Leitor de feeds

High accuracy of external ventricular drainage placement using anatomical landmarks.

PubMED - qua, 10/21/2020 - 07:15

High accuracy of external ventricular drainage placement using anatomical landmarks.

Neurochirurgie. 2020 Oct 17;:

Authors: Brenke C, Fürst J, Katsigiannis S, Carolus AE

Abstract
BACKGROUND: The conventional approach for external ventricular drainage (EVD) application is the freehand method. Technical devices can improve the accuracy of placement, but they have not yet replaced anatomical landmarks owing to the cost and effort that they entail. There is disagreement as to whether freehand EVD application is safe enough to be accepted as a standard technique. Many authors have investigated the final catheter position in retrospect. They describe variable rates of malpositioning. However, few studies have assessed in how far cranial surface anatomy has really been respected during burr-hole drilling and catheter insertion. The aim of this study was to investigate parameters that might play a part in determining the final intracranial catheter position.
METHODS: 100 pre- and postprocedural thin-layer computed-tomography (CT) scans of EVD patients were analysed with the help of JiveX® and OsiriX Lite® software. A series of anatomical and catheter-related parameters, including inter alia intraventricular blood, midline shift, burr-hole location and catheter entrance angle, were correlated with the final catheter position.
RESULTS: A majority of EVDs show an optimal or nearly optimal position. Only the deviation of catheter entrance angle has a significant influence on catheter malpositioning. The burr-hole location can vary within an area of several centimetres around the coronary suture.
CONCLUSIONS: The freehand application of EVD is safe as long as the intracranial anatomy is not disfigured to a large extent, the surface measurements are carried out precisely and the puncturing is done perpendicularly to the skull.

PMID: 33080249 [PubMed - as supplied by publisher]

New method for quantification of severity of isolated scaphocephaly linked to intracranial volume.

PubMED - seg, 10/19/2020 - 22:01

New method for quantification of severity of isolated scaphocephaly linked to intracranial volume.

Childs Nerv Syst. 2020 Oct 18;:

Authors: Kronig ODM, Kronig SAJ, Van Adrichem LNA

Abstract
PURPOSE: The aim is to implement Utrecht Cranial Shape Quantificator (UCSQ) for quantification of severity of scaphocephaly and compare UCSQ with the most used quantification method, cranial index (CI). Additionally, severity is linked to intracranial volume (ICV).
METHODS: Sinusoid curves of 21 pre-operative children (age < 2 years) with isolated scaphocephaly were created. Variables of UCSQ (width of skull and maximum occiput and forehead) were combined to determine severity. CI was calculated. Three raters performed visual scoring for clinical severity (rating of 6 items; total score of 12 represents most severe form). Pearson's correlation test was used for correlation between UCSQ and visual score and between both CIs. ICV was calculated using OsiriX. ICV was compared to normative values and correlated to severity.
RESULTS: Mean UCSQ was 22.00 (2.00-42.00). Mean traditional CI was 66.01 (57.36-78.58), and mean visual score was 9.1 (7-12). Correlations between both traditional CI and CI of UCSQ and overall visual scores were moderate and high (r = - 0.59; p = 0.005 vs. r = - 0.81; p < 0.000). Mean ICV was 910 mL (671-1303), and ICV varied from decreased to increased compared to normative values. Negligible correlation was found between ICV and UCSQ (r = 0.26; p > 0.05) and between ICV and CI and visual score (r = - 0.30; p > 0.05 and r = 0.17; p > 0.05, respectively).
CONCLUSION: Our current advice is to use traditional CI in clinical practice; it is easy to use and minimally invasive. However, UCSQ is more precise and objective and captures whole skull shape. Therefore, UCSQ is preferable for research. Additionally, more severe scaphocephaly does not result in more deviant skull volumes.

PMID: 33070215 [PubMed - as supplied by publisher]

Peritoneal cavity circumference on computed tomography predicts outcomes in acute pancreatitis.

PubMED - qua, 10/14/2020 - 15:21

Peritoneal cavity circumference on computed tomography predicts outcomes in acute pancreatitis.

