Dissertations / Theses on the topic 'Radiographic anatomy'

Orientador: Solange Maria de Almeida<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba<br>Made available in DSpace on 2018-08-12T22:00:11Z (GMT). No. of bitstreams: 1 Ladeira_DanielaBraitSilva_M.pdf: 1017119 bytes, checksum: 322eb3926821425fc8da5596828faa73 (MD5) Previous issue date: 2009<br>Resumo: A realização de medidas precisas em radiografias panorâmicas é duvidosa, devido à distorção por ampliação de imagens. Por ser um método tomográfico, somente a porção do objeto localizada na camada de imagem do aparelho estará livre de distorção. O objetivo nesse trabalho foi determinar a camada de imagem do aparelho panorâmico Orthopantomograph OP 100 e avaliar a relação entre distâncias intergoníacas e medidas lineares em radiografias panorâmicas. Para a determinação da camada de imagem foi construído um phantom constituído por uma placa acrílica de 14cm², com sua superfície contendo perfurações a cada 0,5cm. O phantom foi posicionado no local do apoio de mento do aparelho panorâmico, com sua superfície paralela ao plano horizontal. Esferas metálicas de 0,315cm foram inseridas nas perfurações, e executadas radiografias panorâmicas. Cada coluna de cada quadrante foi individualmente preenchida pelas esferas para a execução das radiografias, em três planos horizontais diferentes: alturas orbital, oclusal e mentual. As imagens radiográficas obtidas foram analisadas e a camada de imagem localizada. Mostrou-se curva no plano horizontal, e mais estreita na região anterior; no plano vertical, apresentou discreta assimetria da cavidadeorbitária em direção ao mento, e entre os lados direito e esquerdo. Na etapa seguinte, mandíbulas maceradas foram separadas em três grupos de dez mandíbulas cada, de acordo com as distâncias intergoníacas: G1(8,2cm), G2(9,0cm) e G3(9,6cm). As mandíbulas receberam em sua superfície, triângulos retângulos isósceles confeccionados com esferas metálicas de 0,198cm, fixados nas regiões de incisivos, caninos/pré-molares, molares, ângulo e ramo da mandíbula. As mandíbulas foram individualmente radiografadas sobre o phantom, nos limites da camada de imagem, primeiramente com os triângulos fixados na superfície externa, e em uma segunda etapa, na superfície interna. As imagens radiográficas dos triângulos foram medidas, e obtiveram-se duas medidas para cada triângulo, uma vertical e outra horizontal, e calculadas as medianas entre as medidas internas e externas. Após análise estatística utilizando-se o teste de Tukey (a=0,05), observou-se que não houve diferenças estatisticamente significativas nas medidas verticais e horizontais entre os grupos G1, G2 e G3. Concluiu-se não haver relação entre a distância intergoníaca e medidas lineares horizontais e verticais. Porém, as medidas variaram entre as diferentes regiões de um mesmo grupo. Essa variação foi maior para as medidas horizontais em relação às verticais.<br>Abstract: Precise measures in panoramic radiographs are questionable due to the image distortion. As a tomographic method, only the structures located on the image layer is free of distortion. The aim in this work was to determine the image layer of the panoramic Orthopantomograph OP 100 unit and to evaluate the relationship between intergoniac distances and linear measures in panoramic radiographies. To determine the image layer it was idealized a phantom produced by a 14cm² acrylic plate with holes every 0,5cm. The phantom was placed on the panoramic device mental support, with the surface parallel to the horizontal plan. 0,315cm metal spheres were inserted in the holes and then, panoramic radiographies were taken. A column of each quadrant was filled by the spheres to radiographic exposure in three horizontal plains: orbital, occlusal and symphysis levels. The radiographic images were examined and the image layer was located. It showed curve in the horizontal plane with narrowing in the anterior region; in the vertical plan, it showed slight asymmetry of the orbital cavity toward the symphysis, and between the right and left sides. After that, dry mandibles were separated in three different groups with ten mandibles per group according the intergoniac distances: G1(8,2cm), G2(9,0cm) e G3(9,6cm). Isosceles rectangular triangles confectioned with 0,198cm metal spheres were set in the regions of incisors, canines/ bicuspid, molars, angle and mandibular ramus. Each mandible was radiographed separately on the phantom in the image layer limits. At first the triangles were set on the external surface and, in a second step, they were set on the internal surface. After all the radiographic images taken, the triangles were measured resulting in two measures for each triangle, one vertical and another one horizontal. The median values between the internal and external measures were calculated and the data were submitted to Tukey Test (a=0,05). There were no statistically significant differences in vertical and horizontal measures among the groups G1, G2 and G3. Thus, it was possible to conclude that there is not relationship between the intergoniac distance and horizontal and vertical linear measures. However, the measures ranged between the different regions of one same group and this variation was greater for horizontal measures in relation to vertical.<br>Mestrado<br>Radiologia Odontologica<br>Mestre em Radiologia Odontológica

Despite affecting many organ systems, the leading cause of morbidity and mortality in the cystic fibrosis (CF) population is lung disease. For the current studies we investigated elements of CF lung disease in a porcine model of CF and in people with CF. Our primary analysis tool was chest computed tomography (CT). To investigate early CF lung disease we examined three week old CF and non-CF pigs. We found three week old CF pigs to have large, irregular tracheal smooth muscle bundles, airways of reduced size, airways of irregular shape, and airways of abnormal distensibility. Three week old CF pig lung parenchyma was more heterogenous in density than three week non-CF pigs, especially in the right cephalad lung. The degree of lung tissue heterogeneity in CF pigs correlated with the degree of lung infection. Three week old CF pigs also had significantly more air trapping upon exhalation, evidence of airflow obstruction, than non-CF pigs. The degree of air trapping correlated with the degree of mucus accumulation in the airways. These data show that CF pigs spontaneously develop hallmark features of CF lung disease within weeks of birth, and that abnormal airway growth and development in CF may contribute to lung disease. This study helped set the foundation for future comparative studies involving CF therapeutics, for example, antibiotics and mucolytics. In adults with CF we performed a before drug, after drug study. The drug was ivacaftor, and it restores the basic underlying defect in a subset of people with CF: impaired function of a particular anion channel. We hypothesized that abnormal airway smooth muscle behavior in people with CF, known as “CF asthma,” is, in part, a primary pathogenic mechanism of CF lung disease. We tested our hypothesis by assaying smooth muscle tone before and after administration of ivacaftor. We limited the time duration to two days. We reasoned two days was long enough for ivacaftor to become effective, but not long enough to reverse long standing lung infection and inflammation which could affect smooth muscle function independently. The implication being, that observed changes would be directly due to restoration of the CF defect. We found evidence suggesting relaxation of airway and vascular smooth muscle tone. And, the change in airway smooth muscle tone correlated with the change in vascular smooth muscle tone. These data suggest that impaired smooth muscle function is a primary element of CF lung disease. Many of the people in our two day ivacaftor study returned for follow up after one year of ivacaftor therapy. We hypothesized that radiographic features of lung disease would improve following one year of ivacaftor therapy. We observed no change in lung volume upon inspiration, but a reduction in expiratory lung volume, approximately half of which occurred within two days. Our airway measurements were confounded by errors in scan reconstruction, however, other published studies report airway wall thinning over long term ivacaftor administration. Taken together, these studies of pigs with CF and people with CF, help us understand this disease.

Most authors recommend drawing the mechanical axis on a three-foot (90 cm) full leg length x-ray for accurate assessment of knee alignment. Three foot x-rays are difficult to perform and reproduce and involve undue radiation to the gonads. The purpose of this project is to propose a new radiographic technique whereby the mechanical axis of the knee can be assessed on a short A/P x-ray of the entire tibia.<br>Methodology. 21 normal adults and 25 patients with malaligned knees were investigated in the following manner--the patient was x-rayed in standing position with the legs positioned exactly parallel to one another and vertical to the floor. Under these circumstances, the ankles were apart by a distance (distance F$ sb1$) equal to the distance between the femoral heads (distance F). The mechanical axes were hence parallel to one another and parallel to the long axis of the x-ray cassette and vertical to the floor. Two separate x-rays were taken, a three-foot (90cm) long x-ray and a short x- ray of the entire tibia. The mechanical axis was determined on the 90 cm, three-foot long x-ray.<br>A vertical line drawn on the short x-ray starting from the centre of the ankle and extended upwards and parallel to the long axis of the x-ray cassette could accurately identify the mechanical axis of the knee using either technique. (Fig. 1)<br>The technique has been called the "Parallel Mechanical Axes X-ray Technique". It has been validated and it will be demonstrated that such an x-ray technique: (1) Standardizes positioning of the lower extremities. (2) Is a precise, easily controllable method to assess knee alignment. (3) A short x-ray of the entire tibia is sufficient, thus reducing the cost of x-rays by 50%. (4) Obviates the need to visualize the pelvis thus minimizing net radiation exposure. (5) May be used in clinics and smaller hospitals, since it requires simple and inexpensive x-ray facilities.

Objetivos: Desenvolver um programa de computador sobre anatomia em radiografias panorâmicas; analisar a opinião de peritos a respeito do software como método de ensino-aprendizado; analisar a aceitação do método proposto, pelos alunos do 2 0 , 3 0 e 4 0 anos de graduação da Faculdade de Odontologia da Universidade Federal de Goiás. Métodos: O software elaborado resultou em um programa tutorial multimídia interativo, estruturado em módulos, compostos dos seguintes temas: formação da imagem na técnica panorâmica, seqüência para interpretação radiográfica, anatomia radiográfica em panorâmicas, jogos e avaliação. Após a conclusão do programa, aplicou-se um questionário a 56 entrevistados (10 professores Doutores em Radiologia, denominados peritos, e 46 alunos de graduação) com a finalidade de avaliar o software como método de ensino-aprendizado. Resultados: As respostas foram analisadas por meio de análise estatística descritiva e verificou-se que: 100% dos avaliadores não fariam qualquer modificação no layout, navegação e conteúdo do módulo de anatomia radiográfica, objetivo central do software; 98% dos alunos e 60% dos peritos aprovaram as imagens desse mesmo módulo. 100% dos entrevistados gostariam de ter mais acesso a softwares educacionais e afirmaram que o programa apresentou-se explicativo e de fácil entendimento. 100% dos peritos declararam que o programa atingiu todos os objetivos propostos e se constitui de um método de ensino-aprendizado válido. Conclusão: O programa foi amplamente aceito pela população 13 pesquisada, tornado sua aplicação factível e pertinente como método de ensino-aprendizado<br>Objectives: To develop a software about panoramic radiography; to analyze professors opinions about the software as a teacher and learning method; to analyze graduation students - 2 0 , 3 0 and 4 0 levels / Dentistry Scholl of Goiás / Brazil - acceptation of the method. Methods: The software was developed, resulting in a multimedia tutorial containing pages about panoramic technique, interpretation sequences, panoramic radiographic anatomy, games and tests. After the completing said program, a questionnaire was applied to ten professors PhDs in Radiology, denominated experts, and 46 dental graduating students, with the purpose to analyze their opinions about the program as a teaching and learning method. Results: The answers was analyzed descriptively, and it could be observed that, 100% of experts wouldn’t make any alteration on the layout, navigation and texts in the most important part of the program, that is panoramic radiography anatomy; 98% of the students and 60% of the experts approved the images of the refereed modulus. 100% of the interviewed would like to have more educational software, and declared that the program was clear and easily understanding. 100% of the experts affirmed that the program reached all objectives proposed and can be considered as a valid teaching and learning method Conclusion: The program interested and was great accepted by the interviewed population, becoming completely feasible and pertinent the application of the said instrument as a teaching and learning method

