scholarly journals Microvasculature of the Plantar Plate Using Nano-Computed Tomography

2018 ◽  
Vol 3 (2) ◽  
pp. 2473011418S0000
Author(s):  
Fred Finney ◽  
Jaron Scott ◽  
Karl Jepsen ◽  
James Holmes ◽  
Paul Talusan
Keyword(s):  
Computed Tomography ◽  
Soft Tissues ◽  
Proximal Phalanx ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Phosphomolybdic Acid ◽  
Vascular Density ◽  
Plantar Plate ◽  
Tibial Arteries ◽  
Mtp Joints

Category: Basic Sciences/Biologics, Lesser Toes, Midfoot/Forefoot Introduction/Purpose: Lesser toe plantar plate attenuation or disruption is being increasingly implicated in a variety of very common clinical complaints including metatarsalgia, metatarsal-phalangeal (MTP) joint subluxation and dislocation, hammertoe, crossover toe, etc. A multitude of surgical techniques and devices have been recently developed to facilitate surgical repair of the plantar plate. However, the microvascular anatomy, and therefore the healing potential in large part, has not been addressed. We sought to answer this question by employing a novel technique involving microvascular perfusion and nano-computed tomography (Nano-CT) imaging. Methods: 12 human adult cadaveric lower extremities were amputated distal to the knee. The anterior and posterior tibial arteries were dissected and cannulated proximal to the ankle joint and were perfused with a barium solution. The soft tissues of each foot were then counterstained with phosphomolybdic acid (PMA). The 2nd through 4th toe MTP joints of 12 feet were imaged with Nano-CT at 14-micron resolution. Images were then reconstructed for three-dimensional analysis of the plantar plate microvasculature and calculation of the vascular density along the length of the plantar plate. Results: A microvascular network extends from the surrounding soft tissues at the attachments of the plantar plate on both the metatarsal and proximal phalanx. The mid-substance of the plantar plate appears to be relatively hypovascular. Analysis of the vascular density along the length of the plantar plate demonstrated a consistent trend with increased vascular density at approximately the proximal 30% and distal 20% of the plantar plate (Figure 1). Conclusion: There is a vascular network extending from the surrounding soft tissues into approximately the proximal 30% and the distal 20% of the plantar plate. The hypovascular mid-portion of the plantar plate may play an important role in the underlying patho-anatomy and pathophysiology of this area. We believe our findings likely have significant clinical implications for the reparative potential of this region, and therefore the surgical procedures currently described to accomplish anatomic plantar plate repair.

scholarly journals Microvasculature of the Plantar Plate Using Nano–Computed Tomography

2018 ◽  
Vol 40 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Fred T. Finney ◽  
Aaron McPheters ◽  
Natalie V. Singer ◽  
Jaron C. Scott ◽  
Karl J. Jepsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissues ◽  
Proximal Phalanx ◽  
Surgical Techniques ◽  
Phosphomolybdic Acid ◽  
Vascular Density ◽  
Plantar Plate ◽  
Tibial Arteries ◽  
Clinical Conditions ◽  
Mtp Joints

Background: Lesser toe plantar plate attenuation or disruption is being increasingly implicated in a variety of common clinical conditions. A multitude of surgical techniques and devices have been recently developed to facilitate surgical repair of the plantar plate. However, the microvascular anatomy, and therefore the healing potential in large part, has not been defined. We investigated the microvasculature of the plantar plate by employing a novel technique involving microvascular perfusion and nano–computed tomography (nano-CT) imaging. Methods: Twelve human adult cadaveric lower extremities were amputated distal to the knee. The anterior and posterior tibial arteries were perfused with a barium solution. The soft tissues of each foot were then counterstained with phosphomolybdic acid (PMA). The second through fourth toe metatarsophalangeal (MTP) joints of 12 feet were imaged with nano-CT at 14-micron resolution. Images were then reconstructed for analysis of the plantar plate microvasculature and calculation of the vascular density along the length of the plantar plate. Results: A microvascular network extends from the surrounding soft tissues at the attachments of the plantar plate on both the metatarsal and proximal phalanx. The midsubstance of the plantar plate appears to be relatively hypovascular. Analysis of the vascular density along the length of the plantar plate demonstrated a consistent trend with increased vascular density at approximately the proximal 29% and distal 22% of the plantar plate. Conclusion: There is a vascular network extending from the surrounding soft tissues into the proximal and distal attachments of the plantar plate. Clinical relevance: The hypovascular midportion of the plantar plate may play an important role in the underlying pathoanatomy and pathophysiology of this area. These findings may have significant clinical implications for the reparative potential of this region and the surgical procedures currently described to accomplish anatomic plantar plate repair.