Eur J Radiol. 2020 Oct 03;132:109327

Authors: Monreal-Robles R, Kohn-Gutiérrez AE, Sordia-Ramírez J, Zúñiga-Segura JA, Palafox-Salinas JA, de la Rosa-Pacheco S, Elizondo-Riojas G, González-González JA

Abstract
OBJECTIVES: We investigated the role of novel intra-abdominal parameters measured by computed tomography (CT) in the prediction of clinical outcomes in acute pancreatitis (AP).
METHODS: Patients with AP underwent an abdominal CT scan on admission to define different intra-abdominal parameters (abdominal circumference, peritoneal cavity circumference, intraabdominal visceral fat area, and subcutaneous fat area) at the L2-L3 level using the open-source image analysis software Osirix Lite v.11.0.4 to predict clinical outcomes.
RESULTS: Eighty patients with AP were analyzed. Peritoneal cavity circumference (PCC) was the only variable independently associated with outcomes. PCC showed an area under ROC for prediction of severity in AP of 0.830. A PCC ≥ 85 cm increased the risk of severity of AP (RR 15.7), persistent systemic inflammatory response syndrome (RR 9.3), acute peripancreatic fluid collection (RR 6.4), necrotizing pancreatitis (RR 21.50), and mortality (RR 2.4). We found a 4.7-fold increase in the risk of developing severe AP for each 10 cm increase in PCC.
CONCLUSIONS: PCC measurement at the L2-L3 level using a non-enhanced abdominal CT scan on admission in patients with AP is useful in the early prediction of severity, persistent systemic inflammatory response syndrome, local complications, and mortality.

PMID: 33049650 [PubMed - as supplied by publisher]

Comparison between bracing and hollowing trunk exercise with a focus on the change in T2 values obtained by magnetic resonance imaging.

PubMED - sex, 10/09/2020 - 08:51

Comparison between bracing and hollowing trunk exercise with a focus on the change in T2 values obtained by magnetic resonance imaging.

PLoS One. 2020;15(10):e0240213

Authors: Muramoto Y, Kuruma H

Abstract
The purpose of this study was to compare the muscle activity of Bracing and Hollowing trunk exercises by means of T2 values using MRI. Subjects were 19 healthy adult males, of whom 10 (with mean height ± SD: 172.3 ± 4.7 cm, mean weight ± SD: 64.3 ± 5.4 kg, mean age ± SD 21.5 ± 1.9 years) performed hollowing and 9 (with mean height ± SD: 171.3 ± 2.1 cm, mean weight ± SD: 68.5 ± 11.7 kg, mean age ± SD: 23.0 ± 2.6 years) performed bracing. They were assessed using MRI. The imaging was completed using Osirix software, which measured T2 values from the transversus abdominis (TrA), internal oblique (IO), external oblique (EO), and multifidus (MF) muscles. Subsequently, T2 values recorded before the exercise were compared with those recorded after the exercise to evaluate the extent of change effected by exercise on the muscles. MRI T2 values indicated that the TrA and IO regions were activated to a significantly greater degree after bracing. No significant changes occurred in any muscle before and after hollowing. It was determined that the activity of the deeper trunk muscles was higher in bracing than in hollowing on comparing the T2 values obtained in the MRI.

PMID: 33031452 [PubMed - as supplied by publisher]

On the Intracochlear Location of Straight Electrode Arrays After Cochlear Implantation: How Lateral Are Lateral Wall Electrodes?

PubMED - qui, 10/08/2020 - 08:39

On the Intracochlear Location of Straight Electrode Arrays After Cochlear Implantation: How Lateral Are Lateral Wall Electrodes?

Otol Neurotol. 2020 Sep 22;:

Authors: Salcher R, Boruchov A, Timm M, Steffens M, Giesemann A, Lenarz T, Warnecke A

Abstract
OBJECTIVE: Cochlear implants are the gold standard for patients with severe sensorineural hearing loss. A focused electrical stimulation of individual spiral ganglion neurons has not been achieved yet because the scala tympani is a fluid-filled compartment and does not offer a matrix for neuritic outgrowth. Coating of the electrode contacts with swelling hydrogels could fill that gap between the electrode array and the medial wall of the cochlea. Therefore, the exact position of the electrode array within the scala tympani has to be known.
STUDY DESIGN: Retrospective analysis of patient data sets.
SETTING: Tertiary referral center. A total of 95 patients with cochlear implants from one manufacturer were included in this study. The lateral wall, the modiolar wall, and the cochlear implant electrode were segmented using OsiriX MD. For repositioning and reconstructing the respective contours and measuring distances, files were analyzed in MATLAB. The distances from the edge of each electrode contact to the cochlear walls showed no significant differences. But between the different contacts within each patient, there were significant differences. Around 180 degree insertion, electrodes start to get in contact with the lateral wall. The tip of the electrode array was always facing toward the modiolar wall independent of the length of the electrode. We established a method to analyze the position of electrodes within the cochlea.

