The Persistent Sciatic Artery

Following the invention of the first computed tomography (CT) scanner in the early 1970s, many innovations in three-dimensional (3D) diagnostic imaging technology have occurred, leading to a wide range of applications in craniofacial clinical practice and research. Three-dimensional image analysis provides superior and more detailed information compared with conventional plain two-dimensional (2D) radiography, with the added benefit of 3D printing for preoperative treatment planning and regenerative therapy. Current state-of-the-art multidetector CT (MDCT), also known as medical CT, has an important role in the diagnosis and management of craniofacial injuries and pathology. Three-dimensional cone beam CT (CBCT), pioneered in the 1990s, is gaining increasing popularity in dental and craniofacial clinical practice because of its faster image acquisition at a lower radiation dose, but sound guidelines are needed to ensure its optimal clinical use. Recent innovations in micro-computed tomography (micro-CT) have revolutionized craniofacial biology research by enabling higher resolution scanning of teeth beyond the capabilities of MDCT and CBCT, presenting new prospects for translational clinical research. Even after four decades of refinement, CT technology continues to advance and broaden the horizons of craniofacial clinical practice and phenomics research.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/adj.12154

Application of three-dimensional computed tomography in craniofacial clinical practice and research.

Cervical column morphology was examined in 41 adult patients with a skeletal deep bite, 23 females aged 22-42 years (mean 27.9) and 18 males aged 21-44 years (mean 30.8) and compared with the cervical column morphology in an adult control group consisting of 21 subjects, 15 females, aged 23-40 years (mean 29.2 years) and six males aged 25-44 years (mean 32.8 years) with neutral occlusion and normal craniofacial morphology. None of the patients or control subjects had received orthodontic treatment. For each individual, a visual assessment of the cervical column and measurements of the cranial base angle, vertical craniofacial dimensions, and morphology of the mandible were performed on a profile radiograph. In the deep bite group, 41.5 per cent had fusion of the cervical vertebrae and 9.8 per cent posterior arch deficiency. The fusion always occurred between C2 and C3. No statistically significant gender differences were found in the occurrence of morphological characteristics of the cervical column (females 43.5 per cent, males 38.9 per cent). Morphological deviations of the cervical column occurred significantly more often in the deep bite group compared with the control group (P < 0.05). Logistic regression analysis showed that the vertical jaw relationship (P < 0.05), overbite (P < 0.001), and upper incisor inclination (P < 0.01) were significantly correlated with fusion of the cervical vertebrae (R(2) = 0.40).

Cervical vertebral body fusions in patients with skeletal deep bite.

Cervical vertebral column morphology related to craniofacial morphology and head posture in preorthodontic children with Class II malocclusion and horizontal maxillary overjet

Introduction Humans are sexually dimorphic. Identification of remnants of skeletal and decomposing parts of human is one of the most difficult skills in forensic medicine. Forensic anthropologists often receive an incomplete skeleton, which are recovered fragmented but some bones are often recovered intact e.g. maxilla. However, typical identification methods may be inconclusive, especially when certain extreme post-mortem changes have developed. The aim of this study is to compare the size and volume of the maxillary sinus between males and females by CT Scan for gender determination. Methods 102 cases (61 males & 41 females) were studied from Gwalior region. The sinus measurements were taken from series of CT Head images on DICOM viewing software using inbuilt electronic caliper. Independent sample t -test & discriminant function analysis were done using Graph pad prism & Word Excel Sheet windows 2007 version. Results The dimensions & volume of the maxillary sinus of male was found to be larger than those of female & this difference was statistically significant ( p Discussion We can conclude that CT measurements of maxillary sinus dimensions & volume may be useful for identification of gender in forensic anthropology to some extent when other methods are inconclusive.

Measurements of maxillary sinus volume and dimensions by computed tomography scan for gender determination

Objective: To investigate anatomical variations and abnormalities of cervical spine morphology in unoperated infants with cleft lip and palate. Design: Retrospective cross-sectional investigation of infants born with nonsyndromic cleft lip and palate using computed tomography scans acquired for investigation of a spectrum of clinical conditions. Setting: Computed tomography scan data were obtained from 29 unoperated cleft lip and palate infants and 12 noncleft infants of Malay origin, ages 0 to 12 months. Methods: Observational study of cervical spine computed tomography scans. Heights of cervical vertebral bodies (C2-C7) and intervertebral spaces were measured from landmarks identified from computed tomography reformats and three-dimensional computed tomography reconstructions. Linear modeling of heights and spaces, with age as a covariate, was undertaken to identify differences between the samples. Results: Anomalous features observed in the cleft lip and palate sample included short posterior ...

