scholarly journals The valid diagnostic parameters in static bilateral CT scan to predict unstable syndesmotic injury with ankle fracture

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0031
Author(s):  
Si Wook Lee
Keyword(s):  
Ct Scan ◽  
Surface Area ◽  
Ankle Fracture ◽  
Ct Scans ◽  
Syndesmotic Injury ◽  
Roc Curve Analysis ◽  
Uninjured Side ◽  
Significant Difference ◽  
Posterior Translation ◽  
Preoperative Ct

Category: Trauma Introduction/Purpose: The purpose of this study is to evaluate valid and reasonable parameters to predict syndesmotic injury in ankle fracture. Methods: Seventy patients who underwent preoperative bilateral CT scans were enrolled retrospectively. On preoperative x-ray, tibiofibular overlap (TFO) and tibiofibular clear space (TFCS) were measured. On preoperative CT scan, anterior fibular distance (AFD), posterior fibular distance (PFD), anterior translation distance (AT), fibular diastasis (FD), anterior-posterior translation (APT), fibular length (FL), surface area of syndesmosis (SAS), surface area of syndesmosis of 1.5 cm above the ankle joint line (SAS1.5) were measured. Those measured values were divided with those of uninjured side, in order to minimize the differences among the individuals. Results: Statistically significant differences has been shown between The measurements of ratio (Injured/Uninjured) of TFO, PFD, APT, Diastasis, and SAS of groups which required transfixation have shown statistically significant difference, compared to those of groups which did not require transfixation. Other measurements were not showing significant difference. Furthermore, using ROC curve analysis, a ratio of measurement which is the most reasonable to predict transfixation was SAS (95% confidence interval = 0.598 – 0.869, cut of value = 1.555) Conclusion: Measuring TFO, PFD, APT, Diastasis, and SAS from CT scans and comparing with uninjured side preoperatively can provide surgeon an reasonable evidence to perform transfixation intraoperatively

scholarly journals The Valid Diagnostic Parameters in Bilateral CT Scan to Predict Unstable Syndesmotic Injury with Ankle Fracture

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 812
Author(s):  
Si-Wook Lee ◽  
Kyung-Jae Lee ◽  
Chul Hyun Park ◽  
Hyuk-Jun Kwon ◽  
Beom-Soo Kim
Keyword(s):  
Ct Scan ◽  
Ankle Fracture ◽  
Operating Characteristic ◽  
Stress Test ◽  
Roc Curve Analysis ◽  
Posterior Translation ◽  
Preoperative Ct ◽  
Group A ◽  
Group B ◽  
Anterior Posterior

The purpose of this study is to evaluate the reasonable parameters to predict unstable syndesmotic injuries in ankle fractures. Seventy consecutive patients who underwent preoperative bilateral computed tomography (CT) scans were enrolled. Group A consisted of 20 patients intraoperatively diagnosed with syndesmotic injuries according to an intraoperative stress test and group B consisted of 50 patients who had nosyndesmotic injuries. The tibiofibular overlap (TFO) and tibiofibular clear space (TFCS) were measured using preoperative ankle radiographs. Measuring the anterior fibular distance (AFD), posterior fibular distance (PFD), anterior translation distance (AT), fibular diastasis (FD), anterior-posterior translation (APT), fibular length (FL), and surface area of syndesmosis (SAS) 1.0 and 1.5 which 1.0 cm and 1.5 cm above the tibial plafond was done via preoperative CT scan. The ratio of measurements (Injured/Intact) of the TFO, PFD, APD, and SAS 1.0 showed statistically significant differences. The researchers identified the SAS 1.0 as the most reasonable parameter to predict transfixation using receiver-operating characteristic (ROC) curve analysis. The SAS 1.0 is most valid parameter to predict syndesmotic injuries in this study and these results show that performing a bilateral CT scan on an ankle fracture may provide substantial information in measuring valid parameters.