L'objectif de cette thèse était de développer des méthodes destinées à la mise en correspondance d'images (recalage) cardiaques multimodales. Une méthode de recalage rigide a été mise au point pour recaler des Images par Résonance Magnétique (IRM) et de Tomographie d'Emission de Positions (TEP). Elle est basée sur le recalage de structures thoraciques préalablement segmentées. De même, une méthode de recalage élastique a été développée et appliquée au recalage d'images cardiaques intra-patient par RM et TEP. Elle repose sur une combinaison du critère d'information mutuelle et d'informations de gradient pour guider la déformation régularisée d'une image vers une image cible. Enfin, une approche pour la création de cartographies individualisées anatomiques et fonctionnelles en trois dimensions (3-D) du cœur incluant des informations structurelles issues de l'IRM et des informations fonctionnelles provenant de la TEP et de la Magnétocardiographie a également été mise au point<br>The objective of this thesis was to develop methods for multimodal cardiac image registration and fusion. A rigid registration method has been developed to register Magnetic Resonance (MR) with Positron Emission Tomography (PET) images of the thorax and heart. It is based on the matching of thoracic structures previously segmented from the images. This method has evaluated on a reference simulated image data set and clinical data. An elastic registration method is also proposed and applied to the registration of intra-patient cardiac MR and PET images. It combines the mutual information criteria with a gradient based measure to control the deformation of the floating image to the target image. Finally, an approach for the building of 3D individualized anatomical and functional maps of the heart is introduced from the joint registration of structural information from MRI and functional information from PET and magnetocardiography

El camaleó vetllat (Chamaeleo calyptratus) i el camaleó pantera (Furcifer pardalis) són dues de les espècies de camaleó més populars al món, i en conseqüència, dues de les que més freqüentment s’atenen a les consultes veterinàries. Les diferents tècniques de diagnòstic per imatge solen incloure’s de forma rutinària als protocols diagnòstics en medicina herpetològica com són la radiografia, la ecografia, la tomografia computeritzada y la ressonància magnètica. Tot i així, els estudis publicats sobre descripció anatòmica mitjançant tècniques d’imatge són escassos, i la interpretació d’aquestes últimes es basa en l’experiència pròpia del clínic o bé per extrapolació d’altres espècies prèviament estudiades. Per aquest motiu, els objectius d’aquest estudi anatòmic prospectiu van ser desenvolupar protocols de diagnòstic per imatge en aquestes espècies i descriure l’anatomia dels òrgans de la cavitat celòmica en animals sans, mitjançant l’ús de la radiografia, l’ecografia i la tomografia computeritzada. Es van incloure disset camaleons vetllats (7 mascles i 10 femelles) i quinze camaleons pantera (13 mascles i 2 femelles) sans en base als resultats de l’examen físic general i de l’estudi corològic. L’estudi es va realitzar en camaleons sedats mitjançant l’administració d’alfaxalona (Alfaxan®, Crawley, UK) 4-6 mg/kg IV a la vena ventral de la cua. Un cop sedats, es va realitzar un estudi radiogràfic amb dues projeccions (lateral dreta i dorsoventral) amb xassís de mamografia. Seguidament, es va realitzar un estudi ecogràfic complet de la cavitat celòmica amb l’ús de sonda lineal de 15 a 18-MHz en decúbit lateral dret. Finalment, es va realitzar una tomografia computeritzada helicoidal amb un escàner de 16 talls en decúbit esternal. Es va realitzar l’estudi postmortem d’un exemplar de cada espècie per tal d’aclarir, il·lustrar i avaluar les troballes de les proves d’imatge. Els resultats obtinguts suggereixen que les diferents tècniques d’imatge estudiades permeten la visualització del fetge (incloent la vena cava caudal i las venes hepàtiques), la vesícula biliar, l’estómac, els intestins, les gònades, els cossos grassos i els ronyons en camaleons vetllats i pantera. La bufeta de la orina només es va identificar mitjançant ecografia i tomografia. La melsa, el pàncrees i les glàndules adrenals van ser identificades als estudis postmortem però no van poder visualitzar-se mitjançant cap tècnica d’imatge. En conclusió, aquest estudi proporciona una guia de les característiques anatòmiques normals dels òrgans celòmics mitjançant tècniques de diagnòstic per imatge en camaleons vetllats i camaleons pantera. D’aquesta manera, les troballes poden ser utilitzades com a referència durant els exàmens de pacients malalts o per a futurs estudis d’investigació.<br>El camaleón velado (Chamaeleo calyptratus) y el camaleón pantera (Furcifer pardalis) son dos de las especies de camaleón más populares en el mundo, y en consecuencia, dos de las que más frecuentemente se atienden en la consulta veterinaria. Las diferentes técnicas de diagnóstico por imagen suelen incluirse de forma rutinaria en los protocolos diagnósticos en medicina herpetológica, entre ellas la radiografía, la ecografía, la tomografía computerizada y la resonancia magnética. Sin embargo, los estudios publicados sobre descripción anatómica mediante técnicas de imagen son escasos, y la interpretación de estas últimas se basa en la experiencia propia del clínico o bien por extrapolación de otras especies ya estudiadas. Por este motivo, los objetivos de este estudio anatómico prospectivo fueron desarrollar protocolos de diagnóstico por imagen en estas especies y describir la anatomía de los órganos de la cavidad celómica en animales sanos, mediante el uso de radiografía, ecografía y tomografía computerizada. Se incluyeron diecisiete camaleones velados (7 machos y 10 hembras) y quince camaleones pantera (13 machos y 2 hembras) sanos en base a los resultados del examen físico general y del estudio coprológico. El estudio se realizó en camaleones sedados tras la administración de alfaxalona (Alfaxan®, Crawley, UK) 4-6 mg/kg IV en la vena ventral de la cola. Una vez sedados, se realizó un estudio radiográfico con dos proyecciones (lateral derecha y dorsoventral) con chasis de mamografía. Seguidamente, se realizó un estudio ecográfico completo de la cavidad celómica mediante sonda lineal de 15 a 18-MHz en decúbito lateral derecho. Finalmente, se realizó una tomografía computerizada helicoidal con un scanner de 16 cortes en decúbito esternal. Se realizó el estudio post mortem de un ejemplar de cada especie por tal de esclarecer, ilustrar y evaluar los hallazgos de imagen. Los resultados obtenidos sugieren que las diferentes técnicas de imagen estudiadas permiten la visualización del hígado (incluyendo la vena cava caudal y las venas hepáticas), la vesícula biliar, el estómago, los intestinos, las gónadas, los cuerpos grasos y los riñones en camaleones velados y pantera. La vejiga de la orina solo pudo identificarse mediante ecografía y tomografía. El bazo, el páncreas y las glándulas adrenales fueron identificados en los estudios post mortem pero no pudieron ser visualizados mediante ninguna de las técnicas de imagen. En conclusión, este estudio proporciona una guía de las características anatómicas normales de los órganos celómicos mediante técnicas de diagnóstico por imagen en camaleones velados y camaleones pantera. De esta forma, los hallazgos pueden ser utilizados como referencia para exámenes de pacientes enfermos o para futuros estudios de investigación.<br>Veiled chameleon (Chamaeleo calyptratus) and Panther chameleon (Furcifer pardalis) are the most popular chameleons over the world, and consequently, two of the most frequently species attended in veterinary practice. The most commonly used imaging techniques in diagnostic protocols in herpetology include radiography, ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI). However, few studies about imaging description in reptiles have been published. The objectives of this prospective anatomic study were to develop imaging techniques for these species and to describe the normal anatomy of the coelomic organs using radiography, US and CT scan. Seventeen healthy veiled chameleons (7 males and 10 females) and fifteen healthy panther chameleons (13 males and 2 females) were included in the study. Animals were considered to be healthy on the basis of the results of a complete physical examination and coprology testing. The imaging study was performed in sedated chameleons after the administration of alfaxalone (Alfaxan®, Crawley, UK) 4-6 mg/kg IV in the ventral vein of the tail. A right lateral and dorsoventral radiographic views were performed with a mammography cassette plate in all animals. Then, an ultrasound was performed in right lateral recumbency using a linear 15 to 18-MHz transducer. Finally, a CT examination was performed with a 16-slice helical CT scanner in sternal recumbency. Post-mortem study of one chameleon of each species were used to clarify and illustrate coelomic anatomy and to assess imaging findings. The results of the current study suggest that the different imaging techniques (radiography, ultrasonography and computed tomography) allow the visualization of the liver (including caudal vena cava and hepatic veins), gallbladder, stomach, intestines, gonads, fat bodies and kidneys in healthy veiled and panther chameleons. The urinary bladder was identified using US and CT examination. The spleen, pancreas and adrenal glands were identified in post-mortem studies, but could not be visualized with any imaging technique. In conclusion, this study provides a guide of the normal imaging anatomic features of the coelomic organs in veiled chameleons and panther chameleons. Findings can be used as a reference for future research studies or for examinations of clinically ill patients.

Le but de cette thèse est de proposer un algorithme de recalage non-rigide adapté au recalage atlas / sujet dans un environnement clinique. Les applications médicales sont la planification pré-opératoire pour la radiothérapie conforme des tumeurs cérébrales, et pour la stimulation cérébrale profonde continue des patients atteints de la maladie de Parkinson. Dans ces applications, le recalage non-rigide est utilisé pour déformer les segmentations de l’atlas (effectuées par un expert) dans la géométrie du patient. L’algorithme proposé utilise un champ de déplacement dense pour modeler finement la transformation, et un critère de similarité basé sur l’intensité pour estimer les appariements entre les deux images. L’inversibilité de la transformation estimée est garantie grâce à une nouvelle méthode de rééchantillonage rapide. La régularisation est implémentée à l’aide d’un modèle visco-élastique : une régularisation non-stationnaire et éventuellement anisotrope du champ de déplacement modélise la variabilité spatiale de la déformabilité des différentes structures ; une régularisation non-stationnaire de la dérivée temporelle du critère de similarité permet de pondérer l’information fournie par les différents voxels, et d’éviter les possibles erreurs causées par les pathologies dans l’image du patient. L’utilisation d’un schéma numérique semi-implicite permet des temps de calcul courts. Nous proposons aussi une implémentation parallèle sur une ferme d’ordinateurs personnels qui permet de réduire le temps de calcul à quelques minutes. Finalement, nous utilisons des méthodes de type « grille de calcul » pour connecter l’ordinateur parallèle à un système de visualisation<br>The purpose of this thesis is to provide a nonrigid registration algorithm adapted to atls to subject registration in a clinical environment. The clinical applications addressed are the pre-operative planning of conformal brain radiotherapy and of the deep brain stimulation of Parkinsonian patients. In these applications, the nonrigid registration is used to deform expert segmentations of an anatomical atlas image into a patient’s geometry. The proposed algorithm uses a dense displacement field to finally model the transformation, and an intensity-based similarity criterion to estimate the matches between the two images. The invertibility of the recovered transformation is guaranteed thanks to a new and fast regridding method. The regularization is implemented in a two-step viscoelastic-like model. A non-stationary and possibly anisotropic regularization of the displacement field models the space-varying deformability of different structures. A non-stationary regularization of the temporal derivative of the similarity criterion allows to weight informative vs. Non-informative voxels, and to avoid errors due to pathologies in the patient image. The use of a semi-implicit numerical scheme enables fair computation times. We also propose a parallel implementation on a cluster of personal computers that further reduces the execution time to only a few minutes. Finally, we use grid computing methods to tightly couple the quite heavy parallel architecture to a lightweight visualization system

