scholarly journals Anatomical localization of the transverse-sigmoid sinus junction: Comparison of existing techniques

2019 ◽  
Vol 10 ◽  
pp. 186 ◽  
Author(s):  
Samuel Hall ◽  
Yee-Chiung (Peter) Gan
Keyword(s):  
Posterior Fossa ◽  
Three Dimensional ◽  
Transverse Sinus ◽  
Sigmoid Sinus ◽  
Cranial Computed Tomography ◽  
Anatomical Landmarks ◽  
Qualitative And Quantitative ◽  
Computed Tomography Images ◽  
Contrast Enhanced ◽  
Anatomical Localization

Background: Anatomical localization remains integral to neurosurgery, particularly in the posterior fossa where neuronavigation is less reliable. There have been many attempts to define the location of the transverse- sigmoid sinus junction (TSSJ) using anatomical landmarks, to aid in the placement of the “strategic burr hole” during a retrosigmoid approach. There is a paucity of research allowing direct comparison of such techniques. Methods: Using high-resolution contrast-enhanced cranial computed tomography images, we constructed three-dimensional virtual cranial models. Fifty models (100 sides) were created from a retrospective sample of images performed in a New Zealand population. Ten methods of anatomical localization were applied to each model allowing qualitative and quantitative comparisons. The “key point” was defined as the point on the outer surface of the skull that directly overlaid the junction of the posterior fossa dura, transverse sinus (TS), and sigmoid sinus (SS). The proximity of each method to this “key point” was compared quantitatively, in addition to other descriptive observations. TSSJ localization methods analyzed included: (1) asterion; (2) emissary foramen; (3) Lang and Samii; (4) Day; (5) Rhoton; (6) Avci; (7) Ribas; (8) Tubbs; (9) Li; and (10) Teranishi. Results: Mean distance to the “key point” showed two tiers of accuracy, those <10 mm, and those >10 mm: Li (6.3 mm), Ribas (6.6 mm), Tubbs (6.8 mm), Teranishi (7.8 mm), Day (8.4 mm), emissary foramen (12.0 mm), Avci (13.0 mm), asterion (13.9 mm), Lang and Samii (15.6 mm), and Rhoton (17.4 mm). The asterion would most frequently overlie the TS (63%) and was often supratentorial (14%). Conclusion: Each method has a unique profile of dura or sinus exposure. There are significant differences in the accuracy of localization of the TSSJ among anatomical localization methods.

scholarly journals Surface Landmarks Combined With Image-guided Sinus Location in the Retrosigmoid Approach and Their Clinical Feature Analysis

2021 ◽  
Author(s):  
Weichi Wu ◽  
Chao Ke ◽  
Zhaoyang Liu ◽  
Xiaoyu Guo ◽  
Yi Zhou ◽  
...  
Keyword(s):  
Transverse Sinus ◽  
Sigmoid Sinus ◽  
The Body ◽  
Retrosigmoid Approach ◽  
Preoperative Imaging ◽  
Anatomical Landmarks ◽  
Image Information ◽  
Inferior Margin ◽  
Venous Sinuses ◽  
Preoperative Image

Abstract Background During craniotomy for the cerebellopontine angle (CPA) lesion by the typical retrosigmoid approach, the exact exposure of the margin of the venous sinuses complex remains an essential but risky step. This study aimed to reveal the exact position of asterion and sinuses by combining preoperative imaging with intraoperative landmarks. and analyse their clinical features. Methods From February 2008 through November 2019, 94 patients who underwent removal of vestibular schwannoma (VS) through retrosigmoid craniotomies were enrolled in the series. We utilized preoperative images, including computed tomography (CT) and/or magnetic resonance imaging (MRI) combined with intraoperative anatomical landmarks, to determine the exact location of the sigmoid sinus and the transverse and sigmoid sinuses junction (TSSJ). MRI T1 sequences with gadolinium and/or the CT bone window were used to measure the distance relationship of the asterion to the sigmoid sinus.Results In 94 cases of retrosigmoid craniotomies, we observed the asterion lay 12.71 millimeter on the posterior to the body surface projection of the TSSJ averagely. Intraoperative surface landmarks combined with preoperative image information identifying the distance from the asterion to sigmoid sinus at the transverse sinus level, enabled an appropriate initial burr-hole (the margin of the TSSJ ). Just one case had a minor laceration of the sigmoid sinus when the bone flap was opened.Conclusions By combining intraoperative anatomical landmarks with preoperative image information, the margin of the venous sinuses, especially the inferior margin of the transverse sinus in the retrosigmoid approach can be well and truly identified. The distance from the intersection of the asterion and occipitomastoid suture to the TSSJ is the shortest between the occipitomastoid suture and the sigmoid sinus.