scholarly journals Trephine Craniotomy versus Burr Hole Drainage for Chronic Subdural Hematoma—An Institutional Analysis of 156 Patients

2020 ◽  
Vol 17 (02) ◽  
pp. 110-120
Author(s):  
Ramesh Chandra Vemula ◽  
B. C.M. Prasad ◽  
Venkat Koyalmantham ◽  
Kunal Kumar
Keyword(s):  
Ct Scan ◽  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Surgical Intervention ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
P Value ◽  
First Choice ◽  
Significant Difference ◽  
Preoperative Ct

Abstract Introduction Some neurosurgeons believe that doing a trephine craniotomy (TC) decreases the chance of recurrence in chronic subdural hematoma (cSDH). But this is not supported by any evidence. Methods A retrospective analysis of patients who were operated for cSDH from 2014 to 2019 at our institute was done. Factors causing recurrence were studied. Results A total of 156 patients were operated in the given period, among which 88 underwent TC and 68 patients underwent burr hole drainage (BHD) for evacuation of cSDH. All patients underwent two trephines or two burr holes placed according to the maximum thickness of the hematoma. Rate of recurrence in trephine group was 12.5% and in burr-hole group was 11.76% and was not statistically significant. Significant factors for recurrence included nontraumatic cSDH, anticoagulant use, presence of membranes, preoperative computed tomography (CT) showing iso- or mixed-density subdural collection and SDH volume > 60 mL. There was selection bias for the procedure. Patients with subdural membranes were preferentially taken for TC as the percentage of subdural membrane found intraoperatively was significantly greater in trephine group (51.1%) than burr-hole group (17.6%) (p value < 0.001).When all the patients who showed membranes in CT scan were excluded, there was no statistical difference in the base line characteristics of both the groups. After excluding the patients with membranes in preoperative CT scan, there was no significant difference in recurrence rate between the two groups.In TC group with membranes, 8 out of 45 had recurrence, whereas in burr-hole group with membranes, 8 out of 12 had recurrence. This difference was statistically significant. (p value < 0.001). Conclusion Surgical intervention in both modalities improves patient outcome with an overall recurrence rate of 12.17%. In the absence of any identifiable membranes in preoperative CT scan, BHD is the preferred surgical intervention. We prefer TC as first choice for patients with membranes in CT scan.

scholarly journals Chest CT Imaging Characteristics of COVID-19 Pneumonia in Surviving and Non-Surviving Hospitalized Patients: A Retrospective Study in a Referral Center in Tehran, Iran

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Sara Besharat ◽  
Fatemehsadat Rahimi ◽  
Siamak Afaghi ◽  
Farzad Esmaeili Tarki ◽  
Fatemeh Pourmotahari ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Ct Scan ◽  
Chest Ct ◽  
Ct Scans ◽  
Early Management ◽  
Ct Findings ◽  
Imaging Characteristics ◽  
Significant Difference ◽  
Chest Ct Scan ◽  
Lung Lobes

