Explore the vast range of titles available.

Objectives As a new pelvic fixation technique, the dual S2AI screws fixation technique could provide highly stable distal strength, and have wide clinical prospect in the correction of severe kyphoscoliosis. However, the ideal trajectory parameters, indications and clinical outcomes of this technique have not been reported so far. This study aimed to determine the anatomical parameters of dual S2AI screws in the normal Chinese adult population, investigating the indications of this technique and evaluating the feasibility and clinical outcomes. Methods Fifteen males and 15 females with normal pelvis underwent a pelvic CT scan to determine ideal dual S2AI screws trajectories. Sagittal angle (SA), transverse angle (TA), maximal length (ML), sacral length, and skin distance were measured. Subsequently, we retrospectively reviewed the data of 16 patients (seven males and nine females) who underwent dual S2AI screw fixation and 23 patients who underwent single S2AI screw fixation between January 2014 and December 2019. Preoperative, postoperative, and latest follow‐up measurements of Cobb angle, coronal balance (CB), spinal pelvic obliquity (SPO), and regional kyphosis (RK) were obtained. The mean follow‐up time was 16.7 ± 7.1 months (range: 12–30 months). Independent t‐test was used to determine the difference in the analysis of the trajectories. The paired sample non‐parametric Wilcoxon test was performed to assess the changes in radiographic parameters between different time points and different groups. Results For both male and females, the proximal S2AI screws had significantly higher TA and ML, but a lower SA than distal screws. Females showed significantly more caudal (SA: 25.03° ± 2.32° vs. 29.82° ± 2.47°, t = 7.742, P < 0.001) trajectories of distal screw. Additionally, ML in the females were significantly shorter than that in males (106.81 mm ± 6.79 mm vs. 101.63 mm ± 6.55 mm, t = 3.007, P = 0.003, 124.41 mm ± 7.57 mm vs. 116.23 mm ± 7.03 mm, t = 4.337, P < 0.001). Eight had unilateral and eight had bilateral dual S2AI screw placement. Respectively, both the single S2AI and dual S2AI groups showed significant postoperative improvement of Cobb angle, RK angle and SPO angle. In patients with dual S2AI screws fixation, two patients found that screws loosening occurred in one of dual screws at 1‐year follow‐up, and in patients with single S2AI screws fixation, six patients found screw loosing as well as two patients found screw breakage at 1‐year follow‐up. None of all patients had any prominent loss of correction. Conclusion The ideal trajectory of dual S2AI screw could be well established. The dual S2AI screw fixation technique is feasible in patients with severe kyphoscoliosis, and provides satisfactory correction of deformity with few postoperative complications. In this study, we verified the feasibility of the dual S2AI screws by constructing trajectories in the normal adult pelvis by 3D‐CT, and evaluated its clinical outcomes in 16 patients treated with this technique. Our study elucidated the ideal trajectory parameters of dual S2AI screws in normal pelvis, and confirm the favorable clinical outcomes of this technique in severe kyphoscoliosis. Our findings may help understand the technical essential, advantages and indications of this new technique.

Objective To compare a new classification with the Garden classification by exploring their relationships with vascular injury. Methods This retrospective study enrolled 73 patients with subcapital femoral neck fracture from July 2015 to November 2018, including 32 males and 41 females with an average age of 47.2 years. All patients were classified by the Garden classification using anteroposterior X‐ray imaging and by a new classification system based on three‐dimensional CT imaging. The blood supply of the affected femoral head in these patients was evaluated based on DSA images. Correlations between the two classifications and the degree of vascular injury were assessed. Results The results of the DSA examination indicated that eight patients had no retinacular vessel injury, 20 patients had one retinacular vessel injury, 35 patients had two retinacular vessel injuries, and 10 patients had three retinacular vessel injuries. The degree of vascular injury was used to match the two fracture classifications. Forty‐nine Garden classifications (Type I‐IV: 8, 12, 23, 6, respectively, 67.12%) and 66 new classifications (Type I‐IV: 8, 20, 32, 6, respectively, 90.41%) corresponded to the degree of vascular injury (p < 0.05). The Garden classification showed moderate reliability, and the new classification showed near perfect agreement (Interobserver agreement of k = 0.564 [0.01] in Garden classification vs. Garden classification k = 0.902 [0.01] for the five observers). Conclusions The new classification system can accurately describe the degree of fracture displacement and judge the extent of vascular injury. 73 patients with subcapital FNF from July 2015 to November 2018. All patients were classified by the Garden classification using anteroposterior X‐ray imaging and by a new classification system based on three‐dimensional CT imaging. The blood supply of the affected femoral head in these patients was evaluated based on DSA images. Correlations between the two classifications and the degree of vascular injury were assessed.

