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Folia Morphologica 2022The foramen magnum (FM) is an important landmark because of its close relationship to key structures such as the brainstem and spinal cord, an extension of the medulla...
BACKGROUND
The foramen magnum (FM) is an important landmark because of its close relationship to key structures such as the brainstem and spinal cord, an extension of the medulla oblongata. Because of the similarity in their shape, the existence of a relationship between cranial length and anteroposterior diameter of the FM, and between cranial width and transverse diameter of the FM may reveal the magnificent harmony of the skull and FM. Based on this idea, we investigated the existence of this harmony in skulls that we used in our study.
MATERIALS AND METHODS
In this study, 60 adult dry skulls belonging to the Turkish population were examined. The anteroposterior and transverse diameters of the foramen magnum and the length and width of the skull were measured. Measurements were made directly on the skull using a digital sliding calliper. New indices and ratios were applied with those measurements.
RESULTS
Our study suggests that FM width and FM length could be estimated by using the cranial length and cranial width measurements in the skull by accepting the mean of these coefficients (4.62) as the golden ratio. The average of the coefficients of cranial width to FM width ratio (4.62 ± 0.35 [95% CI: 4.52-4.70]) and the average of the coefficients of cranial length to the FM length ratio (4.62 ± 0.50 [95% CI: 4.49-4.76]) were found to be equal to each other. In order to check the accuracy of this hypothesis, FM width and FM lengths were estimated with the help of new equations.
CONCLUSIONS
In the present study, the ratio between the anteroposterior and transverse diameters of both FM and the cranium was estimated at 4.62, indicating a magnificent harmony between cranial and subcranial structures. With this ratio, it is easy to estimate FM's size based on simple cranial measurements.
Topics: Foramen Magnum; Head; Pilot Projects; Skull; Spinal Cord
PubMed: 33634836
DOI: 10.5603/FM.a2021.0018 -
BMC Medical Imaging Dec 2022Ultrasound imaging is used for diagnosis, treatment, and blood vessel visualization during venous catheter placement. However, various physiological factors (e.g., body...
BACKGROUND
Ultrasound imaging is used for diagnosis, treatment, and blood vessel visualization during venous catheter placement. However, various physiological factors (e.g., body temperature and exercise) influence vein diameters, which are expected to exhibit daily or diurnal fluctuations. Therefore, this study aimed to determine the intraday (short-term) and interday (long-term) reproducibility of repeated measurements of the depth and diameter of peripheral superficial veins.
METHODS
Twenty-three healthy young women (mean age, 21.7 ± 0.8 years) participated in the study to examine the short- and long-term reproducibility of the depth and diameter of the cutaneous vein in the left elbow fossa acquired by ultrasound imaging. Short-term measurement intervals were 10 s, and the probe was released from the skin for each acquisition, which was repeated five consecutive times. Long-term measurements were performed at the same time on the next day following the same procedure. The acquired images were analyzed for vein depth and diameter using ImageJ software. The intraclass correlation coefficient (ICC) was calculated to determine the short- and long-term reproducibility of the measurements. The relationship between the venous depth and venous diameter intra-individual variation was analyzed, as well as the influence of body composition (body fat and muscle mass) on the venous diameter and depth.
RESULTS
For vein depth measurements, the short- and long-term ICCs were 0.94-0.96 and 0.88, respectively. For the vein diameter, the short- and long-term ICCs were 0.94-0.97 and 0.67, respectively. The short-term ICCs for both vein depth and diameter exceeded 0.9, indicating that the ultrasound vascular measurement was sufficiently reliable. However, long-term reproducibility was slightly lower, especially for the vein diameter. No correlation was found between the intra-individual variation of the vein diameter and vein depth. Although the vein diameter and body fat mass uncorrelated, the vein depth and body fat mass significantly correlated (r = 0.675, 95% confidence interval = 0.281-0.830).
CONCLUSIONS
The long-term reproducibility of vein diameters was somewhat lower than that of the short-term reproducibility. This could be attributed to fluctuations in the physiological state of the participant rather than to the instability of the measurement. Therefore, ultrasound measurement of the peripheral superficial vein is sufficiently reliable.
Topics: Humans; Female; Young Adult; Adult; Reproducibility of Results; Ultrasonography; Adipose Tissue; Angiography; Body Composition
PubMed: 36461013
DOI: 10.1186/s12880-022-00945-9 -
The Annals of Otology, Rhinology, and... Feb 2021To measure the dimensions of the cricoid cartilage in adults and to investigate the age-related change of the dimensions of the cricoid cartilage.
OBJECTIVES
To measure the dimensions of the cricoid cartilage in adults and to investigate the age-related change of the dimensions of the cricoid cartilage.
