scholarly journals Complications of hip preserving surgery

2021 ◽  
Vol 6 (6) ◽  
pp. 472-486
Author(s):  
Markus S. Hanke ◽  
Till D. Lerch ◽  
Florian Schmaranzer ◽  
Malin K. Meier ◽  
Simon D. Steppacher ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Periacetabular Osteotomy ◽  
Preoperative Evaluation ◽  
Femoral Torsion ◽  
Labral Tears ◽  
Hip Preserving Surgery ◽  
Technical Advances ◽  
Additional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Preoperative evaluation of the pathomorphology is crucial for surgical planning, including radiographs as the basic modality and magnetic resonance imaging (MRI) and case-based additional imaging (e.g. 3D-CT, abduction views). Hip arthroscopy (HAS) has undergone tremendous technical advances, an immense increase in use and the indications are getting wider. The most common indications for revision arthroscopy are labral tears and residual femoroacetabular impingement (FAI). Treatment of borderline developmental dysplastic hip is currently a subject of controversy. It is paramount to understand the underlining problem of the individual hip and distinguish instability (dysplasia) from FAI, as the appropriate treatment for unstable hips is periacetabular osteotomy (PAO) and for FAI arthroscopic impingement surgery. PAO with a concomitant cam resection is associated with a higher survival rate compared to PAO alone for the treatment of hip dysplasia. Further, the challenge for the surgeon is the balance between over- and undercorrection. Femoral torsion abnormalities should be evaluated and evaluation of femoral rotational osteotomy for these patients should be incorporated to the treatment plan. Cite this article: EFORT Open Rev 2021;6:472-486. DOI: 10.1302/2058-5241.6.210019

scholarly journals Hip preservation

2020 ◽  
Vol 5 (10) ◽  
pp. 630-640
Author(s):  
Markus S. Hanke ◽  
Florian Schmaranzer ◽  
Simon D. Steppacher ◽  
Till D. Lerch ◽  
Klaus A. Siebenrock
Keyword(s):  
Surgical Planning ◽  
Periacetabular Osteotomy ◽  
Slipped Capital Femoral Epiphysis ◽  
Developmental Dysplasia ◽  
Perthes Disease ◽  
Long Term Results ◽  
Inclusion Type ◽  
Open Treatment ◽  
Hip Preserving Surgery ◽  
Magnetic Resonance Imaging Mri

Classical indications for hip preserving surgery are: femoro-acetabular impingement (FAI) (intra- and extra-articular), hip dysplasia, slipped capital femoral epiphysis, residual deformities after Perthes disease, avascular necrosis of the femoral head. Pre-operative evaluation of the pathomorphology is crucial for surgical planning including radiographs as the basic modality and magnetic resonance imaging (MRI) and/or computed tomography (CT) to evaluate further intra-articular lesions and osseous deformities. Two main mechanisms of intra-articular impingement have been described: (1) Inclusion type FAI (‘cam type’). (2) Impaction type FAI (‘pincer type’). Either arthroscopic or open treatment can be performed depending on the severity of deformity. Slipped capital femoral epiphysis often results in a cam-like deformity of the hip. In acute cases a subcapital re-alignment (modified Dunn procedure) of the femoral epiphysis is an effective therapy. Perthes disease can lead to complex femoro-acetabular deformity which predisposes to impingement with/without joint incongruency and requires a comprehensive diagnostic workup for surgical planning. Developmental dysplasia of the hip results in a static overload of the acetabular rim and early osteoarthritis. Surgical correction by means of periacetabular osteotomy offers good long-term results. Cite this article: EFORT Open Rev 2020;5:630-640. DOI: 10.1302/2058-5241.5.190074

scholarly journals A detailed analysis of anatomical plausibility of crossed and uncrossed streamline rendition of the dentato-rubro-thalamic tract (DRT(T)) in a commercial stereotactic planning system