Background It is important to understand pulmonary vein drainage pattern variations and their frequency in order to perform safe anatomical pulmonary resection. Methods Variations and frequencies were assessed using three‐dimensional computed tomography angiography (3D‐CT) in 194 patients. In cases where the tumor or lymph node caused atelectasis or compression of hilar structures, the involved lobes were excluded from the analyses. Results We confirmed variant drainage patterns in 15/189 (8.0%) patients in the right upper lobe (RUL), 29/189 (15.3%) in the right middle lobe (RML), 18/192 (9.5%) in the right lower lobe (RLL), and 5/187 (2.6%) in the left upper lobe (LUL). There was no variant type in the left lower lobe (LLL). There were 14 (7.4%) cases of anomalous superior posterior pulmonary vein of RUL (V2) drainage: V2 draining to the superior pulmonary vein (SPV) (n = 2, 1.1%), V2 to the inferior pulmonary vein (IPV) (n = 7, 3.7%), V2 to the left atrium (LA) (n = 2, 1.1%), and V6 to the apical pulmonary vein of the RLL (n = 3, 1.6%). There was a posterior pulmonary vein, V3 to RML pulmonary vein in one case (0.5%). The RML pulmonary vein drained into the IPV in 14 (7.4%) and into the LA in 15 (7.9%) cases. The right V6 directly drained into the LA in 15 (7.9%) and V6 into the SPV in 3 (1.6%) cases. The lingular pulmonary vein drained into the IPV in one case (0.5%) and into the LA in two cases (1.1%). The inferior lingular pulmonary vein V5 drained into the IPV and into the LA in one case (0.5%), respectively. Conclusion We describe anomalous pulmonary venous drainage patterns and their frequencies particular to anatomic surgical resection. 3D‐CT is useful to find such variations.

Swyer‐James‐MacLeod syndrome (SJMS) is an uncommon obliterative lung disease that is radiologically characterized by hyperlucency of a part of or the entire lung. A 33‐year‐old man presented to our hospital for chest tightness. A chest X‐ray revealed unilateral hyperlucency of left lower lung, and contrast‐enhanced computed tomography (CT) of the chest disclosed a hyperlucent left lung without vascularity. Three‐dimensional CT reconstruction and ventilation–perfusion scan findings were concordant with SJMS. We herein report a case of SJMS in a patient who showed the characteristic multimodal imaging findings. Swyer‐James‐Macleod syndrome (SJMS) is an uncommon obliterative lung disease that is defined radiologically as hyperlucency of a part of or the entire lung. We present a case of SJMS in a patient who showed unique multimodal imaging findings.

Objective To propose a new classification method based on CT three-dimensional reconstruction for inferior articular process injury following percutaneous endoscopic interlaminar lumbar discectomy (PEID), and to analyze the impact of > 50% inferior articular process(IAP) defect on clinical outcomes. Methods A retrospective analysis was conducted on 100 PEID patients. IAP injuries were classified into four types based on CT three-dimensional reconstruction, and the inter- and intra-observer reliability was assessed using the Kappa consistency test. Patients were divided into two groups based on IAP defect size: Group A (defect ≤ 50%) and Group B (defect > 50%). VAS, ODI, clinical outcomes, and lumbar instability were compared between the two groups, and IAP changes were observed. Results The classification showed good inter- and intra-observer consistency. There were no significant differences in VAS, ODI, clinical outcomes, or lumbar instability between the two groups ( P  > 0.05). Both groups showed varying degrees of IAP regeneration and remodeling. Conclusion The classification of IAP injuries based on CT three-dimensional reconstruction demonstrates good inter- and intra-observer consistency. In the short term, patients with > 50% IAP defects (Types III and IV) show no difference in lumbar stability or clinical outcomes compared to those with ≤ 50% defects (Types I and II).However, for patients with complete IAP loss (Type IV), the potential long-term risk of lumbar instability and related clinical complications remains a concern.