La compréhension des pathologies et leur diagnostic nécessitent une représentation tridimensionnelle de notre squelette. Comparativement aux modalités d’imagerie telles que le CT scan ou l’IRM, le système EOS, s’inscrit comme un moyen peu irradiant permettant la reconstruction tridimensionnelle des os à partir de radiographies bi-planes en position érigée. Des méthodes de reconstruction 3D du membre inférieur ont été proposées et sont déjà implémentées en clinique. Cependant, elles nécessitent un opérateur expérimenté. Cette thèse a pour objectif la quasi-automatisation de ces méthodes afin de réduire la dépendance et les temps opérateurs tout en conservant la précision des précédentes. Dans ce but, nous avons développé une nouvelle approche se caractérisant par une solution initiale basée sur une saisie intuitive suivie d’une phase d’ajustement entièrement automatisée. Cette dernière s’appuie sur une déformation statistique (régression par processus gaussien) couplée à un algorithme de minimal path adapté permettant la détection automatique de contours images. Ce nouveau processus de reconstruction rapide (2 min. temps opérateur) a été évalué en termes de forme et de paramètres cliniques pour le fémur, le tibia, la patella et le bassin. Comparativement aux travaux précédents, les erreurs que nous obtenons en termes de justesse sur les paramètres cliniques sont inférieurs ou comparables dans une tolérance de 1°. De plus, nous avons montré que notre approche est systématiquement plus reproductible, quand bien même l’opérateur est novice. Ces travaux rendront les méthodes de reconstruction 3D du membre inférieur plus efficaces conduisant à un diagnostic plus précis<br>For better understanding and efficient diagnosis of musculoskeletal and osteoarticular pathologies and a more efficient diagnosis, 3D modeling of the skeleton is essential. Compared to imaging modalities such as CT-scan or MRI, the EOS system allows to acquire the 3D skeletal geometry from low dose bi-planar x-rays in standing position. To obtain these reconstructions, various methods have already been proposed and implemented in clinical routine. Nevertheless, these processes rely on a qualified operator. This work aims to automate the process, thus lowering the inter operator variability and accelerating the reconstruction with a comparable precision. Therefore, a new methodology is proposed, which relies on an initial solution based on an intuitive digitization followed by an entirely automatic optimization. This last step relies on a statistical deformation (gaussian process regression) combined with an adapted minimal path algorithm allowing automatic detection of the image contours. This fast and robust approach yields a precise 3D reconstruction in less than two minutes and has been validated in terms of shape and clinical parameters for femur, tibia, patella and pelvis. Compared to previous works, we obtained lesser or identical errors on clinical parameters within a tolerance of 1°. In addition, the approach allows better reproducibility even though the operator is a beginner. The proposed tools open the way for a more efficient 3D reconstruction of the lower limbs leading to a more accurate diagnosis

Every endodontic treatment may lead to failures due to internal anatomical changes. Among these faults is the which links pulp chamber floor with the periodontium in the furcation area. So the purpose of this study was to evaluate the presence of this canal in 360 human permanent mandibular molars which were kept dehydrated, using four evaluation methods: radiography, naked eye (NE), dental microscope (DM) and clearing technique. The used methods (radiography and clearing) were compared to verify the presence of the furcation canal, and observed the presence of foramina through the methods (NE and DM) by the pulp chamber floor and by the furcation; as well they were compared to the results between the complete rhizogenesis groups and the incomplete ones. Three hundred and sixty mandibular molars were used that belong to the collection of the Dental Anatomy Course of the Morphology Department of UFSM, all of them with an intact pulp chamber floor and stored in dry containers. They were rehydrated, sectioned to 1,5 mm apically to the furcation and up to 0.5 mm of pulp chamber floor. After that, they were immersed in 1% sodium hypochlorite (24 hours), rinsed under running water and immersed again in 1% sodium hypochlorite in ultrasonic (10 minutes) followed by another rinsed under running water and dried at room temperature. Then they were stored individually in glass containers, numbered and capped. All evaluations were made by the one observer, being the radiography evaluation with for four samples radiographed on each piece of film with a magnifying glass (4x); the NE and DM (30x) with directional lighting in the sample; and clearing technique each sample in its container with liquid on a X-ray box and with the aid of DM (30x). Through the radiography analysis the furcation canal wasn't clear, but as a slightly radiolucent area in the furcation region in 9,04% of the samples, suspecting its presence in 2,33% and it was not found in 88,63%; through the clearing technique the canal was not found in 100%;to the NE were evident foramina in 20,9% of the furcation and 1,9% in the pulp chamber floor; through DM, 62,1% in the furcation and 5% in the pulp chamber floor. The RC group presented foramina in 61,1% in the furcation and 5,8% in the pulp chamber floor; the RI group with 64,7% in the furcation and 3% in the pulp chamber floor. Given the developed conditions in this work it's possible to conclude that radiographic evaluation really does not work as an effective means of diagnosis, but as an aid exam, important to schedule medical procedures. Observing the assessments by the NE and DM, the foramina number is much higher in the furcation than in the pulp chamber floor and can be sites of deposition of dental plaque, making cleaning more difficult in the area when exposed in the oral cavity, and there was no foramina incomplete rhizogenesis group, the use of dental microscope is an excellent tool for the visualization of dental anatomical details; the clearing technique is an excellent evaluation method, since we have the full three-dimensional visualization of internal dental anatomy, and there is a need of studying more about the use of stored dehydrated teeth in some of the methods of research.<br>Todo tratamento endodôntico pode levar a insucessos devido às alterações anatômicas internas. Dentre estas está o canal cavo-interradicular, que comunica o assoalho da câmara pulpar com o periodonto na região da furca. Assim foi propósito deste trabalho avaliar a presença deste canal em 360 molares inferiores permanentes humanos que se encontravam armazenados desidratados, utilizando quatro métodos de avaliação: radiografias, a olho nu (ON), pelo microscópio odontológico (MO) e diafanização. Foram comparados os métodos (radiográfico e diafanização) utilizados para verificar a presença do canal cavo-interradicular; e observada a presença de foraminas através dos métodos (ON e MO) pelo assoalho da câmara pulpar e furca; bem como comparados os resultados entre os grupos de rizogênese completa (RC) e incompleta (RI). Foram utilizados 360 molares inferiores pertencentes ao acervo da Disciplina de Anatomia e Escultura Dental da UFSM, todos com assoalho da câmara pulpar intacto e armazenado em recipientes secos. Os mesmos foram rehidratados, seccionados, até 1,5 mm apicalmente à furca e até 0,5 mm do assoalho pulpar. Após, foram imersos em hipoclorito de sódio 1% (24h), lavados em água corrente e nova imersão em hipoclorito de sódio 1% em ultrassom (10 min.), seguida de nova lavagem em água corrente e secos à temperatura ambiente. Depois, foram armazenados individualmente em recipientes de vidro, numerados e tampados. Todas as avaliações foram feitas pelo mesmo operador, sendo a radiográfica com quatro amostras por película com uma lupa (4x); a ON e MO (30x) com iluminação artificial direcional na amostra; e pela diafanização cada amostra em seu recipiente com líquido, sobre um negatoscópio e com auxílio do MO (30x). Pela análise radiográfica o canal cavo-interradicular não se mostrou evidente, mas como uma zona levemente radiolúcida na região da furca em 9,04% das amostras; com suspeita da sua presença em 2,33% e não foi encontrado em 88,63%; pela diafanização, o canal não foi encontrado em 100%; a ON foram evidentes foraminas em 20,9% na furca e 1,9% no assoalho pulpar; pelo MO, 62,1% na furca e 5% no assoalho pulpar. O grupo RC apresentou foraminas em 61,1% na furca e 5,8% no assoalho pulpar; o grupo RI com 64,7% na furca e 3% no assoalho pulpar. Diante das condições desenvolvidas neste trabalho pode-se concluir que o exame radiográfico realmente não serve como um meio de diagnóstico efetivo, mas sim como um exame auxiliar, importante para programar procedimentos clínicos; pelas avaliações a ON e MO, o número de foraminas é bem maior na furca que no assoalho pulpar, podendo ser sítios de deposição de placa bacteriana, dificultando a limpeza da região quando exposta na cavidade bucal, e não houve maior número de foraminas no grupo rizogênese incompleta; o uso do microscópio odontológico é uma ferramenta excelente para visualização dos detalhes anatômicos dentários; a diafanização é um excelente método avaliativo, visto que temos a total visualização em terceira dimensão da anatomia interna dental; e que há necessidade de se estudar mais a respeito da utilização de dentes armazenados desidratados em algumas metodologias de pesquisas.

A artrite reumatóide (AR) é uma patologia crônica e sistêmica de etiologia desconhecida provavelmente multifatorial na qual há um predomínio de acometimento da sinóvia. Afeta de 0,5 a 1 % da população com predomínio nas mulheres. O diagnóstico precoce e o inicio da terapêutica adequada são fundamentais e podem modificar a evolução da doença reduzindo as graves seqüelas. O custo do exame de ressonância magnética (RM) é a maior limitação neste método de diagnóstico. O objetivo deste estudo foi avaliar a especificidade e a sensibilidade da ressonância magnética (RM) da mão e do punho de pacientes com AR precoce de acordo com os parâmetros do OMERACT (comitê internacional para avaliação de medidas em reumatologia para análise da ressonância magnética) correlacionando com a radiologia convencional. Foram avaliados 19 pacientes com AR (idade: 22-64 anos) e um grupo controle composto por 10 indivíduos sem história de patologias prévias com idade de 26-46 anos. Foram realizados exames de radiografia (RX) e RM da mão e do punho dominante. Treze articulações foram avaliadas pelo RX convencional (radio-ulnar distal, radiocarpal, intercarpal e metacarpofalângicas do primeiro ao quinto dedo e articulação interfalângicas proximais do primeiro ao quinto dedo). As lesões ósseas no RX foram classificadas de acordo com o método de Van Der Heiidje com graduações de 0 a 4 para redução do espaço articular e de 0 a 5 para erosão óssea. Foram realizados exames de RM num equipamento marca GE 1,5 T Signa Horizon LX (General Eletric medical systems) utilizando T1, T2 eco de spin e T1 eco de Spin com saturação de gordura após a infusão do contraste paramagnético gadopentato dimegumina. O protocolo foi realizado de acordo com as padronizações do OMERACT. Como resultados obtivemos que a RM foi mais sensível na pesquisa de erosão óssea (94,7%) que o RX (78,9%). Somente as articulações intercarpais e metacarpo-falângicas do segundo dedo demonstraram correlação estatística entre os 2 métodos (r=0,47 p=0,04 e r=0,63 p=0,004). Para erosão óssea os compartimentos radiocarpal (73,7%) e intercarpal (84,2%) foram os mais sensíveis e com maior acurácia. Além disso, a RM foi muito sensível no estudo da sinovite presente em 100% dos pacientes com AR comparados com 20% do grupo controle. Quando estudados nos sítios anatômicos o carpo foi o local mais sensível para a sinovite (100%). O edema intra-ósseo foi mais detectado no punho com uma alta especificidade (90%), porém com baixa acurácia (50%) um achado importante é que a analise simultânea do punho e da mão não aumentou a detecção de um maior número de pacientes com AR. Concluindo, a RM foi mais sensível que o RX no estudo da AR precoce. Este trabalho demonstrou que o estudo do punho apresentou uma ótima sensibilidade e especificidade no diagnóstico precoce da AR e somente o estudo deste compartimento parece ser adequado com redução do custo do exame para os pacientes, portanto na análise do AR precoce o punho parece apresentar melhor desempenho.<br>Rheumatoid arthritis (RA) is a chronic and systemic disease of unknown etiology probably multifactorial with a predominant involvement of synovial tissue. The disease prevalence is 0.5-1% and affects more often women. Early diagnosis and therapy are essential to modify the course of the disease and reduce the degree of severe late sequelae. The cost of MRI of this region is a major limitation for the use of this sensitive exam. We therefore decided to evaluate if the wrist magnetic resonance with a simultaneous reading of wrist and hand compartments according to the OMERACT parameters would be sensitive and accurate to diagnose early RA. We have evaluated 19 patients with RA (ages: 22-64 years) and 10 age-matched controls. X-ray and MRI evaluated the dominant wrist all subjects. Thirteen joints were evaluated by conventional radiography: radio-ulnar distal (DRU), radiocarpal joint (RC), intercarpal (IC), metacarpo-phalageal (first to fifth finger) and phalangophalangeal (first to fifth finger). The bone lesion in the radiograph was scored by the method of Van Der Heidje for joint damage and for joint narrowing space. Wrist MRI imaging was performed with 1,5 T GE Signa Horizon LX 8,2 (General Eletric medical systems) with multiplanar T1, T2 (spin echo and fast spin echo) and T1 fat sat after intravenous injection of gadopentetate dimeglumine, according to the definitions of OMERACT. The MRI was more sensitive to detect erosion (94.7%) than the conventional X-ray (78.9%), and only intercarpal and metacarpofalangic joints of the second finger showed statistic correlation in the two methods (r=0.47 p=0.04 e r= 0.63 p=0.004). Of interest, among the anatomic compartments evaluated the radiocarpal (73.7%) and intercarpal joints (84.2%) were the most sensitive and accurate to detect erosion. Moreover, the MRI was also very sensitive to detect synovitis, present in 100% of the AR compared 20% in the control group, p<0,001. With regards to the anatomic site, synovitis was uniformly observed in all carpal joints (100%). Edema was also more frequently detected in the wrist joints with a high specificity (90%) but low accuracy (50%). Importantly, the simultaneous reading of wrist and hands did not identify additional cases. MRI imaging was more sensitive than conventional radiography in detecting early lesion in RA Our data support the notion that wrist MRI has an excellent sensitivity and specificity to diagnose early RA, and therefore only this assessment seems to be adequate, with a reduced cost for the patients. Additionally, we have demonstrated that the reading may be restrict to the wrist compartment, overcoming the technical limitations of the hand anatomical site.