2021 ◽  
Author(s):  
Volker A. Coenen ◽  
Bastian E. Sajonz ◽  
Peter C. Reinacher ◽  
Christoph P. Kaller ◽  
Horst Urbach ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Ground Truth ◽  
Planning System ◽  
Single Subject ◽  
Fiber Structure ◽  
Native Space ◽  
Volume Of Interest ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Abstract Background An increasing number of neurosurgeons use display of the dentato-rubro-thalamic tract (DRT) based on diffusion weighted imaging (dMRI) as basis for their routine planning of stimulation or lesioning approaches in stereotactic tremor surgery. An evaluation of the anatomical validity of the display of the DRT with respect to modern stereotactic planning systems and across different tracking environments has not been performed. Methods Distinct dMRI and anatomical magnetic resonance imaging (MRI) data of high and low quality from 9 subjects were used. Six subjects had repeated MRI scans and therefore entered the analysis twice. Standardized DICOM structure templates for volume of interest definition were applied in native space for all investigations. For tracking BrainLab Elements (BrainLab, Munich, Germany), two tensor deterministic tracking (FT2), MRtrix IFOD2 (https://www.mrtrix.org), and a global tracking (GT) approach were used to compare the display of the uncrossed (DRTu) and crossed (DRTx) fiber structure after transformation into MNI space. The resulting streamlines were investigated for congruence, reproducibility, anatomical validity, and penetration of anatomical way point structures. Results In general, the DRTu can be depicted with good quality (as judged by waypoints). FT2 (surgical) and GT (neuroscientific) show high congruence. While GT shows partly reproducible results for DRTx, the crossed pathway cannot be reliably reconstructed with the other (iFOD2 and FT2) algorithms. Conclusion Since a direct anatomical comparison is difficult in the individual subjects, we chose a comparison with two research tracking environments as the best possible “ground truth.” FT2 is useful especially because of its manual editing possibilities of cutting erroneous fibers on the single subject level. An uncertainty of 2 mm as mean displacement of DRTu is expectable and should be respected when using this approach for surgical planning. Tractographic renditions of the DRTx on the single subject level seem to be still illusive.

The Diagnostic Value of MRI in Traumatic Brachial Plexus Injury

1994 ◽  
Vol 19 (1) ◽  
pp. 55-59 ◽  
Author(s):  
M. OCHI ◽  
Y. IKUTA ◽  
M. WATANABE ◽  
K. KIMOR ◽  
K. ITOH
Keyword(s):  
Brachial Plexus ◽  
Nerve Root ◽  
Brachial Plexus Injury ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Nerve Roots ◽  
Surgical Exploration ◽  
Nerve Root Avulsion ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Findings in 34 patients with traumatic brachial plexus injury documented by surgical exploration and intra-operative somatosensory-evoked potentials were correlated with findings on myelography and magnetic resonance imaging (MRI) to determine whether MRI can identify nerve root avulsion. The coronal and sagittal planes were not able to demonstrate avulsion of the individual nerve roots. The axial and axial oblique planes did provide useful information to determine which nerve root was avulsed in the upper plexus, although it was difficult to clearly delineate the lower cervical rootlets. The accuracy of MRI was 73% for C5 and 64% for C6 and that of myelograpby 63% for C5 and 64% for C6. Thus, the diagnostic accuracy of MRI for upper nerve roots was slightly superior to myelography. Although its primary diagnostic value is limited to the upper nerve roots whose avulsion is relatively difficult to diagnose by myelography, MRI can provide useful guidance in the waiting period prior to surgical exploration after brachial plexus injury.

scholarly journals Use of Magnetic Resonance Imaging to Predict Outcome after Stroke: A Review of Experimental and Clinical Evidence