PMID: 33026778 [PubMed - as supplied by publisher]

Changes of Ocular Dimensions as a Marker of Disease Progression in a Murine Model of Pigmentary Glaucoma.

PubMED - ter, 10/06/2020 - 08:23

Changes of Ocular Dimensions as a Marker of Disease Progression in a Murine Model of Pigmentary Glaucoma.

Front Pharmacol. 2020;11:573238

Authors: Fiedorowicz M, Wełniak-Kamińska M, Świątkiewicz M, Orzeł J, Chorągiewicz T, Toro MD, Rejdak R, Bogorodzki P, Grieb P

Abstract
Purpose: The elevation of intraocular pressure (IOP), a major risk factor in glaucoma, is an important parameter tracked in experimental models of this disease. However, IOP measurement in laboratory rodents is challenging and may not correlate with some key pathological events that occur in the development of glaucoma. The aims of this study were to quantify changes in ocular morphology in DBA/2J mice that develop spontaneous, age-dependent, pigmentary glaucoma and to check the possible correlation of these parameters with IOP.
Method: Eye morphology was evaluated with MRI in DBA/2J, DBA/2J-Gpnmb+/SjJ, and C57BL/6J female mice ages 3, 6, 9, 12, and 15 months. The animals were anesthetized with isoflurane. A planar receive-only surface coil (inner diameter = 10 mm) was placed over each animal's left eye and the image was acquired with a 7T small animal-dedicated magnetic resonance tomograph and T2-weighted TurboRARE sequence. Ocular dimensions were manually quantitated using OsiriX software. IOP was measured with rebound tonometry.
Results: In the control animals, no age-related changes in the ocular morphology were noted. Since 6 months of age, the anterior chamber deepening and elongation of the eyeballs of DBA/2J mice was detectable. We found a significant, positive correlation between IOP and axial length, anterior chamber area, or anterior chamber width in C57BL/6J mice but not in DBA/2J mice. However, after excluding the measurements performed in the oldest DBA/2J mice (i.e. analyzing only the animals ages 3 to 12 months), we demonstrated a significant positive correlation between IOP and anterior chamber width.
Conclusion: High-resolution magnetic resonance imaging of the eye area in mice enables reproducible and consistent measures of key dimensions of the eyeball. We observed age-dependent alterations in the eye morphology of DBA/2J mice that mostly affected the anterior chamber. We also demonstrated a correlation between some of the ocular dimensions and the IOP of C57Bl/6J mice and DBA/2J mice with moderately advanced glaucomatous pathology.

PMID: 33013417 [PubMed]

Curvilinear Multiplanar Reconstruction to Predict Useful Length and Diameter of Cochlear Lumen for Cochlear Implantation.

PubMED - sab, 09/26/2020 - 07:16
Related Articles

Curvilinear Multiplanar Reconstruction to Predict Useful Length and Diameter of Cochlear Lumen for Cochlear Implantation.

Otol Neurotol. 2020 Sep 24;:

Authors: Guigou C, Schein A, Trouilloud P, Lalande A, Hussain R, Bozorg Grayeli A