Objectives General thoracic surgeons must be familiar with anatomical variation in the pulmonary vessels and bronchi. Here, we analyzed the bronchovascular pattern of the right middle lobe (RML) and right lower lobe (RLL) of the lung using three-dimensional CT angiography and bronchography (3DCTAB). Methods We reviewed the anatomical patterns of the pulmonary vessels and bronchi in 270 patients using 3DCTAB images. Results The branching patterns of vessels and bronchi of RML and S 6 were classified according to the number of stems. The single-stem type was the most common, except in the artery of the RML, for which the two-stem type was the most common. The artery and bronchus of S*, which is an independent segment between S 6 and S 10 , were observed in 20.4% of cases. The branching pattern of A 7 (B 7 ) was classified into four types. The A 7 a (B 7 a) type was observed in 74.8% of cases, and was the most common. The branching pattern of the artery and bronchus of S 8−10 was classified into five and three types, respectively. The A 8 and A 9  + A 10 type, and the B 8 and B 9  + B 10 type, were observed in 68.1 and 80.4% of cases, respectively, and were the most common types. The branching pattern of V 8−10 was more complex than that of A 8−10 and B 8−10 . Conclusion We explored the bronchovascular patterns of RML and RLL and their frequencies using a large number of 3DCTAB images. Our data can be used by thoracic surgeons to perform safe and precise lung resections.

Purpose The purpose of this study was to evaluate the influence of tibial tunnel position in pullout repair for a medial meniscus (MM) posterior root tear (MMPRT) on postoperative MM extrusion. Methods Thirty patients (median age 63 years, range 35–72 years) who underwent transtibial pullout repairs for MMPRTs were included. Three-dimensional computed tomography images of the tibial surface were evaluated using a rectangular measurement grid for assessment of tibial tunnel position and MM posterior root attachment. Preoperative and postoperative MM medial extrusion (MMME) and posterior extrusion (MMPE) at 10° and 90° knee flexion were measured using open magnetic resonance imaging. Results Tibial tunnel centers were located more anteriorly and more medially than the anatomic center (median distance 5.8 mm, range 0–9.3 mm). The postoperative MMPE at 90° knee flexion was significantly reduced after pullout repair, although there was no significant reduction in MMME or MMPE at 10° knee flexion after surgery. In the correlation analysis of the displacement between the anatomic center to the tibial tunnel center and improvements in MMME, and MMPE at 10° and 90° knee flexion, there was a significant positive correlation between percentage distance and improvement of MMPE at 90° knee flexion. Conclusion This study demonstrated that the nearer the tibial tunnel position to the anatomic attachment of the MM posterior root, the more effective the reduction in MMPE at 90° knee flexion. Our results emphasize that an anatomic tibial tunnel should be created in the MM posterior root to improve the postoperative MMPE and protect the articular cartilage in a knee flexion position. Placement of an anatomic tibial tunnel significantly improves the MMPE at 90° of knee flexion after MM posterior root pullout repair. Level of evidence IV.

Objective Volume measurement software is not routinely utilized in clinical practice before splenic artery embolization. To explore the function of such software measurement in this context, we conducted a retrospective study. Methods We divided patients into two groups: 38 patients in Group A underwent three-dimensional reconstruction using Revolution CT, and 37 patients in Group B underwent imaging with normal CT technology. We compared the changes in liver function test results and haematological parameters between these two groups. Results A total of 75 patients who underwent splenic artery embolization from January 2018 to January 2023 were included. The preoperative baseline data were not significantly different (all P values > 0.05). Both groups showed improvements in liver function and hypersplenism-related parameters. Within 2 weeks after surgery, Group A had significantly greater WBC (5.54 ± 1.92 × 10^9/L) and PLT (65.80 ± 20.12 × 10^9/L) counts than Group B (WBC: 4.14 ± 1.96 × 10^9/L; PLT: 52.70 ± 14.78 × 10^9/L; P  < 0.05), indicating better control of hypersplenism. At 2 months postintervention, Group A demonstrated more favourable improvements in postintervention splenic volume (reduced from 1045 ± 122.9 cm³ to 489.5 ± 84.93 cm³), portal vein diameter (from 1.51 ± 0.19 cm to 1.28 ± 0.13 cm), and portal vein flow velocity (increased from 17.70 ± 5.25 cm/s to 23.56 ± 6.40 cm/s) than Group B. Moreover, a 53.2% splenic volume reduction was noted in Group A, which was significantly greater than the 31.4% reduction in Group B. Additionally, Group A had fewer adverse reactions, with lower liver/gastrointestinal toxicity (χ²=4.242, P  = 0.039) and fever severity (χ²= 4.805, P  = 0.028). Conclusions This study suggests that using Revolution CT prior to splenic artery embolization provides an effective method for managing hypersplenism, enhancing liver function, and reducing the risk of complications.