METHODS
After performing the multiplanar reconstruction and correcting the slant of the cervical computed tomography scans, the transverse and anteroposterior internal diameters of the inlet (TD-in and APD-in) and outlet (TD-out and APD-out) of the cricoid cartilage were measured, respectively. The angle between the arch and lamina of the cricoid cartilage in the middle sagittal plane was measured. The ratios of transverse to anteroposterior diameter for the inlet (Ratio-in) and outlet (Ratio-out) of the cricoid cartilage were calculated, respectively.
RESULTS
A total of 1200 adults were included in this study, with 600 males and 600 females. The TD-in is the smallest cricoid diameter and the APD-in is the largest cricoid diameter. The mean cricoid diameters and the cricoid angle in males were larger than those in females. The cricoid inlet is oval shaped and the cricoid cartilage is "funnel-shaped" in the middle sagittal plane. The shape of the outlet of the cricoid cartilage varies greatly among individuals. In males, the APD-in and APD-out were negatively correlated with age while the Ratio-in and Ratio-out was positively correlated with age. In females, the APD-out were negatively correlated with age while the Ratio-out was negatively correlated with age.
CONCLUSIONS
The dimensions of the cricoid cartilage change as age advances in adult population and the sexual dimorphism of the cricoid outlet occurs after 50 years old.
Topics: Aged; Aged, 80 and over; Aging; Cricoid Cartilage; Female; Humans; Male; Middle Aged; Retrospective Studies; Sex Characteristics; Tomography, X-Ray Computed
PubMed: 32646280
DOI: 10.1177/0003489420940339 -
Journal of Vascular Surgery. Venous and... May 2022The aim of this study was to examine lymphatic diameters in lower limbs of healthy volunteers in different body positions using lymphatic ultrasound examinations.
OBJECTIVE
The aim of this study was to examine lymphatic diameters in lower limbs of healthy volunteers in different body positions using lymphatic ultrasound examinations.
METHODS
Thirty-five healthy volunteers participated in this study. Those who had a history of varicose veins in the leg, deep venous thrombosis, or surgery on their legs or abdomen were excluded. We measured the vertical width of the lymphatics with a 33 MHz linear ultrasound probe, at 20 cm above the knee (thigh) and 10 cm below the knee (lower leg). First, the participants were placed supine, then sitting, and then standing. We performed lymphatic ultrasound examinations in each body position. The Student t test was used to compare lymphatic vessel diameters in the supine, sitting, and standing positions. The significance level was set at .05.
RESULTS
Among 35 healthy volunteers, 17 were men and 18 were women. Mean age was 30.9 (range, 23-55) years. The mean body mass index was 21.3 kg/m (range, 29.0-16.1 kg/m). We could not detect lymphatic vessels in 1 thigh and 3 lower legs, leaving 69 thighs and 67 lower legs for evaluation. In the thigh, the mean lymphatic diameters in the supine and standing positions were 0.154 mm and 0.150 mm, respectively, which were not significantly different. In the lower leg, the mean lymphatic diameters in the supine, sitting, and standing positions were 0.160 mm, 0.163 mm, and 0.164 mm, respectively, which were not significantly different. In the thigh, the mean lymphatic diameter in the supine position was larger in the men (0.17 mm) than in the women (0.14 mm) (P = .022). Similarly, in the lower leg, the mean lymphatic diameter in the supine position was greater in the men (0.19 mm) than in the women (0.14 mm) (P = .0044). There was no correlation between the supine lymphatic diameters and the age or body mass index of the participants.
CONCLUSIONS
In healthy legs, lymphatic diameters do not change with body positioning. Supine lymphatic vessel diameters are greater in men than in women.
Topics: Adult; Female; Humans; Leg; Lower Extremity; Lymphatic Vessels; Male; Ultrasonography; Varicose Veins
PubMed: 34597838
DOI: 10.1016/j.jvsv.2021.09.007 -
Aesthetic Plastic Surgery Aug 2023Osteocartilaginous deformities in cleft rhinoplasties may be restored with numerous techniques. However, the anteroposterior (AP) diameter lengths of the nostrils may...
BACKGROUND
Osteocartilaginous deformities in cleft rhinoplasties may be restored with numerous techniques. However, the anteroposterior (AP) diameter lengths of the nostrils may still be unequal and should also be addressed. A technique was designed to balance nostril AP diameter lengths and apical shapes.
MATERIALS AND METHODS
Balance between AP nostril diameters was accomplished by reduction of the AP diameter of the nostril at the non-cleft side by medial crural reduction and augmentation of the AP diameter of the nostril at the cleft side by three-parted mini-flap reconstruction at the soft triangle. The cleft-side AP diameter length was divided by the non-cleft-side AP diameter length of the same preoperative, per-operative and 1-year postoperative base view photographs of each patient, and "nostril balancing ratio" was obtained. The more this ratio was near to "one," the more the AP nostril diameters were equal.
