Three-dimensional motion patterns of the carpal bones: an in vivo study using three-dimensional computed tomography and clinical applications

A three-dimensional (3D) CT technique was developed to analyze in vivo segmental carpal kinematics. Transverse CT data of the distal forearm, carpals and proximal metacarpals was acquired and 3D reconstructed in various wrist positions. Carpal kinematics were analyzed in two groups of 20 asymptomatic volunteers, one group in neutral position, flexion and extension (45°), and the other group in neutral position, radial (15°) and ulnar deviation (30°). Qualitative analysis included the 3D study of carpal anatomy, and comparison of carpal bone position between the different sets of data obtained. Carpal bone motion was quantified using rigid body and finite helical axis concepts. The results, although agreeing in principle with previous findings, showed important individual variations in carpal bone motion. Clinical applications were conducted in a series of 25 patients with various wrist disorders. There was no significant difference between the injured wrist and the heterolateral, asymptomatic wrist, but there was a significant difference between asymptomatic volunteers and both the injured wrist and heterolateral wrist of patients. In particular, scaphoid motion was altered bilaterally in our patient group, suggesting the existence of anatomic and/or kinematic factors predisposing to certain carpal pathologies. This hypothesis needs to be confirmed and refined.     

Comparative study of the pneumatization of the mastoid air cells and paranasal sinuses using three-dimensional reconstruction of computed tomography scans

Purpose  

The purpose of this study was to investigate the relationship between the pneumatization of mastoid air cells and PNS using three-dimensional (3D) reconstruction of computed tomography (CT) scans of the PNS.     

基于CTA三维重建的中国女性髂内动脉解剖学分型

目的 利用CTA三维重建技术,探讨中国女性髂内动脉的解剖学分型及特点.方法 选取2009年8月至2010年10月在我院妇科住院并行盆腔CTA扫描的连续患者170例,获取其CTA原始数据集,利用Mimics10.01软件构建其盆腔动脉血管网三维数字化模型,参照Yamaki等的分型标准对髂内动脉进行分型并进行对比分析.结果...     

基于CT三维重建的成人第5掌骨的形态学及临床意义

目的 通过对成人第5掌骨CT三维重建数据进行测量,探讨人类第5掌骨形态学特点及临床意义,为临床手术和器械设计提供依据。方法 对医学影像工作站内留存的114例第5掌骨CT扫描进行三维重建,基于三维模型测量第5掌骨长度、掌骨头半径、掌骨弓半径和1/2掌骨弓圆心角、掌骨头偏心距和偏心比及髓腔狭部内径。结果 成人掌骨长度（51.55±3.01）mm,掌骨头半径（6.59±0.49）mm,掌骨弓半径（99.58±26.83）mm,1/2掌骨弓圆心角（15.90±3.36）°,掌骨头偏心距平均（0.49±0.26）mm,掌骨头偏心比平均（7.4±3.9）%,髓腔峡部内径平均（2.28±0.77）mm。结论 男性掌骨长度、掌骨头半径、掌骨头偏心距及髓腔峡部内径大于女性,其余指标性别间差异无显著性;左右手之间差异也无显著性。     

Three-dimensional reconstruction of a levator claviculae muscle

Summary During routine radiological examination of a 72 year-old woman a soft-tissue shadow in the left posterior triangle of the neck was observed. Three-dimensional reconstruction of this structure suggested that it might be a muscular variant: a levator claviculae muscle. In our case it took origin from the upper part of the cervical column and was inserted into the lateral third of the clavicle. With this example as a background, the general significance of anatomical muscular variants for modern imaging techniques is discussed.

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Reconstruction tridimensionnelle d'un muscle élévateur de la clavicule

Résumé Lors d'un examen radiologique de routine (TDM, IRM) pratiqué chez une femme de 72 ans, une image tissulaire molle fut mise en évidence dans le triangle cervical postérieur gauche. La reconstruction tridimensionnelle de cette structure a suggéré qu'il pouvait s'agir d'une variante musculaire, en l'occurrence d'un muscle élévateur de la clavicule. Dans notre cas, l'origine musculaire était située au niveau de la colonne cervicale supérieure et son insertion distale sur le tiers latéral de la clavicule. Cette exemple nous amène à rappeler l'aspect général des variantes anatomiques musculaires dans le contexte des techniques d'imagerie moderne.