Partial Fat-saturated Contrast-enhanced Three-dimensional MR Angiography Compared with Non-Fat-saturated and Conventional Fat-saturated MR Angiography

Radiology ◽  
2000 ◽  
Vol 216 (1) ◽  
pp. 298-303 ◽  
Author(s):  
Paul R. Hilfiker ◽  
Robert J. Herfkens ◽  
Steve G. Heiss ◽  
Marcus T. Alley ◽  
Dominik Fleischmann ◽  
...  
Keyword(s):  
Mr Angiography ◽  
Three Dimensional ◽  
Contrast Enhanced

scholarly journals Application of subject-specific adaptive mechanical loading for bone healing in a mouse tail vertebral defect

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Angad Malhotra ◽  
Matthias Walle ◽  
Graeme R. Paul ◽  
Gisela A. Kuhn ◽  
Ralph Müller
Keyword(s):  
Mechanical Loading ◽  
Bone Defect ◽  
Bone Healing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Dependent Manner ◽  
Micro Computed Tomography ◽  
Computed Tomography Images ◽  
Bone Defect Healing ◽  
Subject Specific

AbstractMethods to repair bone defects arising from trauma, resection, or disease, continue to be sought after. Cyclic mechanical loading is well established to influence bone (re)modelling activity, in which bone formation and resorption are correlated to micro-scale strain. Based on this, the application of mechanical stimulation across a bone defect could improve healing. However, if ignoring the mechanical integrity of defected bone, loading regimes have a high potential to either cause damage or be ineffective. This study explores real-time finite element (rtFE) methods that use three-dimensional structural analyses from micro-computed tomography images to estimate effective peak cyclic loads in a subject-specific and time-dependent manner. It demonstrates the concept in a cyclically loaded mouse caudal vertebral bone defect model. Using rtFE analysis combined with adaptive mechanical loading, mouse bone healing was significantly improved over non-loaded controls, with no incidence of vertebral fractures. Such rtFE-driven adaptive loading regimes demonstrated here could be relevant to clinical bone defect healing scenarios, where mechanical loading can become patient-specific and more efficacious. This is achieved by accounting for initial bone defect conditions and spatio-temporal healing, both being factors that are always unique to the patient.

scholarly journals Immersive 3D virtual reality imaging in planning minimally invasive and complex adult cardiac surgery

2020 ◽  
Vol 1 (1) ◽  
pp. 62-70
Author(s):  
Amir H Sadeghi ◽  
Wouter Bakhuis ◽  
Frank Van Schaagen ◽  
Frans B S Oei ◽  
Jos A Bekkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Virtual Reality ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Preoperative Planning ◽  
Operating Time ◽  
Three Dimensional ◽  
Cardiothoracic Surgery ◽  
Planning Tool ◽  
Computed Tomography Images

Abstract Aims Increased complexity in cardiac surgery over the last decades necessitates more precise preoperative planning to minimize operating time, to limit the risk of complications during surgery and to aim for the best possible patient outcome. Novel, more realistic, and more immersive techniques, such as three-dimensional (3D) virtual reality (VR) could potentially contribute to the preoperative planning phase. This study shows our initial experience on the implementation of immersive VR technology as a complementary research-based imaging tool for preoperative planning in cardiothoracic surgery. In addition, essentials to set up and implement a VR platform are described. Methods Six patients who underwent cardiac surgery at the Erasmus Medical Center, Rotterdam, The Netherlands, between March 2020 and August 2020, were included, based on request by the surgeon and availability of computed tomography images. After 3D VR rendering and 3D segmentation of specific structures, the reconstruction was analysed via a head mount display. All participating surgeons (n = 5) filled out a questionnaire to evaluate the use of VR as preoperative planning tool for surgery. Conclusion Our study demonstrates that immersive 3D VR visualization of anatomy might be beneficial as a supplementary preoperative planning tool for cardiothoracic surgery, and further research on this topic may be considered to implement this innovative tool in daily clinical practice. Lay summary Over the past decades, surgery on the heart and vessels is becoming more and more complex, necessitating more precise and accurate preoperative planning. Nowadays, operative planning is feasible on flat, two-dimensional computer screens, however, requiring a lot of spatial and three-dimensional (3D) thinking of the surgeon. Since immersive 3D virtual reality (VR) is an upcoming imaging technique with promising results in other fields of surgery, we aimed in this study to explore the additional value of this technique in heart surgery. Our surgeons planned six different heart operations by visualizing computed tomography scans with a dedicated VR headset, enabling them to visualize the patient’s anatomy in an immersive and 3D environment. The outcomes of this preliminary study are positive, with a much more reality-like simulation for the surgeon. In such, VR could potentially be beneficial as a preoperative planning tool for complex heart surgery.