Le rachis est constitué d'un ensemble de vertèbres entourées de tissus mous. Celui-ci est flexible, mais il est aussi rigide par morceau. Un modèle articulé permet de prendre en compte la nature particulière des déformations acceptables du rachis en vue de la création d'un modèle statistique. Cependant, les modèles articulés appartiennent naturellement à une variété Riemannienne et non à un espace vectoriel ce qui nous a amené à utiliser la moyenne de Fréchet et une mesure généralisée de la covariance lors de la création des modèles statistiques. Ceux-ci peuvent être visualisés de façon intuitive et comparés à l'aide de tests d'hypothèses. L'analyse d'un grand groupe de patients scoliotiques a révélé que la variabilité de la forme du rachis est inhomogène et anisotrope et qu'il est aussi possible de localiser les niveaux vertébraux significativement affectés par un traitement orthopédique. L'analyse par composantes principales dans le plan tangent de la moyenne de Fréchet permet quant à elle d'extraire des modes de déformations typiques qui facilitent l'analyse de grandes bases de données. Ces déformations typiques révélèrent des groupements cliniquement intéressants chez les patients scoliotiques. Finalement, une procédure d'estimation d'un maximum a posteriori permet la reconstruction 3D de modèles complets à partir de modèles 3D incomplets ou à partir de repères 2D identifiés sur des radiographies. Les résultats obtenus indiquent que notre méhode de reconstruction à partir de repères 2D est plus performante que la méthode la plus utilisée actuellement. De plus, une erreur inférieure à 2 mm a été obtenue lorsqu'au moins 25 % des vertèbres étaient disponibles pour la reconstruction d'un modèle complet du rachis. Les résultats obtenus indiquent donc qu'un modèle statistique de la géométrie du rachis complet basé sur une modélisation articulée mène à des statistiques descriptives interprétables cliniquement et à des algorithmes qui permettent d'obtenir des modèles 3D du rachis dans des circonstances où cela aurait été impossible par le passé.

An acht isolierten Hinterbeinen gliedmaßengesunder Rinder wurden röntgen- und querschnittsanatomische Untersuchungen des Tarsus, Metatarsus und der Phalangen durchgeführt. Im Gegensatz zu anderen Tierarten gab es bisher für das Rind noch keine Erkenntnisse zur Interpretation von MRT-Befunden. Zur besseren Orientierung werden magnetresonanztomographische und anatomische Schnitte gegenübergestellt und bewertet. Es sind 23 transversale Ebenen in T1-gewichteten Sequenzen beschrieben worden. Die röntgenanatomischen Untersuchungen erfolgten immer in den beiden Standardebenen und für Sprunggelenk und Zehe zusätzlich in zwei schrägen Aufnahmerichtungen. Mit den Untersuchungen wurde nachgewiesen, dass die verwendeten Röntgenrichtungen für eine umfassende Darstellung von Knochen und Gelenken geeignet sind. Durch die verschiedenen Aufnahmerichtungen konnten die meisten Bereiche überlagerungsfrei herausprojiziert und der Beurteilung zugänglich gemacht werden. Fast alle anatomischen Strukturen wurden in der MRT-Untersuchung dargestellt und voneinander differenziert. Über den direkten Vergleich zum anatomischen Sägeschnitt zeichneten sich die MRT-Befunde durch einen sehr hohen Informationsgehalt aus. Das Magic Angle Phänomen konnte im Bereich von Sehnen und Bändern nachgewiesen werden. Die Aufzweigungen des Ramus profundus des N. plantaris lateralis konnten im Rahmen dieser Untersuchung bis in den mittleren Metatarsusbereich nachgewiesen werden. Sie sind bei anderen Tierarten als Nn. metatarsei plantares in der Nomenklatur zu finden. Ausgehend von einer sehr umfangreichen Literaturauswertung erfolgte eine umfassende Zusammenstellung des Erkenntnisstandes unter anatomischen und orthopädischen Gesichtspunkten. Die dabei zusammengetragenen Ergebnisse bilden eine entscheidende Grundlage für die Auswertung und Interpretation von Befunden der Hintergliedmaße des Rindes mit Hilfe der bildgebenden Diagnostik<br>The study was based on the evaluation of eight hindlimbs from animals free from orthopedic disease. The tarsus, metatarsus and phalanges were examined radiographically and by MRI to characterize anatomical structures. Twenty-three transverse MRI sections of each limb were collected using T1 weighted images. Corresponding MRI and cross-section anatomical preparations were compared to optimize understanding of structural features. In addition to standard 0° and 90° views of the hindlimbs, oblique views of the tarsus and phalanges were made. Comparison of photographs and images was satifactory for the evaluation of bony structures without superimposition in most cases. MRI examination resulted in visualization and differentiation of tissues in almost every situation. The magic angle phenomenon was observed in areas of tendons and ligaments. The terminal branches of the R. profundus of the N. plantaris lateralis were discernable to the level of the middle of the metatarsus. These branches are described in other species as the Nn. metatarsei plantares. This work was undertaken to document anatomical findings and relationships which may be used as a resource for interpretation of images obtained from the hindlimbs of cattle using various diagnostic imaging modalities

Os métodos de controle de qualidade tradicionais aplicados ao radiodiagnóstico, é a melhor maneira de garantir a boa qualidade das imagens produzidas. No entanto, a investigação de particularidades oriundas do processo de formação de imagens radiológicas requer ferramentas computacionais complementares, em função do número de variáveis envolvidas. Entretanto, os fantomas computacionais baseados em voxels não conseguem representar as variações morfométricas necessárias para a simulação de exames cujo diagnóstico é baseado em imagem. Neste trabalho foi desenvolvido um novo tipo de fantoma computacional, baseado em modelagem 3D, que possui as vantagens apresentadas pelos fantomas computacionais tradicionais sem os problemas encontados nestes. A ferramenta de modelagem utilizada, o Blender, é disponibilizada gratuitamente na internet. A técnica utilizada foi a box modeling, que consiste na deformação de uma primitiva básica, nesse caso um cubo, até que apresente a forma da estrutura que se deseja modelar. Para tanto, foram utilizadas como referencia, imagens obtidas de atlas de anatomia e fotografias de um esqueleto fornecido pela Universidade de Mogi das Cruzes. Foram modelados o sistema ósseo, os órgãos internos e a anatomia externa do corpo humano. A metodologia empregada permitiu a alteração de parâmetros do modelo dentro da ferramenta da modelagem. Essa possibilidade foi mostrada através da variação, dos formatos do intestino e do aumento da quantidade de tecido adiposo da malha referente a pele. A simulação das imagens radiológicas foi realizada a partir de coeficientes de atenuação de massa de materiais, ossos e tecidos e de modelos com diversas características físicas. Essa versatilidade permite prever a influência que as diferenças morfométricas entre os indivíduos provocam nas imagens, propriciando dessa forma, uma ferramenta relevante complementar aos métodos de controle de qualidade tradicionais.<br>The conventional methods of quality control applied to radio diagnosis are the best way to have assured good quality of the produced images. Due the amount of variables to consider, the study of particular issues of the process of formation of radiological images requires complementary computational tools. However, the computational voxel based phantoms are not suitable to represent the morphometrical variations, intended for test simulations with image based diagnosis. This work developed a new type of computational phantom, based on 3D modelling. It has the same advantages of the conventional ones, without some of their restrictions. The modeling tool employed, Blender, is available on internet for free download. The project uses the technique called box modeling, which consists in the deformation of a primitive form (a cube, in this case) until it presents a similar form to that it is wanted to model. In order to achieve it, some images, obtained from anatomy atlas and a skeleton pictures obtained from University of Mogi das Cruzes, were used as reference. Were built models from skeletal system, internal organs and external human body anatomy. The applied methodology allowed model´s parameter settings on the modelling tool. This option was presented by means of intestine format variation and increase of adipose tissue on the mesh that represents skin. The simulation of radiological images was done by means of x-ray mass attenuation coefficients, bones and tissues and models with diferent physical characteristics. This flexibility allows the analysis and forecasting of the influences that morphometrical differences of individual implies on images, revealing an important tool that complements the conventional quality control tools.

