齿状突骨折的定量三维计算机断层扫描 (Q3DCT) 分析。
- 作者列表："Verbeek BM","Janssen SJ","Pielkenrood BJ","Schwab JH
:The primary aim of this paper is to introduce Quantitative 3-dimensional Computed Tomography (Q3DCT) for odontoid fractures to assess if fracture characteristics differ between the Anderson and d'Alonso subclasses. Secondarily, we assessed if high energy injury and older age influenced fracture morphology. This retrospective imaging study includes 66 patients who visited one of two level I trauma centers for an odontoid fracture. With the use of 3-Dimensional polygon mesh models we determined the total number of fragments, the volume of each fragment, the degree of displacement of the odontoid, and the fracture surface area. We found that type III fractures consisted of more fracture fragments (median:3, IQR:2-3) than type II odontoid fractures (median:2, IQR:2-3) (p < 0.001). The volume of the odontoid fracture fragment was almost twice as large in type III odontoid fractures (median:19%, IQR:14-25%) as compared to type II fractures (median:10%, IQR:8.5-12%) (p < 0.001). Type II fractures were more displaced (median:3.8 mm, IQR:2.9-6.3 mm) compared to type III fractures (median:2.2 mm, IQR:1.0-3.5 mm) (p < 0.001). This 3-dimensional displacement was predominantly due to substantially more posterior displacement of type II odontoid fractures. In conclusion, type III odontoid fractures were more comminuted, had a larger odontoid fragment, had a larger fracture surface, but were less (posteriorly) displaced when compared to type II fractures. The mechanism of injury and age at diagnosis both dictated the fracture type, but when accounting for fracture type the influence of these two factors on fracture morphology was limited.
: 本文的主要目的是介绍齿状突骨折的定量三维计算机断层扫描 (Q3DCT)，以评估Anderson和d 'alonso亚类的骨折特征是否不同。其次，我们评估高能量损伤和年龄是否影响骨折形态。这项回顾性影像学研究包括66例因齿状突骨折到两个I级创伤中心之一就诊的患者。通过使用三维多边形网格模型，我们确定了碎片的总数、每个碎片的体积、齿状突的移位程度和骨折表面积。我们发现III型骨折包括更多的骨折碎片 (中位数: 3，IQR:2-3) 比II型齿状突骨折 (中位数: 2，IQR:2-3) (p <0.001)。与II型骨折 (中位数: 19%，IQR: 25%-10%) 相比，III型齿状突骨折 (中位数: 8.5，IQR:14-12%) 齿状突骨折碎片的体积几乎是II型骨折 (中位数: 0.001，IQR:-) 的两倍 (p < )。与III型骨折相比，II型骨折移位更多 (中位数: 3.8mm，IQR:2.9-6.3mm) (中位数: 2.2mm，IQR:1.0-3.5mm) (p <0.001)。这种三维移位主要是由于II型齿状突骨折的后移位。总之，与II型骨折相比，III型齿状突骨折较粉碎性，齿状突碎片较大，骨折表面较大，但移位较少。损伤的机制和诊断时的年龄都决定了骨折类型，但是当考虑骨折类型时，这两个因素对骨折形态的影响是有限的。
METHODS:OBJECTIVES:The aim was to evaluate the image quality and sensitivity to artifacts of compressed sensing (CS) acceleration technique, applied to 3D or breath-hold sequences in different clinical applications from brain to knee. METHODS:CS with an acceleration from 30 to 60% and conventional MRI sequences were performed in 10 different applications in 107 patients, leading to 120 comparisons. Readers were blinded to the technique for quantitative (contrast-to-noise ratio or functional measurements for cardiac cine) and qualitative (image quality, artifacts, diagnostic findings, and preference) image analyses. RESULTS:No statistically significant difference in image quality or artifacts was found for each sequence except for the cardiac cine CS for one of both readers and for the wrist 3D proton density (PD)-weighted CS sequence which showed less motion artifacts due to the reduced acquisition time. The contrast-to-noise ratio was lower for the elbow CS sequence but not statistically different in all other applications. Diagnostic findings were similar between conventional and CS sequence for all the comparisons except for four cases where motion artifacts corrupted either the conventional or the CS sequence. CONCLUSIONS:The evaluated CS sequences are ready to be used in clinical daily practice except for the elbow application which requires a lower acceleration. The CS factor should be tuned for each organ and sequence to obtain good image quality. It leads to 30% to 60% acceleration in the applications evaluated in this study which has a significant impact on clinical workflow. KEY POINTS:• Clinical implementation of compressed sensing (CS) reduced scan times of at least 30% with only minor penalty in image quality and no change in diagnostic findings. • The CS acceleration factor has to be tuned separately for each organ and sequence to guarantee similar image quality than conventional acquisition. • At least 30% and up to 60% acceleration is feasible in specific sequences in clinical routine.
METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.
METHODS:OBJECTIVE:The primary purpose of this study was to evaluate the effectiveness of a three-dimensional (3D) software tool (smart planes) for displaying fetal brain planes, and the secondary purpose was to evaluate its accuracy in performing automatic measurements. MATERIAL AND METHODS:This prospective study included singleton fetuses with a gestational age (GA) greater than 18 weeks. Transabdominal two-dimensional ultrasound (2DUS) and 3D smart planes images were respectively used to obtain the basic planes of the fetal brain, with five parameters measured. The images, by either two-dimensional (2D) manual or 3D automatic operation, were reviewed by two experienced sonographers. The agreements between two measurements were analyzed. RESULTS:A total of 226 cases were included. The rates of successful detection by automatic display were as high as 80%. There was substantial agreement between the measurements of the biparietal diameter, head circumference and transcerebellar diameter, but poor agreement between the measurements of cisterna magna and lateral ventricle width. CONCLUSIONS:Smart Planes might be valuable for the rapid evaluation of fetal brain, because it simplifies the evaluation process. However, the technology requires improvement. In addition, this technology cannot replace the conventional manual US scans; it can only be used as an additional approach.