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BMJ (Clinical Research Ed.) Jun 2011
Topics: Child, Preschool; Diagnosis, Differential; Gait; Humans; Magnetic Resonance Imaging; Male; Movement Disorders; Pelvis; Radiography
PubMed: 21697233
DOI: 10.1136/bmj.d3565 -
The Journal of Arthroplasty Jul 2023Measuring cup orientation is time consuming and inaccurate, but orientation influences the risk of impingement and dislocation following total hip arthroplasty (THA).... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Measuring cup orientation is time consuming and inaccurate, but orientation influences the risk of impingement and dislocation following total hip arthroplasty (THA). This study designed an artificial intelligence (AI) program to autonomously determine cup orientation, correct for pelvis orientation, and identify cup retroversion from an antero-posterior pelvic radiographs.
METHODS
There were 2,945 patients between 2012 and 2019 identified to have 504 computed tomographic (CT) scans of their THA. A 3-dimensional (3D) reconstruction was performed on all CTs, where cup orientation was measured relative to the anterior pelvic plane. Patients were randomly allocated to training (4,000 x-rays), validation (511 x-rays), and testing (690 x-rays) groups. Data augmentation was applied to the training set (n = 4,000,000) to increase model robustness. Statistical analyses were performed only on the test group in their accuracy with CT measurements.
RESULTS
AI predictions averaged 0.22 ± 0.03 seconds to run on a given radiograph. Pearson correlation coefficient was 0.976 and 0.984 for AI measurements with CT, while hand measurements were 0.650 and 0.687 for anteversion and inclination, respectively. The AI measurements more closely represented CT scans when compared to hand measurements (P < .001). Measurements averaged 0.04 ± 2.21°, 0.14 ± 1.66°, -0.31 ± 8.35°, and 6.48° ± 7.43° from CT measurements for AI anteversion, AI inclination, hand anteversion, and hand inclination, respectively. AI predictions identified 17 radiographs as retroverted with 100.0% accuracy (total retroverted, n = 45).
CONCLUSION
The AI algorithms may correct for pelvis orientation when measuring cup orientation on radiographs, outperform hand measurements, and may be implemented in a timely fashion. This is the first method to identify a retroverted cup from a single AP radiograph.
Topics: Artificial Intelligence; Pelvis; Arthroplasty, Replacement, Hip; Humans; Hip Prosthesis
PubMed: 36893991
DOI: 10.1016/j.arth.2023.02.076 -
Journal of Anatomy Jun 2020Knowledge of the ontogenetic pattern of morphological features is essential to improve biological interpretations. The study of morphological features of the pelvic...
Knowledge of the ontogenetic pattern of morphological features is essential to improve biological interpretations. The study of morphological features of the pelvic girdle and hind limb apparatus throughout growth is an excellent approach to understand how the skeletal morphology and muscles are interrelated during growth in a bird with a specialized mode of locomotion. The Greater Rhea (Rhea americana) is a large cursorial palaeognathous bird with long legs and powerful musculature. The postnatal shape changes of the pelvis of this bird were studied with geometric morphometric techniques, using landmarks and semilandmarks. In addition, regression analyses were used to explore the association between pelvic shape changes with muscle and body mass. The pelvises of 16 specimens of Rhea americana from 1 month old to adulthood were studied in dorsal and lateral views. Noticeable differences in pelvic shape were noted between ages, particularly in lateral view. In young birds, the pre- and post-acetabular ilium was subequal in length, whereas in adults the pre-acetabular ilium became shorter. In dorsal view, the main shape changes observed were the progressive thinning of both ilium portions and the elongation of the vertex craniolateralis ilii from chicks to adulthood. In this view, the only clear differentiation was between young and adult birds. Shape differences were influenced by body mass and pelvic muscles; the post-acetabular muscle mass explained the highest percentage of the variation. The specialized locomotion of Greater Rhea is reflected in their pelvic musculoskeletal system, in which the change to a longer post-acetabular ilium correlates with the growth of the powerful post-acetabular muscles. The actions of these muscles provide the necessary strength to support the body mass, minimize the body swinging movements and propel the body forward during locomotion. Bone morphology is affected by the forces produced by body mass and the muscle activity, demonstrating the presence of common growth mechanisms, which are primordial and gave rise to a functional and properly proportioned adult.
Topics: Animals; Biological Evolution; Female; Hindlimb; Locomotion; Male; Pelvis; Rheiformes; Running
PubMed: 31972872
DOI: 10.1111/joa.13158 -
European Spine Journal : Official... Feb 2002A prospective analysis of the sagittal profile of 100 healthy young adult volunteers was carried out in order to evaluate the relationship between the shape of the...