INTRODUÇÃO: Os ligamentos mediais responsáveis pela manutenção da estabilidade da articulação patelofemoral (PF) são o ligamento patelofemoral medial (LPFM), o ligamento patelotibial medial (LPTM) e o ligamento patelomeniscal medial (LPMM). Sobre o LPFM, existem vários estudos anatômicos, radiológicos, biomecânicos, e a evolução clínica de sua lesão e reconstrução; no entanto, pouco se sabe sobre o LPTM e o LPMM. MÉTODOS: O LPFM, o LPTM e o LPMM foram dissecados em 9 joelhos. Todos os ligamentos foram enviados para avaliação histológica, corados pelo método de hematoxilina e eosina (HE), após o teste biomecânico. Foram medidos o comprimento e a largura bem como a relação das inserções com referências anatômicas (epicôndilo medial do fêmur, tubérculo dos adutores no fêmur, linha articular, tendão patelar e menisco medial). Esferas metálicas foram introduzidas nas inserções e radiografias em ântero-posterior (AP) e perfil (P) realizadas. Foram medidas as distâncias entre as inserções e as linhas de base (na tíbia, linha do planalto, borda medial do planalto e borda medial da espinha medial; e na patela, linha da cortical posterior e bordas proximal e distal da patela). Os ensaios de tração dos ligamentos foram executados em uma máquina de ensaios mecânicos KRATOS. RESULTADOS: Todos os materiais apresentaram tecido conjuntivo denso característico de tecido ligamentar. Com o estudo anatômico verificamos que o LPFM se encontrou na camada 2, com comprimento de 60.6 mm e largura de 15,3 mm no fêmur e 20,7 mm na patela. Inseriu-se entre o tubérculo dos adutores e o epicôndilo medial no fêmur e no pólo proximal da patela. O LPTM tinha um comprimento de 36,4 mm e largura de 7,1 mm. Sua inserção tibial se encontrou 13,7 mm distal a articulação e 11,6 mm medial ao tendão patelar formando um ângulo de 18,5o com este. A inserção na patela foi 3,6 mm proximal a sua borda distal. O LPMM se encontrou na camada 3 e seu comprimento foi de 33,7 mm e largura de 8,3 mm. Com uma inserção meniscal no corno anterior, 26,6 mm medial ao tendão patelar e formando ângulo com tendão patelar de 42,8o. Sobre os parâmetros radiográficos, a inserção tibial do LPTM se encontrou 9,4 mm, na incidência AP, e 13,5 mm, na incidência P, distal a articulação. Quanto ao posicionamento médio lateral a inserção se encontrou a 30% do comprimento do planalto de medial para lateral e na borda medial da espinha medial. A inserção patelar era 4,8 mm proximal a sua borda distal. Na análise biomecânica verificamos que o LPTM era mais rígido que o LPFM (médias de 17,0 N/mm versus 8,0 N/mm, respectivamente) e apresentou menor deformação no limite de resistência máxima (8,6 mm Resumo Betina Bremer Hinckel versus 19,3 mm). CONCLUSÃO: Os ligamentos foram identificados em todos os joelhos. Os parâmetros anatômicos e radiográficos das inserções foram bem definidos. Os enxertos comumente utilizados para as reconstruções ligamentares do joelho são suficientes para a reconstrução do LPFM e do LPTM<br>INTRODUCTION: The medial ligaments responsible for maintaining the stability of the patellofemoral (PF) joint are the medial patellofemoral ligament (MPFL), the medial patellotibial ligament (MPTL) and the medial patellomeniscal ligament (MPML). There are several studies on the anatomical, imaging, and biomechanical characteristics of the MPFL, and clinical outcome of its injury and reconstruction; however, little is known about the MPTL and MPML. METHODS: The MPFL, MPTL and MPML were dissected in 9 knees. All ligaments underwent histological evaluation by hematoxylin eosin stain after the biomechanical test. The length and width and the insertions relationship with anatomical references (medial epicondyle of the femur, adductor tubercle of the femur, joint line, patellar tendon and medial meniscus) were measured. Steel balls were introduced at the insertions and radiographs in anteroposterior (AP) and profile (P) views were performed. The distance between the insertions to baselines were measured (in the tibia, the plateau line, the medial plateau border and the medial border of the medial tibial spine; and in the patella the posterior cortical line and the proximal and distal patellar borders). The tensile tests of the ligaments were performed on a mechanical testing machine KRATOS. RESULTS: All materials showed dense connective tissue characteristic of ligaments. With the anatomical study we found that the MPFL was in layer 2, it has length of 60.6 mm and width of 15,3 mm in the femur and 20,7 mm in the patella. Inserting between the adductor tubercle and the medial epicondyle on the femur and in the inferior pole of the patella. The MPTL was found in layer 2, its length was 36.4 mm and width of 7.1 mm. Its tibial insertion was found 13.7 mm distal to the joint line and 11.6 mm medial to the patellar tendon at an angle of 18,5o with it. On the patella it was 3.6 mm proximal to its distal border. The MPML was in layer 3 and its length was 33.7 mm and width of 8.3 mm. The meniscal insertion was in the anterior horn, 26.6 mm medial to the patellar tendon and a 42,8o angle with it. In regards to the radiographic parameters the tibial insertion of LPTM was 9.4 mm, in the AP, and 13.5 mm, in the P, distal to the joint line. The medial lateral position was at 30% from medial to lateral on the tibial plateau and on the medial edge of the medial spine. The patellar insertion was 4.8 mm proximal to the distal border of the patella. In the biomechanical analysis we verified that the MPTL was more rigid then the MPFL (average of 17.0 N / mm versus 8.0 N / mm, respectively) and showed less deformation in the maximum tensile strength (8,6 mm versus 19,3 mm). CONCLUSION: The ligaments were identified in all knees. The anatomical and radiographic insertion parameters were well

Orientadores: Christiano de Oliveira Santos, Deborah Queiroz de Freitas França<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba<br>Made available in DSpace on 2018-08-24T14:32:39Z (GMT). No. of bitstreams: 1 Brito_AnaCarolineRamosde_M.pdf: 1219025 bytes, checksum: ef2bdb09a94a5029e24c443278f93c29 (MD5) Previous issue date: 2014<br>Resumo: Procedimentos cirúrgicos na região anterior de mandíbula estão sujeitos a hemorragias no transcirúrgico ou distúrbios sensoriais no pós-operatório. Para evitar possíveis lesões a vasos e nervos, faz-se necessário uma avaliação cuidadosa dessa região. Achados anatômicos como a alça anterior do nervo mentual (AANM) e o canal incisivo mandibular (CIM) encontram-se na região interforaminal. O objetivo deste estudo foi comparar a apresentação dessas estruturas (AANM e CIM) em radiografias panorâmicas (PAN) e tomografias computadorizadas de feixe cônico (TCFC) e determinar sua extensão anterior ao forame mentual (FM), em PAN e nas reconstruções panorâmica e parassagital da TCFC. A amostra consistiu de imagens de 91 indivíduos que possuíam PAN e TCFC. Foram consideradas as presenças da AANM e do CIM e; quando presentes, mediu-se o comprimento da extensão mesial ao FM, da AANM e/ou CIM, com diâmetro maior ou igual a 1 mm, tanto na PAN quanto na TCFC. Duas medidas mesiais ao FM foram obtidas, tendo dois planos de orientação distintos: 1) na PAN e na reconstrução panorâmica da TCFC, o plano de orientação foi a base da mandíbula; 2) o plano oclusal orientou a contagem dos cortes parassagitais da TCFC, que possuíam 0,25 mm de espessura. A análise estatística dos dados empregou os teste Kappa, ICC, McNamer Bowker, ANOVA com teste de post hoc de Tukey e teste t. Na TCFC, a prevalência da AANM chegou a 53,3% e do CIM a 58,8%. Já na PAN, a frequência de AANM chegou a 23,1% e do CIM a 19,8%. A PAN apresentou maior dificuldade de visualização para as duas estruturas. A extensão anterior ao FM dessas estruturas variou de 1,00 mm (ou 0 mm quando AANM e CIM estavam ausentes) até 19,0 mm, quando observadas na TCFC. A PAN superestimou as medidas em aproximadamente 2,0 mm em média. A grande variação das medidas demonstrou que não é possível determinar uma distância anterior ao FM segura para a instalação de implantes. Considerando as limitações da PAN, recomenda-se o uso da TCFC para avaliações pré-cirúrgicas de implantes, na região anterior de mandíbula, de forma a evitar lesões a vasos e nervos<br>Abstract: Surgical procedures in the anterior mandible are susceptible to hemorrhage or sensory disturbances in the perioperative or postoperative period. To prevent possible injuries to vessels and nerves a careful assessment of this region is necessary. Anatomical findings such as the anterior loop of the mental nerve (ALMN) and the mandibular incisive canal (MIC) are found in the interforaminal region. The aim of this study was to compare the presentation of these structures (ALMN and MIC) on panoramic radiographs (PAN) and on cone beam computed tomography (CBCT) and to determine its anterior extension to mental foramen (MF), in PAN and in both panoramic reconstructions and cross-section from CBCT exams. The sample consisted of diagnostic images of 91 individuals who had PAN and CBCT. Presence of ALMN and MIC was assessed; when present, the length of mesial extension of ALMN and/or MIC (with diameter greater than 1 mm) from the mental foramen (MF), was measured in both PAN and CBCT. Mesial extension to the MF was measured in two ways: for PAN and CBCT panoramic reconstructions, the plane of orientation was the inferior margin of the mandible; for cross-sections the occlusal plane guided the measurement. The statistical analysis employed the Kappa, ICC, McNamer Bowker, ANOVA with post hoc Tukey test and t test. On CBCT, 53.3% of the hemimandibles showed ALMN and 58.8% showed MIC. Considering PAN, the frequency of ALMN was 23.1% and 19.8% for MIC. PAN presented more difficulties for viewing both structures. The anterior extension to from the MF of these structures ranged from 1.00 mm (or 0 mm when ALMN and MIC were absent) to 19.00 mm, when observed in CBCT. PAN overestimated the measurements by approximately 2.0 mm on average. The measurements showed that it is not possible to determine a safe mesial distance from the MF for implant placement. Considering the limitations of PAN, it is recommended the use of CBCT for pre-surgical assessments of implants in the anterior region of the mandible to avoid potential sensory and hemorrhagic complications<br>Mestrado<br>Radiologia Odontologica<br>Mestra em Radiologia Odontológica

