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Biomedical subjects

D Magid

Publications and source records attributed to D Magid.

102 records · Page 6Linked to original sources

Three-dimensional imaging and display of musculoskeletal anatomy.

Conventional three-dimensional imaging uses thresholding, or surface rendering technique, which limits accuracy and detail, and hinders soft tissue definition. Volumetric image rendering preserves all CT data, not just surface boundaries, and therefore overcomes these limitations. Three-dimensional images thus generated can be used for muscular and vascular anatomy as well as skeletal structures, with preservation of subtle detail. Representative cases are used to illustrate this technique and its implications for therapy and plastic and reconstructive surgery.

Humans↗

Pulmonary carcinoid tumors: CT assessment.

Computed tomography assessment of 634 surgically proven solitary pulmonary nodules included 12 pulmonary carcinoid tumors. Five were central (involving or directly abutting the bronchial tree), and seven were peripheral (surrounded by parenchyma). Three central and one peripheral lesion had CT numbers indicative of focal calcifications, frequently in the periphery of the nodule. Nodule size ranged from 1.2 to 3 cm. Nine nodules were smooth and round, two were irregular and lobulated, and in one the entire peripheral contour was difficult to assess because of postobstructive atelectasis secondary to tumor occlusion of the bronchus. The calculated average CT number ranged from 80.5 to 179 HU.

Adult↗

Fidelity of three-dimensional CT imaging for detecting fracture gaps.

Simulated femoral neck fractures with varying amounts of distraction were studied using four modifications in a volumetric, three-dimensional CT reconstruction program to allow an objective comparison of volumetric versus surface (thresholded) rendering. Binary classification caused spurious fusion of gaps less than 2.0 mm or, at settings preserving these gaps, produced false holes in adjacent bone. Fracture gaps were visible to 0.0 mm using volumetric CT image rendering technique.

Femoral Neck Fractures↗

Pneumocystis carinii involvement of the liver and spleen: CT demonstration.

Patients with acquired immunodeficiency syndrome (AIDS) are subject to a variety of infections, including Mycobacteria avium intracellulare, cytomegalovirus, Cryptosporidium, and Pneumocystis carinii. Pneumocystis is most commonly associated with a potentially fatal pneumonia in AIDS patients. Other organ involvement by Pneumocystis is rare. We present a patient with hepatic and presumed splenic infiltration by Pneumocystis.

Acquired Immunodeficiency Syndrome↗

Simulated femoral repositioning with three-dimensional CT.

Three-dimensional volumetric rendering of CT data has proven to be valuable in the evaluation of the hip. Although video loop animation allows review of the anatomy from all perspectives, it does not show the functional range of motion of the femur in the acetabulum. We have developed a technique termed simulated dynamic CT that gives dynamic animated three-dimensional viewing capabilities. This technique incorporates static CT data with gait and movement data to produce a sequence of dynamic images simulating range of motion. Additionally, this technique allows simulation of surgical techniques to visually anticipate the results of reduction and traction and potential limitations in subsequent hip movement. To assess the potential of this technique, two dysplastic hip patients were studied prior to reconstruction. In each case the perspective thus gained led to altered surgical management.

Child↗

Three-dimensional volumetric display of CT data: effect of scan parameters upon image quality.

Of the many steps involved in producing high quality three-dimensional (3D) images of CT data, the data acquisition step is of greatest consequence. The principle of "garbage in, garbage out" applies to 3D imaging--bad scanning technique produces equally bad 3D images. We present a formal study of the effect of two basic scanning parameters, slice thickness and slice spacing, on image quality. Three standard test objects were studied using variable CT scanning parameters. The objects chosen were a bone phantom, a cadaver femur with a simulated 5 mm fracture gap, and a cadaver femur with a simulated 1 mm fracture gap. Each object was scanned at three collimations: 8, 4, and 2 mm. For each collimation, four sets of scans were performed using four slice intervals: 8, 4, 3, and 2 mm. The bone phantom was scanned in two positions: oriented perpendicular to the scanning plane and oriented 45 degrees from the scanning plane. Three-dimensional images of the resulting 48 sets of data were produced using volumetric rendering. Blind review of the resultant 48 data sets was performed by three reviewers rating five factors for each image. The images resulting from scans with thin collimation and small table increments proved to rate the highest in all areas. The data obtained using 2 mm slice intervals proved to rate the highest in perceived image quality. Three millimeter slice spacing with 4 mm collimation, which clinically provides a good compromise between image quality and acquisition time and dose, also produced good perceived image quality. The studies with 8 mm slice intervals provided the least detail and introduced the worst inaccuracies and artifacts and were not suitable for clinical use. Statistical analysis demonstrated that slice interval (i.e., table incrementation) was of primary importance and slice collimation was of secondary, although significant, importance in determining perceived 3D image quality.

Data Display↗

The acetabulum in congenital and neuromuscular hip instability.

Acetabular morphology in congenital and neuromuscular hip instability was evaluated with computed tomography (CT) and plain radiography. Thirty-three unstable hips in 27 children with congenital hip dysplasia, cerebral palsy, or spina bifida were studied. Fourteen normal hips in 14 children served as controls. Unstable hips in the children with congenital hip dysplasia demonstrated anterior and superior acetabular deficiency with increased acetabular anteversion. Global deficiency was present in acetabuli of cerebral palsy and spina bifida patients with anterior, posterior, and superior deficiencies. The acetabuli in cerebral palsy patients had significant posterior deficiency and were the shallowest of the groups evaluated.

Acetabulum↗

The hip in Stickler syndrome.

Stickler syndrome is an autosomal dominant connective tissue disorder with a prevalence similar to that of Marfan syndrome. No previous study has examined hip pain or abnormalities in a large series of patients with Stickler syndrome. The purpose of this study was to describe hip abnormalities and their correlation with age and chronic hip pain in a cohort of 51 patients followed at the National Institutes of Health. Ten percent of patients had protrusio acetabuli, 21% coxa valga, and 34% of adults had hip osteoarthritis. Sixty-three percent of all patients and 79% of adults had chronic hip pain. In addition, 16% of adult patients had a history of femoral head failure during youth. Arthritic changes and adult age were associated with hip pain. In summary, hip abnormalities are commonly observed in Stickler syndrome. Young patients require careful evaluation of hip pain, and regular screening of children with Stickler syndrome may be indicated for early detection of hip complications.

Abnormalities, Multiple↗

Acetabular and pelvic fractures in the pediatric patient: value of two- and three-dimensional imaging.

Pediatric trauma is a significant source of morbidity and mortality in pediatric patients. Prompt and accurate assessment of injuries is necessary for the best outcome. Computed tomography (CT) has become a well-accepted, rapid, relatively noninvasive way to assess the trauma patient. In certain cases of pelvic trauma, two- and three-dimensional CT (2D/3D CT) adds detail not otherwise obtainable or appreciated. Although the benefits must be balanced against the slight increase in delivered radiation dose, we believe that 2D/3D CT is often an important part of patient management.

Acetabulum↗

Multiplanar imaging of the hip: a systematic approach.

Computed tomography has become an invaluable adjunct for the evaluation of musculoskeletal pathology. Although the transaxial image presentation has distinct advantages over conventional radiography, the ability to reformat the acquired data into coronal, sagittal, or oblique planes contributes to a more thorough understanding of complex anatomy such as that of the hip joint. This article reviews our experience with a series of over 500 hip cases using the multiplanar reformatting and display [MPR/D] package developed for use on the Siemens Somatom DR-3 scanner.

Acetabulum↗