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Odontogenic myxoma (OM) is a slow-growing, painless, aggressive and non-metastatic central jaw tumor of mesenchymal origin. Radiographically, it can vary from a unilocular radiolucent lesion to a multilocular lesion with well-defined or diffuse margins. The aim of this paper is to recognize the radiographic and tomographic characteristics of OM in a patient who attended the Dental Clinic of the Faculty of Dentistry of the Universidad Nacional Mayor de San Marcos in Lima-Peru. Case presentation: 86 year old male patient, who in the panoramic radiography indicated for his oral rehabilitation, a unilocular radiolucent image was found in the anterosuperior area with partially defined limits, corticalized edges and oval shape. In the volumetric tomography there was evidence of thinning and erosion of both bone tables, thinning of the floor of the nasal cavity. The radiolucent image seems to havean extension close to the alveolar ridge.In adition, there was an effacement of the cortices of the nasopalatine duct. The lesion was enucleated and an anatomopathological examination was performed. Diagnosis was odontogenic myxoma. The patient was evaluated at one year and six months with satisfactory results. The wide variety of radiographic characteristics of odontogenic myxoma leads us to think of a large number of differential diagnoses, being the histological evaluation together with the imaging analysis the ones that provide a definitive diagnosis. Although the anterosuperior area is the least common for its presentation, radiolucent images in this area should be considered as possible odontogenic myxomas, since this condition is more frequent in latín race.

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El mixoma odontogénico (MO) es un tumor mandibular central de origen mesenquimal, de crecimiento lento, indoloro, agresivo y no metastásico. Radiográficamente, puede variar desde una lesión unilocular radiolúcida a una lesión multilocular con márgenes bien definidos o difusos. El objetivo de este trabajo es reconocer las características radiográficas y tomográficas del MO en un paciente que acudió a la Clínica Odontológica de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos en Lima-Perú. Presentación del caso: Paciente masculino de 86 años, en la radiografía panorámica indicada para rehabilitación oral, se encontró una imagen radiolúcida unilocular en la zona anterosuperior con límites parcialmente definidos, bordes corticalizados y forma ovalada. En la tomografía volumétrica se evidenció adelgazamiento y erosión de ambas tablas óseas, adelgazamiento del piso de la cavidad nasal, la imagen radiolúcida parece tener una extensión cercana a la cresta alveolar. Además, había un adelzamiento de las corticales del conducto nasopalatino. La lesión fue enucleada y se realizó un examen anatomopatológico. El diagnóstico fue mixoma odontogénico. La paciente fue evaluada al año y a los seis meses con resultados satisfactorios. La gran variedad de características radiográficas del mixoma odontogénico nos lleva a pensar en un gran número de diagnósticos diferenciales, siendo la evaluación histológica junto con el análisis de imagen los que proporcionan un diagnóstico definitivo. Aunque el área anterosuperior es la menos común para su presentación, las imágenes radiolúcidas en esta área deben ser consideradas como posibles mixomas odontogénicos, ya que esta condición es más frecuente en la raza latina.

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ABSTRACT Introduction: Lung diseases are common in patients with end stage kidney disease (ESKD), making differential diagnosis with COVID-19 a challenge. This study describes pulmonary chest tomography (CT) findings in hospitalized ESKD patients on renal replacement therapy (RRT) with clinical suspicion of COVID-19. Methods: ESKD individuals referred to emergency department older than 18 years with clinical suspicion of COVID-19 were recruited. Epidemiological baseline clinical information was extracted from electronic health records. Pulmonary CT was classified as typical, indeterminate, atypical or negative. We then compared the CT findings of positive and negative COVID-19 patients. Results: We recruited 109 patients (62.3% COVID-19-positive) between March and December 2020, mean age 60 ± 12.5 years, 43% female. The most common etiology of ESKD was diabetes. Median time on dialysis was 36 months, interquartile range = 12-84. The most common pulmonary lesion on CT was ground glass opacities. Typical CT pattern was more common in COVID-19 patients (40 (61%) vs 0 (0%) in non-COVID-19 patients, p < 0.001). Sensitivity was 60.61% (40/66) and specificity was 100% (40/40). Positive predictive value and negative predictive value were 100% and 62.3%, respectively. Atypical CT pattern was more frequent in COVID-19-negative patients (9 (14%) vs 24 (56%) in COVID-19-positive, p < 0.001), while the indeterminate pattern was similar in both groups (13 (20%) vs 6 (14%), p = 0.606), and negative pattern was more common in COVID-19-negative patients (4 (6%) vs 12 (28%), p = 0.002). Conclusions: In hospitalized ESKD patients on RRT, atypical chest CT pattern cannot adequately rule out the diagnosis of COVID-19.