A prospective analysis of the sagittal profile of 100 healthy young adult volunteers was carried out in order to evaluate the relationship between the shape of the pelvis and lumbar lordosis and to create a databank of the morphologic and positional parameters of the pelvis and spine in a normal healthy population. Inclusion criteria were as follows: no previous spinal surgery, no low back pain, no lower limb length inequality, no scoliotic deviation. For each subject, a 30 x 90-cm sagittal radiograph including spine, pelvis and proximal femurs in standing position on a force plate was performed. The global axis of gravity was determined with the force plate. Each radiograph was digitized using dedicated software. The spinal parameters registered were values for thoracic kyphosis and lumbar lordosis. The pelvic angles measured were: pelvic incidence, sacral slope and pelvic tilt. The global axis of gravity was on average 9 mm anterior of the center of the femoral heads. The anatomic parameter of pelvic incidence angle varied from 33 degrees to 85 degrees (mean: 51.7 degrees, SD: 11 degrees). The average lumbar lordosis was 46.5 degrees. The average thoracic kyphosis was 47 degrees. We found a statistical correlation between incidence angle and lumbar lordosis (r=0.69, P<0.001) and between sacral slope angle and lumbar lordosis (r=0.75, P<0.001). Spine and pelvis balance around the hip axis in order to position the gravity line over the femoral heads. We propose a scheme of sagittal balance of the standing human body.
Topics: Adult; Female; Humans; Kyphosis; Lordosis; Male; Middle Aged; Pelvis; Postural Balance; Radiography; Reference Values; Spine
PubMed: 11931071
DOI: 10.1007/s005860000224 -
Obstetrics and Gynecology Clinics of... Sep 2009Normal physiologic function of the pelvic organs depends on the anatomic integrity and proper interaction among the pelvic structures, the pelvic floor support... (Review)
Review
Normal physiologic function of the pelvic organs depends on the anatomic integrity and proper interaction among the pelvic structures, the pelvic floor support components, and the nervous system. Pelvic floor dysfunction includes urinary and anal incontinence; pelvic organ prolapse; and sexual, voiding, and defecatory dysfunction. Understanding the anatomy and proper interaction among the support components is essential to diagnose and treat pelvic floor dysfunction. The primary aim of this article is to provide an updated review of pelvic support anatomy with clinical correlations. In addition, surgical spaces of interest to the gynecologic surgeon and the course of the pelvic ureter are described. Several concepts reviewed in this article are derived and modified from a previous review of pelvic support anatomy.
Topics: Female; Humans; Muscle, Skeletal; Pelvic Floor; Pelvic Organ Prolapse; Pelvis
PubMed: 19932407
DOI: 10.1016/j.ogc.2009.09.002 -
Journal of Clinical Neurophysiology :... Aug 2014Currently, the means to assess the autonomic nervous system primarily depend on end organ functional measurement: intravesical pressure, skin resistance, and penile... (Review)
Review
Currently, the means to assess the autonomic nervous system primarily depend on end organ functional measurement: intravesical pressure, skin resistance, and penile strain gauge tension, for example. None of these measures has been generally accepted in the operating room. Nevertheless, the segmental and peripheral pelvic autonomic nerve supply is placed at risk during both pelvic and lower spine surgery. In this difficult era of suboptimal post-prostatectomy outcomes, the urological literature does reveal the salutary development of safer dissection techniques about the peri-prostatic and cavernous plexus. Means of reliably specific nerve identification remain elusive. The need for actual nerve monitoring (not just identification) has only recently been proposed. Data from the animal lab reinforce an appreciation of the intimate and elegant interconnectedness of autonomic and somatic structures, particularly at the segmental level. Also, the biochemistry of erectile tissue engorgement (in both sexes) is very well understood (the electrophysiology increasingly so). Understanding these principles should permit parallel investigation and implementation of neurophysiological techniques which both identify and monitor pelvic autonomic function. The predicates for these proposed new approaches in the operating room are discussed in this review.
Topics: Autonomic Nervous System; Humans; Monitoring, Intraoperative; Pelvis; Spinal Cord
PubMed: 25083841
DOI: 10.1097/WNP.0000000000000055 -
IEEE Transactions on Medical Imaging May 2020Surgical resection is the main clinical method for the treatment of bone tumors. A critical procedure for bone tumor resection is to plan a set of cut planes that enable...
