• Title/Summary/Keyword: Spiral computed tomography

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Customized Cranioplasty Implants Using Three-Dimensional Printers and Polymethyl-Methacrylate Casting

  • Kim, Bum-Joon;Hong, Ki-Sun;Park, Kyung-Jae;Park, Dong-Hyuk;Chung, Yong-Gu;Kang, Shin-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.541-546
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    • 2012
  • Objective : The prefabrication of customized cranioplastic implants has been introduced to overcome the difficulties of intra-operative implant molding. The authors present a new technique, which consists of the prefabrication of implant molds using three-dimensional (3D) printers and polymethyl-methacrylate (PMMA) casting. Methods : A total of 16 patients with large skull defects (>100 $cm^2$) underwent cranioplasty between November 2009 and April 2011. For unilateral cranial defects, 3D images of the skull were obtained from preoperative axial 1-mm spiral computed tomography (CT) scans. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of the cranium as a model. For bilateral cranial defects, precraniectomy routine spiral CT scan data were merged with postcraniectomy 3D CT images following a smoothing process. Prefabrication of the mold was performed by the 3D printer. Intraoperatively, the PMMA implant was created with the prefabricated mold, and fit into the cranial defect. Results : The median operation time was $184.36{\pm}26.07$ minutes. Postoperative CT scans showed excellent restoration of the symmetrical contours and curvature of the cranium in all cases. The median follow-up period was 23 months (range, 14-28 months). Postoperative infection was developed in one case (6.2%) who had an open wound defect previously. Conclusion : Customized cranioplasty PMMA implants using 3D printer may be a useful technique for the reconstruction of various cranial defects.

Acute Abdominal Aortic Occlusion after Open Heart Surgery - A case report - (개심술 후에 발생한 급성 복부 대동맥 차단 -1예 보고-)

  • Han, Won-Kyung;Cho, Joon-Yong;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.710-713
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    • 2005
  • Acute abdominal Aortic occlusion is rare but it is a vascular emergency with high mortality and morbidity. There­fore, delay in diagnosis can have severe impact on the prognosis. A 60-year-old women complained of paresthesia, paralysis, and severe pain in bilateral lower extremities on 13th day after open heart surgery for mitral stenosis, atrial fibrillation, coronary arterial stenosis, tricuspid regurgitation, and atrial septal defect. Her skin was mottled and cool from the umbilicus to the feet, and there were no palpable pulses in the lower exteremities. We diagnosed an acute abdominal aortic occlusion using the Multi-Detector Row Spiral Computed Tomography and successfully treated the problem with emergent thrombo-embolectomy and Aortobifemoral bypass.

Lung Perfusion Imaging and $Tc^{99m}-Macroaggregated$ Human Serum Albumin

  • Haider, Kh.H.;Ilyas, M.;Hyder, Q.;Kim, Chong-Kook
    • Journal of Pharmaceutical Investigation
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    • v.31 no.2
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    • pp.73-80
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    • 2001
  • Lung perfusion scanning, invariably combined with ventilation studies provides a reliable and non-invasive mean to diagnose lung related pathologies despite the availability of modern techniques such as angiography, magnetic resonance imaging, magnetic resonance angiography, and helical (spiral) computed tomography. The technique involves the generation of images by radiations emitted from radioisotopes introduced in to the lungs. Various radiopharmaceuticals have been proposed and designed to incorporate $Tc^{99m}$ in to macroparticulate form for lung perfusion imaging. However, most of these have associated difficulties such as reproducibility of the product with regards to particle size distribution and poor elimination from the lung capillary bed. $Tc^{99m}$ macroaggregated albumin $(Tc^{99m}-MAA)$ is used extensively for clinical lung perfusion imaging and is considered as the radiopharmaceutical of choice. It is non-toxic, safe, and being biodegradable, is easily eliminated from the lung capillary bed by proteolytic enzyme metabolism and by mechanical forces due to lung movement.

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Performance Comparison of Commercial and Customized CNN for Detection in Nodular Lung Cancer (결절성 폐암 검출을 위한 상용 및 맞춤형 CNN의 성능 비교)

  • Park, Sung-Wook;Kim, Seunghyun;Lim, Su-Chang;Kim, Do-Yeon
    • Journal of Korea Multimedia Society
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    • v.23 no.6
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    • pp.729-737
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    • 2020
  • Screening with low-dose spiral computed tomography (LDCT) has been shown to reduce lung cancer mortality by about 20% when compared to standard chest radiography. One of the problems arising from screening programs is that large amounts of CT image data must be interpreted by radiologists. To solve this problem, automated detection of pulmonary nodules is necessary; however, this is a challenging task because of the high number of false positive results. Here we demonstrate detection of pulmonary nodules using six off-the-shelf convolutional neural network (CNN) models after modification of the input/output layers and end-to-end training based on publicly databases for comparative evaluation. We used the well-known CNN models, LeNet-5, VGG-16, GoogLeNet Inception V3, ResNet-152, DensNet-201, and NASNet. Most of the CNN models provided superior results to those of obtained using customized CNN models. It is more desirable to modify the proven off-the-shelf network model than to customize the network model to detect the pulmonary nodules.

