatment of complex ambush teeth in the anterior maxilla,and also has a certain guidance value of diagnosis and treatment.
RESUMO
Objective:To evaluate the feasibility of 3D reconstruction techniques based on multi-depth cameras for daily patient positioning in radiotherapy.Methods:Through region of interest (ROI) extraction, filtering, registration, splicing and other processes, multi-depth cameras (Intel RealSense D435i) were used to fuse point clouds in real-time manner to obtain the real optical 3D surface of patients. The reconstructed surface was matched with the external contour of the localization CT to complete the positioning. In this article, the feasibility of the system was validated by using multiple models. Clinical feasibility of 5 patients with head and neck radiotherapy, 10 cases of chest radiotherapy and 5 cases of pelvic radiotherapy was also validated. The data of each group were analyzed by paired t-test. Results:The system running time was 0.475 s, which met the requirement of real-time monitoring. The six-dimensional registration errors in the model experiment were (1.00±0.74) mm, (1.69±0.69) mm, (1.36±0.87) mm, 0.15°±0.14°, 0.25°±0.20°, 0.13°±0.13° in the x, y, z, rotational, pitch and roll directions, respectively. In the actual patient positioning, the mean positioning errors were (0.77±0.51) mm, (1.24±0.67) mm, (0.94±0.76) mm, 0.61°±0.41°, 0.69°±0.55°, and 0.52°±0.35° in the x, y, z, rotational, pitch and roll directions, respectively. The translational error was less than 2.8 mm, and the positioning error was the largest in the pelvic region. Conclusions:Real-time 3D reconstruction techniques based on multi-depth cameras is applicable for patient positioning during radiotherapy. The method is accurate in positioning and can detect the small movement of the patient's position, which meets the requirements of radiotherapy.