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RESUMO Introdução: Doenças pulmonares são comuns em pacientes com doença renal em estágio terminal (DRET), dificultando o diagnóstico diferencial com COVID-19. Este estudo descreve achados de tomografia computadorizada de tórax (TC) em pacientes com DRET em terapia renal substitutiva (TRS) hospitalizados com suspeita de COVID-19. Métodos: Indivíduos maiores de 18 anos com DRET, encaminhados ao pronto-socorro com suspeita de COVID-19 foram incluídos. Dados clínicos e epidemiológicos foram extraídos de registros eletrônicos de saúde. A TC foi classificada como típica, indeterminada, atípica, negativa. Comparamos achados tomográficos de pacientes com COVID-19 positivos e negativos. Resultados: Recrutamos 109 pacientes (62,3% COVID-19-positivos) entre março e dezembro de 2020, idade média de 60 ± 12,5 anos, 43% mulheres. A etiologia mais comum da DRET foi diabetes. Tempo médio em diálise foi 36 meses, intervalo interquartil = 12-84. A lesão pulmonar mais comum foi opacidades em vidro fosco. O padrão típico de TC foi mais comum em pacientes com COVID-19 (40 (61%) vs. 0 (0%) em pacientes sem COVID-19, p < 0,001). Sensibilidade 60,61% (40/66), especificidade 100% (40/40). Valores preditivos positivos e negativos foram 100% e 62,3%, respectivamente. Padrão atípico de TC foi mais frequente em pacientes COVID-19-negativos (9 (14%) vs. 24 (56%) em COVID-19-positivos, p < 0,001), enquanto padrão indeterminado foi semelhante em ambos os grupos (13 (20%) vs. 6 (14%), p = 0,606), e padrão negativo foi mais comum em pacientes COVID-19-negativos (4 (6%) vs. 12 (28%), p = 0,002). Conclusões: Em pacientes com DRET em TRS hospitalizados, um padrão atípico de TC de tórax não pode excluir adequadamente o diagnóstico de COVID-19.

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SUMMARY: Since machine learning algorithms give more reliable results, they have been used in the field of health in recent years. The orbital variables give very successful results in classifying sex correctly. This research has focused on sex determination using certain variables obtained from the orbital images of the computerized tomography (CT) by using machine learning algorithms (ML). In this study 12 variables determined on 600 orbital images of 300 individuals (150 men and 150 women) were tested with different ML. Decision tree (DT), K-Nearest Neighbour (KNN), Logistic Regression (LR), Random Forest (RF), Linear Discriminant Analysis (LDA), and Naive Bayes (NB) algorithms of ML were used for unsupervised learning. Statistical analyses of the variables were conducted with Minitab® 21.2 (64-bit) program. ACC rate of NB, DT, KNN, and LR algorithms was found as % 83 while the ACC rate of LDA and RFC algorithms was determined as % 85. According to Shap analysis, the variable with the highest degree of effect was found as BOW. The study has determined the sex with high accuracy at the ratios of 0.83 and 0.85 through using the variables of the orbital CT images, and the related morphometric data of the population under question was acquired, emphasizing the racial variation.

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Dado que los algoritmos de aprendizaje automático dan resultados más fiables, en los últimos años han sido utilizados en el campo de la salud. Las variables orbitales dan resultados muy exitosos a la hora de clasificar correctamente el sexo. Esta investigación se ha centrado en la determinación del sexo utilizando determinadas variables obtenidas a partir de las imágenes orbitales de la tomografía computarizada (TC) mediante el uso de algoritmos de aprendizaje automático (AA). En este estudio se probaron 12 variables determinadas en 600 imágenes orbitales de 300 individuos (150 hombres y 150 mujeres) con diferentes AA. Se utilizaron algoritmos de AA de árbol de decisión (DT), K-Nearest Neighbour, regresión logística (RL), Random Forest (RF), análisis discriminante lineal (ADL) y Naive Bayes (NB) para el aprendizaje no supervisado. Los análisis estadísticos de las variables se realizaron con el programa Minitab® 21.2 (64 bits). La tasa de ACC de los algoritmos NB, DT, KNN y RL se encontró en % 83, mientras que la tasa de ACC de los algoritmos ADL y RFC se determinó en % 85. Según el análisis de Sharp, la variable con el mayor grado de efecto se encontró como BOW. El estudio determinó el sexo con alta precisión en las proporciones de 0,83 y 0,85 mediante el uso de las variables de las imágenes de TC orbitales, y se adquirieron los datos morfométricos relacionados de la población en cuestión, enfatizando la variación racial.

