Volumetric measurements of the subcortical structures of healthy adult brains in the Turkish population.

BACKGROUND: The interest in the morphological development of brain structures during childhood and adolescence arises from discussions on subcortical anomalies and sexual dimorphism, from adolescent changes in cognitive functions supported by cortical and subcortical structures to a wide range of childhood neuropsychiatric diseases. This study aims to investigate the subcortical structures regarding age/gender changes in the healthy adult human brain using web-based volBrain. MATERIALS AND METHODS: In this study, 303 normal healthy adults (males and females) were examined using a 1.5 T unit with a 20-channel head coil. RESULTS: The volumes of white matter, grey matter, total brain, cerebrospinal fluid, and total intracranial volume were significantly higher in males than those in females. Our analysis revealed a significantly larger accumbens volume in females. With the age of less than or equal to 50 years, older males were found to have higher total lateral ventricle, putamen, thalamus, amygdala, cerebrum, white matter and grey matter volumes than females. In the age group of 50 years and older mean total volumes of thalamus, globus pallidus and accumbens were higher in females than those in males. Right hemisphere volumes in younger and older age groups were higher except for caudate volume in the older age group; the mean of caudate was significantly higher in females than those in males. CONCLUSIONS: These conclusions might be important for the explanation of the effects of gender and age in cross-sectional structural magnetic resonance imaging studies. Also, knowing the volume changes of the subcortical structures can provide convenience about the prevention, diagnosis, and treatment of various neuromental disorders.

Examination of inclinations of the spine at childhood and adolescence.

BACKGROUND: Spine is a column that consists of consecutively lined up vertebras. It includes medulla spinalis. It contributes the motions of head, neck and body. Spine is not a straight column. There is a convexity towards the front of the spine (lordosis) at cervical and lumbar areas in adults and a convexity towards the back of the spine (kyphosis) at thoracic and sacral spine areas. MATERIALS AND METHODS: In this study, lateral magnetic resonance images of 731 children between 1 and 16 years of age were examined and their cervical lordosis, thoracic kyphosis and lumbar lordosis angles were measured with Cobb method using ImageJ programme for every age group. RESULTS: The mean calculated cervical lordosis angles in 1-16-year-old children were found to be 20.51o ± 6.11o (minimum 17.96o ± 6.29o, maximum 23.50o ± ± 4.14o). It has been observed that cervical angle values decrease with age. The mean thoracic kyphosis angle measured was 28.71o ± 6.99o (minimum 24.55o ± ± 5.65o, maximum 30.44o ± 4.68o). Lumbar lordosis angle was 28.08o ± 7.39o (minimum 20.36o ± 6.59o, maximum 32.68o ± 6.03o). Thoracic kyphosis and lumbar lordosis angle values increased with age. In our study, a statistical differ- ence was found in increasing thoracic kyphosis angle between 1-year-old group and 14-year-old group. Statistical difference was also found in decreasing cervical lordosis angle value between 1-year-old group and 16-year-old group. When we compare our study results with literature values, cervical lordosis values were similar, but lumbar lordosis values were lower. CONCLUSIONS: In summary, we think that knowing sagittal plane inclinations of the spine developing in childhood and adolescence will contribute to earlier de- termination of pathologies. We also hope that it will contribute to clinical stages and other studies in this field.

Chiari type I malformation with high foramen magnum anomaly.

A 14-year-old male with a neck pain and hypoesthesia in the upper extremities was diagnosed with Chiari type I malformation (CMI) and syringomyelia. The posterior part of the occipital bone was removed via cranio-cervical decompression. The accuracy of measuring the posterior cranial fossa (PCF) and foramen magnum (FM) dimensions were evaluated and compared with the literature. The linear PCF and FM dimensions as well as volumes were measured using computed tomography (CT) images with different techniques. The volume data were compared with similar data from literature. Use of the posterior fossa approach remains controversial when treating patients with minor little brain stem dislocation, small PCF, and or incomplete C1, but the approach can easily be applied if FM and PCF sizes are known. Linear measurements that were assessed for concordance with CT measurements had the best agreement. Quantification of PCF volume and high FM should be taken into consideration for differential diagnosis of tonsillar herniation and prediction of surgical outcome in CMI.

Estimation of spleen volume and surface area of the newborns' cadaveric spleen using stereological methods.