Purpose To explore the anatomical types and variations of lung segments and subsegment bronchi based on CT 3D reconstruction technology, and to provide anatomical theoretical support for thoracic surgeons in terms of surgical techniques. Methods The 3D CT reconstructed images of 541 patients were retrospectively analyzed. We explored the anatomical structure of the bronchi in the middle lobe of the right lung, sorted out the variations, and classified them in detail according to different bronchial types. Results In the CT 3D reconstruction of 541 patients, the bronchial anatomical types of the right middle lobe were divided into two types. There were 530 cases (98.0%) of two-branched type and 11 cases (2.0%) of three-branched type, and no four-branched type was found in the data of this paper. In addition, the spatial relationship between B 4 and B 5 , and the spatial relationship between subsegmental bronchi B 4a , B 4b , B 5a , and B 5b are analyzed. The most common anatomical type and spatial relationship of the right middle lobe bronchi in the two-branched type were B 4 and B 5 in the external-internal relationship, B 4a and B 4b in the external-internal relationship, and B 5a and B 5b in the upper and lower relationship, and this subtype was 416 cases (76.9%). In addition, 23 cases (3.9%) were found to have a spatial relationship between B 4 and B 5 in the right middle lobe similar to the lingual bronchial subtype in the left upper lobe. Conclusion We used a large number of CT 3D reconstructed images to explore the anatomical types and variations of the bronchi in the middle lobe of the right lung. Thoracic surgeons can use our data to guide increasingly delicate lobectomy and segmentectomy.

Background Nasal septum deviation (NSD) plays a vital role in paranasal sinus development, influencing sinonasal structures and maxillary sinus volume (MSV). This study aims to identify the NSD types and ascertain their impact on sinonasal variants, MSV, and morphometry of the infundibulum using three-dimensional (3D) computed tomography (CT) scans. Methods CT images of 300 patients (150 females and 150 males), aged between 18 and 70 years, were retrospectively analyzed. The prevalences of NSD types, NS pneumatization (NSP), middle concha bullosa (MCB), paradoxical middle turbinate (PMT), MS mucosal thickening (MSMT), accessory maxillary ostium (AMO), uncinate process (UP) variants, and inferior turbinate hypertrophy (ITH) were evaluated. Also, MSV, MO width (MOW), infundibulum length (IL) and angle (IA) were measured. Statistical analyses of data was done taking into account gender, laterality, and age. Results The greater the degree of NSD, the greater the likelihood of MCB, PMT and ITH occurring on the opposite side. Conversely, AMO, hypoplastic MS, MSMT, and hook-shaped UP were more prevalent on the same side of the deviation. The strongest associations with ipsilateral hyperplastic MS and being a young male were exhibited by PMT and MCB. Moderate and severe NSD, AMO, hook-shaped UP, hypoplastic MS and MSMT were more prevalent in older subjects, while younger subjects had more NSP, extensive MCB, PMT with a significant difference. The mean MSV, MOW and IL were found to be lower in MS on the same side of NSD, while the largest IA was observed in MS with severe NSD, as well as larger IA on the ipsilateral side of deviation, with a significant difference. However, we found that, as the degree of NSDA increased, the mean IL decreased and the mean MOW increased. The mean MOW and IL values indicated a positive correlation with ageing, whereas the MSV and IA values decreased with increasing age. Conclusions Despite their significance, our understanding of how sinonasal structures, MSV, and infundibulum morphometry vary and covary with NSD remains limited, a crucial aspect in the planning of dental implantology and endoscopic sinus surgery.