Total Wrist Arthroplasty Alignment and Its Potential Association with Clinical Outcomes

2021 ◽  
Author(s):  
Bardiya Akhbari ◽  
Kalpit N. Shah ◽  
Amy M. Morton ◽  
Janine Molino ◽  
Douglas C. Moore ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Outcomes ◽  
Three Dimensional ◽  
Radial Component ◽  
Single Type ◽  
Radiographic Images ◽  
Computed Tomography Images ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Wrist Arthroplasty

Abstract Purpose There is a lack of quantitative research that describes the alignment and, more importantly, the effects of malalignment on total wrist arthroplasty (TWA). The main goal of this pilot study was to assess the alignment of TWA components in radiographic images and compare them with measures computed by three-dimensional analysis. Using these measures, we then determined if malalignment is associated with range of motion (ROM) or clinical outcomes (PRWHE, PROMIS, QuickDash, and grip strength). Methods Six osteoarthritic patients with a single type of TWA were recruited. Radiographic images, computed tomography images, and clinical outcomes of the wrists were recorded. Using posteroanterior and lateral radiographs, alignment measurements were defined for the radial and carpal components. Radiographic measurements were validated with models reconstructed from computed tomography images using Bland–Altman analysis. Biplanar videoradiography (<1mm and <1 degree accuracy) was used to capture and compute ROM of the TWA components. Linear regression assessed the associations between alignment and outcomes. Results Radiographic measures had a 95% limit-of-agreement (mean difference ±  1.96 × SD) of 3 degrees and 3mm with three-dimensional values, except for the measures of the carpal component in the lateral view. In our small cohort, wrist flexion–extension and radial–ulnar deviation were correlated with volar–dorsal tilt and volar–dorsal offset of the radial component and demonstrated a ROM increase of 3.7 and 1.6 degrees per degree increase in volar tilt, and 10.8 and 4.2 degrees per every millimeter increase in volar offset. The carpal component's higher volar tilt was also associated with improvements in patient-reported pain. Conclusions We determined metrics describing the alignment of TWA, and found the volar tilt and volar offset of the radial component could potentially influence the replaced wrist's ROM. Clinical Relevance TWA component alignment can be measured reliably in radiographs, and may be associated with clinical outcomes. Future studies must evaluate its role in a larger cohort.

scholarly journals Three-dimensional assessment of the anterior and inferior loop of the inferior alveolar nerve using computed tomography images in patients with and without mandibular asymmetry

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae-Young Kim ◽  
Michael D. Han ◽  
Kug Jin Jeon ◽  
Jong-Ki Huh ◽  
Kwang-Ho Park
Keyword(s):  
Computed Tomography ◽  
Symmetry Group ◽  
Three Dimensional ◽  
Inferior Alveolar Nerve ◽  
Mental Foramen ◽  
3D Analysis ◽  
Mandibular Asymmetry ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Mandibular Body