Assuntos

Humanos , Masculino , Feminino , Órbita/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Determinação do Sexo pelo Esqueleto , Aprendizado de Máquina , Órbita/anatomia & histologia , Algoritmos , Modelos Logísticos , Antropologia Forense , Imageamento Tridimensional

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SUMMARY: The Synsacrum is constructed of pelvic bones, sacral, lumbar vertebrae and some thoracic vertebrae, and it takes the form of a thin sheet of bone which is curled downwards at the sides. This study is designed to assess the morphometric specialization of the lumbosacral portion of the vertebral section in flying and non-flying winged creatures. Several parameters (ratio of cranial/caudal parts and diameter/length) of the lumbosacral vertebral column were calculated in computed tomography (CT). The ratio of diameter/length of the synsacrum was the narrowest in ostrich while the widest was in pigeon. While the cranial/caudal ratio was the smallest in ostrich and the largest in pigeon. The parameters of penguin were closed to that of pigeon. It is supposed that this ratio is related to the bird locomotion, flying, swimming or/and strolling.

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El sinsacro está formado por huesos pélvicos, sacros, vértebras lumbares y algunas vértebras torácicas, y toma la forma de una fina lámina de hueso curvada a los lados hacia abajo. Este estudio está diseñado para evaluar la especialización morfométrica de la porción lumbosacra de la sección vertebral en criaturas aladas voladoras y no voladoras. Se calcularon varios parámetros (relación de partes craneal/caudal y diámetro/longitud) de la columna vertebral lumbosacra en tomografía computarizada (TC). La relación diámetro/longitud del sinsacro fue la más estrecha en avestruz mientras que la más ancha fue en paloma. Mientras que la relación craneal/caudal fue la más pequeña en avestruz y la más grande en la paloma. Los parámetros del pingüino estaban cerrados en relación a los de la paloma. Se supone que esta relación está relacionada con la locomoción de las aves, volando, nadando y/o caminando.

Assuntos

Animais , Coluna Vertebral/diagnóstico por imagem , Aves/anatomia & histologia , Tomografia Computadorizada por Raios X

RESUMO

El foramen mental, una abertura en la parte inferior de la mandíbula, es la salida de un ramo del nervio alveolar inferior, proporcionando sensibilidad a la mandíbula y la piel del mentón. Su variabilidad anatómica es importante en procedimientos dentales y quirúrgicos. Nuestro estudio en San Luis Potosí, México, examinó la posición y características morfológicas del foramen mental en una muestra de tomografías computarizadas de la mandíbula. En mujeres, la zona entre el primer y segundo premolar fue la más común, mientras que en hombres, fue la misma zona pero con mayor prevalencia en el lado izquierdo. Se observaron diferencias en la dirección del foramen mental entre sexos y lados de la mandíbula, con la dirección posterior predominante en ambos sexos. Estos hallazgos concuerdan con estudios previos en diferentes poblaciones, aunque se identifican variaciones significativas en la prevalencia y ubicación específica del foramen. La comparación con otros estudios resalta la importancia de considerar factores étnicos y geográficos en la interpretación de los resultados. Las diferencias anatómicas observadas tienen implicaciones clínicas importantes para procedimientos dentales y quirúrgicos, subrayando la necesidad de enfoques adaptados a la población específica para mejorar la precisión y seguridad de las intervenciones en el área del mentón.

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SUMMARY: The mental foramen, an opening at the bottom of the jaw, is the exit of the inferior alveolar nerve branch, providing sensation to the jawbone and skin of the chin. Its anatomical variability is important in dental and surgical procedures. Our study was carried out in San Luis Potosí, Mexico and examined the position and morphological characteristics of the mental foramen in a sample of lower jaw CT scans. In women, the area between the first and second premolar was the most common, while in men, it was the same area but with a greater prevalence on the left side. Differences in the direction of the mental foramen were observed between sexes and sides of the mandible, with the posterior direction predominating in both sexes. These findings are consistent with previous studies in different populations, although significant variations in the prevalence and specific location of the foramen are identified. The comparison with other studies highlights the importance of considering ethnic and geographic factors in the interpretation of results. The anatomical differences observed have important clinical implications for dental and surgical procedures, underscoring the need for approaches tailored to the specific population to improve precision and safety of interventions in the mental foramen area.