Os dentes incisivos inferiores apresentam, em sua maioria, canal radicular único, que pode ter conformações distintas. De acordo com a literatura científica, a presença de um segundo canal radicular pode ser constatada em 10 a 40% dos casos. A não-detecção do segundo canal é um importante fator para o insucesso do tratamento endodôntico. Esta pesquisa foi realizada com os seguintes objetivos: 1) comparar a eficácia na identificação de padrões anatômicos internos em incisivos inferiores permanentes extraídos com uso de imagem radiográfica periapical digital e de tomografia computadorizada de feixe cônico (TCFC); e 2) determinar a prevalência de 2 canais radiculares em incisivos inferiores em imagens de TCFC de um banco de dados de exames previamente realizados, associando com localização do dente, gênero e idade do paciente. Na primeira etapa da pesquisa, 40 dentes incisivos inferiores foram submetidos a escaneamento em microtomógrafo computadorizado da FOB-USP (Skyscan 1074) para estabelecer o padrão ouro do tipo anatômico interno de cada dente. Os dentes foram então classificados em: Tipo I (1 canal radicular regular, n=12), Tipo Ia (1 canal radicular oval, n=12) e Tipo III (2 canais radiculares, n=16). Em seguida, os dentes foram divididos em 10 grupos de 4 dentes e posicionados em alvéolos de uma mandíbula humana para exposição radiográfica periapical digital direta com duas tomadas variando o ângulo horizontal de incidência (Schick CDR) e para escaneamento em 3 tomógrafos (Kodak 9000 3D, Veraviewepocs 3De e NewTom 5G) da Universidade de Loma Linda, CA, EUA. Dois examinadores treinados classificaram o tipo anatômico de cada dente e suas respostas foram comparadas ao padrão ouro estabelecido por microtomografia. Para descrição dos resultados, utilizou-se a porcentagem (%) de respostas certas / erradas. Aplicou-se o teste do qui-quadrado (X2), com nível de significância estatística de 5%, para verificação da associação entre variáveis. As concordâncias inter e intraexaminador foram determinadas por teste de kappa. Na segunda etapa da pesquisa, foram interpretadas imagens de incisivos inferiores de 100 pacientes, cujos exames estavam disponíveis no banco de dados do tomógrafo i-CAT Classic da FOB-USP. Dois examinadores avaliaram a anatomia interna de incisivos inferiores, em reconstruções axiais, sagitais e coronais, classificando-a de acordo com o número de canais radiculares. A prevalência de 2 canais radiculares foi relacionada à localização do dente e ao gênero e idade do paciente. Para descrição dos dados coletados, utilizou-se a porcentagem (%). Para verificar a associação entre variáveis, utilizou-se o teste do qui-quadrado (X2), com nível de significância estatística de 5%. Para a concordância intra e interexaminador, utilizou-se o teste de kappa. Como resultado da primeira etapa da pesquisa, obteve-se alto índice de detecção de tipos anatômicos para todos os métodos avaliados (p <0,05). Para dentes com Tipo I (1 canal radicular regular), as imagens de TCFC foram superiores em comparação à radiografia periapical digital com dupla exposição (RP= 67% de acerto; TCFC= 98% de acerto, p <0,05). Considerando os 3 aparelhos de TCFC, não houve diferença estatística significante entre eles para identificação do Tipo I. Já para dentes com Tipo Ia (1 canal radicular oval), houve diferença estatística significante somente entre radiografia periapical digital com dupla exposição e o tomógrafo NewTom (RP= 44% de acerto; TCFC NewTom= 88% de acerto). Não houve diferença significante entre os outros 2 tomógrafos e radiografia periapical ou entre os 3 tomógrafos. Considerando dentes com Tipo III (2 canais radiculares), não houve diferença estatística significante entre nenhum dos métodos. Todos os métodos apresentaram números de respostas certas semelhantes para o Tipo III, sugerindo que a radiografia periapical com dupla angulação é suficiente para identificação de 2 canais radiculares em incisivos inferiores. A concordância intraexaminador para radiografia periapical foi regular (kappa=0,40 a 0,66) e de boa a excelente para os aparelhos de TCFC (kappa=0,62 a 0,85). A concordância interexaminador para radiografia periapical foi de ruim a regular (kappa=0,25 a 0,32) e de boa a excelente para os aparelhos de TCFC (kappa=0,62 a 0,92). Na segunda etapa da pesquisa, o total de 386 incisivos inferiores foi avaliado, sendo 192 incisivos centrais e 194 incisivos laterais. A prevalência de 2 canais radiculares constatada no total de dentes foi de 16,5%, sendo de 13% em incisivos centrais e de 20% nos incisivos laterais (p >0,05). Não houve diferença estatisticamente significante entre gêneros e idades. A concordância intra e interexaminador foi regular (kappa intra=0,60; kappa inter=0,57). Como conclusão da primeira etapa da pesquisa, observou-se que a identificação do número de canais radiculares foi efetiva em todos os métodos. No entanto, limitações foram encontradas para a diferenciação da forma do canal radicular. Na segunda etapa da pesquisa, concluiuse que a presença de 2 canais radiculares em incisivos inferiores de pacientes da região de Bauru é de aproximadamente 20% e não depende da localização do dente ou de gênero e idade do paciente.<br>Mandibular incisors most commonly have a single root canal, which can present with different anatomic configurations. According to the literature, the presence of a second root canal can be observed in 10 - 40% of the teeth. Difficulty in detecting the second root canal is an important factor for the endodontic treatment failure. The aim of this research was: 1) to compare the efficacy of digital periapical radiography (PA) with double exposure and cone beam computed tomography (CBCT) in the identification of internal anatomic patterns in mandibular incisors, and 2) to determine the prevalence of 2 root canals in mandibular incisors using cone beam computed tomographic images of a patient database, comparing to tooth position and patients gender and age. In the first part of this research, 40 extracted mandibular incisors underwent microcomputed tomographic (micro-CT) scanning (Skyscan 1074) in order to establish the gold standard for internal anatomic pattern. The teeth were classified according to: Type I (1 regular root canal, n=12), Type Ia (1 oval root canal, n=12), and Type III (2 root canals, n=16). Then, the teeth were divided into 10 groups of 4 teeth and placed in a preserved human mandible for direct digital periapical radiographic double exposure (Schick CDR) and CBCT scans using Kodak 9000 3D, Veraviewepocs 3De and NewTom 5G. Two blinded examiners classified the anatomic pattern of each tooth and their answers were compared to the gold standard (microtomographic images). Percentage (%) of right / wrong answers was used for the statistical analysis of the results. Chi-square test (X2) was used to verify the association between variables (p <.05). Inter and intraexaminer agreements were determined using kappa values. In the second part of this research, CBCT images of a 100 patients database from FOB-USP were examined. Two examiners assessed the internal anatomy of mandibular incisors in axial, sagittal and coronal reconstructions and classified the teeth according to the number of root canals. The prevalence of 2 root canals was related to the tooth location and patients gender and age. Percentage (%) was used to describe the collected data. Chi-square test (X2) was used to verify the association between variables (p <.05). Inter and intraexaminer agreements were determined using kappa values. The results of the first part of the research showed a high level of identification of anatomic patterns for all the methods (p <0.05). Considering Type I (1 regular root canal), CBCT images were better in comparison to PA (PA= 67%; CBCT= 98%, p <0.05). There was no significant difference between the 3 CBCT scanners. For Type Ia (1 oval root canal), there was a significant difference between PA and CBCT imaging using the NewTom unit only (PA= 44%, NewTom CBCT= 88%). No significant differences were found between the other 2 CBCT units and PA or between the 3 CBCT units. Considering Type III (2 root canals), there was no significant difference between the various methods. All the methods presented similar corrected answers index for Type III, which may suggest that PA with double exposure is sufficient for the identification of 2 root canals in mandibular incisors. The intraexaminer agreement was fair for PA (kappa=0.40 to 0.66) and good to very good for the CBCT units (kappa=0.62 to 0.85). The interexaminer agreement was poor to fair for PA (kappa=0.25 to 0.32) and good to very good for CBCT units (kappa=0.62 to 0.92). In the second part of this research, the total amount of 386 mandibular incisors was assessed in CBCT images (192 mandibular central incisors and 194 mandibular lateral incisors). The overall prevalence of 2 root canals was 16.5%, and 13% in mandibular central incisors and 20% in mandibular lateral incisors (p >0.05). There was no significant difference between gender and age. The intra and interexaminer agreement was fair (kappa intra=0.60; kappa inter=0.57). For the first part of this research, it is possible to conclude that the identification of the number of root canals was effective using all the methods. However, limitations were found in differentiating the shape of the root canal. As a conclusion of the second part of this research, the presence of 2 root canals in mandibular incisors of Bauru region patients is approximately 20% and it does not depend on tooth location or patients gender and age.

La present tesi doctoral s’ha centrat en el repte d’aconseguir, mitjançant Fabricació Additiva (FA), models per a assaig quirúrgic, sota la premissa que els equips per fer-los haurien de ser accessibles a l’àmbit hospitalari. L’objectiu és facilitar l’extensió de l’ús dels prototips com a eina de preparació d’operacions quirúrgiques, transformant la pràctica mèdica actual de la mateixa manera que en el seu moment ho van fer tecnologies com les que van facilitar l’ús de radiografies. El motiu d’utilitzar FA, en lloc de tecnologies més tradicionals, és la seva capacitat de materialitzar de forma directa les dades digitals obtingudes de l’anatomia del pacient mitjançant sistemes d’escanejat tridimensional, fent possible l’obtenció de models personalitzats. Els resultats es centren en la generació de nou coneixement sobre com aconseguir equipaments d’impressió 3D multimaterials accessibles que permetin l’obtenció de models mimètics respecte als teixits vius. Per facilitar aquesta buscada extensió de la tecnologia, s’ha focalitzat en les tecnologies de codi obert com la Fabricació per Filament Fos (FFF) i similars basades en líquids catalitzables. La recerca s’alinea dins l’activitat de desenvolupament de la FA al CIM UPC, i en aquest àmbit concret amb la col·laboració amb l’Hospital Sant Joan de Déu de Barcelona (HSJD). El primer bloc de la tesi inclou la descripció de l’estat de l’art, detallant les tecnologies existents i la seva aplicació a l’entorn mèdic. S’han establert per primer cop unes bases de caracterització dels teixits vius -sobretot tous- per donar suport a la selecció de materials que els puguin mimetitzar en un procés de FA, a efectes de millorar l’experiència d’assaig dels cirurgians. El caràcter rígid dels materials majoritàriament usats en impressió 3D els fa poc útils per simular tumors i altres referències anatòmiques. De forma successiva, es tracten paràmetres com la densitat, la viscoelasticitat, la caracterització dels materials tous a la indústria, l’estudi del mòdul elàstic de teixits tous i vasos, la duresa d’aquests, i requeriments com l’esterilització dels models. El segon bloc comença explorant la impressió 3D mitjançant FFF. Es classifiquen les variants del procés des del punt de vista de la multimaterialitat, essencial per fer models d’assaig quirúrgic, diferenciant entre solucions multibroquet i de barreja al capçal. S’ha inclòs l’estudi de materials (filaments i líquids) que serien més útils per mimetitzar teixits tous. Es constata com en els líquids, en comparació amb els filaments, la complexitat del treball en processos de FA és més elevada, i es determinen formes d’imprimir materials molt tous. Per acabar, s’exposen sis casos reals de col·laboració amb l’HJSD, una selecció d’aquells en els que el doctorand ha intervingut en els darrers anys. L’origen es troba en la dificultat de l’abordatge d’operacions de resecció de tumors infantils com el neuroblastoma, i a la iniciativa del Dr. Lucas Krauel. Finalment, el Bloc 3 té per objecte explorar nombrosos conceptes (fins a 8), activitat completada al llarg dels darrers cinc anys amb el suport dels mitjans del CIM UPC i de l’activitat associada a treballs finals d’estudis d’estudiants de la UPC, arribant-se a materialitzar equipaments experimentals per validar-los. La recerca ampla i sistemàtica al respecte fa que s’estigui més a prop de disposar d’una solució d’impressió 3D multimaterial de sobretaula. Es determina que la millor via de progrés és la de disposar d’una pluralitat de capçals independents a fi de capacitar la impressora 3D per integrar diversos conceptes estudiats, materialitzant-se una possible solució. Cloent la tesi, es planteja com seria un equipament d’impressió 3D per a models d’assaig quirúrgic, a fi de servir de base per a futurs desenvolupaments.<br>La presente tesis doctoral se ha centrado en el reto de conseguir, mediante Fabricación Aditiva (FA), modelos para ensayo quirúrgico, bajo la premisa que los equipos para obtenerlos tendrían que ser accesibles al ámbito hospitalario. El objetivo es facilitar la extensión del uso de modelos como herramienta de preparación de operaciones quirúrgicas, transformando la práctica médica actual de la misma manera que, en su momento, lo hicieron tecnologías como las que facilitaron el uso de radiografías. El motivo de utilizar FA, en lugar de tecnologías más tradicionales, es su capacidad de materializar de forma directa los datos digitales obtenidos de la anatomía del paciente mediante sistemas de escaneado tridimensional, haciendo posible la obtención de modelos personalizados. Los resultados se centran en la generación de nuevo conocimiento para conseguir equipamientos de impresión 3D multimateriales accesibles que permitan la obtención de modelos miméticos respecto a los tejidos vivos. Para facilitar la buscada extensión de la tecnología, se ha focalizado en las tecnologías de código abierto como la Fabricación por Hilo Fundido (FFF) y similares basadas en líquidos catalizables. Esta investigación se alinea dentro de la actividad de desarrollo de la FA en el CIM UPC, y en este ámbito concreto con la colaboración con el Hospital Sant Joan de Déu de Barcelona (HSJD). El primer bloque de la tesis incluye la descripción del estado del arte, detallando las tecnologías existentes y su aplicación al entorno médico. Se han establecido por primera vez unas bases de caracterización de los tejidos vivos – principalmente blandos – para dar apoyo a la selección de materiales que los puedan mimetizar en un proceso de FA, a efectos de mejorar la experiencia de ensayo de los cirujanos. El carácter rígido de los materiales mayoritariamente usados en impresión 3D los hace poco útiles para simular tumores y otras referencias anatómicas. De forma sucesiva, se tratan parámetros como la densidad, la viscoelasticidad, la caracterización de materiales blandos en la industria, el estudio del módulo elástico de tejidos blandos y vasos, la dureza de los mismos, y requerimientos como la esterilización de los modelos. El segundo bloque empieza explorando la impresión 3D mediante FFF. Se clasifican las variantes del proceso desde el punto de vista de la multimaterialidad, esencial para hacer modelos de ensayo quirúrgico, diferenciando entre soluciones multiboquilla y de mezcla en el cabezal. Se ha incluido el estudio de materiales (filamentos y líquidos) que serían más útiles para mimetizar tejidos blandos. Se constata como en los líquidos, en comparación con los filamentos, la complejidad del trabajo en procesos de FA es más elevada, y se determinan formas de imprimir materiales muy blandos. Para acabar, se exponen seis casos reales de colaboración con el HJSD, una selección de aquellos en los que el doctorando ha intervenido en los últimos años. El origen se encuentra en la dificultad del abordaje de operaciones de resección de tumores infantiles como el neuroblastoma, y en la iniciativa del Dr. Lucas Krauel. Finalmente, el Bloque 3 desarrolla numerosos conceptos (hasta 8), actividad completada a lo largo de los últimos cinco años con el apoyo de los medios del CIM UPC y de la actividad asociada a trabajos finales de estudios de estudiantes de la UPC, llegándose a materializar equipamientos experimentales para validarlos. La investigación amplia y sistemática al respecto hace que se esté más cerca de disponer de una solución de impresión 3D multimaterial de sobremesa. Se determina que la mejor vía de progreso es la de disponer de una pluralidad de cabezales independientes, a fin de capacitar la impresora 3D para integrar diversos conceptos estudiados, materializándose una posible solución. Para cerrar la tesis, se plantea cómo sería un equipamiento de impresión 3D para modelos de ensayo quirúrgico, a fin de servir de base para futuros desarrollos.