BACKGROUND: The purpose of this study was to compare different techniques for the estimation of spleen volume and surface area using magnetic resonance imaging (MRI) images, ultrasonography (USG) images and cadaveric specimen, and to evaluate errors associated with volume estimation techniques based onfluid displacement. MATERIALS AND METHODS: Five new born cadavers, aged 39.7 ± 1.5 weeks, weighted 2.220 ± 1.056 g, were included in the present study. Three different methods were used to assess the spleen volume. The vertical section technique was applied using cycloid test probes for estimation of spleen surface area in MRI. RESULTS: The mean ± standard deviation of spleen volumes by fluid displacement was 4.82 ± 3.85 cm³. Volumes determined by the Cavalieri's principle using physical section and point-counting techniques were 4.45 ± 3.47 cm³ and 4.65 ± 3.75 cm³, respectively; volumes measured by USG and cadaver using ellipsoid formula were 4.70 ± 3.02 cm3 and 5.98 ± 4.58 cm³, respectively. No significant differences were found among all methods (p > 0.05). The spleen surface area was calculated as a 32.3 ± 20.6 cm² by physical sections using cadaver and also it was determined on axial, sagittal and coronal MR planes as 24.9 ± 15.2 cm², 18.5 ± 5.92 cm² and 24.3 ± 12.7 cm², respectively. CONCLUSIONS: As a result, MR images allow an easy, reliable and reproducible volume and surface area estimation of normal and abnormal spleen using Cavalieri'sprinciple. We consider that our study may serve as a reference for similar studies to be conducted in future. :

Comparison of two volumetric techniques for estimating volume of intracerebral ventricles using magnetic resonance imaging: a stereological study.

The size of brain ventricles is especially relevant in some brain diseases such as epilepsy, schizophrenia and other neurodegenerative diseases. Many studies have been conducted to assess the brain ventricles. To the best of our knowledge, however, there is no fourth, third and lateral ventricles volume study evaluating the efficiency and accuracy of point-counting and planimetry methods of the Cavalieri principle in the literature. In the current study, we estimated the volume of intracerebral ventricles in normal subjects using stereological methods. The volumes of fourth, third and lateral ventricle were estimated in 14 young Turkish volunteers (7 males and 7 females), aged between 18 and 36 years and free of any neurological symptoms and signs, using serial magnetic resonance imaging (MRI). Volumes of intracerebral ventricles were determined on MRIs using the point-counting and planimetry methods. The mean results of the point-counting method were 14.7 +/- 4.2, 8.7 +/- 3.0 and 131.8 +/- 33.1 mm(3) for the fourth, third and lateral ventricles, respectively. The mean results of the planimetry method were 15.4 +/- 3.4, 8.6 +/- 3.5 and 153.7 +/- 34.6 mm(3) for the fourth, third and lateral ventricles, respectively. Ventricle volumes obtained by the two different methods were not statistically different (p > 0.05) and they correlated well with each other. Good agreement was found between results obtained with the point-counting and planimetry techniques. The findings of the present study using stereological methods could provide data for the evaluation of normal and pathological volumes of intracerebral ventricles.

Unbiased estimation of the calcaneus volume using the Cavalieri principle on computed tomography images.

The size and shape of tarsal bones are especially relevant when considering some orthopedic diseases such as clubfoot. For this reason, the measurements of the tarsal bones have been the subject of many studies, none of which has used stereological methods to estimate the volume. In the present stereological study, we estimated the volume of calcaneal bone of normal feet and dry bones. We used a combination of the Cavalieri principle and computer tomographic scans taken from eight males and nine dry calcanei to estimate the volumes of calcaneal bones. The mean volume of dry calcaneal bones was estimated, producing mean results using the point-counting method and Archimedes principle being 49.11+/-10.7 or 48.22+/-11.92 cm(3), respectively. A positive correlation was found between anthropometric measurements and the volume of calcaneal bones. The findings of the present study using the stereological methods could provide data for the evaluation of normal and pathological volumes of calcaneal bones.

Comparison of four methods for the estimation of intracranial volume: a gold standard study.

Investigators can infer how much reduction in volume has occurred since brain volume was at its peak, by combining measures of brain volume with measures of intracranial volume (ICV). Several methodologies have been proposed to asses the ICV. However, we have not seen a gold-standard study evaluating the results of the methodologies for the assessment of ICV. In the present study, the actual intracranial volume of 20 dry skulls was measured using the water-filling method, using this as a gold standard. Anthropometry, cephalometry, point-counting, and planimetry techniques were applied to the same skulls to estimate the ICV. Anthropometric and cephalometric measurements were carried out directly on skulls and roentgenograms, respectively. Consecutive computed tomography sections at a thickness of 10 mm were used to estimate the ICV of the skulls by means of the point-counting and planimetry methods. The mean (+/-SD) of the actual ICV measured by the water-filling method was 1,262.0 +/- 160.4 cm(3) (1,389.5 +/- 96.5 cm(3) for males and 1,134.5 +/- 94.3 cm(3) for females, respectively). Our results showed that the estimated values obtained by all four methods differed from the actual volumes of the skulls (P < 0.05). The data obtained by anthropometry resulted in overestimation. However, cephalometry, point-counting, and planimetry methods produced underestimation. After calibration, there were no significant differences between the actual volumes and the results of the four methods (P > 0.05). While the anthropometric method is easy and quick to apply, its result may deviate from the actual values. The optimized stereological techniques of point-counting and planimetry methods may provide unbiased ICV results since they take the third dimension of the structures into account.