Abstract
OBJECTIVE: Evaluate the useful length and the diameter of the cochlear lumen (CL) using routine imaging before cochlear implantation to study inter-individual variability and its impact on the insertion depth of the electrode carrier (EC).
STUDY DESIGN: Prospective cross-sectional study.
SETTING: Tertiary referral center.
PATIENTS: Thirty-one preoperative and postimplantation temporal bone CT scans were analyzed by two investigators.
INTERVENTION: Images were analyzed via orthogonal multiplanar reconstruction (Osirix) to measure the lengths of the entire CL and the basal turn. By means of curvilinear reconstruction, the CL was unfolded and the diameters of the CL and of the EC were measured every 2 mm from the round window (RW) to the apex.
RESULTS: Very high-inter individual variability was found for the length of the basal turn (RSD > 1000%), the entire CL length (RSD > 800%), and the CL diameter at the RW (RSD > 600%). CL diameter was not correlated to the CL length. The inserted EC/total visible CL length ratio was 1.0 ± 0.12. Reliability of the measures was acceptable for the CL length and the diameter at 16 mm from the RW (Crohnbach's alpha > 0.7, n = 31).
CONCLUSION: CL length and diameter can be directly measured in a reliable manner by commercially available tools. These parameters potentially influence the EC insertion and should be assessed before cochlear implant surgery.

PMID: 32976342 [PubMed - as supplied by publisher]

Venous drainage of the left liver: an evaluation of anatomical variants and their clinical relevance.

PubMED - qua, 09/23/2020 - 09:57
Related Articles

Venous drainage of the left liver: an evaluation of anatomical variants and their clinical relevance.

Clin Radiol. 2020 Sep 18;:

Authors: Cawich SO, Johnson P, Gardner MT, Pearce NW, Sinanan A, Gosein M, Shah S

Abstract
AIM: To evaluate the variations in venous drainage from the left liver.
MATERIALS AND METHODS: A retrospective evaluation was performed of all consecutive abdominal computed tomography (CT) examinations at a tertiary referral facility between 1 January and 30 June 2018. Osirix (Pixmeo SARL, Bernex, Switzerland) was used to examine the major hepatic veins and their tributaries in each scan. The classification of variants as proposed by Nakamura and Tsuzuki was used to describe the findings. The following information was collected: ramification pattern, number, length and diameter of middle (MHV) and left (LHV) hepatic vein tributaries. Two researchers collected data independently, and the average measurements were used as the final dimensions.
RESULTS: Of 102 examinations evaluated, only 27 demonstrated the conventional venous drainage patterns. The LHV and MHV combined to form a common trunk that emptied into the inferior vena cava (IVC) in 75 (73.5%) cases. The common trunk had a mean length of 8.89 mm and mean diameter of 20.18 mm. Other patterns included Nakamura and Tsuzuki type I (27.5%), type II (29.4%) and type III variants (16.7%). In addition, 4.9% of patients had absent superior middle veins and 80% had supernumerary short hepatic veins (4%).
CONCLUSION: Only 26.5% of patients in this population had conventional venous drainage from the left liver. Surgeons and radiologists in hepatobiliary practice should be aware of these variants in order to minimise morbidity when performing invasive procedures.

PMID: 32958222 [PubMed - as supplied by publisher]

Impact Of Total Psoas Area And Lean Muscular Area In Mortality After Endovascular Aortic Aneurysm Repair.

PubMED - dom, 09/20/2020 - 09:40
Related Articles

Impact Of Total Psoas Area And Lean Muscular Area In Mortality After Endovascular Aortic Aneurysm Repair.

Ann Vasc Surg. 2020 Sep 16;:

Authors: Oliveira VC, Oliveira P, Moreira M, Correia M, Lima P, Silva JC, Pereira RV, Fonseca M

Abstract
BACKGROUND: Sarcopenia has assumed growing relevance as a morbimortality predictor after major abdominal surgery. The aim of this study is to access total psoas muscle area (TPA) and lean muscular area (LMA) impact in morbimortality after elective EVAR.
METHODS: Asymptomatic patients submitted to aortic endoprothesis implantation between January 1, 2014 and December 31, 2018 at our Vascular Surgery Department were retrospectively evaluated. After exclusion criteria were applied, 105 patients were included in the study; preoperative CT scans were evaluated using OSIRIX software (Bernex, Switzerland). Two observers independently calculated TPA at the most caudal level of the L3 vertebra and respective density, therefore calculating LMA. Patients were separated by tertiles with the lowest being considered sarcopenic and with higher muscle steatosis and compared with the higher tertiles. Patient demographics and intra- and post-operative period variables were collected. Charlson Comorbidity Index (CCI) was calculated and surgical complications classified according to Clavien-Dindo. The Intraclass Correlation Coefficient (ICC) and Bland-Altman plot were made to characterize inter-observer variability. Survival analysis were performed with the Kaplan-Meier method and differences between survival curves were tested with the Log-Rank test. The effect of sarcopenia on patient survival was assessed using Cox proportional hazard models.
RESULTS: Considering TPA, univariate analyses revealed that patients in the lower tertile had inferior survival (p=.03) while multivariate analyses showed increased likelihood of mortality (p=.039, HR 3.829). For LMA, univariate analyses revealed that patients in the lower tertile had inferior survival (p=.013) while multivariate analyses showed increased likelihood of mortality (p=.026, HR 4.153). When analyzing patients in the lowest tertile of both TPA and LMA, both univariate (p=.002) and multivariate (p=.018, HR 4.166) analyses reveled inferior survival.
CONCLUSIONS: Our study reveals reduced survival in patients with low TPA and low LMA submitted to elective EVAR; these factors should probably be taken into consideration in the future for pre-operative risk evaluation and surgical planning.