The Effective Image Diagnosis Using Curved MPR from MDCT (MDCT에서 Curved MPR을 이용한 효과적인 영상진단)

  • Song, Jong-Nam;Jang, Yeong-Ill
    • Korean Journal of Digital Imaging in Medicine
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    • v.12 no.2
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    • pp.139-143
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    • 2010
  • Two-dimensional(2D) images like Multi Planar Reconstruction(MPR) Image or Maximum Intensity Projection(MIP) were used for the purpose of diagnosis, but MPR image's quality were limited due to its superior limit of Z-axis ability to produce permitted radiation exposure virtuous in the permitted time limit from the existing Spiral CT. However, in company with the development of the Multi Detector Computed Tomography(MDCT), we were able to get the Data with the equal amount of Voxel, also get varied reconstructions as in the aspect of our needs. This present study propose a reconstruction technique which is to extract a field using Region of interest(ROI) segmentation method for improvement of the quality of the medical image and after that reconstruct the concerned part using the four-directed symmetry method of the oval, than using the reconstructed data, reorganize the image by using the Curved MPR method. If current proposed method is used, it is highly effective because of its ability to accurately display the disease concerned part, which will reduce the decoding time and also effectively provide information based on the accuracy of the decode.

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The width of the incisive canal and labial alveolar bone of the incisive canal: an assessment on CT images (전산화단층영상에서 절치관 및 순측 치조골 폭경에 관한 연구)

  • Roh Yang-Gyun;Jang Hyun-Seon;Kim Byung-Ock;Kim Jin-Soo
    • Imaging Science in Dentistry
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    • v.36 no.3
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    • pp.145-149
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    • 2006
  • Purpose : To assess the width of the labial alveolar bone of the incisive canal and the width of the incisive canal on spiral computed tomographic images of the anterior portion of the maxilla. Materials and Methods : Study materials included 38 CT scans taken for preoperative planning of implant placement. Axial cross-sectioned image entirely showing the incisive canal was selected and scanned with 600 DPI resolution. The width of the labial alveolar bone of the incisive canal at an orifice to the oral cavity, middle portion, and an orifice to the nasal cavity and the diameter of the incisive canal at the middle portion were determined by two specialist using Digora for Windows 2.1 The statistical analyses were carried out using SPSS 12.0.1. Results : When the maxillary central incisors remained, the mean labial alveolar bone width were $6.81{\pm}1.41mm,\;6.46{\pm}1.33mm$, and $7.91{\pm}1.33mm$. When the maxillary central incisors were missed the mean width were $5.42{\pm}2.20mm,\;6.23{\pm}2.29mm$, and $7.89{\pm}2.13mm$. Conclusions : The labial alveolar bone width at middle portion and an orifice to the nasal cavity were of no statistical significant difference according to presence of the maxillary central incisors (P>0.05). The width between oral cavity and nasal cavity, middle portion and to nasal cavity revealed statistically significant difference (P<0.05).

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Clinical Study of Tumor Angiogenesis and Perfusion Imaging Using Multi-slice Spiral Computed Tomography for Breast Cancer

  • Xu, Na;Lei, Zhen;Li, Xiao-Long;Zhang, Jun;Li, Chen;Feng, Guo-Quan;Li, Di-Nuo;Liu, Jing-Yi;Wei, Qiang;Bian, Ting-Ting;Zou, Tian-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.429-433
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    • 2013
  • Objectives: To explore the correlation between multi-slice spiral CT (MSCT) perfusion parameters and the expression of vascular endothelial growth factor (VEGF) as well as matrix metalloproteinase-2 (MMP-2) in breast cancer. Methods: Forty five breast cancer patients and 16 patients with benign breast tumor, both confirmed by pathology examination, were enrolled. All underwent MSCT perfusion imaging to obtain perfusion maps and data for parameters including blood flow (BF), blood volume (BV) and permeability surface (PS). Cancer patients did not receive treatment prior to surgery. The expression of VEGF and MMP-2 were examined with both immunohistochemistry and Western blotting. Results: The levels of VEGF and MMP-2 by immunohistochemistry were significantly higher in the breast cancer group (P < 0.01) than the benign tumor group. Relative OD values from Western blotting were also higher in cancer cases (P < 0.05). Similarly, the mean MSCT perfusion parameters (BF, BV, PS) were significantly higher in the breast cancer group (P < 0.01), BF and BV positively correlating with VEGF expression (r = 0.878 and 0.809 respectively, P < 0.01); PS and VEGF and MMP-2 expression were also positively correlated (r= 0.860, 0.786 respectively, P < 0.01). Conclusion: There is a correlation between breast cancer MSCT perfusion parameters and VEGF andMMP-2 expression, which might be useful for detection of breast lesions, qualitative diagnosis of breast cancer, and evaluation of breast cancer treatment.