     

Symphysis pubis distance in adults: a retrospective computed tomography study

Background In this retrospective study, symphysis pubis (SP) distance was measured by transverse computed tomography scans. The relation between the SP distance and age, gender, number of birth and body-mass index was studied. Methods Symphysis pubis joint distances were evaluated for the patients who had undergone abdominal or pelvic computed tomography examination for other medical reasons between the dates of March and May 2007. Anterior, middle, and posterior SP joint distances were measured at transverse planes. Normal joint width in women and men was determined. The relation between obtained values, and age, gender, number of birth, as well as body-mass index was studied. Results Symphysis pubis narrows at anterior concurrently with ageing (r = −0.115; P = 0.007). Narrowing, though less, is also observed at posterior (r = −1.50 P = 0.000); however, middle part does not change (r = 0.030; P = 0.489). Number of birth and body-mass index values do not affect SP width. The widths measured at anterior and middle of the SP were significantly higher in women (P = 0.010 and P = 0.002). Conclusions Osteoarthritic changes develop in SP with ageing. However, osteoarthritis in SP, was found to be clinically and radiologically different from that in other symphyseal joints, as SP hardly ever moves, and vertically processing interpubic disc combines pelvis girdle with counterforces, and is supported by very strong ligaments and muscles. Anterior and middle part of the SP joint is wider in women, because fibrocartilaginous disc is too thick to provide the mobility. An erratum to this article can be found at     

喉组织切片与喉CT图像的对照研究及三维重建

目的对喉部MSCT和组织切片图像及其三维重建的比较研究。方法 30例(21男,9女)结构完整的喉标本,全喉连续大切片,HE染色,专业微距照相系统拍照,专业图像分析;30名(12男,18女)健康志愿者经64排高分辨率薄层MSCT扫描,得到喉部CT图像。在用3D-Doctor软件进行MSCT三维重建。测量组织切片和MSCT三维重建喉甲状软骨、环状软骨和6个切面会厌前间隙和声门旁间隙的面积,进行两组独立样本的t检验。结果 MSCT图像中甲状软骨、会厌软骨和环状软骨能清晰显示,但杓状软骨显示不全。会厌前间隙和声门旁间隙内容结构无法显示,而组织切片清晰显示间隙内容。组织切片和MSCT甲状软骨、环状软骨的测量结果无显著性差异(P0.05)。除了甲状软骨声带附着处至上、下切迹距离等四项数据无性别差异(P0.05)以外,其他数据均有性别差异(P0.05)。MSCT切割平面与组织切片会厌前间隙和声门旁间隙面积的测量结果无显著性差异(P0.05)。结论 MSCT对超过其分辨率的细微结构显示欠佳,其三维重建的细节效果不如组织切片完整清晰。组织切片能对MSCT起到良好的补充作用,使得MSCT及其三维重建作为临床医疗诊断和影像学检查的辅助工具,更适合于临床应用。     

Rotation of the cervical spinal column: a computed tomography in vivo study

Summary The functional anatomy of the spinal column has mainly been studied in the cadaver. The aim of our study was to determine in vivo the normal axial rotation of the cervical column using computed tomography (CT). Sixty subjects, divided into decades from 20 to 80 years of age were studied. The CT protocol comprised an axial cut at the level of the skull base (C0) and at each vertebral level in the neck, in the neutral position (with the nasal septum vertical) and during rotation of the head. To reduce the exposure to irradiation the subjects were divided into two groups: 40 were studied from C0 to the fifth cervical vertebra (C5) with unilateral rotation at C0 of 10°, 20° and 40° (20 rotations to the left and 20 to the right), and 20 subjects were studied from C0 to the first thoracic vertebra (T1) with a maximum rotation at C0 to left and right. The angular position of a vertebra was defined as the anteroposterior axis with reference in the neutral position to the axis of C0, and in rotation was related to its original axis. At each vertebral level the mean angle of rotation and its standard deviation were calculated (n=30) for the successive intermediate and maximum rotations at C0 level. The rotation of the cervical spine took place mainly at two levels: 58% between C1 and C2 and 24% between C3 and C6. The pairs of vertebrae C0/C1 and C2/C3 provided functional couples where the rotation was minimal. Rotation of the lower cervical spine occurred very early. The percentage of rotation with respect to C0 of each cervical vertebra was constant during the successive rotations. The neutral positions of the vertebrae below the atlas were variable. The findings on rotation to left and to right were comparable. This study determined in vivo the distribution of rotation at each vertebral level of the cervical spine during partial and maximum rotation of the skull base. It facilitates the application of CT to the examination of disorders affecting the rotation of the cervical spinal column.

