The clinical value of three-dimensional measurement in the diagnosis of thoracic myelopathy caused by ossification of the ligamentum flavum

Chen, Yan; Tan, Haoyuan; Chenglong, Ji; Yu, Xue-Wei; Jia, Huai-Cheng; Li, Fudong; Jiang, Guicheng; Li, Weishi; Zhou, Feifei; Ye, Zhen; Sun, Jingchuan; Shi, Jiangang

doi:10.21037/qims-20-713

Cited by 8 publications

(11 citation statements)

References 32 publications

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“…None of the ASRM, ESHRE-ESGE, or Congenital Uterine Malformation by Experts (CUME) has provided detailed descriptions of normal and arcuate uterus. The 3D morphological parameters can diagnose the thoracic myelopathy resulting from thoracic ossification of the ligamentum flavum more accurately than 2D morphological parameters (18). This study found that ECL, EVM, EVL, ESM, and ESL were significantly lower in arcuate uterus compared to normal uterus using the 3D measurement approach.…”

Section: Resultsmentioning

confidence: 71%

Three-dimensional measurement and analysis of morphological parameters of the uterus in infertile women

Feng¹,

Zhang²,

Zhou³

et al. 2022

Quant Imaging Med Surg

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Background: To determine differences in endometrial cavity anteroposterior diameter, thickness, volume, and diameter lines of uterine body and thickness, and volume of upper, middle, and lower regions of the endometrium in infertile women using a new method for three-dimensional (3D) reconstruction based on two-dimensional (2D) ultrasound images.Methods: This retrospective cross-sectional study included a total of 81 infertile women, who underwent 2D ultrasound standard examination. We created 3D models of the uterine body, endometrial cavity, and endometrium based on 2D ultrasound images. The parameters that were measured and analyzed in a 3D plane included volume and diameter lines of endometrial cavity, surface area, thickness, volume, and diameter lines of uterine body, and surface area, thickness, and volume of upper, middle, and lower region of the endometrium. These parameters were used for comparisons between normal and arcuate uterus, between non-pregnant and pregnant infertile women, and between nulliparous and multiparous infertile women.The differences between the different regions of the endometrium and the correlations between age and the parameters were also determined in this study.

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Section: Resultsmentioning

confidence: 71%

Three-dimensional measurement and analysis of morphological parameters of the uterus in infertile women

Feng¹,

Zhang²,

Zhou³

et al. 2022

Quant Imaging Med Surg

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“…However, it is difficult to simultaneously assess the severity and range of compression based only on the 1D or 2D radiological parameters (14,21). Our previous study found that the 3D OR could precisely reflect the oppressive state of OLF from multiple dimensions and thus predict the clinical grade of thoracic myelopathy (14). Herein, we introduce the 3D OR to test this hypothesis and report whether it could be used as an indicator to identify DO in patients with OLF.…”

Section: Discussionmentioning

confidence: 94%

“…In this study, we first proposed that the formation of DO was associated with the severity of OLF compression of the dura mater and the contact area of the OLF and the dura mater. However, it is difficult to simultaneously assess the severity and range of compression based only on the 1D or 2D radiological parameters (14,21). Our previous study found that the 3D OR could precisely reflect the oppressive state of OLF from multiple dimensions and thus predict the clinical grade of thoracic myelopathy (14).…”

Section: Discussionmentioning

confidence: 99%

“…Radiological studies regarding OLF-DO are relatively rare, and the diagnostic accuracy of imaging signs still needs to be improved (11,12). Furthermore, there are variations in how the slices through tissues are obtained based on the spinal curvature, especially for the upper or middle thoracic spine, which might lead to deviations in the results of conventional measurement methods (13)(14)(15)(16). Therefore, most of the current findings can only be applied to the lower thoracic spine, despite nearly 50% of DOs being located in the upper and middle segments (9,12,14,15).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, we speculate that the formation of DO is associated with the severity of OLF compression of the dura mater and the contact area of the OLF and the dura mater. Considering that OLF compression is not a 2-dimensional (2D) problem and is rather a 3D problem (14,21,22), a novel 3D imaging analysis based on CT scans was used in the present study. This may correct the measurement deviation caused by spinal curvature with multiplanar reconstruction (MPR).…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional imaging analysis for the diagnosis of dural ossification in thoracic ossification of the ligamentum flavum: a multicenter study

Chen¹,

Ling²,

Zhao³

et al. 2023

Quant Imaging Med Surg

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Background: Unforeseen dural ossification (DO) increases the risk of complications in the surgical management of thoracic ossification of the ligamentum flavum (OLF). Several methods have been proposed to identify DO; however, these approaches either have low diagnostic accuracy or poor feasibility.Therefore, we aimed to determine the relationship between DO and the severity and range of thoracic OLF compression using a 3-dimensional (3D) imaging analysis and to evaluate its superiority in diagnosing DO over conventional measurement methods.Methods: A total of 114 consecutive patients who underwent decompressive laminectomy for thoracic OLF in 4 institutions were retrospectively enrolled and divided into DO and non-DO groups. Univariate analysis was performed to determine the relationship between OLF compression and DO. We measured the 3D occupying ratio (OR; 3D OR = OLF volume/normal canal volume × 100%), calculated its cutoff values, and compared its diagnostic value in DO with that of conventional 1D and 2D radiological parameters in the whole thoracic spine.Results: The 3D OR in the DO group (50.9%±7.9%) was significantly higher than that in the non-DO group (30.8%±7.5%; P<0.01). The overall reliability and reproducibility for measurements of the 3D OR (intra-and interobserver correlation coefficients 0.94 and 0.90, respectively) were excellent. Thus, the 3D OR could be used as an indicator to distinguish between DO and non-DO, with high diagnostic accuracy (91.2%). Moreover, a 3D OR of >43%, known as the "ossification zone", was indicative of DO in OLF, whereas a value of <37% was considered the "safe zone". Additionally, the 3D OR [area under the curve (AUC) =0.98, 95% confidence interval (CI): 0.93-0.99] showed a statistically higher diagnostic value for DO in the upper, middle, lower, and whole thoracic spine than did both 1D (AUC =0.81; 95% CI: 0.73-0.88) and 2D (AUC =0.87; 95% CI: 0.79-0.92) parameters (P<0.01).Conclusions: DO was significantly associated with the severity and range of OLF compression. The 3D OR could be used as a critical diagnostic indicator for identifying DO in the whole thoracic spine, owing to its superiority over conventional radiological parameters. Classification of the 3D OR could maximize the clinical feasibility and thus help surgeons to decrease the incidence of DO-related surgical complications.

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Clinical progression of ossification of the ligamentum flavum in thoracic spine: a 10- to 11-year follow-up study

Fan

Sun

Chen³

et al. 2022

Eur Spine J

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The clinical value of three-dimensional measurement in the diagnosis of thoracic myelopathy caused by ossification of the ligamentum flavum

Cited by 8 publications

References 32 publications

Three-dimensional measurement and analysis of morphological parameters of the uterus in infertile women

Three-dimensional measurement and analysis of morphological parameters of the uterus in infertile women

Three-dimensional imaging analysis for the diagnosis of dural ossification in thoracic ossification of the ligamentum flavum: a multicenter study

Clinical progression of ossification of the ligamentum flavum in thoracic spine: a 10- to 11-year follow-up study

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