PMID: 32949746 [PubMed - as supplied by publisher]

Clinical outcome following intraoperative computed tomography-assisted secondary orbital reconstruction.

PubMED - dom, 09/20/2020 - 09:40
Related Articles

Clinical outcome following intraoperative computed tomography-assisted secondary orbital reconstruction.

J Plast Reconstr Aesthet Surg. 2020 Aug 25;:

Authors: Shyu VB, Chen HH, Chen CH, Chen CT

Abstract
BACKGROUND: Secondary post-traumatic orbital reconstructions are challenging. Portable computed tomography (CT) provides the option to acquire real-time, intraoperative images that help to detect the insufficient reconstruction of the orbit immediately. We retrospectively analyzed patients who received intraoperative CT imaging and analyzed the effect of intraoperative CT scans on revision rates and orbital volume changes before, during, and after surgery.
METHODS: From August 2014 to September 2016, eleven patients received intraoperative cone-beam CT scans to evaluate the results of secondary orbit reconstruction using Medpor + titanium implants. Patient demographics, surgical details, CT scanning protocol, and follow-up results were analyzed. 3D CT volumetry was used to analyze the orbital volume based on OsiriX MD software.
RESULTS: Based on intraoperative CT findings, seven cases required intraoperative revision to further augment the orbital cavity or adjust implants. The mean preoperative measured enophthalmos was 3.41±1.4 mm (range: 2-6 mm), which decreased to 0.73±0.4 mm (range: 0-1 mm) at postop assessment (p<0.0001). On the fracture side, there was a significant difference between preoperative vs. intraoperative and preoperative vs. postoperative volume measurements (p<0.01 for both subsets), but no significant difference between intraoperative vs. postoperative measurements.
CONCLUSION: Intraoperative CT is a valuable tool in secondary orbital reconstruction cases based on clinical enophthalmos evaluation and 3D CT volumetry. For these patients, the avoidance of another revision surgery may outweigh the disadvantage of increased operation time and additional radiation exposure.

PMID: 32948495 [PubMed - as supplied by publisher]

Is conventional radiography still relevant for evaluating the acromioclavicular joint?

PubMED - seg, 09/14/2020 - 02:55

Is conventional radiography still relevant for evaluating the acromioclavicular joint?

Orthop Traumatol Surg Res. 2020 Sep 08;:

Authors: Guillotin C, Koch G, Metais P, Gallinet D, Godeneche A, Labattut L, Collin P, Bonnevialle N, Barth J, Garret J, Clavert P, Francophone Arthroscopy Society (SFA)

Abstract
INTRODUCTION: Conventional radiography using an anteroposterior view of the acromioclavicular (AC) joint is the gold standard for evaluating arthritic degeneration.
OBJECTIVE: Based on a standardised AP view of the AC joint, the objective of this study was to determine whether this radiographic view is reliable and reproducible for evaluating the AC joint space.
METHODS: A cadaver scapula-clavicle unit, free of osteoarthritis, was used for this study. The scapula was positioned in a stand; and then with fluoroscopy guidance, a strict AP view of the AC joint was taken. Starting from this "0" position, a radiograph was taken by varying the angle by 5°, 10°, and 15° in every plane in space. All radiographs were taken during a single session to ensure the distance between the X-ray tube and scapula did not change. The images were then exported to OsiriX for processing; the superior and inferior AC distance and the joint area were measured.
RESULTS: There was no reproducibility in the AC joint measurements as a function of the incidence angle relative to a strict AP view.
CONCLUSION: Conventional radiography using an AP view of the AC joint cannot be used to do a fine analysis of arthritic degeneration of this joint. It is likely that only CT scan or MRI is sufficient to analyse osteoarthritis in this joint.
LEVEL OF EVIDENCE: IV, basic science study.