Assuntos

Humanos , Masculino , Feminino , Tomografia Computadorizada de Feixe Cônico , Forame Mentual/diagnóstico por imagem , Estudos Transversais , Estudos Retrospectivos , Mandíbula/diagnóstico por imagem

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SUMMARY: In this study, we aim to share the volumes of the carpal bone and the ratio of these volumes to the total volume of wrist bones from Computed Tomography (CT) images obtained from individuals of different ages and sex using 3D Slicer. Right wrist CT images of 0.625 mm slice thickness of 42 healthy individuals (21 female, 21 male) of both sexes were included in our study. Volume calculations were made by loading the images into 3D Slicer, an open-source software package. In this study, mean capitate volume was the largest in both sexes (male 3479.9±679.2; female 2207.1±272.1 mm3), while pisiform had the smallest mean volume (male 810.0±141.2; female 566.6±97.7 mm3). This order was ordered from largest to smallest as hamate, scaphoid, trapezium, lunate, triquetrum, trapezoid, and pisiform. According to this study, carpal bone volumes were larger in males than in females (p0.05). In this study, it was seen that carpal bone volume differed according to sex. However, it was observed that the bone volumes of both sexes took up the same amount in the total bone volume. This information will be very useful in sex determination, 3D anatomical material creation, implant applications and reconstructive surgery.

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Nuestro objetivo fue determinar los volúmenes de los huesos del carpo y la relación entre estos volúmenes y el volumen total de estos huesos a partir de imágenes de TC obtenidas de individuos de diferentes edades y sexos utilizando 3D Slicer. En el estudio se incluyeron imágenes de TC del carpo de la mano derecha de los participantes en el estudio, con un grosor de corte de 0,625 mm, en 42 individuos sanos (21 mujeres, 21 hombres) de ambos sexos. Los cálculos de volumen se realizaron cargando las imágenes en 3D Slicer, un paquete de software de código abierto. El volumen medio del hueso capitado fue el mayor en ambos sexos (hombre 3479,9 ± 679,2; mujer 2207,1 ± 272,1 mm3), mientras que el hueso pisiforme tuvo el volumen medio más pequeño (hombre 810,0 ± 141,2; mujer 566,6 ± 97,7 mm3). De mayor a menor el volumen de los otros huesos fue: hamato, escafoides, trapecio, lunato, piramidal, trapezoide y pisiforme. Según este estudio, los volúmenes óseos del carpo eran mayores en hombres que en mujeres (p0,05). En este estudio se observó que el volumen de los huesos del carpo difería según el sexo. Sin embargo, se observó que los volúmenes óseos de ambos sexos ocuparon la misma cantidad del volumen óseo total. Esta información será de gran utilidad en la determinación del sexo, creación de material anatómico 3D, aplicaciones de implantes y cirugía reconstructiva.

Assuntos

Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Ossos do Carpo/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Caracteres Sexuais , Imageamento Tridimensional , Fatores Sexuais , Titulometria

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OBJECTIVES: This study evaluated the impact of variations in anteroposterior and lateral tilts of patients' head on radiation-weighted doses to organs/tissues and effective doses using three different cone beam computed tomography machines. METHODS: An anthropomorphic phantom was used to estimate radiation doses in three CBCT machines (OP300, Eagle X 3D, and Eagle Edge). Thermoluminescent dosimeters were placed in regions corresponding to pre-stablished organ/tissues. CBCT examinations from the posterior mandible and anterior maxilla regions were acquired, with three different anteroposterior angulations (0°, 30°, and 45°), and from the posterior mandible in three different lateral angulations (0°, 20° to the left, and 20° to the right side). Radiation-weighted doses for each organ/tissue and effective doses were calculated for each machine and angulation. RESULTS: For the posterior mandible acquisitions, anteroposterior angulations of the head at 30° and 45° yielded a reduction in effective doses in all three devices. A 20° tilt to the right side resulted in lower doses than to the left (same side as the FOV). For the anterior maxilla, increased anteroposterior angulation was associated with reduction in effective dose in two devices. CONCLUSION: Effective doses are lower when small FOV CBCT exams of the posterior mandible and anterior maxilla are acquired with increased anteroposterior head angulation at 30° and 45°. For FOV in the posterior mandible, a 20° lateral tilt towards the side opposite to the FOV also yields lower effective doses. The main contribution to these dose reductions is the decrease in dose to salivary glands.