scholarly journals Presence of Neovascularization in Torn Plantar Plates of the Lesser Metatarsophalangeal Joints

2021 ◽  
pp. 107110072199003
Author(s):  
Natalie V. Singer ◽  
Noah E. Saunders ◽  
James R. Holmes ◽  
David M. Walton ◽  
Fred T. Finney ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Proximal Phalanx ◽  
Surgical Techniques ◽  
Phosphomolybdic Acid ◽  
Ct Imaging ◽  
Control Group ◽  
Vascular Density ◽  
Computed Tomographic ◽  
Plantar Plate ◽  
Metatarsophalangeal Joints

Background: Recent surgical techniques have focused on anatomic repair of lesser toe metatarsophalangeal (MTP) plantar plate tears, yet it remains unknown whether the plantar plate has the biological capacity to heal these repairs. Therefore, a better understanding of the plantar plate vasculature in response to injury may provide further insight into the potential for healing after anatomic plantar plate repair. Recently, a study demonstrated that the microvasculature of the normal plantar plate is densest at the proximal and distal attachments. The purpose of this study was to compare the intact plantar plate microvasculature network to the microvasculature network of plantar plates in the presence of toe deformity using similar perfusion and nano–computed tomographic (CT) imaging methods. Methods: Seven fresh-frozen human cadaveric lower extremities with lesser toe deformities including hammertoe or crossover toe were perfused using a barium solution. The soft tissues of each foot were counterstained with phosphomolybdic acid (PMA). Then using nano-CT imaging, the second through fourth toe metatarsophalangeal joints of 7 feet were imaged. These images were then reconstructed, plantar plate tears were identified, and 11 toes remained. The plantar plate microvasculature for these 11 toes was analyzed, and calculation of vascular density along the plantar plate was performed. Using analysis of variance (ANOVA), this experimental group was compared to a control group of 35 toes from cadaveric feet without deformity and the vascular density compared between quartiles of plantar plate length proximal to distal. A power analysis was performed, determining that 11 experimental toes and 35 control toes would be adequate to provide 80% power with an alpha of 0.05. Results: Significantly greater vascular density (vascular volume/tissue volume) was found along the entire length of the plantar plate for the torn plantar plates compared to intact plantar plates (ANOVA, P < .001). For the first quartile of length (proximal to distal), the vascular density for the torn plantar plates was 0.365 (SD 0.058) compared to 0.281 (SD 0.036) for intact plantar plates; in the second quartile it was 0.300 (SD 0.044) vs 0.175 (SD 0.025); third quartile it was 0.326 (SD 0.051) vs 0.117 (SD 0.015); and fourth (most distal) quartile was 0.600 (SD 0.183) vs 0.319 (SD 0.082). Conclusion: Torn plantar plates showed increased vascular density throughout the length of the plantar plate with an increase in density most notable in the region at or just proximal to the attachment to the proximal phalanx. Our analysis revealed that torn plantar plates exhibit neovascularization around the site of a plantar plate tear that does not exist in normal plantar plates. Clinical Relevance: The clinical significance of the increased vascularity of torn plantar plates is unknown at this time. However, the increase in vasculature may suggest that the plantar plate is a structure that is attempting to heal.

scholarly journals A Comparison of Microvasculature of Normal versus Torn Lesser Toe Metatarsophalangeal Joint Plantar Plates Using Nano-CT Imaging

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0045
Author(s):  
Natalie Singer ◽  
David M. Walton ◽  
James R. Holmes ◽  
Paul G. Talusan
Keyword(s):  
Soft Tissues ◽  
Proximal Phalanx ◽  
Surgical Techniques ◽  
Metatarsophalangeal Joint ◽  
Phosphomolybdic Acid ◽  
Ct Imaging ◽  
Control Group ◽  
Vascular Density ◽  
Plantar Plate ◽  
Plate Length