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Anatomie in vivo de la rotation de la colonne cervicale: étude tomodensitométrique

Résumé L'anatomie fonctionnelle de la colonne cervicale a principalement été établie in vitro sur cadavre. Notre étude avait pour but de déterminer in vivo, par utilisation de la tomodensitométrie (TDM), les normes fonctionnelles de la rotation axiale de la colonne cervicale. 60 témoins répartis en décades de 20 à 60 ans et au delà ont été explorés. Le protocole TDM comportait une coupe axiale sur la base du crâne (C0) et sur chaque étage vertébral cervical, en position neutre (septum nasal vertical) et au cours de rotations de la tête. Afin d'obtenir une irradiation faible les sujets étaient répartis en deux groupes : 40 sujets étaient explorés de C0 à C5 pour une rotation unilatérale de C0 à 10°, 20° et 40° (20 rotations droites et gauches), 20 sujets étaient explorés de C0 à T1 pour une rotation maximale de C0 à droite et à gauche. La position angulaire d'une vertèbre était définie par son axe antéro-postérieur rapporté, en position neutre à l'axe de C0, et en rotation à son axe initial. A chaque étage vertébral, l'angle moyen de rotation, et sa déviation standard, étaient calculés (n>30) pour les rotations séquentielles et maximales de C0. La rotation de la colonne cervicale s'effectuait principalement à 2 niveaux; 58 % entre C1 et C2 et 24 % entre C3 et C6. Les doublets vertébraux C0/C1 et C2/C3 formaient des couples fonctionnels. La rotation de la colonne cervicale inférieure était très précoce. Le pourcentage de rotation, par rapport à C0, de chaque vertèbre cervicale était constant au cours des rotations séquentielles. La position neutre des vertèbres sous-atloïdiennes était variable. Les résultats en rotations droite et gauche étaient comparables. Cette étude détermine in vivo la répartition de la rotation axiale de la colonne cervicale à chaque segment vertébral pour des rotations séquentielles et maximales de la base du crâne. Elle permet l'application de cette technique TDM à l'exploration de la pathologie de la rotation de la colonne cervicale.

     

胫骨平台线性几何参数在CT三维重建中的测量及其意义

目的　通过CT三维重建技术构建胫骨平台三维模型,准确测定胫骨平台线性几何参数,探讨CT三维重建技术在胫骨平台测量中的应用及临床意义。 方法 随机抽取病房、门诊患者（膝关节正常,且胫骨未受累）及健康志愿者49例,并分别按性别进行分组。通过CT三维重建技术测量胫骨平台相应线性几何参数,包括参数：胫骨平台宽、胫骨内侧平台宽、胫骨内侧平台前后径、胫骨外侧平台宽和胫骨外侧平台前后径。 结果 （1）男性胫骨平台各项线性指标均明显大于女性（P<0.01）;（2）外侧平台比内侧平台宽,前后径小于内侧平台（P<0.05）;（3）胫骨平台宽与内外侧胫骨平台前后径存在着正相关关系（P<0.05）。 结论 CT三维重建技术对胫骨平台线性几何参数的测量,能为国人膝关节假体设计改进提供一定的参考。     

Occipital artery arising from the superior aspect of the carotid bifurcation identified by three-dimensional computed tomography angiography

Variation of the branches of the external carotid artery is well known, but it is extremely rare for the occipital artery (OA) to arise from the carotid bifurcation (CB). A 73-year-old man was found to have this anatomical variation on the right side by three-dimensional CT angiography for vascular mapping of the carotid arteries before superselective intra-arterial catheterization. The OA arose from the CB and the inner diameter of the origin of the OA was 1.5 mm. The CB was located at the level of C3–C4 and 7.9 mm above the tip of the greater horn of the hyoid bone.     