2010 ◽  
Vol 30 (4) ◽  
pp. 703-717 ◽  
Author(s):  
Tracy D Farr ◽  
Susanne Wegener
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Complete Recovery ◽  
Research Translation ◽  
Resonance Imaging ◽  
Preclinical Research ◽  
Stroke Research ◽  
Future Potential ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Despite promising results in preclinical stroke research, translation of experimental data into clinical therapy has been difficult. One reason is the heterogeneity of the disease with outcomes ranging from complete recovery to continued decline. A successful treatment in one situation may be ineffective, or even harmful, in another. To overcome this, treatment must be tailored according to the individual based on identification of the risk of damage and estimation of potential recovery. Neuroimaging, particularly magnetic resonance imaging (MRI), could be the tool for a rapid comprehensive assessment in acute stroke with the potential to guide treatment decisions for a better clinical outcome. This review describes current MRI techniques used to characterize stroke in a preclinical research setting, as well as in the clinic. Furthermore, we will discuss current developments and the future potential of neuroimaging for stroke outcome prediction.

Sex Offending Behaviors and Adults

2020 ◽  
pp. 145-163
Author(s):  
Shane T. Spiker
Keyword(s):  
Sexual Behavior ◽  
Special Needs ◽  
Sex Offender ◽  
Treatment Plan ◽  
Lessons Learned ◽  
Sex Offending ◽  
Behavior Interventions ◽  
Inappropriate Sexual Behavior ◽  
The Individual

Sex-related behavior can present challenges in the community and present serious impacts on individuals with special needs. When considering sex offender types of behavior, special considerations are made for supervision, prevention, and education for the individual and the community at large. William is an elderly gentleman who presents with inappropriate sexual behavior resulting in both child and adult victims. The following chapter discusses his history along with some unique challenges related to his sexual behavior, interventions considered as part of his treatment plan, and some lessons learned from working with William and his unique considerations.

Prosthodontics

2019 ◽  
Author(s):  
Nicholas Longridge ◽  
Pete Clarke ◽  
Raheel Aftab ◽  
Tariq Ali
Keyword(s):  
Treatment Planning ◽  
Clinical Skills ◽  
Treatment Plan ◽  
Work Load ◽  
Daily Basis ◽  
Digital Dentistry ◽  
Production Methods ◽  
Black And White ◽  
Reading Key ◽  
The Individual

Prosthodontics comprises most of the routine restorative treatments that practitioners perform on a daily basis. Much restorative work re¬sults from the impact of caries and periodontal disease. However, the prevalence of toothwear is dramatically increasing and can be expected to form a more prominent feature of the modern practitioner’s work¬load. There is a considerable theory base in prosthodontics, covering all aspects of fixed and removable treatments, both conventional and contemporary. Although the individual management of teeth can be tricky, a challenge many new practitioners struggle with is treatment planning on a patient level. Treatment planning is rarely black and white, with considerable variations in opinion among clinicians, even for more simple cases. The staging of treatment planning is fairly consistent across the profession (e.g. relief of pain first, then investigatory phase, etc.), but in complex cases, a second opinion may be warranted. Not only is treatment plan¬ning a difficult skill, but so is the execution. It takes practice to become adept at the variety of clinical skills in prosthodontics and the staging of treatment, but this makes for a rewarding and fascinating discipline. Modern dentistry has a much greater focus on minimal invasive treat-ment, relying on dentine bonding and adhesive dentistry to limit the need for aggressive preparations of teeth and protect the vitality of the pulp. Moreover, the progression in digital dentistry is exponential, with newer production methods and clinical techniques becoming increasingly accurate and ever more accessible. As such, the modern practitioner needs to have a good understanding of both conventional concepts and modern alternatives in order to be able to apply the material and tech¬nique of choice to achieve an optimal outcome. The questions in the chapter aim to cover a wide range of topics, testing conventional concepts in both fixed and removable prostho¬dontics, whilst touching on contemporary materials and production methods. It is hoped that the reader will be challenged and the more difficult questions will promote wider reading. Key topics include: ● Diagnosis and treatment planning ● Occlusion ● Toothwear ● Complete dentures ● Removable dentures (including denture design principles) ● Direct restorations ● Crown and bridge ● Implant restorations ● Laboratory processes ● Digital dentistry.

