Objective: To evaluate nasal and upper lip changes after Le Fort I surgery by means of images taken with a three-dimensional computed tomography (3D-CT). Methods: Fifteen patients (9 female and 6 male, mean age 21.9 years) with preoperative and postoperative 3D-CT were studied. The patients underwent maxillary movement with impaction or elongation, and advancement or setback. With the 3D-CT which presents reconstructive soft tissue images, preoperative and postoperative measurement and analysis were performed for nasal tip projection angle, columellar angle, supratip break angle, nasolabial angle, interalar width, internostril width, columella length and nasal tip projection. Results: Postoperative interalar and internostril widening was significant for all categories of maxillary movement. However, there was little significant relation in all parameters between the amount and direction of maxillary movement. Interestingly, movement of the maxilla with upward did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. Also movement of the maxilla with forward did show a little advancement in the upper lip position. Conclusion: Changes to the nose clearly occur after orthognathic surgery. There was a significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary impaction did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. In addition, we used 3D-CT for more precise analysis as a useful tool.
Purpose: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis. Methods: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed. Results: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was $192.6mm^2$ and the mean volume was $673.2mm^3$. Group B area was $316.2mm^2$ and volume was $1,710.6mm^3$. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume. Conclusion: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.
We tested the hypothesis that micro-computed tomography (micro-CT) analysis provides a better quantitative readout of the therapeutic potential of methotrexate (MTX) for treating collagen-induced arthritis (CIA) in rats and compared to conventional histopathological examination. Rats were divided into three groups: Group 1 (G1) was treated with 0.9% saline, whereas groups 2 (G2) and 3 (G3) were boosted with type II collagen at days 0 and 7. Following the first collagen immunization, rats in G1 and G2 were treated with 0.9% saline and those in G3 were treated with 1.5 mg/kg MTX from day 14 to 28. All rats were sacrificed on day 28, at which point and all hind knee joints were analyzed by micro-CT and histopathological examination. Micro-CT analyses showed that bone volume and trabecular number were significantly decreased in G2 and G3 compared to G1 (p<0.01), as was percent bone volume (p<0.05 and p<0.01, respectively). However, bone surface/bone volume was significantly increased in G2 and G3 compared to G1 (p<0.05 and p<0.01, respectively). Trabecular separation was significantly increased in G3 compared to G1 (p<0.05). Histopathological examination showed that knee joints of rats in G2 and G3 showed severe joint destruction with inflammatory cell infiltration. However, cartilage destruction was slightly reduced in G3 compared to G2. Taken together, these results suggest that MTX treatment reduced cartilage destruction in rats with CIA, and micro-CT analyses made it possible to quantify arthritic bony lesion.
Purpose: The present study will identify risk factors for aspiration in severe trauma patients by comparing patients who showed a sign of aspiration lung disease on chest computed tomography (CT) and those who did not. Methods: We conducted a retrospective review of the Korean Trauma Data Bank between January 2014 and December 2019 in a single regional trauma center. The inclusion criteria were patients aged ≥18 years with chest CT, and who had an Injury Severity Score ≥16. Patients with Abbreviated Injury Scale (AIS)-chest score ≥1 and lack of medical records were excluded. General characteristics and patient status were analyzed. Results: 425 patients were included in the final analysis. There were 48 patients showing aspiration on CT (11.2%) and 377 patients showing no aspiration (88.7%). Aspiration group showed more endotracheal intubation in the ER (p=0.000) and a significantly higher proportion of severe Glasgow Coma Scale (GCS) (p=0.000) patients than the non-aspiration group. In AIS as well, the median AIS head score was higher in the aspiration group (p=0.046). Median oxygen saturation was significantly lower in the aspiration group (p=0.002). In a logistic regression analysis, relative to the GCS mild group, the moderate group showed an odds ratio (OR) for aspiration of 2.976 (CI, 1.024-8.647), and the severe group showed an OR of 5.073 (CI, 2.442-10.539). Conclusions: Poor mental state and head injury increase the risk of aspiration. To confirm for aspiration, it would be useful to perform chest CT for severe trauma patients with a head injury.