Category: Lesser Toes Introduction/Purpose: Recent surgical techniques have focused on anatomic repair of lesser toe metatarsophalangeal (MTP) plantar plate tears. MTP instability has been implicated in a number of common toe deformities as well as metatarsalgia. Recently, a study demonstrated that the microvasculature of the normal plantar plate is densest at the proximal and distal attachments. The purpose of this study was to compare the intact plantar plate microvasculature network to the microvasculature network of plantar plates in the presence of toe deformity using similar perfusion and nano-CT imaging methods. Methods: Eight fresh frozen human cadaveric lower extremities with lesser toe deformities including hammertoe or crossover toe were perfused using a barium solution. The soft tissues of each foot were counterstained with phosphomolybdic acid (PMA). Then using nano-CT imaging the second through fourth toe metatarsophalangeal joints of 8 feet were imaged. These images were then reconstructed, plantar plate tears were identified, and eleven toes remained. The plantar plate microvasculature for these eleven toes was analyzed and calculation of vascular density along the plantar plate was performed. Using ANOVA analysis this experimental group was compared to a control group of 35 toes from cadaveric feet without deformity and the vascular density compared between quartiles of plantar plate length proximal to distal. Results: Demonstrated in Figure 1, of the torn plantar plates the average percent vascular density (vascular volume/tissue volume) in the first quartile of length (proximal to distal) is 0.365 (SD 0.058) compared to 0.281 (SD 0.036) for intact plantar plates; in the second quartile it is 0.300 (SD 0.044) vs 0.175 (SD 0.025); third quartile it is 0.326 (SD 0.051) vs 0.117 (SD 0.015); and fourth (most distal) quartile is 0.600 (SD 0.183) vs 0.319 (SD 0.082) respectively. Using ANOVA testing all differences were found to be significant to p<0.001. Conclusion: Torn plantar plates demonstrate increased vascular density throughout the length of the plantar plate with an increase in density most notable in the region at or just proximal to the attachment to the proximal phalanx. The clinical significance of the increased vascularity of torn plantar plates is unknown at this time. However, the increase in vasculature may suggest that the plantar plate is a structure that is attempting to heal.

Visualization of microvasculature and thrombi by X-ray phase-contrast computed tomography in hepatocellular carcinoma

2016 ◽  
Vol 23 (2) ◽  
pp. 600-605 ◽  
Author(s):  
Jianbo Jian ◽  
Hao Yang ◽  
Xinyan Zhao ◽  
Ruijiao Xuan ◽  
Yujie Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Phase Contrast ◽  
Soft Tissues ◽  
Three Dimensional ◽  
X Ray ◽  
Density Distributions ◽  
Fine Structures ◽  
Tumor Growth And Metastasis ◽  
Micrometer Scale

Visualization of the microvascular network and thrombi in the microvasculature is a key step to evaluating the development of tumor growth and metastasis, and influences treatment selection. X-ray phase-contrast computed tomography (PCCT) is a new imaging technique that can detect minute changes of density and reveal soft tissues discrimination at micrometer-scale resolution. In this study, six human resected hepatocellular carcinoma (HCC) tissues were investigated with PCCT. A histological stain was added to estimate the accuracy of PCCT. The results showed that the fine structures of the microvasculature (measuring 30–100 µm) and thrombi in tiny blood vessels were displayed clearly on imaging the HCC tissues by PCCT. Moreover, density distributions of the thrombi were obtained, which could be reliably used to distinguish malignant from benign thrombi in HCC. In conclusion, PCCT can clearly show the three-dimensional subtle structures of HCC that cannot be detected by conventional absorption-based computed tomography and provides a new method for the imageology of HCC.

Use of computed tomography data for forensic identification of an individual

2020 ◽  
Vol 6 (4) ◽  
pp. 41-45
Author(s):  
Sergey V. Leonov ◽  
Julia P. Shakiryanova
Keyword(s):  
Computed Tomography ◽  
Computer Tomography ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Reference Points ◽  
Forensic Identification ◽  
Dimensional Model ◽  
Three Dimensional Model ◽  
The Face ◽  
Tomography Data