scholarly journals Inferior Glenohumeral Ligament (IGHL) Injuries: A Case Series of Magnetic Resonance (MR) Imaging Findings and Arthroscopic Correlation

2020 ◽  
Vol 13 ◽  
pp. 275-279
Author(s):  
Michael Glass ◽  
Vafa Behzadpour ◽  
Jessica Peterson ◽  
Lauren Clark ◽  
Shelby Bell-Glenn ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Case Series ◽  
Inclusion Criteria ◽  
Glenohumeral Ligament ◽  
Radiology Reports ◽  
Labral Tears ◽  
Tissue Edema ◽  
Cortical Irregularity ◽  
Inferior Glenohumeral Ligament ◽  
Magnetic Resonance Imaging Mri

The inferior glenohumeral ligament (IGHL) complex is commonly assessed by both magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrogram. Our study aimed to compare the accuracy of MR arthrogram compared to MRI using arthroscopic correlation as the gold standard. A retrospective review of cases reporting an IGHL injury was performed. 77 cases met inclusion criteria, while 5 had arthroscopic reports that directly confirmed or refuted the presence of IGHL injury. Two arthroscopic reports confirmed concordant IGHL injuries, while 3 arthroscopic reports mentioned discordant findings compared to MR. Interestingly, all three discordant cases involved MR arthrogram. Findings included soft tissue edema, fraying of the axillary pouch fibers, and cortical irregularity of the humeral neck. Of the two concordant cases, one was diagnosed by MRI, revealing an avulsion of the anterior band, while the second was diagnosed by MR arthrogram showing ill-defined anterior band fibers. Many cases involved rotator cuff or labral tears, which may have been the focus of care for providers, given their importance for shoulder stability. Additionally, a lack of diagnostic confidence in MR reports may have influenced surgeons in the degree to which they assessed the IGHL complex during arthroscopy. In conclusion, radiologists seemed more likely to make note of IGHL injuries when MR arthrograms were performed; meanwhile, all three discordant cases involved MR arthrogram reads. Therefore, additional larger studies are needed with arthroscopic correlation to better elucidate MR findings that confidently suggest injury to the IGHL complex, in order to avoid false positive radiology reports.

Deep learning-based approach for segmentation of glioma sub-regions in MRI

2020 ◽  
Vol 13 (4) ◽  
pp. 389-406
Author(s):  
Jiten Chaudhary ◽  
Rajneesh Rani ◽  
Aman Kamboj
Keyword(s):  
Deep Learning ◽  
Brain Tumor ◽  
Data Augmentation ◽  
Treatment Plan ◽  
Superior Performance ◽  
Content Type ◽  
Proposed Model ◽  
Life Threatening ◽  
Tumor Region ◽  
Magnetic Resonance Imaging Mri

PurposeBrain tumor is one of the most dangerous and life-threatening disease. In order to decide the type of tumor, devising a treatment plan and estimating the overall survival time of the patient, accurate segmentation of tumor region from images is extremely important. The process of manual segmentation is very time-consuming and prone to errors; therefore, this paper aims to provide a deep learning based method, that automatically segment the tumor region from MR images.Design/methodology/approachIn this paper, the authors propose a deep neural network for automatic brain tumor (Glioma) segmentation. Intensity normalization and data augmentation have been incorporated as pre-processing steps for the images. The proposed model is trained on multichannel magnetic resonance imaging (MRI) images. The model outputs high-resolution segmentations of brain tumor regions in the input images.FindingsThe proposed model is evaluated on benchmark BRATS 2013 dataset. To evaluate the performance, the authors have used Dice score, sensitivity and positive predictive value (PPV). The superior performance of the proposed model is validated by training very popular UNet model in the similar conditions. The results indicate that proposed model has obtained promising results and is effective for segmentation of Glioma regions in MRI at a clinical level.Practical implicationsThe model can be used by doctors to identify the exact location of the tumorous region.Originality/valueThe proposed model is an improvement to the UNet model. The model has fewer layers and a smaller number of parameters in comparison to the UNet model. This helps the network to train over databases with fewer images and gives superior results. Moreover, the information of bottleneck feature learned by the network has been fused with skip connection path to enrich the feature map.