Kim, Dong-Wook;Kim, Hee-Joung;Haijo Jung;Soonil Hong;Yoo, Young-Il;Kim, Dong-Hyeon;Kim, Kee-Deog
Proceedings of the Korean Society of Medical Physics Conference
/
2002.09a
/
pp.506-508
/
2002
As an advancement of medical imaging modalities and analyzing software with multi-function, active researches to acquire high contrast and high resolution image being done. In recently, development of medical imaging modalities like as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) is aiming to display anatomical structure more accuracy and faster. Thus, one of the important areas in CT today is the use of CT scanner for the quantitative evaluation of 3-D reconstruction images from 2-D tomographic images. In CT system, the effective slice thickness and the quality of 3-D reconstructed image will be influenced by imaging acquisition parameters (e.g. pitch and scan mode). In diagnosis and surgical planning, the accurate distance measurements of 3-D anatomical structures play an important role and the accuracy of distance measurements will depend on the acquisition parameters such as slice thickness, pitch, and scan mode. The skull phantom was scanned with SDCT for various acquisition parameters and acquisition slice thicknesses were 3 and 5 mm, and reconstruction intervals were 1, 2, and 3 mm to each pitch. 3-D visualizations and distance measurements were performed with PC based 3-D rendering and analyzing software. Results showed that the image quality and the measurement accuracy of 3-D SDCT images are independent to the reconstruction intervals and pitches.
Objective: The increasing use of imaging examinations such as computed tomography (CT) results in increased contrast media use, which increases contrast media-induced adverse reactions (AR). This study investigated the risk factors of ARs to nonionic iodinated contrast media. Methods: This study evaluated patients who were administered iodinated contrast media during CT scanning in Yeouido St. Mary's Hospital in Seoul, Korea in 2012. Among the subjects, those with contrast media-induced ARs were classified as the AR group. The control group included individuals without ARs who were selected through simple random sampling. The effects of sex, age, contrast media type and dose, CT region, previous contrast media administration, allergy history, and comorbidity were analyzed in the AR and control groups. Results: Multivariate logistic regression analyses were performed to evaluate the identified AR risk factors in 103 subjects in the AR group and 412 subjects in the control group. The results confirmed that the risk of developing ARs was significantly higher in females [odds ratio (OR): 2.206; 95% confidence interval (CI): 1.353-3.598], in individuals administered Iohexol (OR: 9.981; 95% CI: 2.361-42.193), in individuals with an allergy history (OR: 3.982; 95% CI: 1.742-9.101), and in individuals with comorbid asthma (OR: 6.619; 95% CI: 1.377-31.826). Most of the ARs were mild and immediate. Conclusion: In patients who were administered contrast media during CT scans, female gender, Iohexol use, allergy history, and asthma were risk factors for ARs. Therefore, special care is required for patients with such risk factors to prevent ARs.
Objective: To explore the value of computed tomography (CT) in the differential diagnosis of glioma stroke and simple cerebral hemorrhage. Materials and Methods: A total of 45 patients with glioma stroke and stroke as the initial symptom in our hospital from Jun., 2009 to Oct., 2013 were selected along with 50 individuals with simple cerebral hemorrhage in the same period randomly collected as a control group. The CT results in both groups were analyzed and compared. Results: In the observation group, there were 25 patients with astrocytoma (55.6%), 11 with oligodendroglioma (24.4%), 8 with ependymoma (17.2%) and 1 with glioblastoma multiforma (GBM, 2.22%). Additionally, the major CT manifestation was coexistence of hemorrhage and tumor signs. By comparison, it could be found that the proportions of patients respectively with peripheral edema and space-occupying effect in the observation group were significantly higher than in the control group (P<0.01). Conclusions: Application of CT examination combined with medical history in patients has very important clinical value in the differential diagnosis of glioma stroke and simple cerebral hemorrhage.