Background: The article presents our own experience of using computer tomography for identification of individuals with known results. Aims: The aim of the study was to verify the possibility of performing an identification study using a three-dimensional model obtained from computed tomography of the head. Identification was performed using a three-dimensional model of the head, based on computer tomography sections made in various projections, with a step of 1.231.25 mm. Two-dimensional images of the face (photos) were used for comparison. All comparative studies were conducted using approved methods of craniofacial and portrait identification: by reference points and contours. The experiment used a computer program that allows you to export DICOM-files of computed tomography results to other formats (InVesalius), as well as computer programs that directly work with the research objects (Autodesk 3ds Max, alternative programs Adobe Photoshop, Smith Micro Poser Pro). Results: In the course of research, it was found that, having computer tomography data of the head, it is possible to conduct identification studies on the following parameters: on the reconstructed three-dimensional model of the soft tissues of the face, on the three-dimensional model of the skull (craniofacial identification), on the features of the structure of the ear. Conclusion: Positive results were obtained when comparing objects, which makes it advisable to use them in practical and scientific activities.

scholarly journals A Perioral Soft Tissue evaluation after Orthognathic Surgery Using Three-Dimensional Computed Tomography Scan

2018 ◽  
Vol 12 (1) ◽  
pp. 366-376
Author(s):  
Rahul Tiwari ◽  
P. Srinivas Chakravarthi ◽  
Vivekanand S. Kattimani ◽  
Krishna Prasad Lingamaneni
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Orthognathic Surgery ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Computed Tomography Scan ◽  
Nasolabial Angle ◽  
Tissue Changes ◽  
Soft Tissue Changes ◽  
Tomography Scan

Background: Facial appearance is an important factor, affects social and psychological well-being. The ideal positioning of jaws and soft tissues is crucial during orthognathic surgery for a better outcome, but the response of facial soft tissues does not always reflect the exact movements of the underlying jaws in 1:1 ratio. So, soft tissue changes following orthognathic surgery require utmost attention during surgical correction to make successful treatment. Aims and Objectives: Evaluation of perioral soft tissue changes after orthognathic surgical procedures. The objectives of the study were to assess and compare pre and post-operative perioral soft tissue changes of lip width, nasolabial and mentolabial angle using Three Dimensional Computed Tomography scan (3DCT). Patient and Methods: The study involved ten patients for evaluation requiring orthognathic surgical procedures (maxillary or mandibular anteroposterior excess or deficiency, transverse deformities, vertical maxillary excess and facial asymmetry) presented to the department of oral and maxillofacial surgery during 2014-2016. Pre and post-operative 3DCT scan were taken after 12 months using iCT 256 slice whole body CT scanner and evaluated for changes using Dicom PMS D view. Results: Significant changes were observed in nasolabial angle after maxillary advancement (1.81°) and maxillary setback procedure (2.73°). The mentolabial angle was significantly increased with mandibular setback procedures (3.27°). Mandibular advancement procedures showed both increase (3.6°) and decrease (7.6°) in mentolabial angle. Conclusion: 3DCT showed a significant difference in perioral soft tissue changes in nasolabial and mentolabial angle but no significant change was observed in lip width. 3DCT is a reliable tool for 3D assessment. The conventional thought of changes in Nasolabial angle after surgery is changing due to the underlying factors which should be considered for prediction.

Simultaneous, laser-sintered, three-dimensional modelling of bony structures and soft tissue for surgical navigation of extended cholesteatoma

2009 ◽  
Vol 124 (5) ◽  
pp. 564-568 ◽  
Author(s):  
M Suzuki ◽  
Y Ogawa ◽  
T Hasegawa ◽  
S Kawaguchi ◽  
K Yukawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Soft Tissues ◽  
Surgical Navigation ◽  
Selective Laser Sintering ◽  
Three Dimensional ◽  
Styloid Process ◽  
Dimensional Structure ◽  
Dimensional Model ◽  
Three Dimensional Model

AbstractAim:To examine the usefulness of a three-dimensional model for surgical navigation of cholesteatoma.Materials and method:A three-dimensional model was prototyped using selective laser sintering. Based on detailed computed tomography data, powder layers were laser-fused and accumulated to create a three-dimensional structure. The computed tomography threshold was adjusted to simultaneously replicate bony structures and soft tissues.Results:The cholesteatoma, major vessels and bony structures were well replicated. This laser-sintered model was used to aid surgery for recurrent cholesteatoma. The cholesteatoma, which extended from the hypotympanum through the styloid process sheath and the internal carotid artery sheath, was removed safely via a minimal skin incision.Conclusion:The laser-sintered model was useful for surgical planning and navigation in a cholesteatoma case involving complex bony structures and soft tissue.

