Osseous Eustachian Tube and Peritubal Cells in Patients With Unilateral Cholesteatoma Comparison Between Healthy and Diseased Sides Using High-Resolution Cone-Beam Computed Tomography

Background: Cone-Beam Computed Tomography (CBCT) with high-resolution parameters may provide an acceptable resolution for bone assessment. Objectives: The purpose of this study is to assess trabecular bone using two cone-beam computed tomography (CBCT) devices with high-resolution parameters in comparison to micro-computed tomography (µCT). Methods: Bone samples (n=8) were acquired from dry mandibles and scanned by two CBCT devices: 1) VV (Veraview R100, Morita; FOV 4x4, 75kV, 9mA, voxel size 0.125µm); and PR (Prexion 3D, Prexion; FOV 5x5, 90kV, 4mA, 37s, voxel size 108µm). Gold-standard images were acquired using µCT (SkyScan 1272; Bruker; 80kV, 125mA, voxel size 16µm). Morphometric parameters (BvTv- Bone Volume Fraction, BsBv- Trabecular specific surface, TbTh- Trabecular thickness and TbSp- Trabecular separation) were measured. Statistical analysis was performed within ANOVA, Spearman Correlation test and Bland-Altmann plots with a statistical significance level at p=0.05. Results: CBCT devices showed similar BvTv values in comparison to µCT. No statistical difference was found for BvTv parameters assessed by CBCT devices and µCT. BsBv values were underestimated by CBCT devices (p<0.01), whereas TbTh and TbSp values were overestimated by them (p<0.01). Positive correlations were found between VV and µCT measurements for BvTv (r2= 0.65, p=0.00), such as between PR and µCT measurements for TbSp (r2= 0.50, p=0.04). For BsBv measurements, PR was negatively correlated with µCT (r2= -0.643, p=0.01). Conclusion: The evaluated CBCT device was able to assess trabecular bone. However, bone parameters were under or overestimated in comparison to µCT.

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Absence of pontine perforators in vertebrobasilar dolichoectasia on ultra-high resolution cone-beam computed tomography

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-016818 ◽

2020 ◽

pp. neurintsurg-2020-016818

Author(s):

Tomas Dobrocky ◽

Eike I Piechowiak ◽

Johannes Goldberg ◽

Enrique Barvulsky Aleman ◽

Patrick Nicholson ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Treatment Planning ◽

Basilar Artery ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Vessel Segment ◽

Vertebrobasilar Dolichoectasia ◽

Cerebellar Artery ◽

The Mean

BackgroundVertebrobasilar dolichoectasia (VBDE) is a rare type of non-saccular intracranial aneurysm, with poor natural history and limited effective treatment options. Visualizing neurovascular microanatomy in patients with VBDE has not been previously reported, but may yield insight into the pathology, and provide important information for treatment planning.ObjectiveTo carry out a retrospective analysis of ultra-high resolution cone-beam computed tomography (UHR-CBCT) in patients with fusiform basilar aneurysms, visualizing neurovascular microanatomy of the posterior circulation with a special focus on the pontine perforators.MethodsUHR-CBCT was performed in seven patients (mean age 59 years; two female) with a VBDE, and in 14 control patients with unrelated conditions.ResultsThe mean maximum diameter of the fusiform vessel segment was 28 mm (range 19–36 mm), and the mean length of the segment was 39 mm (range 15–50 mm). In all patients with VBDE, UHR-CBCT demonstrated an absence of perforating arteries in the fusiform arterial segment and a mean of 3.7 perforators arising from the unaffected vessel segment. The network of interconnected superficial circumferential pontine arteries (brainstem vasocorona) were draping around the aneurysm sac. In controls, a mean of 3.6, 2.5, and 1.2 perforators were demonstrated arising from the distal, mid-, and proximal basilar artery, respectively.ConclusionsThe absence of pontine perforators in the fusiform vessel segment of VBDE is counterbalanced by recruitment of collateral flow from pontine perforators arising from the unaffected segment of the basilar artery, as well as collaterals arising from the anterior inferior cerebellar artery/posterior inferior cerebellar artery and superior cerebellar artery. These alternative routes supply the superficial brainstem arteries (brainstem vasocorona) and sustain brainstem viability. Our findings might have implications for further treatment planning.

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