Purpose: Diffuse axonal injury (DAI) is clinically defined as a coma of over six hours in a head trauma victim without a focal mass lesion. The emergency physician usually resuscitates and stabilizes a comatose head trauma victim in the emergency Department. After assessment and treatment, the prognosis is very important to both the victim and the physician. The prognosis for DAI is based on Glasgow Coma Scale (GCS) and other imaging data. We investigated the prognostic value of computed tomography (CT) and gradient-echo magnetic resonance imaging (GRI) for head trauma victims with DAI. Methods: Fifty-three(53) head trauma victims of DAI were enrolled in this study from 2007 to 2012. During the study period of six years, data on trauma victims were collected retrospectively. We analyzed the differences in the Glasgow Outcome Scale (GOS) result between the CT and the GRI modalities. Results: We classified the study group by using GOS. Between the good outcome subgroup (GOS scores of 4 and 5) and the poor outcome subgroup (GOS score of 1-3), there were no statistical difference in sex, age, initial vital signs and initial GCS score. The good outcome subgroup had non-hemorrhage on CT(52%), which was correlated with good outcome and a shorter awakening time, while a larger number and a deeper location of hemorrhagic lesions on in GRI were correlated with poor outcome in DAI. Conclusion: We conclude that the existence of hemorrhagic lesions on CT, and the number and location of those lesions on GRI had good prognostic value for head trauma victims with DAI.
Lee, Jung Woo;Kim, Han Kyeol;Kim, Sin Rak;Han, Yea Sik;Park, Jin Hyung
Archives of Plastic Surgery
/
v.42
no.1
/
pp.78-83
/
2015
In perforator flap reconstruction, vascular mapping using preoperative computed tomography (CT) angiography is widely used to confirm the existence and location of an appropriate perforator. This study proposes a rapid, accurate, and convenient method for marking the perforator location on the skin surface. For 12 patients who underwent perforator flap reconstruction between November 2011 and November 2013, metal clips were fixed on the skin surface at the anticipated perforator locations, which were decided using a handheld Doppler. CT angiography was used to compare the location between the metal clip and the actual perforator. The metal clip was moved and repositioned, if needed, on the basis of the CT images. The locations of the appropriate perforator and the metal clip, which were observed during the surgery, were then compared. In CT angiography, the mean distance between the metal clip and the perforator was $3{\pm}3.9mm$, and the mean distance that was measured during surgery was $0.8{\pm}0.8mm$. In conclusion, we report a simple, rapid, and precise technique to indicate the accurate location of the appropriate perforator on the skin surface.
Objectives : The purpose of this investigation was to evaluate the remineralization and acid resistance in fluoride varnish by Micro-computed tomography (micro CT). Methods : Specimens of bovine teeth enamel were embedded in resin, polished and randomly divided into 3 groups (a control group, a NaF solution group, a fluoride varnish group). Each group has 3 specimens that was standardized according to Vickers hardness number (VHN). Specimens were immersed in demineralization solution for 72 hours. The control group had no treatment, the NaF solution group was treated by a 5% NaF solution for 4 minutes, and the fluoride varnish group was treated by a fluoride varnish for one hour. All specimens were subjected to a chemical pH cycling method for 14 days. After a chemical pH cycling method, the density were measured using micro CT. Then, specimens were immersed in each demineralization solution for 72 hours. After demineralization processed, the density were measured using micro CT. Results : 1. The density was significantly higher in the fluoride varnish and 5% NaF solution group than that of the control group after 14 days cycling (p<0.05). And the density value of the fluoride varnish group was higher than that of the 5% NaF solution, with no significant difference. 2. The differences of density after acid resistance treatment were statistically significant among 3 groups(p<0.05). Conclusions : It is suggested that fluoride varnish showed the remineralizing effect and acid resistance effect on the enamel, and micro CT could be used to evaluate the change of enamel lesion.
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