Background: Coronavirus disease 2019 (COVID-19) has several chest computed tomography (CT) characteristics, which are important for the early management of this disease, because viral detection via RT-PCR can be time-consuming, resulting in a delayed pneumonia diagnosis. The Radiological Society of North America (RSNA) proposed a reporting language for CT findings related to COVID-19 and defined four CT categories: typical, indeterminate, atypical, and negative. Objectives: To retrospectively evaluate the chest CT characteristics of patients with COVID-19 pneumonia. Patients and Methods: A total of 115 hospitalized laboratory-verified COVID-19 cases, underdoing chest CT scan, were included in this study from April 30 to May 15, 2020. Of 115 cases, 53 were discharged from the hospital, and 62 expired. The initial clinical features and chest CT scans were assessed for the type, pattern, distribution, and frequency of lesions. Moreover, the findings were compared between ward-hospitalized, ICU-admitted, and non-surviving (expired) patients. Results: Of four CT categories, typical CT findings for COVID-19 were more frequent in the expired group (77.4%), compared to the ward-admitted (44.8%) and ICU-admitted (70.8%) groups (P = 0.017). However, no significant difference was observed in the prevalence of intermediate or atypical CT findings between the groups. Negative CT scans for the diagnosis of COVID-19 were significantly fewer in the expired group (0%) as compared to the ward-admitted (10.3%) and ICU-admitted (8.3%) groups (P = 0.0180). Also, the mean number of involved lung lobes and segments was significantly higher in the expired group compared to the other two groups (P = 0.032 and 0.010, respectively). The right upper lobe involvement, right middle lobe involvement, bilateral involvement, central lesion, air bronchogram, and pleural effusion were among CT scan findings with a significantly higher prevalence in non-surviving cases (P < 0.0001, 0.047, 0.01, 0.036, 0.038, and 0.047, respectively). Conclusion: The increased number of involved lung lobes and segments, bilateral and central distribution patterns, air bronchogram, and severe pleural effusion in the initial chest CT scan can be related to the increased severity and poor prognosis of COVID-19.

scholarly journals Comparison of Dorsal-to-Ventral Ratios of the Cervical Paraspinal Musculature in French Bulldogs With and Without Cervical Intervertebral Disk Disease and Two Other Breeds Based on CT Scan Measurements

2021 ◽  
Vol 8 ◽  
Author(s):  
Julia Hart ◽  
Stefan Rupp ◽  
Katinka Hartmann ◽  
Carolin Fischer ◽  
Pia Düver ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ct Scan ◽  
Body Length ◽  
Vertebral Body ◽  
Influencing Factor ◽  
Intervertebral Disk ◽  
Ct Scans ◽  
Height Ratio ◽  
Significant Difference ◽  
Major Factors

Objective: To objectively assess the cervical paraspinal musculature of French bulldogs (FBs) using computed tomography (CT) scan-based measurements, outline differences in other breeds published in the literature, and investigate the potential influence of its cervical paraspinal musculature on predisposed sites for intervertebral disk disease.Animals: Thirty FBs that underwent CT scans of the cervical spine from the skull to C7/T1 were enrolled. Fifteen dogs were patients suffering from intervertebral disk herniation (IVDH group), and 15 dogs underwent CT scans due to brachycephalic obstructive airway syndrome (BOAS group).Methods: At the level of each cervical intervertebral disk from C2/C3 to C7/T1, measurements were performed and statistically analyzed. On the sagittal CT scan reconstruction, the height ratio of the dorsal to ventral paraspinal musculature and the angle of the disk axis to vertebral body length were assessed. On the transverse plane, the area ratio of the dorsal and ventral paraspinal musculature and the ratio of force moments were determined at each intervertebral disk level. Finally, ratios were compared to the values of Labrador retrievers and dachshunds published by Hartmann et al. (1).Results: Comparing the two FB groups, one significant difference was detected in the mean height ratio of the dorsal to ventral paraspinal musculature at the level of C5/C6 (P = 0.0092) and C6/C7 (P = 0.0076), with IVDH FBs having the more prominent dorsal paraspinal musculature. At the level of C3/C4, a significantly less prominent dorsal paraspinal musculature in FBs than in dachshunds (P = 0.0058) and a significantly steeper disk to vertebral body angulation were observed (P = 0.0005).Conclusion: Although some incidental differences were found, most parameters did not significantly differ between the BOAS and IVDH FBs. Significant conformational differences in the cervical paraspinal musculature and disk to vertebral body length angulation were found between FBs and two other breeds (chondrodystrophic and non-chondrodystrophic). This study's findings suggest that the paraspinal musculature is an additional biomechanical influencing factor on the preferential sites of IVDH in the cervical spine and that other major factors exist in IVDH development, especially in FBs.

