J Stomatol Oral Maxillofac Surg. 2025 Jan 12:102230. doi: 10.1016/j.jormas.2025.102230. Online ahead of print.

ABSTRACT

INTRODUCTION: Orbital fractures are common among maxillofacial injuries. The primary objective of this study was to investigate the clinical and radiographic characteristics of pure orbital blowout fractures (OBFs) and their association with post-traumatic diplopia. The secondary objective was to identify predictors of diplopia in pure OBFs.

METHOD: This retrospective cross-sectional study analysed the clinical records and computed tomography (CT) data of patients with pure OBFs, treated between 1st January 2008 and 28th February 2022 at a single tertiary trauma centre in Klang Valley, Kuala Lumpur, Malaysia. Data collected included demographic characteristics and the aetiology of OBFs. Specific factors such as fracture site, size, type, and soft tissue involvement were assessed using CT images, which were converted to DICOM format and analysed with the OsiriX v4.1.2 software. Diplopia was measured using the Hess area ratio percentage (HAR%).

RESULTS: The analysis included records of 70 patients. Motor vehicle accidents (MVAs) accounted for 61.4% of pure OBFs. The largest fracture observed involved both the orbital floor and the medial wall, with a mean size of 6.40 ± 3.05 cm². Among the patients, 41.6% had Type 3 fractures, and 50% (n = 35) had 2-point muscle-soft tissue contact. Fracture size, site, type, and muscle contact were all significantly associated with HAR92% (p < 0.05). Logistic regression revealed that Type 3 fracture was the significant predictor of diplopia (HAR < 92%), with an odds ratio of 19.80 (95% CI: 5.76-68.07, p < 0.001).

CONCLUSION: Fracture site, size, type, and muscle involvement were important factors associated with diplopia. Among these, Type 3 fractures were identified as the primary predictor of HAR < 92%.

PMID:39809363 | DOI:10.1016/j.jormas.2025.102230

Diagnostics (Basel). 2024 Dec 25;15(1):8. doi: 10.3390/diagnostics15010008.

ABSTRACT

Objectives: This study aims to develop and validate a standardized methodology for creating high-fidelity, custom-made, patient-specific 3D-printed vascular models that serve as tools for preoperative planning and training in the endovascular treatment of peripheral artery disease (PAD). Methods: Ten custom-made 3D-printed vascular models were produced using computed tomography angiography (CTA) scans of ten patients diagnosed with PAD. CTA images were analyzed using Syngo.via by a specialist to formulate a medical prescription that guided the model's creation. The CTA data were then processed in OsiriX MD to generate the .STL file, which is further refined in a Meshmixer. Stereolithography (SLA) 3D printing technology was employed, utilizing either flexible or rigid materials. The dimensional accuracy of the models was evaluated by comparing their CT scan images with the corresponding patient data, using OsiriX MD. Additionally, both flexible and rigid models were evaluated by eight vascular surgeons during simulations in an in-house-designed setup, assessing both the technical aspects and operator perceptions of the simulation. Results: Each model took approximately 21.5 h to fabricate, costing €140 for flexible and €165 for rigid materials. Bland-Alman plots revealed a strong agreement between the 3D models and patient anatomy, with outliers ranging from 4.3% to 6.9%. Simulations showed that rigid models performed better in guidewire navigation and catheter stability, while flexible models offered improved transparency and lesion treatment. Surgeons confirmed the models' realism and utility. Conclusions: The study highlights the cost-efficient, high-fidelity production of 3D-printed vascular models, emphasizing their potential to enhance training and planning in endovascular surgery.

PMID:39795536 | DOI:10.3390/diagnostics15010008

Childs Nerv Syst. 2024 Dec 23;41(1):66. doi: 10.1007/s00381-024-06723-y.

ABSTRACT

PURPOSE: This study presents a MATrix LABoratory (MATLAB)-based methodology for calculating intracranial volumes from head computed tomography (CT) data and compares it with established methods.

METHODS: Regions of interest (ROI) were manually segmented on CT images using a stylus pen, facilitated by mirroring a computer desktop onto a tablet. The volumetric process involved three main steps: (1) calculating the volume of a single voxel, (2) counting the total number of voxels within the segmented ROI, and (3) multiplying this voxel count by the single-voxel volume. This method was applied to 83 pediatric head CT scans from patients with minor head trauma, and the volumetric results were compared with those obtained from OsiriX.

