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V Gilsanz

Publications and source records attributed to V Gilsanz.

139 records · Page 8Linked to original sources
PubMedDate not supplied

Digital hand atlas and web-based bone age assessment: system design and implementation.

Bone age assessment is a procedure frequently performed in pediatric patients to evaluate their growth disorder. A simple method commonly used in bone age assessment is atlas matching by a radiological examination of a left-hand radiograph against a small reference set of Greulich-Pyle atlas patterns of normal standards. The method however can lead to significant deviation in age assessment, due to a variety of observers with different levels of training. The Greulich-Pyle atlas developed in the 1950s based on middle upper class white populations, is also not fully applicable for children of today, especially regarding the standard development in other racial groups. In this paper, we present our system design and initial implementation of a digital hand atlas and computer-aided diagnostic (CAD) system for Web-based bone age assessment. The CAD system is built on top of existing picture archiving and communication system (PACS), as well as recent advances in Internet technology. It consists of a hand atlas database, a CAD module and a Java-based Web user interface. The digital atlas is based on a large new set of clinically normal hand images of diverse ethnic groups. A relational image database system is used to organize hand images, their extracted quantitative features and patient data. The digital atlas removes the disadvantages of the currently out-of-date Greulich-Pyle atlas and allows the bone age assessment to be computerized. The Java-based Web user interface allows users to interact with the hand image database from browsers. Users can use a Web browser to push a clinical hand image to the CAD server for a bone age assessment. Quantitative features on the examined image, which reflect the skeletal maturity, are then extracted and compared with patterns from the atlas database to assess the bone age. The digital atlas method based on open system Internet technology provides an alternative to supplement or replace the traditional one for a quantitative, accurate and cost-effective assessment of bone age.

Adolescent↗
PubMedDate not supplied

CT findings in rectal cuff abscess following surgery for Hirschsprung disease.

A rectal cuff abscess following corrective surgery for Hirschsprung disease is an uncommon but serious complication requiring prompt diagnostic and therapeutic attention. Plain films and examinations using contrast medium are insensitive to detection of an abscess due to surgical disruption of the normal anatomy. Computed tomography may be easy to interpret if the corrective surgery performed is well understood. An explanation of the Soave procedure and a case report are presented demonstrating the value of CT in examination of the postoperative pelvis. Knowledge that a cuff abscess following a Soave procedure for Hirschsprung disease can be easily detected by CT will aid in the early diagnosis and treatment, preventing long-term sequelae.

Abscess↗
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Prevalence of incidental paranasal sinuses opacification in pediatric patients: a CT study.

A prospective evaluation of the paranasal sinuses was performed on a consecutive series of 137 pediatric patients referred for cranial CT. Approximately one-half of the patients less than 13 years of age had some degree of maxillary or ethmoid sinus opacification. The prevalence and severity of opacification was approximately the same for the maxillary and ethmoid sinuses. Sphenoid sinus abnormality was less common (16% of patients) and was usually minimal or mild. No incidental frontal sinus abnormalities were observed. This study confirms previous reports, based on plain film radiography, of the prevalence of incidental maxillary sinus opacification in children. However, contrary to some prior studies, we did not find a relatively higher rate of opacification in children less than 1 year of age. This may be due to overdiagnosis of maxillary sinus opacification on plain films, in small children. The diagnosis of sinusitis in childhood must take into account not only the radiographic findings but clinical signs and symptoms. Correlation is needed to avoid overdiagnosis in patients referred for sinus radiography for nonspecific indications or who have incidental opacification noted on radiographic or CT studies of the skull and brain.

Adolescent↗
PubMedDate not supplied

The effect of limping on vertebral bone density: a study of children with tarsal coalition.

To determine whether limping is associated with decreased bone mineralization, the trabecular and integral bone densities (BDs) of 18 Caucasian children exhibiting computed tomographic evidence of tarsal coalition (14 boys, 4 girls, aged 9 years, 5 months to 16 years, 3 months) were compared with those of an age- and sex-matched control group. Patients with tarsal coalition had significantly lower trabecular (p less than 0.05) and integral (p less than 0.05) BD than controls. Trabecular spinal density was approximately 17% lower on the average in patients with tarsal coalition. Among the limping patients, neither the duration of symptoms nor bilaterality was associated with decreased BD. The findings suggest that painful tarsal coalition may decrease vertebral bone mass and predispose to spinal osteoporosis.

Adolescent↗