Yes<br>Objectives: Pelvis radiographs are usually acquired supine despite standing imaging reflecting functional anatomy. We compared supine and erect radiographic examinations for anatomical features, radiation dose and image quality. Methods: 60 patients underwent pelvis radiography in both supine and erect positions at the same examination appointment. Measures of body mass index and sagittal diameter were obtained. Images were evaluated using visual grading analysis and pelvic tilt was compared. Dose–area product values were recorded and inputted into the CalDose_X software to estimate effective dose (ED). The CalDose_X software allowed comparisons using data from the erect and supine sex-specific phantoms (MAX06 & FAX06). Results: Patient sagittal diameter was greater on standing with an average 20.6% increase at the iliac crest (median 30.0, interquartile range [26.0 to 34.0] cm), in comparison to the supine position [24.0 (22.3 to 28.0) cm; p < 0.001]. 57 (95%) patients had posterior pelvic tilt on weight-bearing. Erect image quality was significantly decreased with median image quality scores of 78% (69 to 85) compared to 87% for the supine position [81 to 91] (p < 0.001). In the erect position, the ED was 47% higher [0.17 (0.13 to 0.33) mSv vs 0.12 (0.08 to 0.18) mSv (p < 0.001)], influenced by the increased sagittal diameter. 42 (70%) patients preferred the standing examination. Conclusion: Patient diameter and pelvic tilt were altered on weightbearing. Erect images demonstrated an overall decrease in image quality with a higher radiation dose. Optimal acquisition parameters are required for erect pelvis radiography as the supine technique is not directly transferable.<br>College of Radiographers Industry Partnership Scheme grant.

L'un des principaux défis de l'interprétation radiographique réside dans la compréhension de l’anatomie radiographique, laquelle est intrinsèquement liée à la disposition tridimensionnelle des structures anatomiques et à l’impact du positionnement du tube radiogène vis-à-vis de ces structures lors de l'acquisition de l'image. Traditionnellement, des radiographies obtenues selon des projections standard sont employées pour enseigner l'anatomie radiographique en médecine vétérinaire. La tomodensitométrie − ou communément appelée CT (Computed Tomography) − partage plusieurs des caractéristiques de la radiographie en ce qui a trait à la génération des images. À l’aide d'un plug-in spécialement développé (ORS Visual ©), la matrice contenant les images CT est déformée pour reproduire les effets géométriques propres au positionnement du tube et du détecteur vis-à-vis du patient radiographié, tout particulièrement les effets de magnification et de distorsion. Afin d'évaluer le rendu des images simulées, différentes régions corporelles ont été imagées au CT chez deux chiens, un chat et un cheval, avant d'être radiographiées suivant des protocoles d'examens standards. Pour valider le potentiel éducatif des simulations, dix radiologistes certifiés ont comparé à l'aveugle neuf séries d'images radiographiques simulées aux séries radiographiques standard. Plusieurs critères ont été évalués, soient le grade de visualisation des marqueurs anatomiques, le réalisme et la qualité radiographique des images, le positionnement du patient et le potentiel éducatif de celles-ci pour différents niveaux de formation vétérinaire. Les résultats généraux indiquent que les images radiographiques simulées à partir de ce modèle sont suffisamment représentatives de la réalité pour être employées dans l’enseignement de l’anatomie radiographique en médecine vétérinaire.<br>Understanding radiographic anatomy, which is intimately linked to the comprehension of tridimensional anatomy and the impact of patient, radiographic tube and x-ray detector positioning, represents a challenge for students. Traditionally, radiographs obtained under specific angles of projection have been used for teaching radiographic anatomy. Computed tomography (CT) shares several features with radiography with regard to image production. A plug-in was developed for a DICOM viewer (ORS visual ©) simulating radiographs using CT datasets. This plug-in distorts the CT image matrix to reproduce the magnification and distortion effects that take place in radiographs due to the variations in radiographic tube, patient and detector positioning and angulation. In order to test this model, specific body parts of two dogs, one cat and one horse were radiographed and CT-scanned. The CT datasets were used to generate a total of nine series of radiographic simulations that could be compared to corresponding standard radiographic projections. Ten board-certified veterinary radiologists blindly scored several parameters in these image series, including the visualization of specific anatomical landmarks, image realism and quality, patient positioning, and the educational potential for students and veterinarians of variable degree of veterinary training Overall results indicate that simulated radiographs are representative enough to be used to teach several concepts of image formation and radiographic anatomy in veterinary radiology.

Thesis (M.Tech.: Chiropractic)-Durban University of Technology, 2008<br>To evaluate the lumbar lordosis, lumbosacral angle, lumbosacral disc angle, lumbosacral lordosis angle, intervertebral disc angles and heights, interpedicular distances, sagittal canal diameters and the lumbar gravity line (selected radiographic parameters) in young to middle aged Indian females in Durban. To determine any association between the selected radiographic parameters and the age of the subjects, weight, height and body mass index of the subjects, occupation, smoking, previous pregnancy and leg length inequality (selected anthropometric and demographic factors). Methods: Sixty healthy, asymptomatic, young to middle aged, Indian females were recruited for this study. All subjects underwent a case history, a physical examination and radiographic evaluation (AP and lateral views) of the lumbar spine. SPSS version 15.0 (SPSS Inc., Chicago, Ill, USA) was used to analyze the data. Results: The mean (± SD) of the lumbar lordosis, lumbosacral angle, lumbosacral disc angle and lumbosacral lordosis angle was 49º (± 6º), 39º (± 8º), 12º (± 5º) and 143.2º (± 5º) respectively. For the lumbar intervertebral disc angles at L1-L2, L2-L3, L3-L4, L4-L5 and L5- S1 levels, the mean (± SD) was 6º (± 2º), 8º (± 2º), 10º (± 3º), 12º (± 4º) and 12º (± 5º) respectively. The anterior and posterior intervertebral disc heights at the respective vertebral levels were: L1-L2: anterior: 8 mm (± 2), posterior 5 mm (± 2); L2-L3: anterior: 10 mm (± 2), posterior 5 mm (± 2); L3-L4: anterior: 12 mm (± 2), posterior 5 mm (± 2); L4-L5: anterior: 14 mm (± 3), posterior 5 mm (± 2) and L5-S1: anterior: 13 mm (± 4), posterior 6 mm (± 2). The mean (± SD) of the interpedicular distance at the L1, L2, L3, L4 and L5 vertebral levels was 23 mm (± 2), 24 mm (± 2), 25 mm (± 2), 27 mm (± 2) and 31 mm (± 3) respectively. For the sagittal canal diameter at the L1, L2, L3, L4 and L5 vertebral levels, the mean (± SD) was 20 mm (± 5), 21 mm (± 3), 21 mm (± 3), 21 mm (± 3) and 19 mm (± 3) respectively. The lumbar gravity line intersected the sacrum in 67.3% of the subjects. In 29.1% of the subjects, the lumbar gravity line passed anterior to the sacrum while in 3.6% of the subjects, it passed posterior to the sacrum. iv A significant association was found between lumbar lordosis and the height of the subjects in this study (p = 0.004). A decrease in the intervertebral disc height at L5-S1 was associated with smoking (p = 0.005). A decrease in the intervertebral disc height at L4-L5 was associated with previous pregnancy (p = 0.016). Body mass index of 26–30 kg.m-2 was significantly associated with an increase in the intervertebral disc angles at L3-L4 (p = 0.028) and L4-L5 (p = 0.031). A decrease in the L5-S1 intervertebral disc angle was also significantly associated with smoking (p = 0.023). There was a significant association between previous pregnancy and an increase in the intervertebral disc angle at L3-L4 (p = 0.016). A significant association was found between the age of the subjects and the L5-S1 intervertebral disc angle (p = 0.007). Specifically it was the 23–27 year group and 33–37 year group who were significantly different from each other (p = 0.033). Conclusion: Similarities and differences were found in the mean values of the radiographic parameters measured in this study and those reported in the literature. A number of the selected anthropometric and demographic factors were associated with some of the lumbar radiographic parameters. Further studies are required to establish the clinical significance of these findings.