Surgical resection is the main clinical method for the treatment of bone tumors. A critical procedure for bone tumor resection is to plan a set of cut planes that enable resecting the bone tumor with a safe margin while preserving the maximum amount of healthy bone. Currently, the surgeons rely on manual methods to plan the cut planes, which highly depend on the surgeons' experiences and have been demonstrated to be error-prone, and in turn, increase the recurrence rate or resect much healthy bone. This study targets on improving the precision of cut plane planning for the image guided pelvis tumor resection surgeries. A semi-automatic approach to cut plane planning was proposed via a coarse-to-fine strategy. It can efficiently identify a dangerous region in the 3D space, which contains the bone tumor and its surrounding normal tissue with a safe margin. By projecting the dangerous region into an appropriate 2D space, a segmented boundary-constrained linear regression method was leveraged to plan a set of 3D cut planes that ensure the minimum area of the resected specimen in the 2D space while having the dangerous region cleared. Further, a coarse-to-fine 3D cut plane planning method was developed by incorporating a 3D cut plane refinement scheme with our 2D planning method. Extensive experiments, on the surgical data from nine previous pelvis tumor resection surgeries, demonstrated that our proposed approach substantially improved the localization precision of cut planes ( ) and decreased the amount of resected specimen ( ), as compared to the manual method.
Topics: Humans; Imaging, Three-Dimensional; Neoplasm Recurrence, Local; Osteotomy; Pelvic Neoplasms; Pelvis; Surgery, Computer-Assisted
PubMed: 31714218
DOI: 10.1109/TMI.2019.2951838 -
Acta Chirurgica Belgica 2005recent advances in rectal surgery include total mesorectal excision and preservation of the autonomic pelvic nerves, so that colorectal surgeons have to get some... (Review)
Review
recent advances in rectal surgery include total mesorectal excision and preservation of the autonomic pelvic nerves, so that colorectal surgeons have to get some information on the embryology of the rectum, on the complex anatomy of the pelvic floor and on the distribution of lymphatic nodes. Embryology includes the formation of the hindgut during the first month of the embryo and the subsequent formation of the rectum and anal canal. The mesorectum contains the blood vessels and the lymphatic nodes. To totally excise the mesorectum, the surgeon should follow the "holy plane" described by Heald, between the perirectal fascia and the pelvic fascia. Doing this, the surgeon has the best chance to preserve the autonomic pelvic nerves that comprise the superior hypogastric plexus, the right and left hypogastric nerves and the right and left inferior hypogastric plexuses.
Topics: Colon; Digestive System Surgical Procedures; Humans; Pelvis; Rectum
PubMed: 16315828
DOI: 10.1080/00015458.2005.11679762 -
Lancet (London, England) Aug 1946
Topics: Female; Humans; Pelvis
PubMed: 20995258
DOI: 10.1016/s0140-6736(46)91961-7 -
European Journal of Radiology Sep 2019Within paediatric pelvis imaging there is a lack of systematic dose optimisation studies which consider age and size variations. This paper presents data from dose...
PURPOSE
Within paediatric pelvis imaging there is a lack of systematic dose optimisation studies which consider age and size variations. This paper presents data from dose optimisation studies using digital radiography and pelvis phantoms representing 1 and 5-year-old children.
MATERIAL AND METHOD
Dose optimisation included assessments of image quality and radiation dose. Systematic variations using a factorial design for acquisition factors (kVp, mAs, source-detector distance [SDD] and filtration) were undertaken to acquire AP pelvis X-ray images. Perceptual image quality was assessed using a relative and absolute visual grading assessment (VGA) method. Radiation doses were measured by placing a dosimeter at the radiographic centring point on the surface of each phantom. Statistical analyses for determining the optimised parameters included main effects analysis.
RESULTS
Optimised techniques, with diagnostically acceptable image quality, for each paediatric age were: 1-year-old; 65 kVp, 2 mAs and 115 cm SDD, while, 5-year-old; 62 kVp, 8 mAs and 130 cm SDD both included 1 mm Al +0.1 mm Cu additional filtration. The main effect analysis identified situations in which image quality and radiation dose increased or decreased, except for kVp which showed peak image quality when exposure factors were increased. A set of minimum mAs values for producing diagnostic image quality were identified. Increasing SDD, unlike the other exposure factors, showed no trends for producing non-diagnostic images.
CONCLUSION
The factorial design provided an opportunity to identify suitable acquisition factors. This study provided a method for investigating the combined effect of multiple acquisition parameters on image quality and radiation dose for children.
Topics: Child, Preschool; Humans; Infant; Pelvis; Phantoms, Imaging; Radiation Dosage; Radiographic Image Enhancement; Radiometry
PubMed: 31439232
DOI: 10.1016/j.ejrad.2019.07.014