scholarly journals Anatomical and Radiological Study of Jugular Foramen

2019 ◽  
Vol 08 (03) ◽  
pp. 121-125
Author(s):  
Ajay Kumar ◽  
Alok Tripathi ◽  
Shobhit Raizaday ◽  
Shilpi Jain ◽  
Satyam Khare ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Skull Base ◽  
Jugular Foramen ◽  
Ct Scans ◽  
Transverse Diameter ◽  
Radiological Study ◽  
Significant Difference ◽  
Human Skulls ◽  
The Right

Abstract Background and Aim The purpose of present study was to obtain comprehensive data of morphometric and anatomical details of jugular foramen. Materials and Methods The study was performed on 30 dry adult human skulls along with computed tomography (CT) scans from 30 adult patients. The parameters observed were dimensions, shape, margins, confluence, septations, and distance from jugular foramen to mastoid base. Result In the dry skull observations, only anteroposterior diameter (APD) was significantly different between the right and left side, while for the CT scan observations both transverse diameter and APD exhibit significant difference. Conclusion We believe that data from the present study will help radiologists and neurosurgeons for diagnosis and treatment of skull base pathology around jugular foramen.

scholarly journals The Assessment of Reduction Status Using Radiographic Parameters and Ideal Trans-Fixation Technique for Unstable Syndesmotic Injury with Ankle Fracture

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0033
Author(s):  
Chul-Hyun Park ◽  
Kwang-Soon Song ◽  
Beom-Soo Kim ◽  
Jung-Hoon Choi ◽  
Hyuk-Jun Kwon ◽  
...  
Keyword(s):  
Ankle Fracture ◽  
Mean Value ◽  
Ankle Fractures ◽  
Ct Scans ◽  
Syndesmotic Injury ◽  
Fixation Technique ◽  
Perpendicular Line ◽  
Group A ◽  
The Mean ◽  
The Absolute

Category: Ankle, Trauma Introduction/Purpose: Anatomical restoration of distal tibiofibular syndesmosis is essential in ankle fractures with syndesmotic injury. However, intraoperative reference line of penetrating angle and evaluation of reduction status remains without consensus. The purpose of this study is to analyze the reduction status of syndesmotic injury using radiographic parameters and to find ideal fixation angle treated with trans-fixation in unstable syndesmotic injury. Methods: Twenty-six patients with ankle fractures with syndesmotic injury that underwent preoperative and postoperative bilateral computed tomography (CT) scans were enrolled. A multi-center study was performed in two tertiary medical centers. All patients were treated with tibiofibular trans-fixation screw or tight rope® fixation. The axial sections of bilateral CT scans were reviewed to measure Fibular Diastasis (FD) and Surface Area of Syndesmosis (SAS) at the level of 1.0 cm above ankle joint. Reduction status was measured by calculating the ratio of postoperative and intact side using radiologic parameters. The trans-fixation angles between the perpendicular line of incisura and distal trans-fixation material was measured. Patients were classified by trans-fixation angle into three groups, as showing 0 -1 degree (A), 1-5 degree (B), 5 or more degree (C) in absolute value. Results: The mean value of reduction status ratio was 1.13 in FD and 1.27 in SAS. The absolute mean value of trans-fixation angle was 4.11°. Trans-fixation angle and reduction status had positive correlation in FD (R = 0.522, p = 0.006) and SAS ratio (R = 0.695, p = 0.000). The absolute mean value of trans-fixation angle in group A, B, C was 0.56° (7 cases), 3.01° (12 cases), and 8.90° (7 cases). The mean value of FD ratio in group A, B, C was 1.01, 1.03 and 1.41. FD and SAS ratio had no difference between group A and B but had significant difference between group A, B and C (p < 0.05). Conclusion: Inappropriate trans-fixation technique had correlated with the loss of reduction after treatment of unstable ankle fracture associated with syndesmotic injury. An angle of 5° from the perpendicular line of the incisura is considered as the ideal trans-fixation angle to maintain the reduction status.