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The article addresses the diagnostic value of the combined use of computed tomography (CT) perfusion and dual-energy CT (DECT) in patients with neuroendocrine tumors. It emphasizes the heterogeneity and complexity of these neoplasms, primarily affecting the gastrointestinal tract, bronchopulmonary system, and pancreas. While conventional CT is widely employed in their diagnosis, the combination of CT perfusion and dual-energy CT offers greater precision, particularly in detecting synchronous tumors and characterizing their vascularization. A clinical case of a patient with chronic abdominal symptoms, whose diagnosis was facilitated using both combined techniques, is presented. The discussion explores how CT perfusion assesses tumor vascularization and how dual-energy CT improves soft tissue differentiation, resulting in increased diagnostic accuracy. It is highlighted that this approach not only enhances detection rates but also positively impacts clinical management and healthcare costs. Therefore, the importance of considering these advanced tools in the diagnosis of neuroendocrine tumors to improve diagnostic precision and efficiency in patient care is underscored.

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A 49-year-old female patient, asymptomatic, presented to the cardiology office for a right atrial mass, identified incidentally in a non-electrocardiogram (ECG)-gated contrast-enhanced computed tomography, performed for follow-up of pulmonary tuberculosis. Echocardiography, surprisingly, showed an anechogenic ovoid mass in the right atrium measuring 40 × 40 mm2, implanted in the interatrial septum without affecting the tricuspid valve. ECG-gated computed tomography angiography (CTA), confirmed the dimensions of the mass, which presented homogeneous content, calcified areas, and a 12-mm pedicle implanted near the ostium of the coronary sinus. Additionally, contrast uptake and infiltration of adjacent structures were ruled out. In the surgical field, an encapsulated mass with blood content was found, which pathology reported as a hematic endocardial cyst (HEC). These are rare cardiac masses, constituting 1.5% of all primary cardiac tumors. It is usually an incidental finding, and its clinical presentation will depend on its dimensions and the intracardiac hemodynamic impact. A highlighting feature is its anechogenic content on ultrasound, however, multimodality imaging allows for making diagnostic assumptions, discerning between primary cardiac tumors, and provides morphological and hemodynamic information useful for therapeutic decision making. The age of the patient, the large size of the HEC, and its location in the interatrial septum make up a completely atypical presentation of this rare disease, which motivated this report.

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PURPOSE: This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Forty-two eligible patients (aged 11-14 years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3 months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05). RESULTS: Twenty-one patients (12 girls and 9 boys; mean initial age, 13.3 years) were included in the TBB group and 21 (5 girls and 16 boys; mean initial age, 13.2 years) were included in the TB group. The TB group exhibited a decrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed a significant width reduction (0.7 mm; p < 0.001), accompanied by a notable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001). CONCLUSIONS: RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.

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Dens invaginatus (DI) is one of the developmental dental anomalies that results in an invagination of the enamel organ into the dental papila during odontogenesis. The purpose of this study is to report a case of nonsurgical endodontic treatment of an Oehlers type II DI in a right maxillary lateral incisor with an extensive periapical damage, along with the two-year clinical and tomographic follow-up. A 30-year-old patient was referred for endodontic treatment of tooth #12. On clinical examination, a change in the shape and color of the crown was observed. The tooth responded negative to pulp sensibility, percussion, palpation and mobility tests. After tomographic evaluation, an Oehlers type II DI was visualized, in addition to an extensive periradicular lesion. The diagnosis was asymptomatic apical periodontitis. The treatment was carried out in two sessions, through intense enhancement of the auxiliary chemical substance with passive ultrasonic irrigation, XP-Endo Finisher and the use of hydroxide-based intracanal medication. Appropriate treatment in cases with anatomic variations requires an accurate and early diagnosis based on clinical examination and radiographic images. A two-year follow-up of the present case showed that the correct diagnosis associated with appropriate instrumentation techniques, supplementary disinfection, and adequate three-dimensional sealing of the canal with filling material, resulted in regression of the periradicular lesion and bone repair.