Changes in CT Number and Noise Level according to Pitch in Spiral Image Acquisition (나선형영상획득에서 Pitch에 따른 CT 감약계수와 잡음의 변화)

  • Kang, SungJin
    • Journal of the Korean Society of Radiology
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    • v.14 no.7
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    • pp.981-989
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    • 2020
  • In this study, a self-made customized phantom was used to quantitatively measure the change in CT number and noise according to the change of pitch. In order to acquire an image using the phantom, the inside of the phantom was filled with sterile distilled water. Inside the glass tube, a solution obtained by diluting the ratio of normal saline and contrast medium to 100%(NS), 400:1, 200:1, 100:1, 50:1, respectively, was placed and imaged. At this time, the pitch was divided into steps of 0, 0.35, 0.7, 1.05, and 1.4 for each dilution ratio of the solution and imaged, respectively. One-way ANOVA analysis were performed to verify whether the mean of the CT number and noise values measured in all ROIs by dilution ratio showed a significant difference according to the change in pitch. As a result of the experiment, there was no statistically significant difference in the change of the CT number according to the change in the pitch for each dilution ratio, but the noise value tended to increase with the increase of the pitch, and showed a statistically significant difference. In the spiral image acquisition of CT, noise can be changed to a significant level depending on the pitch. Therefore, it will be necessary to set the quality evaluation items and criteria for CT images using the spiral image acquisition method.

A Study of Inter-observer Agreements of Spiral Chest Computed Tomography in Diagnosing Pulmonary Embolism (폐색전증에서 나선형 컴퓨터 전산화 단층촬영의 관찰자간의 일치도에 관한 연구)

  • Kim, Yang-Ki;Lee, Young Mok;Kim, Ki-up;Uh, Soo-taek;Kim, Yong Hoon;Park, Choon Sik;Hwang, Jung-Hwa;Kim, Dong Hun;Goo, Dong-Erk;Choi, Deuk-Lin
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.473-479
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    • 2005
  • Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

Assessment of the proximity between the mandibular third molar and inferior alveolar canal using preoperative 3D-CT to prevent inferior alveolar nerve damage

  • Lee, Byeongmin;Park, Youngju;Ahn, Janghoon;Chun, Jihyun;Park, Suhyun;Kim, Minjin;Jo, Youngserk;Ahn, Somi;Kim, Beulha;Choi, Sungbae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.30.1-30.7
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    • 2015
  • Background: The inferior alveolar nerve (IAN) may be injured during extraction of the mandibular third molar, causing severe postoperative complications. Many methods have been described for evaluating the relative position between the mandibular third molar and the inferior alveolar canal (IAC) on panoramic radiography and computed tomography, but conventional radiography provides limited information on the proximity of these two structures. The present study assessed the benefits of three-dimensional computed tomography (3D-CT) prior to surgical extraction of the mandibular third molar, to prevent IAN damage. Methods: This retrospective study included 4917 extractions in 3555 patients who presented for extraction of the mandibular third molars. The cases were classified into three groups, according to anatomical relationship between the mandibular third molars and the IAC on panoramic radiography and whether 3D-CT was performed. Symptoms of IAN damage were assessed using the touch-recognition test. Data were compared using the chi-square test and Fisher's exact test. Results: Among the 32 cases of IAN damage, 6 cases were included in group I (0.35 %, n = 1735 cases), 23 cases in group II (1.1 %, n = 2063 cases), and 3 cases in group III (0.27 %, n = 1119 cases). The chi-square test showed a significant difference in the incidence of IAN damage between groups I and II. No significant difference was observed between groups I and III using Fisher's exact test. In the 6 cases of IAN damage in group I, the mandibular third molar roots were located lingual relative to the IAC in 3 cases and middle relative to the IAC in 3 cases. The overlap was ${\geq}2mm$ in 3 of 6 cases and 0-2 mm in the remaining 3 cases. The mean distance between the mandibular third molar and IAC was 2.2 mm, the maximum distance 12 mm, and the minimum distance 0.5 mm. Greater than 80 % recovery was observed in 15 of 32 (46.8 %) cases of IAN damage. Conclusions: 3D-CT may be a useful tool for assessing the three-dimensional anatomical relationship and proximity between the mandibular third molar and IAC in order to prevent IAN damage during extraction of mandibular third molars.