scholarly journals Anterior-Posterior Translation and Axial Rotation of the Fibula are Significantly Increased with Sequential Disruption of the Syndesmosis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Conor Murphy ◽  
Thomas Pfeiffer ◽  
Jason Zlotnicki ◽  
Volker Musahl ◽  
Richard Debski ◽  
...  
Keyword(s):  
External Rotation ◽  
Optical Tracking ◽  
Flexion Angle ◽  
Rotational Instability ◽  
Syndesmotic Injury ◽  
Combined Injury ◽  
Tibiofibular Ligament ◽  
Significant Difference ◽  
Posterior Translation ◽  
Anterior Posterior

Category: Ankle, Sports, Trauma Introduction/Purpose: Injury to the Anterior inferior tibiofibular ligament (AITFL), Posterior inferior tibiofibular ligament (PITFL) and Interosseus membrane (IOM) predicts residual symptoms in ankle sprains. Limited kinematic knowledge of the tibiofibular joint results in missed diagnosis and poor clinical outcomes. Lateral fibular displacement on radiologic assessment signifies syndesmotic disruption which dictates operative management. Previous studies demonstrated that fibular motion is multiplanar after injury. The objective of this study is to determine increases in fibular motion with sequential syndesmotic injury and the contribution of the AITFL. Methods: Five fresh-frozen human cadaveric tibial plateau-to-toe specimens with a mean age of 58 years (range 38-73 years) were tested using a 6-degree-of-freedom robotic testing system. The tibia and calcaneus were rigidly fixed. The subtalar joint was fused. The full fibular length was maintained and fibular motion was unconstrained. A 5 Nm external rotation and 5 Nm inversion moment were applied to the ankle at 0°, 15°, and 30° plantarflexion and 10° dorsiflexion. The motion of the fibula was tracked by a 3D optical tracking system. Outcome variables included fibular medial-lateral (ML) translation, anterior-posterior (AP) translation, and external rotation (ER) during each applied moment and flexion angle in the following conditions: 1) intact ankle, 2) AITFL transected, 3) PITFL and IOM transected. Statistical analysis included an ANOVA with a post-hoc Tukey analysis to compare the changes in fibular motion between the intact and injury models at each applied moment and flexion angle (*p<0.05). Results: The only significant differences in fibular motion were during the 5 Nm inversion moment. The posterior translation of the fibula was significantly greater with AITFL injury compared to the intact ankle at 15° and 30° plantarflexion. Significant increases in posterior translation between the intact ankle and AITFL, PITFL, and IOM injury existed at 0°, 15°, and 30° plantarflexion. No significant motion differences were observed between the AITFL injury and combined injury at any condition. When comparing the intact ankle and combined injury, significant increases in ER existed at 0° and 30° plantarflexion and 10° dorsiflexion. The only significant difference in ER between the intact ankle and AITFL injury existed at 0° plantarflexion. Conclusion: This study showed that transecting the AITFL resulted in the largest increases in fibular motion with only minimal further increases after complete syndesmotic injury. Fibular displacement was primarily in the sagittal plane. This study utilized a novel setup with unconstrained motion in a full length, intact fibula. Measuring ML translation alone could underestimate sagittal and rotational instability of the syndesmosis in AITFL injuries. Evaluating fibular AP translation and ER are not part of current standard diagnostic protocols. Physicians may consider more aggressive treatment of isolated AITFL injuries.

