Objectives: The objective of this study was to assess the reliability of three-dimensional (3D) cephalometric approaches by comparing this method with authenticated traditional twodimensional (2D) cephalometry in angular cephalometric measurements. Methods: CT images and lateral cephalometric radiographs of ten patients (five women, five men) were used in this study. Raw CT data of the patients were converted to 3D images with a 3D simulation program (Mimics 9.0, Leuven, Belgium). Lateral cephalometric radiographs were used manually for 2D measurements. The comparisons of the two methods were made using 14 cephalometric angular measurements. The Wilcoxon matched-pairs signed-ranks test (a 5 0.05) was used to determine the difference between the two methods. To assess the intra-and interobserver reproducibility, two sets of recordings made by each observer, in each modality were used. Dahlberg's formula was used to determine the intraobserver reproducibility, and the Wilcoxon matched-pairs signed-rank test (a 5 0.05) was used to assess the interobserver reproducibility. Results: The method errors of both observers ranged from 0.35˚to 0.65˚. In addition, there were no significant differences between the measurements of the two observers (P . 0.05). However, comparison of 2D and 3D parameters showed significant differences in U1-NA and U1-SN measurements (P , 0.05). Conclusions: The 3D angular cephalometric analysis is a fairly reliable method, like the traditional 2D cephalometric analysis. Currently, the 3D system is likely to be more suitable for the diagnosis of cases with complex orthodontic anomalies. However, with the decrease in radiation exposure and costs in the future, 3D cephalometrics can be a suitable alternative method to 2D cephalometry.
Aim: We evaluated cardiovascular (CV) risk stratification for nonfunctioning adrenal incidentalomas (NFAIs) via the coronary-artery-calcium (CAC) score. Materials and Method: The participants were patients with an NFAI (n = 55). They were compared to patients with chest pain, a low-intermediate Framingham-risk score and a non-diagnostic treadmill-exercise test, which served as the control group (n = 49). Subsequently, the NFAI group was subdivided according to a CAC score of <100 Agatston units – mild coronary-artery calcification (n = 40) – and ≥100 Agatston units – moderate-to-severe calcification (n = 15). Results: Similar rates of traditional risk factors were observed between the NFAI and control groups, and lower low-density lipoprotein cholesterol rates were observed in the NFAI group. The CAC score was significantly higher for the NFAI group than the control group. Glucose, potassium, adrenocorticotropic-hormone and basal-cortisol levels were higher in those with a CAC score of ≥100. High-density-lipoprotein cholesterol, estimated glomerular filtration rate and ejection fraction (EF) were higher in those with a CAC score of <100. Adenoma size and location were similar between the groups. Age, EF and glucose were the most significant variables related to CAC score in patients with an NFAI, at ≥100 Agatston units. Discussion: Patients with a low-intermediate CV risk profile and an NFAI have a higher risk of atherosclerosis, when compared to patients with a low-intermediate CV risk profile, but no NFAI. Conclusion: In cases where an NFAI exists, CAC score evaluation may be used to predict increased atherosclerosis, especially in patients of an older age with higher glucose and decreased EF.
Purpose: To evaluate the role of the apparent diffusion coefficient (ADC) measurement made using diffusion‐weighted magnetic resonance imaging (DWMRI) in the differential diagnosis of benign and malignant gastric wall thickening. Materials and Methods: Axial T2‐weighted and DWMRI at b 600 and b 1000 s/mm2 gradients were performed in 94 patients (44 patients with gastric malignancy and 50 patients with benign gastric diseases) with gastric wall thickening which was detected by multidetector computed tomography (MDCT). The ADC values of the gastric lesions and healthy gastric walls in patients with gastric malignancies and in patients with benign gastric diseases were used in the differential diagnosis of benign and malignant lesions of the stomach. Results: The mean ADC values were lower in patients with gastric malignancies (1.62 ± 0.57 and 1.40 ± 0.33 at b 600 and b 1000, respectively) compared to those with healthy gastric walls (2.95 ± 0.59 and 2.18 ± 0.48) and benign gastric diseases (3.08 ± 0.52 and 2.34 ± 0.42) at b 600 and b 1000 gradients (P < 0.0001). Conclusion: The ADC measurement on DWMRI may be used to differentiate between benign and malignant gastric diseases. J. Magn. Reson. Imaging 2012;36:672–677. © 2012 Wiley Periodicals, Inc.
C hronic lower back pain is a critical health-related problem, with over 70% lifetime prevalence reported in industrialised counties [1]. While 80% of patients with acute lower back pain recover within six weeks, the pain lasts for more than three months in approximately 7%-10% of patients, thereby adversely affecting work performance and the economy [2]. Besides the loss in muscle power associated with long-term inactivation and inadequacies in voluntary neural activation, atrophy of type two muscle fibres and changes in connective tis-sues are observed in patients with lower back pain. These changes could be attributed to the non-use and reflex inhibition that result in strength loss in muscles and muscle groups [3].Notwithstanding the primary pathology, other components of the spinal motion segment are also affected in patients with chronic lower back pain [4]. Reportedly, leading changes are in the dimensions and symmetry of the paraspinal muscles, which play a vital role in facilitating movements and the formation of posture [5]. Some stud-ABSTRACT OBJECTIVE: This study aims to assess the change in the dimensions of the lumbar muscles in patients with chronic lower back pain using Magnetic Resonance Imaging (MRI) and to determine pre/post effects of surgery. METHODS:We enrolled 28 individuals (13F/15M; age: 45.39±11.56 years) whose L2-S1 muscle measurements were obtained using MRI, before and at follow-up 6-12 months after surgery. The control group comprising 37 individuals (18F/19M; age: 34.41±10.72 years) who had no lumbar pathology but for whom retrospective archive images were available. In the axial MRI analysis, the cross-sections of m.multifidus, mm.erector spinae and m.psoas major on both sides were measured with the 'closed polygon' technique. RESULTS:The L2-3 and L4-5 levels of the m.multifidus on the right side, the L2-3, L4-5 and L5-S1 levels of the m.multifidus and the L5-S1 levels of the mm. erector spinae on the left side cross-sectional areas were significantly lower than the control group (p<0.05). The right-side m.multifidus and the left-side mm.erector spinae sectional areas were significantly lower than the pre-surgery values at the L5-S1 levels (p<0.05). CONCLUSION:This study demonstrated that chronic lower back pain causes atrophy in the lumbar muscles and established the existence and continuity of atrophy after surgery.
Background:A 27-year-old man was admitted to our hospital with a 2-day history of abdominal pain and vomiting. The pain was non-continuous, poorly localized, and non-colicky and non-radiating in nature. Over the prior 2 months, he reported one other similar episode that had resolved spontaneously. Physical examination revealed left upper abdominal quadrant tenderness and a palpable suprapubic mass. His vital signs were stable and laboratory findings were unremarkable. Plain film of the abdomen showed gas filled bowel loops in the splenic fossa.
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