PMID: 32917580 [PubMed - as supplied by publisher]

Stent graft sizing for endovascular abdominal aneurysm repair using open source image processing software.

PubMED - ter, 09/08/2020 - 05:06
Related Articles

Stent graft sizing for endovascular abdominal aneurysm repair using open source image processing software.

Ann Vasc Surg. 2020 Sep 03;:

Authors: Knöps E, van Schaik J, van der Bogt KEA, Veger HTC, Putter H, Waasdorp EJ, van der Vorst JR

Abstract
INTRODUCTION: An important step to reach a favourable outcome of abdominal endovascular aneurysm repair (EVAR) is pre-operative sizing of the stent graft using computed tomography (CT) angiography images of the abdominal aorta. A variety of costly image processing software options is available to obtain the neccessary aortic measurements. A package that can be used for EVAR sizing is OsiriX Lite® - an open source, freely downloadable image processing option. This study assesses the concurrent validity of OsiriX Lite® when compared to commercially available 3Mensio Vascular® and Siemens Syngo.via®.
METHODS: CTA scans of 20 patiënts that underwent EVAR for abdominal aneurym were selected, 10 elective and 10 ruptured. For each scan, 6 observers determined 20 parameters needed for proper stent graft sizing, 2 using Osirix Lite®, 3 using 3Mensio Vascular® and 1 using Siemens Syngo.via®. For each parameter an intraclass correlation coefficient (ICC) and a p-value was calculated. Inter-rater agreement was interpreted using the Koo and Li Guidelines. Time needed to perform EVAR planning was compared.
RESULTS: Overall inter-rater agreement between the three sizing options was found to be either "good" or "moderate" for 16 out of 20 parameters (80%). Time needed to perform EVAR planning was not significantly different for Osirix Lite® (568 seconds) when compared to 3Mensio Vascular® (603 seconds) or Siemens Syngo.via® (659 seconds) with a p-value of 0.88.
CONCLUSION: The authors conclude that Osirix Lite® is an accurate and time-effective image processing option for pre-operative sizing of an EVAR stent graft when matched to 3Mensio Vascular® and Siemens Syngo.via®.

PMID: 32891744 [PubMed - as supplied by publisher]

Fusion imaging to evaluate the radiographic anatomical relationship between primary tumors and local recurrences in retroperitoneal soft tissue sarcoma.

PubMED - ter, 09/08/2020 - 05:06
Related Articles

Fusion imaging to evaluate the radiographic anatomical relationship between primary tumors and local recurrences in retroperitoneal soft tissue sarcoma.

Surg Oncol. 2020 Sep;34:109-112

Authors: Weigl H, Janssen S, Vassos N, Hohenberger P, Simeonova-Chergou A, Wenz F, Haubenreisser H, Jakob J

Abstract
BACKGROUND: Local recurrence (LR) of retroperitoneal soft tissue sarcoma (RPS) is a common and life-threatening event. The evaluation of the exact anatomical patterns of local recurrence might help to improve local treatment in RPS.
METHODS: Of our local database we extracted ten patients with LR of RPS with axial MRI and/or CT datasets of the primary tumor (PT) and the LR. Using the Osirix DICOM viewer Version v.3.9.4 64-bit (Pixmeo, Geneva, Switzerland) we performed a three-step fusion algorithm consisting of: a) 3-point co-registration of the axial datasets depicting the PT and the LR using three abdominal landmarks b) re-orientation of the datasets and c) image fusion. We evaluated the feasibility of this technique with regard to categorizing the localization of LR as within or distant from the PT.
RESULTS: Fusion imaging was feasible in seven out of ten patients. In the other three patients anatomical shifting of organs after surgery led to a relevant mismatch of anatomical landmarks and impeded interpretation of the fused images. In five of seven patients with successful fusion imaging, local recurrences were located within the anatomical borders of the primary tumor, in two out of seven patients local recurrences were distant to the primary.
CONCLUSIONS: Fusion imaging of primary tumors and local recurrences is feasible in most patients with RPS. Most local recurrences occurred within the anatomical localization of the primary tumor. For further investigations validation of the technique in larger patient cohorts is required.