Combined Image Guidance and Intraoperative Computed Tomography in Facilitating Endoscopic Orientation within and around the Paranasal Sinuses

2008 ◽  
Vol 22 (6) ◽  
pp. 635-641 ◽  
Author(s):  
Sarah K. Wise ◽  
Richard J. Harvey ◽  
John C. Goddard ◽  
Patrick O. Sheahan ◽  
Rodney J. Schlosser
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Paranasal Sinus ◽  
Image Guidance ◽  
Sinus Surgery ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Significant Difference ◽  
Preoperative Ct ◽  
Anatomic Region

Background The utility of image guidance (image-guided surgery [IGS]) and intraoperative computed tomography (CT) scanning as a tool for less experienced endoscopic surgeons to aid in localization of paranasal sinus and skull base anatomic structures was evaluated. Methods Partial endoscopic dissection was performed on cadaver specimens by three fellowship trained rhinologists. Anatomic sites within and around the sinuses were tagged with radio-opaque markers. Otolaryngology residents identified tagged anatomic sites using four successive levels of technology: endoscopy alone (simulating outpatient clinic), endoscopy plus preoperative CT (simulating endoscopic sinus surgery [ESS] without IGS), endoscopy plus IGS registered to preoperative CT (simulating current ESS with IGS), and endoscopy plus IGS registered to real-time intraoperative CT. Responses were graded as follows: consensus rhinologist answer (4 points), close answer without clinically significant difference (3 points), within anatomic region but definite clinical difference (2 points), outside of anatomic region (1 point), no answer (0 points). Results Eleven residents participated. Of 20 specific anatomic sites, IGS-intraoperative CT provided the most accurate anatomic identification at 16 sites. For 8 sites, IGS-intraoperative CT had a significantly higher score than endoscopy alone (p < 0.05; eta2 = 0.29-0.67). For 6 sites, IGS-preoperative CT scan had a significantly higher score than endoscopy alone (p < 0.05; eta2 = 0.30-0.67). All participants found that IGS-intraoperative CT scan made them most comfortable in identifying anatomy. Conclusion Combined IGS and intraoperative CT scan technology may be an instructional adjunct for less experienced paranasal sinus surgeons for dissection and evaluation of unfamiliar or distorted anatomy.

scholarly journals COMPARATIVE ANALYSIS IMAGE RESULTS OF PANCREAS IN PORTAL VEIN PHASE ON CT SCAN ABDOMEN CONTRAST WITHOUT AND WITH MINIMUM INTENSITY PROJECTION IN CT SCAN 64 SLICE

2019 ◽  
Vol 2 (3) ◽  
pp. 101
Author(s):  
Maria Ramandita ◽  
Lailatul Muqmiroh ◽  
Pramono Pramono
Keyword(s):  
Ct Scan ◽  
Ct Scans ◽  
Analytic Method ◽  
Portal Venous Phase ◽  
Minimum Intensity Projection ◽  
Significant Difference ◽  
Venous Phase ◽  
Spss Software ◽  
Contrast Ct ◽  
Minimum Intensity

Background: Minimum Intensity Projection is a post-proccesing technique on CT Scan that useful for showing structures with low Hounsfiled Unit (HU) values such as pancreas. To demonstrate the anatomy and pathology of the pancreatic organs, a contrast CT scan was performed on pancreatic phase but pancreatic phase was rarely used, so it was replaced by the portal venous phase, but this technique is still rarely used among the radiographers. Objective: This study aimed to prove the image of the portal venous pancreatic vein on contrast contrast CT scan by using minimum intensity projection (MinIP) on CT scan 64 slices will produce a more optimal image than without the minimum intensity projection (MinIP). Methods: This study is a retrospective study with an observational analytic method to assess differences of pancreatic image in contrasting contrast CT scans with and with MinIP reforms on CT 64 slice modalities Philips Briliance. 30 images as samples, with the criteria set by the researchers. The image will be post proccesing without and by using MinIP reformat. Image results will be evaluated by two radiologist, then the data obtained will be tabulated and processed using SPSS software version 17. Result: From this research obtained the result that MinIP reformat able to produce pancreas image more optimal than image without MinIP reformat on CT scan 64 slice and shows a significant difference. Overall assessment of the image has an improvement with the MinIP but for the homogeneity of pancreatic images decreased. Conclusions: There was a significant difference between pancreatic venous porta port results in contrasting CT scans of the abdomen without and with MinIP reformat.

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