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Root canal obliteration is caused by hard tissue apposition and is often associated with teeth with a history of trauma, orthodontic movement, caries reaction, restorative procedures near the pulp chamber, and teeth of elderly patients. Preoperative planning of root canal treatment should be thorough and include an assessment of the patient's signs and symptoms in addition to the evaluation of complementary examinations. In a 27-year-old patient with dyschromia of the lower central incisor, a history of dental trauma, and a positive response to vertical percussion, an initial periapical radiograph was obtained that showed calcification of the canal and presence of a periapical lesion. The patient presented with pain on chewing, a positive response to palpation and a vertical percussion test. The diagnosis was symptomatic apical periodontitis. A cone-beam computed tomography scan was requested and a surface scan was performed to establish a static guide. The root canal was accessed in the middle third of the root and the canal was located using a minimally invasive approach. The root canal was treated conventionally. Results obtained showed the success of the treatment after a 3-year clinical and radiographic follow-up. Therefore, the use of an endodontic guide in cases of calcified canals significantly reduces the clinician's working time and offers a more predictable approach to the treatment of these pathologies.

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AIM: To evaluate the impact of acquisition protocols and artifact reduction filters in cone beam computed tomography on diagnosing vertical root fractures in endodontically treated teeth with and without intraradicular posts. MATERIALS AND METHODS: We analyzed 480 tomographic images acquired from two J. Morita scanners (0.125- and 0.08-mm voxel sizes protocols), with application of a blooming artifact reduction filter. Three evaluators assessed these images for root fractures using a 5-point Likert scale. Diagnostic accuracy between filters and protocols was determined using generalized linear models with binomial distribution for the outcome, considering protocol, filter, and dental status. Sensitivity, specificity, positive predictive value, and negative predictive value were also estimated for the filters and protocols. RESULTS: The 0.08-mm voxel size protocol demonstrated a significantly higher percentage of accurate diagnosis compared to the 0.125-mm protocol (p = .001). No statistically significant differences (p ≥ .087) were observed for filter application, interaction between protocol and filter, or dental status. Accuracy, sensitivity, and specificity values were respectively: .93, .87, 1.00 (protocol 1); .99, .99, .99 (protocol 2); .98, .96, .99 (no filter); .95, .90, 1.00 (with filter). CONCLUSION: The new findings found for the two J Morita scanners used in our study were that images acquired using the voxel size of 0.08 mm showed an improvement in the diagnosis of root fractures and the filters in these devices have no relevance significant for the diagnosis.

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Objetivo: El cóndilo mandibular bífido es una alteración morfológica de la articulación temporomandibular en la que el cóndilo presenta un surco en la superficie superior que genera dos cabezas condilares. Esta alteración puede ser unilateral o bilateral. La mayoría de los cóndilos mandibulares bífidos se detectan mediante radiografías panorámicas, sin embargo, la tomografía computarizada Cone Beam de articulación temporomandibular es considerado el examen de elección para el diagnóstico de esta alteración. El propósito de este trabajo es presentar un caso de cóndilo mandibular bífido bilateral detectado incidentalmente mediante una tomografía computarizada Cone Beam solicitada por un diagnóstico presuntivo de osteoartritis. Caso clínico: Una paciente de 22 años sin antecedentes de traumatismos cráneo faciales solicita una tomografía computarizada Cone Beam de articulaciones temporomandibulares por diagnóstico presuntivo de osteoartritis. En la exploración del volumen se encontraron cóndilos mandibulares bífidos con dos cabezas condilares, medial y lateral de forma bilateral, siendo más acentuado en el cóndilo derecho.(AU)

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Aim: The bifid mandibular condyle is a morphological alteration of the temporomandibular joint in which the condyle has a groove on its upper surface that generates two condylar heads. This alteration can be unilateral or bilateral. Most bifid mandibular condyles are detected by panoramic radiographs, however, Cone Beam computed tomography of the temporomandibular joint is considered the test of choice for the diagnosis of this alteration. The purpose of this work is to present a case of bilateral bifid mandibular condyle, incidentally detected by Cone Beam computed tomography requested for a presumptive diagnosis of osteoarthritis. Clinical case: A 22-year old female patient with no history of craniofacial trauma requests a Cone Beam computed tomography of the temporomandibular joints due to a presumptive diagnosis of osteoarthritis. In the volume exploration, bifid mandibular condyles were found with two condylar heads, medial and lateral bilaterally, being more accentuated in the right condyle.(AU)

