Relationship between facial asymmetry and positional plagiocephaly analyzed by three-dimensional computed tomography.
- 作者列表："Sasaki J","Hasegawa S","Yamamoto S","Watanabe S","Miyachi H","Nagao T
PURPOSE:A relationship between positional cranial deformation and facial asymmetry has been suggested; however, details regarding this relationship remain to be clarified. This study aimed to elucidate the relationship between facial asymmetry and positional plagiocephaly using three-dimensional computed tomography (3D-CT). METHODS:One-hundred-and-twenty-nine patients were included, and cranial vault asymmetry index (CVAI) and cephalic index (CI) were used as indicators of positional cranial deformation. Temporal muscle was constructed using 3D-CT data, and its volume was measured. VRL, Me (vertical reference line (VRL)-anterior nasal spine (ANS) and menton (Me) line) angle and the frontal occlusal plane (FOP) angle were measured. RESULTS:CVAI and VRL, Me angle (R2 = 0.31, P < 0.0001), VRL, Me angle and temporal muscle volume (R2 = 0.13, P < 0.0001), and FOP angle and VRL, Me angle were significantly correlated (R2 = 0.32, P < 0.0001), but CVAI and FOP angle were not (R2 = 0.08). Multiple linear regression analysis indicated that CVAI, FOP angle, and variable temporal muscle volume were significant predictors of VRL, Me angle [(F (5, 123) = 14.94, P < .0001, R2 = 0.38)]. CONCLUSIONS:Our results revealed that mandibular deviation was associated with contralateral head slant and ipsilateral increase in temporal muscle volume. Positional plagiocephaly may be a cause of facial asymmetry, and such deviations may occur in the temporal muscle.
目的: 已经提出了颅骨位置变形和面部不对称之间的关系; 然而，关于这种关系的细节仍有待澄清。本研究旨在利用三维计算机断层扫描 (3D-CT) 阐明面部不对称与位置性斜颈的关系。 方法: 纳入109例患者，以颅穹隆不对称指数 (CVAI) 和头位指数 (CI) 作为头颅位置变形的指标。使用3D-CT数据构建颞肌，并测量其体积。测量VRL、Me (垂直参考线 (VRL)-前鼻脊柱 (ANS) 和menton (Me) 线) 角和额咬合平面 (FOP) 角。 结果: CVAI与VRL、Me角 (R2 = 0.31，P <0.0001) 、VRL、Me角与颞肌容积 (R2 = 0.13，P <0.0001) 、FOP角与VRL、Me角显著相关 (R2 = 0.32，P <0.0001)，但CVAI和FOP角不是(R2 = 0.08)。多元线性回归分析表明，CVAI、FOP角和可变颞肌体积是VRL、Me角的显著预测因子 [(F (123) = 14.94，P <.0001，R2 = 0.38)]。 结论: 我们的结果显示下颌偏斜与对侧头部倾斜和同侧颞肌体积增加有关。位置性斜颈可能是面部不对称的原因，这种偏差可能发生在颞肌。
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.