RESULTS: A paired t-test revealed a statistically significant difference (p < 0.001) between volumes obtained with our MATLAB-based method and those from OsiriX, with our method measuring 0.32% higher. However, an unpaired t-test found no statistically significant differences between the volumetric population groups (p = 0.84).

CONCLUSION: The significant difference identified by the paired t-test likely reflects statistical distinctions arising from differences in the calculation methods of the two approaches. Conversely, the unpaired t-test suggests no statistically detectable differences between the volumetric populations. Although this does not imply that the two methods produce identical results, the volumetric populations derived from our method may originate from the same underlying population as those obtained using OsiriX. By taking these points into account, our method has the potential to serve as a valuable tool for volumetric measurements.

PMID:39714545 | DOI:10.1007/s00381-024-06723-y

Clin Imaging. 2024 Dec 5;118:110383. doi: 10.1016/j.clinimag.2024.110383. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate ferumoxytol-enhanced magnetic resonance angiography (FE-MRA) for assessment of endoleaks in patients with abdominal aortic aneurysms (AAA) and chronic kidney disease (CKD) status post endovascular aneurysm repair (EVAR).

METHODS: Of 1854 patients who underwent FE-MRA at a single institution between 03/21/2014 and 08/21/2023, 21 patients with a history of AAA and CKD status post EVAR were retrospectively identified (IRB #13-001341). Multiplanar pre- and post-contrast HASTE, T1-VIBE, and high-resolution breath-held 3D MRA sequences were obtained, where a dose of 4 mg/kg of Ferumoxytol was infused over six minutes. All examinations were performed on either a Siemens 3.0 T Prisma Fit, a Siemens 3.0 T TIM Trio, or a Siemens 1.5 T Avanto MRI scanner. Image post-processing was performed using OsiriX and Vitrea software for endoleak identification and display.

RESULTS: Twenty-six FE-MRA examinations were completed, where 24 were fully diagnostic and 2 were limited by metal artifact. Three patients underwent one follow-up examination, while one patient underwent two follow-up examinations. Endoleaks were identified in seven patients: one Type Ia, two Type Ib, and four Type II. The Type Ia endoleak patient received follow-up imaging two years after initial imaging. A Type II endoleak patient received follow-up imaging six months and one year after initial imaging. In both cases, the Type I and Type II endoleaks were reproducibly visualized. No contrast reactions occurred.

CONCLUSION: For patients with a history of AAA and CKD status post EVAR, FE-MRA is a safe, practical and effective imaging solution for evaluation of Type I and Type II endoleaks.

PMID:39662299 | DOI:10.1016/j.clinimag.2024.110383

Int Ophthalmol. 2024 Nov 14;44(1):431. doi: 10.1007/s10792-024-03352-x.

ABSTRACT

PURPOSE: This study aimed to investigate lacrimal gland (LG) enlargement in thyroid eye disease (TED) patients on magnetic resonance imaging (MRI).

METHODS: A retrospective review was conducted on TED patients who had undergone fat-suppressed contrast-enhanced T1-weighted MRI of the orbits. The lacrimal gland was segmented on OsiriX in consecutive axial and coronal slices to determine its volume. Enlargement was defined as a volume greater than 1100mm3, based on previous normative data. Asymmetric enlargement was defined if one side was enlarged but the contralateral side was not. Clinical data including presentation (active/inactive) and presence or absence of dysthyroid optic neuropathy was evaluated.

RESULTS: The study population consisted of 88 orbits from forty-four patients with a mean age of 53 ± 15 years, with 29 (65%) being female. Twelve patients (27%) had LG enlargement, with eight (18%) having bilateral enlargement and four (9%) having asymmetric enlargement. There was no significant difference in age (p = 0.17) or sex (p = 0.44) between the LG enlarged and non-enlarged groups. There was also no significant difference in the clinical activity (p = 0.46) or prevalence of dysthyroid optic neuropathy (p = 0.63) between the LG enlarged orbits and non-LG enlarged orbits.

CONCLUSION: Lacrimal gland enlargement may be observed in approximately thirty percent of TED patients, with asymmetric enlargement in approximately ten percent of cases.

PMID:39542958 | DOI:10.1007/s10792-024-03352-x