The red panda and ring-tailed lemur are species, which are commonly kept in zoological gardens. The red panda and ring-tailed lemur are classified as vulnerable and endangered, respectively, by the International Union for Conservation of Nature and Natural Resources. The aim of this study was to describe the normal radiographic thoracic anatomy, radiographic and ultrasonographic abdominal anatomy as well as the normal morphology of the pelvis, thoracic and hind limb in captive red pandas and ring-tailed lemurs as a reference for clinical use. Radiography and ultrasonography were performed in adult captive red pandas and ring-tailed lemurs during annual health examinations. Bone specimens of adult red pandas and ring-tailed lemurs were used for gross osteological study. The morphology of the pelvis, thoracic and hind limb of the red panda and ring-tailed lemur supported the presence of strong flexor and supinator muscles and flexibility of limb joints, which are important in arboreal quadrupedal locomotion. However, the scapula of the ring-tailed lemur is modified for both arboreal and terrestrial quadrupedal locomotion. Additionally, the morphology of the pelvis and hind limb of the ring-tailed lemur showed locomotor adaptation for jumping. Normal radiographic and ultrasonographic reference ranges for thoracic structures and abdominal organs were established and ratios were calculated. Knowledge of the normal morphology, radiographic and ultrasonographic anatomy of the red panda and ring-tailed lemur should prove useful in the diagnosis of diseases and for routine health examinations.<br>Thesis (PhD)--University of Pretoria, 2015.<br>tm2016<br>Anatomy and Physiology<br>PhD<br>Unrestricted

Indiana University-Purdue University Indianapolis (IUPUI)<br>Accurate determination of working length during endodontic therapy is critical in achieving a predictable and successful outcome. Working length is determined by the use of electronic apex locators, tactile perception, knowledge of average tooth lengths and dental radiography. Due to the increasing use of digital radiography in clinical practice, a comparison with conventional film in working length determination is justified. The purpose of this study is to determine if there is a difference between Schick digital radiography and Kodak Ultra-speed film in the accurate determination of working lengths when vertical angulation of the object is variable. Twelve teeth with #15 K-flex files at varying known lengths from the anatomical apex were mounted in a resin-plaster mix to simulate bone density. A mounting jig for the standardization of projection geometries allowed for exact changes in vertical angulation as it related to the object (tooth) and the film/sensor. Each tooth was imaged using Schick CDR and Kodak Ultra-speed film at varying angles with a consistent source-film distance and exposure time. Four dental professionals examined the images and films independently and measured the distance from the tip of the file to radiographic apex and recorded their results. The error in working length was calculated as the observed value minus the known working length for each tooth type. A mixed-effects, full-factorial analysis of variance (ANOVA) model was used to model the error in working length. Included in the ANOVA model were fixed effects for type of image, vertical angulation, and the interaction of angle and film type. Tooth type and examiner were included in the model as random effects assuming a compound symmetry covariance structure. The repeatability of each examiner, for each film type, was assessed by estimating the intra-class correlation coefficient (ICC). The ICC was determined when 12 randomly selected images and radiographs were reevaluated 10 days after initial measurements. The repeatability of each examiner for Schick CDR was good with ICCs ranging from 0.67 to 1.0. Repeatability for the conventional film was poor with ICCs varying from -0.29 to 0.55. We found the error in the working length was not significantly different between film types (p = 0.402). After adjusting for angle, we found that error in the working length from the digital image was only 0.02 mm greater (95-percent CI: -0.03, 0.06) than the conventional film. Furthermore, there was not a significant difference among the angles (p = 0.246) nor in the interaction of image type with angle (p = 0.149). Based on the results of our study, we conclude that there is not a statistically significant difference in determining working length between Schick CDR and Kodak Ektaspeed film when vertical angulation is modified.

碩士<br>高雄醫學院<br>牙醫學研究所<br>86<br>The mandibular second molar has many root canal varition, and theC-shaped root canal is the most interesting one. Although the reportedincidence of the C-shaped canal in the mandibular second molar is 32.9%in Chinese, the criteria for its recognition, particularly clinically, are ambuguous. To data, there has been no morphological or radiographic examinations of the C-shaped root in mandibular second molar. The purpose of this study was to use two different methods of evaluation to study this specific canal variation. Total 100 extracted human mandibularsecond molars with C-shaped root were classified and prepared as theaccess opening. After the radiographic examination at two direction withfile negotiated the canal, the teeth were dimineralized and rendedtransparent by clearing agent. Ink was injected to canal system todetermine the root canal morphology. The results illustrated that C-shapedcanals in mandibular second molars with C-shaped roots can vary innumber and shape. Five types of C-shaped root was established. Eighty- nine percent of the C-shaped teeth have continuous C or semicolon pulp chamber floor configuration. Thirty-two percent of the samples havesemicolon canal, and contiunous C type existed twenty-six percentage.Thirty-nine percent of the C- shaped teeth without C-shaped orifice examined were found to have C-shaped canal.Fifty-six percent of thesamples displayed two apical foramen. The radiographic examinationcannotbe the guide alone for the diagonsis of C-shaped canals.

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina<br>Introdução: Uma das complicações após a reconstrução do ligamento cruzado anterior (LCA) é a rotura da plastia, sendo a causa mais comum o erro técnico do cirurgião. O presente trabalho estudou retrospetivamente os doentes que foram sujeitos a cirurgia iterativa e determinou se existiram fatores preditivos de risco acrescentado relativamente à plastia de revisão.Métodos: Foi utilizada uma coorte de doentes, todos operados pelo mesmo cirurgião, onde se identificaram os casos que foram submetidos a cirurgia iterativa. Numa segunda fase a coorte de doentes foi dividida em duas consoante tivesses existido ou não cirurgia iterativa. A avaliação foi feita de acordo com a base de dados clínicos do cirurgião. Procedeu-se à avaliação radiográfica de todos os doentes, determinando no pré-operatório o grau de artrose pela classificação de Ahlback, o eixo epifisário de Dejour e Levigne, a inclinação tibial,identificação da linha de Blumensaat, avaliação da sua morfologia e determinação da báscula epifisária femoral (BEF). No pós-operatório, determinou-se o posicionamento da plastia no fémur e na tíbia, de acordo com o método descrito por Dejour modificado por Fonseca, oângulo da plastia com a interlinha na radiografia de face e a convergência dos túneis.Resultados: Radiograficamente, o valor da BEF foi 36,14 ± 3,92º e o posicionamento femoral no perfil foi 18,13 ± 7,10%. De acordo com as zonas descritas por Fonseca, 95,24% dos doentes tinham o túnel femoral posicionado na ZF1 (16,78 ± 3,3%), enquanto quatro casos tinham o seu posicionamento na ZF2 (45,10 ± 9,31%), diferença que foi estatisticamente significativa (p=0,0001). Os fatores que constituíram relevância estatisticamente significativa foram a BEF (32,82 ± 1,17° casos de cirurgia e 36,64 ± 3,94° casos sem cirurgia iterativa –p=0,002), o posicionamento da plastia no fémur (27,42 ± 15,24% casos de cirurgia e 16,74 ±3,28% casos sem cirurgia iterativa – p=0,03) e o posicionamento da plastia na tíbia – incidência de perfil (46,06 ± 4,92% casos de cirurgia e 44,00 ± 3,00% casos sem cirurgia iterativa – p=0,02).Discussão: Verificou-se que o posicionamento mais anterior da plastia femoral associado a valores inferiores da BEF revelou risco acrescido de cirurgia iterativa pela tensão acrescida exercida no enxerto pelo aumento do conflito com o teto da chanfradura o que consequentemente pode levar a instabilidade e rotura.Conclusão: Foi demonstrado que existe uma correlação inversa entre a BEF e o posicionamento da plastia femoral, através do teste de correlação de Pearson. Não se verificou correlação com o posicionamento tibial.<br>Introduction: One of the complications after anterior cruciate ligament (ACL) reconstructionis tear of the plasty which is mostly caused by technical error. The present study studied retrospectively patients who underwent iterative surgery and determined if there was any predictive risk regarding plasty revision.Methods: A cohort of patients, whom were all operated by the same surgeon, was used to identify cases that underwent iterative surgery. In a second phase the cohort was divided in two whether there was iterative surgery or not. The evaluation was done in consensus with therecords existing in the clinical database. In preoperative time, according with the radiographs, was determined the degree of arthrosis by Ahlback classification, the Dejour and Levigne epiphyseal axis, the tibial inclination, the Blumensaat line, the evaluation of its morphology and determination of the femoral epiphysial scale. In the postoperative, the positioning of the plasty in the femur and the tibia was determined according to the method described by Dejour modified by Fonseca, the angle of the plasty with the articular interline and the tunnelconvergence.Results: Radiographically, the value of the femoral epiphyseal scale was 36.14 ± 3.92º and femoral positioning in profile was 18.13 ± 7.10%. According to the zones described byFonseca, 95.24% of the patients had the femoral tunnel positioned in ZF1 (16.78 ± 3.3%) while four cases had their position in ZF2 (45.10 ± 9.31%), difference that was statistically significant (p=0.0001). Statistically significant factors were femoral epiphysial scale (32.82 ±1.17° cases of surgery and 36.64 ± 3.94° cases without iterative surgery – p=0.002), position of the plasty in the femur (27.42 ± 15.24% cases of surgery and 16.74 ± 3.28% cases without iterative surgery – p=0.03) and positioning of the plasty in the tibia – profile incidence (46.06± 4.92% surgery cases and 44.00 ± 3.00% cases without iterative surgery – p=0.02).Discussion: It was verified that the anterior positioning of the femoral plasty combined with inferior values of the femoral epiphyseal scales revealed an increased risk of iterative surgery due to increased tension on the graft once it origins a bigger conflict between the bevelingceiling which may lead to instability and rupture.Conclusion: It was demonstrated that exists an inverse correlation between the femoral epiphysial scale and the positioning of the femoral plasty through the Pearson correlation test. Regarding tibial positioning no correlation was found.

Introdução: Um correto tratamento endodôntico depende não só da destreza e técnica do Médico Dentista, mas também do conhecimento científico anatómico de todos os diferentes tipos de dentes. Objetivo e Metodologia: Será feita uma revisão bibliográfica narrativa sobre as suas principais caraterísticas anatómicas e métodos de estudo da anatomia do primeiro molar inferior, bem como as suas variações anatómicas, quer ao nível das raízes, quer ao nível do sistema de canais radiculares. Sendo, um dos dentes com maior incidência de tratamento endodôntico, torna-se essencial possuir um grande conhecimento da sua anatomia interna e externa, aumentando assim a eficácia do seu tratamento e diminuindo o risco de iatrogenia. Conclusões: É imperativo o conhecimento anatómico interno e externo do primeiro molar mandibular, bem como da sua abordagem terapêutica otimizando assim o sucesso endodôntico.<br>Introduction: The correct endodontic treatment depends not only on the skill and technique of the dentist, but also on the anatomical scientific knowledge of all different types of teeth. Objective and Methodology: A narrative bibliographic review will be done on the main anatomical characteristics and methods of study of the anatomy of the first mandibular molar, as well as their anatomical variations, both at the root level and at the level of the root canal system. Being one of the teeth with the highest incidence of endodontic treatment, it is essential to have a great knowledge of its internal and external anatomy, thus increasing the effectiveness of its treatment and reducing the iatrogenic risks. Conclusions: The internal and external anatomical knowledge of the first mandibular molar is imperative, as well as its therapeutic approach, thus optimizing endodontic success.

Indiana University-Purdue University Indianapolis (IUPUI)<br>Introduction: During root canal treatment (RCT), an opening is made through the crown of the tooth to access and to disinfect the root canal system (RCS). Traditional endodontic access (TEA) may sacrifice tooth structure and weaken the tooth. Cone beam computed tomography (CBCT) provides information about the exact location of the root canals. This information can be used for the design of a canal-directed endodontic access (CDEA). It may also be used for the 3D printing of an acrylic endodontic stent that could help to create a conservative CDEA. Objective: 1) Evaluate the ability of the Dolphin 3D imaging software to assist in creating a CDEA; 2) Compare tooth structure loss in a CDEA to that in a TEA by measuring the volume of remaining tooth structure, surface area of the access opening at the occlusal, and remaining dentin thickness at the CEJ. Materials and Methods: Thirty extracted human mandibular premolars were used. Teeth with large, wide canals were excluded. CBCT images will be taken for all teeth using Kodak 9000. Fifteen teeth were randomly assigned to the TEA group and 15 teeth were assigned to the CDEA group. The CDEA path was mapped using Dolphin 3D imaging software. Acrylic access stents were designed using Rhino 3D software and printed using a 3D printer. The teeth were accessed through the corresponding stents. The 15 teeth that are part of the traditional access group were accessed without a stent. A CBCT scan was taken post-access for all 30 teeth. Wilcoxon Rank Sum Tests were performed to compare the following outcomes for the two groups: the volume of remaining tooth structure, the surface area of the access opening at the occlusal, and remaining dentin thickness at the CEJ. Results: The remaining dentin thickness (percent loss) was not significantly larger for TEA than for CDEA. The surface area (post-treatment) was significantly larger for TEA than for CDEA, and volume (percent loss) was significantly larger for TEA than for CDEA. Conclusion: The use of the CBCT and Dolphin 3D imaging provided an accurate and more conservative CDEA with the guide of an acrylic stent.