CT三维重建技术对颈椎理想椎弓根螺钉的选择及意义

目的运用CT三维重建技术测量颈椎(C3～C7)理想椎弓根螺钉的形态并探讨临床意义。方法应用CT三维重建技术对56例颈椎(C3～C7)进行模拟椎弓根内固定术,并对理想椎弓根螺钉的形态进行测量,包括理想螺钉的长度、直径、螺钉的偏角(外偏角)及矢状角。结果C3～C7理想椎弓根螺钉的长度分别为(28.2±1.9)、(27.9±2.1)、(29.7±2.0)、(30.8±2.3)、(30.6±2.4)mm;直径分别为(4.3±0.8)、(4.5±0.8)、(4.9±0.8)、(5.4±0.9)、(6.2±0.9)mm;外偏角分别为(48±4)°、(50±5)°、(48±4)°、(43±4)°、(36±3)°;矢状角分别为(9±5)°、(6±4)°、(1±3)°、(-1±4)°、(-1±3)°。结论C3～C7椎弓根的形态变异范围较大,应用CT三维重建技术模拟椎弓根内固定术,可测量理想椎弓根螺钉的形态并进行评估,对术中置入螺钉的角度和形态的选择有指导意义。     

Prevalence and correlates of patient-centred preparatory information provision to computed tomography and magnetic resonance imaging outpatients: A cross-sectional study

Objective

Responsiveness to information preferences is key to high-quality, patient-centred care. This study examined the top ten preparatory information items not delivered in accordance with medical imaging outpatients’ preferences, and patient characteristics associated with reporting a greater number of unmet information preferences.

Diabetes mellitus and brain atrophy: A computed tomography study in an elderly population

Previous studies have suggested that noninsulin dependent diabetes mellitus (NIDDM) could lead to learning and memory deficits. We studied cognitive performance and computed tomography (CT) findings of the brain in elderly subjects with drug treated NIDDM (n = 12), with diet treated NIDDM (n = 13), and in nondiabetic individuals (ND, n = 59). The cognitive performance (orientation and uptodate knowledge, praxic functions, understanding of speech, expressive speech, memory, general reasoning) did not differ between the groups. The drug treated diabetics had more pronounced central temporal atrophy compared to that in the ND subjects as evidenced by wider right temporal horn (ANCOVA adjusted for age, p = 0.011). The drug treated diabetics (all women) also had wider frontal horns than did the ND women. The CT measures of diet treated diabetics were comparable with those of the ND group. The fasting glucose level was positively correlated with the width of the right temporal horn but not with other CT measures in diabetic subjects. The results suggest that NIDDM and poor glucose control may carry a risk for accelarated brain atrophy in the elderly.     

Three-dimensional reconstruction of medieval child mummy in Yangju, Korea, using multi-detector computed tomography

Recently reported studies on the medieval mummies in Korea have been regarded as an invaluable source for studying the physical characteristics of medieval Koreans. However, since the reported medieval mummies were re-buried by their descendants without any scientific investigations, the development of a brief, non-invasive investigation technique was desperately needed among the researchers in Korea. In this regard, we tried to apply high-quality multi-detector computed tomography (MDCT) with three-dimensional (3D) reconstructions and multi-planar reformat (MPR) to investigate Korean mummies.

In our study, after 1.25 or 2.5 mm thin slice axial images were taken, 3D reconstruction and MPR were performed to get more accurate information about internal organs. In this trial, we successfully showed high-quality images for the brain, muscles, bones, heart and liver. During various trials for getting selected organs, we could make the 3D reconstructed images of them. Since we could show that the current MDCT technique could be useful for obtaining high-quality 3D reconstructed images of the internal organs of Korean mummies, this technique will be used in forthcoming similar cases, which could not be investigated using invasive techniques.     

