Optimization of Postprocessing parameters for abdominal Forensic CT scans.

Aim: Postmortem Computed Tomography (PMCT) is gradually introduced at forensic institutes. Image reconstruction software can increase diagnostic potential in CT by increasing distinction between structures and reduction of artifacts. The aim of this study was to develop and evaluate novel image reconstruction parameters for postmortem conditions, to increase image quality and diagnostic potential of CT scans. Method: Twenty PMCT scans of deceased hereof two in severe decay were subjected to four reconstruction techniques: a standard reconstruction algorithm, the detail reconstruction algorithm and two novel algorithms based on the standard algorithm, but with different Hounsfield settings. Image quality was evaluated by visual grading analysis (VGA) by four forensic radiologist observers. Results: The VGA did not prove that any of the reconstruction techniques were superior to the others. For standard and detail, the two pre-defined reconstruction algorithms, VGA scores were indiscernible and were superior to the equally indiscernible Hounsfield reconstructions on parameters translated into Sharpness and Low Contrast Resolution. The two alternative Hounsfield settings were superior with respect to Noise and Artifacts/Beam Hardening. Conclusion: The study elucidates the possiblity for multiple reconstructions specialized for PMCT conditions, to accommodate the special conditions when working with the deceased. Despite the lack of clear improvements in the tested reconstructions, this study provides an insight into some of the possibilities of improving PMCT quality using reconstruction techniques.

[Osteoarthritis of facet and sacroiliac joints].

This review gives a summary of osteoarthritis (OA) of the spine involving the facet and the sacroiliac joints. Facet joint OA is widely prevalent in adults, and is thought to be a common cause of back and neck pain. The prevalence of facet and SI-joint mediated pain increases with age, suggesting that OA might have a particularly important role in older adults with spinal pain. Treatment options of symptomatic facet- and SI-joint degeneration consist of non-opioid analgesics, physiotherapy or in patients with persistent back or leg pain of either spinal decompression or fusion.

[Magnetic resonance imaging as supplement to clinical examination by suspicion of haematocolpos]. / MR-skanning som supplement til klinisk undersøgelse ved mistanke om hæmatokolpos.

Haematocolpos is a rare condition in young women that could be caused by imperforated hymen, vaginal atresia and vaginal agenesis. Haematocolpos is usually diagnosed at early puberty with unspecified abdominal pain and amenorrhoea. Three cases are presented. In one case the radiological examination showed incidentally a urogenital congenital anomaly known as Herlyn-Werner-Wunderlich syndrome. A gynaecological examination should be performed to confirm the presence of imperforated hymen, but in cases in which other pathology is suspected ultrasound and MRI should also be performed.

[Endovascular treatment of diseases of the descending thoracic aorta]. / Endovaskulaer behandling af sygdom i aorta descendens.

INTRODUCTION: Endovascular repair as treatment of aortic diseases seems promising. We report the first Danish results of endografting of the descending thoracic aorta. MATERIALS AND METHODS: Nineteen patients (median age 68 years, range 22-78 years) underwent endovascular treatment of diseases in the descending thoracic aorta: atherosclerotic aneurysm (n = 7), ruptured aneurysm (n = 3), Type B dissection (n = 3), traumatic rupture (n = 3), pseudoaneurysm (n = 2) and a defective aortic prosthesis (n = 1). The patients were followed with chest CT scans and clinically. RESULTS: In all cases the endograft was successfully deployed in the intended positions. Median total hospital stay was 5 days, range 2-21 days. Eight patients had post-implantation syndrome. No deaths occurred within the first post-operative month. During the follow-up period (median 12 months, range 1-56 months) five deaths were observed. One of the patients died from aortobronchial fistula related to the endograft. One patient had an endoleak, and two had expanded aneurysm. None of these patients was treated. CONCLUSION: In selected patients, endoluminal grafting of the descending thoracic aortic is a safe and successful alternative to open graft repair in treating aneurysm, ruptured aneurysm, traumatic rupture and dissection. However, long-term evaluation is still required.

Remodeling of Salter-Harris type II epiphyseal plate injury of the distal radius.

The authors studied the relation between residual angulation at the time of healing and final orientation of the distal radius as well as the clinical outcome in patients after Salter-Harris type II epiphyseal plate injury of the distal radius. Eighty-five patients were reviewed with a median follow-up of 8.5 years. Anteroposterior and lateral radiographs were taken at follow-up. The mobility of both wrists and forearms was examined, together with grip strength. Pain with activities and sports was evaluated. At follow-up, 73 patients (86%) were anatomically normal on radiographs; the remaining 12 patients had an incomplete remodeling of the volar and/or radial inclination of the distal radius. Premature closure of the growth plate in the distal radius or ulna did not occur in any of these children. Complete remodeling was seen in children aged up to 10 years in all but one patient. Remodeling after Salter-Harris type II epiphyseal plate injury occurs in all age groups, but the potential is greater in children up to 10 years of age. The incomplete remodeling does not seem to have any substantial long-term negative effect on mobility of the wrist and grip strength.