PMID: 32891314 [PubMed - in process]

[Long-term evaluation after autologous fat transplantation for breast augmentation].

PubMED - ter, 08/11/2020 - 07:12

[Long-term evaluation after autologous fat transplantation for breast augmentation].

Handchir Mikrochir Plast Chir. 2020 Aug 10;:

Authors: Ueberreiter CS, Ueberreiter K, Mohrmann C, Herm J, Herold C

Abstract
Background The transplantation of autologous fat is an increasingly common but not standardized procedure in aesthetic and reconstructive surgery. Until now only studies about the short-term results after transplantation with autologous fat have been published. In this publication we present our results of a long-term study after fat transplantation.Patients/Material and Methods 14 patients underwent an MRI investigation which was done before and 5-9 years (mean 6 years) years after aesthetic breast lipofilling according to BEAULI-protocol. The difference in volume was calculated with the open source software OsiriX. Two groups were analyzed separately to calculate the influence of body weight changes in final volume gain. In the first group patients with a stable BMI (increase of less than 1 kg/m2) were included. The second group includes patients with a BMI gain exceeding more than 1 kg/m2. The mean increase in BMI was 1,6 kg/m2 (minimum 0 - maximum 3,9). None of the patients lost weight.Results Depending on the desired amount of breast augmentation the patients underwent between one to four operations. An average of 176 ml fat was transplanted per breast and surgery. In the first group a mean volume survival of 74 % (IQR 58 % - 92 %) was observed. In the second group an increase of 135 % (IQR 105 % - 318 %) of the volume of transplanted fat was observed. After an intermediate weight loss one of the patients regained her initial weight.Conclusion In this study the transplantation of autologous fat renders good long-term results. There is a significant correlation between change of weight and fat transplant volume survival over the years. This also explains the very high increase in breast volume in some patients. Autologous fat transplantation seems to be a safe and efficient method for breast augmentation. For further statements studies with larger number of cases are necessary.

PMID: 32777824 [PubMed - as supplied by publisher]

Evaluation of Volumetric Change of Intracerebral Hemorrhage in Patients Treated with Thrombolysis for Intraventricular Hemorrhage.

PubMED - dom, 08/02/2020 - 09:01
Related Articles

Evaluation of Volumetric Change of Intracerebral Hemorrhage in Patients Treated with Thrombolysis for Intraventricular Hemorrhage.

Neurocrit Care. 2020 Jul 31;:

Authors: Staub-Bartelt F, van Lieshout JH, Beez T, Kram R, Hänggi D, Besoglu K

Abstract
BACKGROUND: Intraventricular hemorrhage (IVH) is often caused by irruption of intracerebral hemorrhage (ICH) of basal ganglia or thalamus into the ventricular system. Instillation of recombinant tissue plasminogen activator (rtPA) via an external ventricular drainage (EVD) has been shown to effectively decrease IVH volumes while the impact of rtPA instillation on ICH volumes remains unclear. In this series, we analyzed volumetric changes of ICH in patients with and without intrathecal lysis therapy.
METHODS: Between 01/2013 and 01/2019, 36 patients with IVH caused by hemorrhage of basal ganglia, thalamus or brain stem were treated with rtPA via an EVD (Group A). Initial volumes were determined in the first available computed tomography (CT) scan, final volumes in the last CT scan before discharge. During the same period, 41 patients with ICH without relevant IVH were treated without intrathecal lysis therapy at our neurocritical care unit (Group B). Serial CT scans were evaluated separately for changes in ICH volumes for both cohorts using OsiriX DICOM viewer. The Wilcoxon signed-rank test was performed for statistical analysis in not normally distributed variables.
RESULTS: Median initial volume of ICH for treatment Group A was 6.5 ml and was reduced to 5.0 ml after first instillation of rtPA (p < 0.01). Twenty-six patients received a second treatment with rtPA (ICH volume reduction 4.5 to 3.3 ml, p < 0.01) and of this cohort further 16 patients underwent a third treatment (ICH volume reduction 3.0 ml to 1.5 ml, p < 0.01). Comparison of first and last CT scan in Group A confirmed an overall median percentage reduction of 91.7% (n = 36, p < 0.01) of ICH volumes and hematoma resolution in Group A was significantly more effective compared to non-rtPA group, Group B (percentage reduction = 68%) independent of initial hematoma volume in the regression analysis (p = 0.07, mean 11.1, 95%CI 7.7-14.5). There were no adverse events in Group A related to rtPA instillation.
CONCLUSION: Intrathecal lysis therapy leads to a significant reduction in the intraparenchymal hematoma volume with faster clot resolution compared to the spontaneous hematoma resorption. Furthermore, intrathecal rtPA application had no adverse effect on ICH volume.