RESULTS
Seventy-eight unilateral-cleft rhinoplasty were performed between January/2019 and May/2022. Forty-two of them required nostril AP diameter equalization. Twenty-nine patients were female, thirteen were male. Thirty-three of them were operated for a primary cleft rhinoplasty. Nine of them for secondary cleft rhinoplasty. Mean age was 28 years (22-39 years). Mean follow-up was 25 months (6-40 months). The preoperative, per-operative and postoperative mean "nostril balancing ratios" were 0.714 (0.621-0.813), 0.743 (0.721-0.752) and 0.971 (0.943-0.976), respectively.
CONCLUSION
Balancing AP diameter symmetry with MCO at the non-cleft side and three-parted mini skin flap reconstruction at the cleft side may provide the satisfactory results. Three mini-flaps at the soft triangle may remold the nostril apex in an oval shape, which may result in a better shape symmetry.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Adult; Female; Humans; Male; Cleft Lip; Nose; Plastic Surgery Procedures; Retrospective Studies; Rhinoplasty; Treatment Outcome; Young Adult
PubMed: 36323963
DOI: 10.1007/s00266-022-03153-6 -
The Korean Journal of Internal Medicine Jan 2022While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to...
BACKGROUND/AIMS
While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm.
METHODS
The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath.
RESULTS
The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm.
CONCLUSION
We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.
Topics: Body Mass Index; Coronary Angiography; Female; Hand; Humans; Male; Radial Artery; Ultrasonography
PubMed: 35000375
DOI: 10.3904/kjim.2020.685 -
Radiography (London, England : 1995) May 2022To design a custom phantom of the coronary arteries to optimize CT coronary angiography (CCTA) protocols.
INTRODUCTION
To design a custom phantom of the coronary arteries to optimize CT coronary angiography (CCTA) protocols.
METHODS
Characteristics of the left and right coronary arteries (mean Hounsfield Unit (HU) values and diameters) were collected from consecutive CCTA examinations (n = 43). Four different materials (two mixtures of glycerine, gelatine and water, pig hearts, Ecoflex™ silicone) were scanned inside a Lungman phantom using the CCTA protocol to find the closest model to in vivo data. A 3D printed model of the coronary artery tree was created using CCTA data by exporting a CT volume rendering into Autodesk Meshmixer™ software. The model was placed in an acid bath for 5 h, then covered in Ecoflex™, which was removed after drying. Both the Ecoflex™ and pig heart were later filled with a mixture of contrast (Visipaque 320 mg I/ml), NaCl and gelatin and scanned with different levels of tube current and iterative reconstruction (ASiR-V). Objective (HU, noise and size (vessel diameter) and subjective analysis were performed on all scans.
RESULTS
The gelatine mixtures had HU values of 130 and 129, Ecoflex™ 65 and the pig heart 56. At the different mA/ASiR-V levels the contrast filled Ecoflex™ had a mean HU 318 ± 4, noise 47±7HU and diameter of 4.4 mm. The pig heart had a mean HU of 209 ± 5, noise 38±4HU and a diameter of 4.4 mm. With increasing iterative reconstruction level the visualisation of the pig heart arteries decreased so no measurements could be performed.
CONCLUSION
The use of a 3D printed model of the arteries and casting with the Ecoflex™ silicone is the most suitable solution for a custom-designed phantom.
IMPLICATIONS FOR PRACTICE
Custom designed phantoms using 3D printing technology enable cost effective optimisation of CT protocols.
Topics: Animals; Coronary Vessels; Humans; Printing, Three-Dimensional; Radiation Dosage; Silicones; Swine; Tomography, X-Ray Computed
PubMed: 34556417
DOI: 10.1016/j.radi.2021.09.001 -
Revista Portuguesa de Cardiologia :... Jul 2023Several studies comparing optical coherence tomography (OCT) and intravascular ultrasound (IVUS) have revealed that OCT consistently provides smaller area and diameter...
INTRODUCTION AND OBJECTIVES
Several studies comparing optical coherence tomography (OCT) and intravascular ultrasound (IVUS) have revealed that OCT consistently provides smaller area and diameter measurements. However, comparative assessment in clinical practice is difficult. Three-dimensional (3D) printing offers a unique opportunity to assess intravascular imaging modalities. We aim to compare intravascular imaging modalities using a 3D-printed coronary artery in a realistic simulator and to assess whether OCT underestimates intravascular dimensions, exploring potential corrections.
METHODS
A standard realistic left main anatomy with an ostial left anterior descending artery lesion was replicated using 3D printing. After provisional stenting and optimization, IVI was obtained. Modalities included 20 MHz digital IVUS, 60 MHz rotational IVUS (HD-IVUS) and OCT. We assessed luminal area and diameters at standard locations.