Assuntos

Humanos , Bezoares , Volvo Intestinal , Obstrução Intestinal , Tomografia Computadorizada por Raios X , Laparotomia

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The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success rates. Cone-beam computed tomography (CBCT) offers superior diagnostic capabilities over conventional radiography, enabling the pre-operative detection of root configurations and canal numbers, facilitating personalized endodontic treatments. A total of 2173 teeth of a Mexican population, including 1057 first mandibular molars and 1116 s mandibular molars, were studied using only CBCT to identify C-shaped canals and radix configurations of patients who were treated from 2018 to 2023 at the Department of Radiology at the Faculty of Dentistry, Juarez University of the State of Durango, Mexico. C-shaped canals were identified in 160 teeth, with a prevalence of 0.2% in first mandibular molars and 14.1% in second mandibular molars. The highest frequency was in the left second mandibular molar (3.7) at 14.8%. Gender differences were significant, with higher prevalence in females (27.3%) compared to males (13.3%). The most common C-shaped canal configuration was type C2 (39.3%). Radix entomolaris was found in 52 teeth, with a prevalence of 3.4% in first mandibular molars and 1.4% in second mandibular molars. This research on a Mexican population using cone-beam computed tomography (CBCT) highlights significant findings in the prevalence and types of C-shaped canals and radix entomolaris in mandibular molars for this population. The left second mandibular molar (3.7) showed the highest prevalence at 14.8%, followed closely by the right second mandibular molar (4.7) at 13.5%, with a significant difference (p < 0.001). We found a significant difference in the prevalence of C-shaped canals between genders (p = 0.004, OR 1.78). Additionally, radix entomolaris (p < 0.001) was more frequently identified in first mandibular molars to a significant degree. These insights underscore the importance of CBCT in diagnosing complex root anatomies, which can greatly enhance the success rates of endodontic procedures by allowing for more tailored and precise treatments for this population.

RESUMO

This study explores the efficacy of texture analysis by using preoperative multi-slice spiral computed tomography (MSCT) to non-invasively determine the grade of cellular differentiation in head and neck squamous cell carcinoma (HNSCC). In a retrospective study, MSCT scans of patients with HNSCC were analyzed and classified based on its histological grade as moderately differentiated, well-differentiated, or poorly differentiated. The location of the tumor was categorized as either in the bone or in soft tissues. Segmentation of the lesion areas was conducted, followed by texture analysis. Eleven GLCM parameters across five different distances were calculated. Median values and correlations of texture parameters were examined in relation to tumor differentiation grade by using Spearman's correlation coefficient and Kruskal-Wallis and Dunn tests. Forty-six patients were included, predominantly female (87%), with a mean age of 66.7 years. Texture analysis revealed significant parameter correlations with histopathological grades of tumor differentiation. The study identified no significant age correlation with tumor differentiation, which underscores the potential of texture analysis as an age-independent biomarker. The strong correlations between texture parameters and histopathological grades support the integration of this technique into the clinical decision-making process.

RESUMO

OBJECTIVES: To retrospectively investigate the impact of pre-treatment Extracellular Volume Fraction (ECV) measured by Computed Tomography (CT) on the response of primary lesions to preoperative chemotherapy in abdominal neuroblastoma. METHODS: A total of seventy-five patients with abdominal neuroblastoma were retrospectively included in the study. The regions of interest for the primary lesion and aorta were determined on unenhanced and equilibrium phase CT images before treatment, and their average CT values were measured. Based on patient hematocrit and average CT values, the ECV was calculated. The correlation between ECV and the reduction in primary lesion volume was examined. A receiver operating characteristic curve was generated to assess the predictive performance of ECV for a very good partial response of the primary lesion. RESULTS: There was a negative correlation between primary lesion volume reduction and ECV (r = -0.351, p = 0.002), and primary lesions with very good partial response had lower ECV (p < 0.001). The area under the curve for ECV in predicting the very good partial response of primary lesion was 0.742 (p < 0.001), with a 95 % Confidence Interval of 0.628 to 0.836. The optimal cut-off value was 0.28, and the sensitivity and specificity were 62.07 % and 84.78 %, respectively. CONCLUSIONS: The measurement of pre-treatment ECV on CT images demonstrates a significant correlation with the response of the primary lesion to preoperative chemotherapy in abdominal neuroblastoma.