Imaging the Cerebrovascular Tree in the Cadaveric Head for Planning Surgical Strategy

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1222-1228 ◽  
Author(s):  
Jin-Cheng Zhao ◽  
Chi Chen ◽  
Sami S. Rosenblatt ◽  
Joel R. Meyer ◽  
Robert R. Edelman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Agent ◽  
Skull Base ◽  
Surgical Planning ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Surgical Anatomy ◽  
Vascular Lesions ◽  
Preoperative Imaging ◽  
Computed Tomographic

Abstract OBJECTIVE The objective of the study was to identify whether an integration of cadaveric dissections with preoperative imaging information may enable a better understanding of pathological anatomy, especially vascular lesions, and thus allow for greater precision in surgical planning. METHODS We selected a computed tomographic contrast agent and experimentally determined the proportion of it that could mix compatibly with the silicone compound. The resultant mixture was injected into the cerebrovascular systems of six fresh human cadaveric heads. The specimens underwent computed tomography for the purpose of digital virtual exposures in parallel with laboratory dissections performed on these specimens. RESULTS The 1:8 ratio of contrast agent to silicone rubber was determined to be appropriate for both computed tomography and subsequent laboratory dissection of the specimens. The blood vessels in computed tomographic scans demonstrated a higher attenuation than surrounding soft tissues. The opacity consistency of the injected vessels was a critical parameter for a clear three-dimensional rendering of the vascular structures in the natural surroundings of the skull base. Static and dynamic three-dimensional images of the cadaveric vascular tree were obtained as viewed through surgical corridors of various skull base approaches. CONCLUSION We demonstrated a new cadaveric preparation model for imaging and dissection. This model allows for static and dynamic three-dimensional examination of the surgical anatomy from a neurosurgeon's perspective. It may facilitate the study of cerebrovascular system morphology/pathology in relation to the skull base as a tool for surgical planning.

scholarly journals Angiology of the Plantar Plate

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Fred Finney ◽  
Basma Khoury ◽  
Jaron Scott ◽  
Ken Kozloff ◽  
Todd Irwin ◽  
...  
Keyword(s):  
Blood Supply ◽  
Perfusion Imaging ◽  
Surgical Techniques ◽  
Vascular Supply ◽  
Micro Ct ◽  
Ct Scanner ◽  
Micro Computed Tomography ◽  
Surgical Interventions ◽  
Plantar Plate ◽  
Mtp Joints

Category: Basic Sciences/Biologics, Lesser Toes, Midfoot/Forefoot Introduction/Purpose: Hammertoes, crossover toes, and claw toes are common deformities and can be a major source of pain and dysfunction. These deformities result from instability of the metatarsophalangeal (MTP) joint due to incompetence of the plantar plate and/or collateral ligaments. Non-operative management is the first line of treatment. When non-operative treatment is unsuccessful, surgical interventions have been described. Newer surgical techniques focus on performing anatomic repairs of plantar plates. The vasculature of the foot has been well studied, but the vascular supply of the plantar plate has not been described. This study presents a new technique for imaging the microvasculature of the lesser toe plantar plates through micro- computed tomography (micro-CT) in order to better understand tear pathology and the capacity of healing with plantar plate repairs. Methods: The posterior tibial and dorsalis pedis arteries of a fresh frozen human cadaver foot were dissected and cannulated at the ankle for perfusion distally. After administration of an anticoagulant, each artery was perfused with Microfil® Silicone Rubber, a contrast agent. The compound was then allowed to cure, and the foot was fixed in formalin. The foot was sectioned through the metatarsal shafts for imaging, and imaging of the lesser toe MTP joints was performed using a Bruker Skyscan 1176 micro-CT scanner at 18 micron slices. Computerized reconstruction of the images was performed for three dimensional visualization of the vasculature. Results: Post-perfusion imaging of the lesser toe MTP joints using micro-CT allows for visualization of the plantar plate microvasculature. Preliminary imaging suggests that micro-CT is a useful modality for analysis of the blood supply of the plantar plate. Conclusion: Anatomic repair of the plantar plate has become a viable treatment option for MTP joint instability. One important question that remains to be answered is whether plantar plate tears have the capacity to heal. We present a novel technique for imaging of lesser toe plantar plate microvascularity using micro-CT. Preliminary results of post-perfusion imaging of the plantar plate are promising for developing a better understanding of its blood supply. Further definition of the plantar plate vascular supply will help clinicians understand the capacity for healing after repairs and may provide some insight to the biological causes plantar plate tears.

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