PMID: 32737761 [PubMed - as supplied by publisher]

Contralateral adrenal thinning as a distinctive feature of mild autonomous cortisol excess of the adrenal tumors.

PubMED - ter, 07/28/2020 - 08:17

Contralateral adrenal thinning as a distinctive feature of mild autonomous cortisol excess of the adrenal tumors.

Eur J Endocrinol. 2020 Sep;183(3):325-333

Authors: Kong SH, Kim JH, Shin CS

Abstract
Objective: To identify radiologic features that correlate with mild autonomous cortisol excess using planar and volumetric analysis.
Design: Cross-sectional study.
Methods: In the study, 64 patients with overt Cushing syndrome (CS), 59 patients with mild autonomous cortisol excess (MACE), and 64 patients with nonfunctioning adrenal tumors (NFAT) with evaluable CT scans were included. Patients with NFAT and MACE were BMI-matched with those with overt CS. Planar and volumetric analyses of CT scans were performed in DICOM images using OsiriX software.
Results: The mean age was 56.6 ± 1.01 years, and 123 patients (65.1%) were female. In the order of NFAT, MACE, and overt CS, the diameters and volumes of the adenoma increased, while limb widths and volumes of the contralateral adrenal gland decreased. Patients with MACE or overt CS were more likely to have osteoporosis than those with NFAT (P = 0.006), and patients with overt CS were more likely to experience a fragility fracture than those with NFAT or MACE (P = 0.002). Among radiologic features, the limb width of the contralateral adrenal gland correlated with the cortisol level after overnight dexamethasone suppression test (r = -0.583, P < 0.001).
Conclusions: The study showed that the contralateral adrenal limb thinning was a distinctive radiologic feature of autonomous cortisol excess in the planar and volumetric analysis.

PMID: 32717717 [PubMed - as supplied by publisher]

MRI based volumetric measurements of vestibular schwannomas in patients with neurofibromatosis type 2: comparison of three different software tools.

PubMED - qui, 07/16/2020 - 09:16
Related Articles

MRI based volumetric measurements of vestibular schwannomas in patients with neurofibromatosis type 2: comparison of three different software tools.

Sci Rep. 2020 Jul 14;10(1):11541

Authors: Kollmann P, Mautner VF, Koeppen J, Wenzel R, Friedman JM, Salamon J, Farschtschi S

Abstract
Neurofibromatosis type 2 is a neurogenetic disorder with an incidence of about 1:33.000. Hallmarks are bilateral benign vestibular schwannomas, which can lead to deafness or brainstem compression. Volumetric tumor measurements are essential to assess the efficacy of new therapies. We present a statistical and methodical comparison of three volumetric image analysis tools. We performed volumetric measurements on phantoms with predefined volumes (0.1 to 8.0 ml) and tumors seen on 32 head MRI scans from eight NF2 patients with BrainLab, ITK-Snap, or OsiriX. The software was compared with regard to accuracy and reproducibility of the measurements and time required for analysis. The mean volume estimated by all three software programs differed significantly from the true volume of the phantoms, but OsiriX and BrainLab gave estimates that were not significantly different from each other. For the actual tumors, the estimated volumes with all three software tools showed a low coefficient of variability, but the mean volume estimates differed among the tools. OsiriX showed the shortest analysis time. Volumetric assessment of MRI images is associated to an intrinsic risk of miscalculation. For precise volumes it is mandatory to use the same volumetric tools for all measurements.

PMID: 32665659 [PubMed - in process]