Abstract Background The purpose of this study was to investigate the differences in configuration and dimensions of the anterior loop of the inferior alveolar nerve (ALIAN) in patients with and without mandibular asymmetry. Method Preoperative computed tomography images of patients who had undergone orthognathic surgery from January 2016 to December 2018 at a single institution were analyzed. Subjects were classified into two groups as “Asymmetry group” and “Symmetry group”. The distance from the most anterior and most inferior points of the ALIAN (IANant and IANinf) to the vertical and horizontal reference planes were measured (dAnt and dInf). The distance from IANant and IANinf to the mental foramen were also calculated (dAnt_MF and dInf_MF). The length of the mandibular body and symphysis area were measured. All measurements were analyzed using 3D analysis software. Results There were 57 total eligible subjects. In the Asymmetry group, dAnt and dAnt_MF on the non-deviated side were significantly longer than the deviated side (p < 0.001). dInf_MF on the non-deviated side was also significantly longer than the deviated side (p = 0.001). Mandibular body length was significantly longer on the non-deviated side (p < 0.001). There was no significant difference in length in the symphysis area (p = 0.623). In the Symmetry group, there was no difference between the left and right sides for all variables. Conclusion In asymmetric patients, there is a difference tendency in the ALIAN between the deviated and non-deviated sides. In patients with mandibular asymmetry, this should be considered during surgery in the anterior mandible.

scholarly journals Automatic 3D dense phenotyping provides reliable and accurate shape quantification of the human mandible

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pieter-Jan Verhelst ◽  
H. Matthews ◽  
L. Verstraete ◽  
F. Van der Cruyssen ◽  
D. Mulier ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Surface Registration ◽  
Anatomical Landmarks ◽  
Centroid Size ◽  
Intraclass Correlation Coefficients ◽  
Total Variability ◽  
Automatic Phenotyping

AbstractAutomatic craniomaxillofacial (CMF) three dimensional (3D) dense phenotyping promises quantification of the complete CMF shape compared to the limiting use of sparse landmarks in classical phenotyping. This study assesses the accuracy and reliability of this new approach on the human mandible. Classic and automatic phenotyping techniques were applied on 30 unaltered and 20 operated human mandibles. Seven observers indicated 26 anatomical landmarks on each mandible three times. All mandibles were subjected to three rounds of automatic phenotyping using Meshmonk. The toolbox performed non-rigid surface registration of a template mandibular mesh consisting of 17,415 quasi landmarks on each target mandible and the quasi landmarks corresponding to the 26 anatomical locations of interest were identified. Repeated-measures reliability was assessed using root mean square (RMS) distances of repeated landmark indications to their centroid. Automatic phenotyping showed very low RMS distances confirming excellent repeated-measures reliability. The average Euclidean distance between manual and corresponding automatic landmarks was 1.40 mm for the unaltered and 1.76 mm for the operated sample. Centroid sizes from the automatic and manual shape configurations were highly similar with intraclass correlation coefficients (ICC) of > 0.99. Reproducibility coefficients for centroid size were < 2 mm, accounting for < 1% of the total variability of the centroid size of the mandibles in this sample. ICC’s for the multivariate set of 325 interlandmark distances were all > 0.90 indicating again high similarity between shapes quantified by classic or automatic phenotyping. Combined, these findings established high accuracy and repeated-measures reliability of the automatic approach. 3D dense CMF phenotyping of the human mandible using the Meshmonk toolbox introduces a novel improvement in quantifying CMF shape.

scholarly journals Effect of Structural Differences on the Mechanical Properties of 3D Integrated Woven Spacer Sandwich Composites

Materials ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4284
Author(s):  
Lvtao Zhu ◽  
Mahfuz Bin Rahman ◽  
Zhenxing Wang
Keyword(s):  
Mechanical Properties ◽  
Composite Materials ◽  
Three Dimensional ◽  
Sheet Thickness ◽  
Physical And Mechanical Properties ◽  
Sandwich Composites ◽  
Computed Tomography Images ◽  
And Performance ◽  
Industrial Textiles ◽  
Load Conditions

Three-dimensional integrated woven spacer sandwich composites have been widely used as industrial textiles for many applications due to their superior physical and mechanical properties. In this research, 3D integrated woven spacer sandwich composites of five different specifications were produced, and the mechanical properties and performance were investigated under different load conditions. XR-CT (X-ray computed tomography) images were employed to visualize the microstructural details and analyze the fracture morphologies of fractured specimens under different load conditions. In addition, the effects of warp and weft direction, face sheet thickness, and core pile height on the mechanical properties and performance of the composite materials were analyzed. This investigation can provide significant guidance to help determine the structure of composite materials and design new products according to the required mechanical properties.

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