基于多层螺旋CT影像对胸骨后组织随年龄变化特征的观察

目的:基于多层螺旋CT（MSCT）影像探讨胸骨后解剖结构随年龄的变化特征。方法:回顾性研究。纳入青岛大学附属泰安市中心医院2020年8—12月行胸部MSCT检查的1 000例受检者的影像学资料。男500例、女500例,年龄0.5～100（50.23±28.49）岁。按每10岁进行分组,共分为10组,观察和统计在胸骨柄后...     

肺支气管血管CT三维重建辅助胸腔镜下解剖性肺段或亚段切除术前定位的应用效果观察

目的 探讨肺支气管血管CT三维重建（3D-CTBA）在单孔胸腔镜（VATS）解剖性肺段或肺亚段切除术前定位中的可靠性与临床效果。方法 回顾性研究。纳入2020年1月—2022年2月在徐州市中心医院胸外科行3D-CTBA辅助单孔VATS解剖性肺段或肺亚段切除术的肺结节患者207例。其中男78例、女129例,年龄27~93（57.4±11.7）岁,肺结节最大径0.2~4.3（1.1±0.6）cm。依据术前3D-CTBA影像解剖的定位和设计进行手术。观察指标：（1）围术期及术后随访情况;（2）评价3D-CTBA无创定位肺结节的可靠性。结果 （1）患者手术均顺利完成,均R0切除,无中转开胸。手术时间（131.4±59.7）min,术中出血量（92.6±76.6）mL。引流管留置时间（4.5±2.4）d。术后并发症发生率5.8%（12/207）,其中持续肺漏气（>7 d）6例、切口脂肪液化2例、乳糜胸2例、迟发性胸腔积液2例。术后30 d无二次手术。患者均获随访2~34（16.1±7.3）个月,无肿瘤复发或死亡。（2）术中解剖观察与术前3D-CTBA对比,切除的肺结节所在肺段或肺亚段的血管、支气管及其分支均与影像所示的解剖结构匹配。所有靶区肺结节完整切除且有明确的病理诊断,与影像定位相符。结论 3D-CTBA用于单孔VATS解剖性肺段或亚段切除术的手术前定位精准可靠,临床效果满意。     

Bone tunnel change develops within two weeks of double-bundle anterior cruciate ligament reconstruction using hamstring autograft: A comparison of different postoperative immobilization periods using computed tomography

Background

The purpose of this study was to evaluate bone tunnel changes following anterior cruciate ligament (ACL) reconstruction during the early postoperative period using computed tomography (CT), and to understand the impact of postoperative immobilization on these changes.

Thyroid dimensions of Korean adults on routine neck computed tomography and its relationship to age, sex, and body size

The purpose of this study was to establish a “normal” range of dimensions of the thyroid gland on routine neck computed tomography in the Korean population and to investigate the possible influence of some physiological factors on the thyroid dimension. Neck computed tomography scans of 100 adults (57 males, 43 females; mean age=55.2 years) were reviewed retrospectively to measure the size of the thyroid gland and to evaluate its relationship to the trachea and cervical vertebra. For right and left lobes, the mean width was 15.7±2.6 mm and 15.2±3.1 mm, the mean thickness was 20.9±3.4 mm and 18.9±3.4 mm, the mean length was 61.8±8.6 mm and 58.5±8.3 mm, the mean estimated volume of each lobe was 8.8±3.1 cm³ and 7.6±3.0 cm³, respectively. The mean volume of total thyroid glands (including isthmus) was 17.5±6.6 cm³. There was no significant difference between the total study group and the normal thyroid function group. The dimensions of the right lobe were significantly larger that those of the left. There was no significant difference between males and females. In multiple regression analysis, it was likely that the influence of body weight on the thyroid dimension was most pronounced. Our study presents initial data for assessing the thyroid gland on neck computed tomography scans in Koreans, and thereby provides suitable limit values of normal thyroid glands.