RESULTS
Considering all coregistered measurements, OCT significantly underestimated area, minimal diameter and maximal diameter measurements in comparison to IVUS and HD-IVUS (p<0.001). No significant differences were found between IVUS and HD-IVUS. A significant systematic dimensional error was found in OCT auto-calibration by comparing known reference diameter of guiding catheter (1.8 mm) to measured mean diameter (1.68 mm±0.04 mm). By applying a correction factor based on the reference guiding catheter area to OCT, the luminal areas and diameters were not significantly different compared to IVUS and HD-IVUS.
CONCLUSION
Our findings suggest that automatic spectral calibration method for OCT is inaccurate, with a systematic underestimation of luminal dimensions. When guiding catheter correction is applied the performance of OCT is significantly improved. These results may be clinically relevant and need to be validated.
Topics: Humans; Coronary Artery Disease; Predictive Value of Tests; Ultrasonography, Interventional; Heart; Coronary Vessels; Tomography, Optical Coherence
PubMed: 36893842
DOI: 10.1016/j.repc.2023.03.001 -
Nigerian Journal of Clinical Practice Jun 2022Assessment of intravascular volume status is important in pediatric patients admitted to the emergency departments and pediatric intensive care units. Inferior vena cava...
BACKGROUND
Assessment of intravascular volume status is important in pediatric patients admitted to the emergency departments and pediatric intensive care units. Inferior vena cava (IVC) diameter and collapsibility index are used to evaluate the intravascular volume status in adults. The normal range of IVC diameter is available for adults and the normal range considered for adults is between 1.7 to 2.1 cm, but such normative data is limited for children of all ages.
AIMS
Our aim in this study was to obtain the IVC and the aorta diameter reference values and the mean vena cava collapsibility index in healthy and normovolemic children.
SUBJECTS AND METHODS
Vena cava inferior and aorta images in B mode were obtained. IVC diameter in the inspiratory and the largest IVC diameter in the expiratory were recorded, and the vena cava collapsibility index was calculated.
RESULTS
Ultrasonographic measurements were performed in total on 1938 children. A significant positive correlation was found between IVC and aorta diameters with age. The collapsibility index was found as 37.2% (SD 11.8) in the overall study population. In addition, the reference values for the IVC and aorta diameters obtained from the measurements were also acquired.
CONCLUSIONS
We believe that our IVC and aorta diameter measurements obtained from a large number of participants may be used as reference values in emergency departments and intensive care units.
Topics: Adult; Aorta; Child; Humans; Intensive Care Units; Prospective Studies; Ultrasonography; Vena Cava, Inferior
PubMed: 35708424
DOI: 10.4103/njcp.njcp_1801_21 -
Radiation Research Oct 2020In this work, we present a methodology to analytically determine microdosimetric quantities in radioimmunotherapy and targeted radiotherapy with alpha particles. Monte...
In this work, we present a methodology to analytically determine microdosimetric quantities in radioimmunotherapy and targeted radiotherapy with alpha particles. Monte Carlo simulations using the Geant4-DNA toolkit, which provides interaction models at the microscopic level, are performed for monoenergetic alpha particles traversing spherical sites with diameters of 1, 5 and 10 µm. An analytical function is fitted against the data in each case to model the energy imparted by monoenergetic particles to the site, as well as the variance of the distribution of energy imparted. Those models allow us to obtain the mean and dose-mean values of specific energy (z) and lineal energy (y) for polyenergetic arrangements of alpha particles. The energetic spectrum is estimated by considering the distance that each particle needs to travel to reach the sensitive target. We apply this methodology to a simple case in radioimmunotherapy: a spherical cell that has its membrane uniformly covered by 211At, an alpha emitter, with a spherical target representing the nucleus, placed at the center of the cell. We compare the results of our analytical method with calculations using Geant4-DNA of this specific setup for three nucleus sizes corresponding to our three functions. For nuclei with diameter of 1 µm and 5 µm, all mean and dose-mean quantities for y and z were in an agreement within 4% to Geant4-DNA calculations. This agreement improves to approximately 1% for dose-mean lineal energy and dose-mean specific energy. For the 10-µm-diameter case, discrepancies scale to approximately 9% for mean values and 3% for dose-mean values. Dose-mean values are within Geant4-DNA uncertainties in all cases. Our method provides accurate analytical calculations of dose-mean quantities that may be further employed to characterize radiobiological effectiveness of targeted radiotherapy. The spatial distributions of sources and targets are required to calculate microdosimetric-relevant quantities.
Topics: Algorithms; Alpha Particles; Cell Nucleus; Computer Simulation; Dose-Response Relationship, Radiation; Models, Biological; Monte Carlo Method; Radioimmunotherapy; Radiometry; Radiotherapy Dosage
PubMed: 33045091
DOI: 10.1667/RADE-20-00045.1