Assuntos

Neoplasias Abdominais , Neuroblastoma , Tomografia Computadorizada por Raios X , Humanos , Neuroblastoma/diagnóstico por imagem , Neuroblastoma/tratamento farmacológico , Neuroblastoma/cirurgia , Neuroblastoma/patologia , Masculino , Feminino , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Pré-Escolar , Criança , Lactente , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/tratamento farmacológico , Neoplasias Abdominais/patologia , Neoplasias Abdominais/cirurgia , Resultado do Tratamento , Curva ROC , Valor Preditivo dos Testes , Adolescente , Carga Tumoral/efeitos dos fármacos , Sensibilidade e Especificidade , Valores de Referência , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Reprodutibilidade dos Testes

RESUMO

Recent evidence suggests that the invasive air sac system evolved at least three times independently in avemetatarsalians: in pterosaurs, sauropodomorphs and theropods. Data from sauropodomorphs showed that the pneumatic architecture in vertebrae first developed in camellate-like trabeculae in the Triassic, later in camerate systems in Jurassic neosauropods, and finally camellate tissue in Cretaceous titanosaurs. This evolutionary trajectory has support from a considerable sampling of sauropodomorph taxa. However, the evolution of pneumatic bone tissues in Theropoda is less understood. We analyzed the computed tomography of Majungasaurus and Rahonavis, using densitometry rendering to differentiate the microarchitecture along the presacral axial skeleton of late Ceratosaurians and early Paravians. We also compared these results with scans of other theropod clades. Our analysis revealed an increase in pneumatic complexity in early paravians compared to the ceratosaurians. Majungasaurus presents some apneumatic neural spines, a condition also observed in Allosaurus. Majungasaurus also features some apneumatic centra despite the presence of lateral pneumatic fossae. This raises caution when evaluating PSP solely based on external morphology. We also found evidence of distinct patterns of PSP in maniraptorans. Considering that Majungasaurus, a late abelisaurid, inherited from their ceratosaurian ancestors, some apneumatic elements such as the neural spine and some centra, Rahonavis, an early paravian, took a different trajectory toward the full pneumatization of the axial skeleton. This characteristic provided paravians an advantage in gliding and flying. Also, unlike Sauropoda, pneumaticity in Theropoda apparently developed by increasing chamber volumes toward paravians. Similar studies on early Theropoda are needed to elucidate their condition and better describe the evolutionary trajectory of different groups.

RESUMO

Objective: Guided Bone Regeneration (GBR) is a dental surgical procedure that uses barrier membranes to prevent soft tissue invasion and conduct new bone growth. This study aimed to define a Prognosis Recovery score (PR score) to objectively classify post-surgery responders from non-responder patients who underwent GBR using Cone Beam Computed Tomography (CBCT). Methods: This prospective-observational-longitudinal-cohort study recruited 250 individuals who were assigned to: Conventional-Apical-Surgery (CAS, n = 39), Apical-Surgery using human fascia lata Membrane placement (ASM, n = 42), and Apical-Surgery using human fascia lata Membrane placement and lyophilized allograft Bone powder (ASMB, n = 39); and Apical-Surgery using collagen membrane Porcine origin and Bovine Bone-matrix (ASPBB, n = 130), an independent external validation cohort. Surgery was performed, and evolution was monitored by CBCTs at 0, 6-, 12-, 18-, and 24 months post-surgery. Results: Normalized lesion volumes were calculated, and non-linear time evolution morphology curves were characterized. The three-time evolution bone growth patterns were: a linear tendency (PR0), "S'' shaped log-logistic (PR1), and "C" cellular growth (PR2). The treatment success rates were PR2-46 %, PR2-88 %, and PR2-95 %/PR1-5% for CAS, ASM, and ASMB groups. The xenograft ASPBB counterpart achieved PR2-92 % and PR1-8%. The score PR had a sensitivity, specificity, and accuracy of 100 %. Conclusions: Patients' treatment success can be quantitatively, objectively, and precisely predicted with the Prognosis Recovery score (using only two CBCTs), according to their biological response to allograft or xenograft materials (time-evolution bone growth curves), reducing cost and radiation exposure. Clinical significance: Through digital imaging and bioinformatic analysis of bone regeneration observed in CBCTs, we defined a Prognosis Recovery (PR) score using only two CBCT volume assessments (0 and 6 months). The PR score allowed us to define three time-evolution curves depending on the biomaterials used and to classify patients in a quantitative, objective, and accurate way.