The potential of support vector machine as the diagnostic tool for schizophrenia: A systematic literature review of neuroimaging studies

2011 ◽  
Vol 26 (S2) ◽  
pp. 1363-1363 ◽  
Author(s):  
M.P. Collins ◽  
S.E. Pape
Keyword(s):  
Support Vector Machine ◽  
Diagnostic Tool ◽  
Literature Search ◽  
Structural Mri ◽  
Support Vector ◽  
Systematic Literature Search ◽  
Resonance Imaging ◽  
Pubmed Database ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

IntroductionSchizophrenia is a relatively common chronic psychotic mental illness, which usually continues throughout life. Current diagnosis is based on a set of psychiatrist-applied diagnostic criteria. There can be considerable differences between diagnostic classification based upon either the set of criteria used, or the individual who applies the criteria. For this reason, the development of an objective test to inform the diagnosis could be highly beneficial.ObjectivesTo assess the use of Support Vector Machine (SVM) as a potential diagnostic tool for schizophrenia, with a particular focus on the application of SVM to Magnetic Resonance Imaging (MRI) data.AimsTo show the use of SVM on MRI data to be a potentially viable diagnostic test.MethodA systematic literature search was carried out using the PubMed database, Web of Knowledge as well as Google Scholar. This search was conducted using the terms ‘Schizophrenia’, ‘SVM’/‘Support Vector Machine’ and ‘MRI/fMRI’. This was followed by the application of criteria relating to relevance to the desired search topic (as assesed by the author). Ten publications were identified as relevant.ResultsResults showed strong evidence that the application of SVM to MRI data can reliably differentiate between patients with schizophrenia and healthy controls.ConclusionsThe results indicate that using SVM to analyse MRI data can be reliably used to identify schizophrenia, although there is some variability between the results produced. The potential of SVM in application to fMRI (as opposed to structural MRI) data is yet to be fully explored.

scholarly journals Simultaneous Measurement of Gastric Emptying of a Soup Test Meal Using MRI and Gamma Scintigraphy

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 170 ◽  
Author(s):  
Asseel Khalaf ◽  
Caroline L. Hoad ◽  
Elaine Blackshaw ◽  
Jaber Alyami ◽  
Robin C. Spiller ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Test Meal ◽  
Retention Rate ◽  
Stomach Contents ◽  
Individual Variability ◽  
Gamma Scintigraphy ◽  
Clinical Value ◽  
Significant Difference ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Measurement of gastric emptying is of clinical value for a range of conditions. Gamma scintigraphy (GS) has an established role, but the use of magnetic resonance imaging (MRI) has recently increased. Previous comparison studies between MRI and GS showed good correlation, but were performed on separate study days. In this study, the modalities were alternated rapidly allowing direct comparison with no intra-individual variability confounds. Twelve healthy participants consumed 400 g of Technetium-99m (99mTc)-labelled soup test meal (204 kcal) and were imaged at intervals for 150 min, alternating between MRI and GS. The time to empty half of the stomach contents (T1/2) and retention rate (RR) were calculated and data correlated. The average T1/2 was similar for MRI (44 ± 6 min) and GS (35 ± 4 min) with a moderate but significant difference between the two modalities (p < 0.004). The individual T1/2 values were measured, and MRI and GS showed a good positive correlation (r = 0.95, p < 0.0001), as well as all the RRs at each time point up to 120 min. Gastric emptying was measured for the first time by MRI and GS on the same day. This may help with translating the use of this simple meal, known to elicit reliable, physiological, and pathological gastrointestinal motor, peptide, and appetite responses.

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