A three-dimensional computed tomographic analysis of the cervical spine in unoperated infants with cleft lip and palate.

Persistent sciatic artery is a very uncommon embryological vascular variant. This case report highlights this rare vascular anomaly, diagnostic difficulty, complication and subsequent treatment in a 43-year-old man who presented with sudden onset of right leg pain for a few hours. He was unable to walk because of pain and numbness. Emergency right lower limb angiogram showed a large aneurysm that was initially thought to arise from the right common femoral artery, associated with thrombus formation within the right popliteal artery. A below knee amputation was performed due to worsening ischaemia of the right leg. The persistent right sciatic artery was later obliterated using percutaneous stenting and endovascular grafting, with deployment of two wallstents.

Bilateral persistent sciatic arteries with unilateral complicating aneurysm.

The purpose of this study was to analyse the linear and area dimensions and morphological shape of sella turcica to determine if differences exist due to gender or age and compared with available global data. A total of 183 (113 men and 70 women) Malay subjects who had their computed tomography (CT) scan at the Radiology Department, Hospital University Sains Malaysia (HUSM) for ordinary diagnosis not related to craniofacial deformities. The selected age groups were divided into four groups as children (0-6 years), preadolescents (7-12 years), adolescents (13-20 years) and adults (21-35 years). The images were processed using Mimics V17.0 software. Conventional measurements included three different heights of the sella turcica (anterior, posterior, median), its length, diameter, area and width, measured in relation to the Frankfort reference line (FH). Morphometric methods were used to assess shape. No significant differences in size of the sella were found except at sella height anterior between genders. When age was evaluated, significant differences were found among all age groups. The study found that sella turcica presented with a three different shapes: in a U shape (57.9 %), in a J shape (24.5 %) and shallow (17.5 %). Sella shape and dimensions reported in the current study can be used for discovering Pathological enlargement of the pituitary fossa and may also be helpful in providing reference data in the assessment of racial, gender and age specific variation in Malay population.

Size and Morphology of Sella Turcica in Malay populations: A 3D CT Study

Cone-beam computed tomography (CBCT) is an imaging system which has advantages over computed tomography (CT). Recently, CBCT has become widely used for oral and maxillofacial imaging. In CT scan, Hounsfield Unit (HU) is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value). The aim of the present (in vitro) study was to investigate the relationship between gray scale in CBCT and HU in CT scan. In this descriptive study, the anthropomorphic head phantom was scanned with CBCT and CT scanner. Gray scales and HUs were detected on images at the crown of the teeth, trabecular and cortical bone of mandible. The images were analyzed to obtain the gray scale value and HU value. The obtained value then used to investigate the relationship between CBCT gray scales and HUs. For the statistical analysis, t-test, Pearson’s correlation and regression analysis were used. The differences between the gray scale of CBCT and HU of CT were ...

Relationship between Hounsfield unit in CT scan and gray scale in CBCT

Maxillary sinus; Growth; 3D Scans; Volume Objective: To study the size of the maxillary sinus which includes linear and volume measurements. Methods: Three dimensional computed tomography (3D CT) images of 144 Malays (288 maxillary sinuses) with no clinical evidence of craniofacial and maxillary sinus abnormalities were selected. The subjects aged from 0.4 to 30 years (mean = 13.7 ; SD = 8.53), underwent the CT scanning using General Electric (GE) Light Speed Plus CT Scanner System (Wisconsin, USA) at the Radiology department, HUSM for reasons other than research purposes. The initial 2D formats were then reconstructed into 3D utilising OsiriX V3.7 (Geneva, Switzerland) software. Linear dimensions and volume of maxillary sinus were measured for different age categories and gender. Results: The maxillary sinus increased in sizes and volume from birth to 30 years of age. Females demonstrated to have significantly larger maxillary sinus width (p=0.02), height (p=0.04) and depth (p<0.01) than males in 0-6 years age category. The male’s maxillary sinus width and height were significantly larger than females in 7-12 (p<0.01) and 21-30 (p=0.02) years age categories. Moreover, maxillary sinus depth were found to be larger in males than females in 21-30 years age category (p<0.01). Males also exhibited larger maxillary sinus volume than females in 7-12 (p<0.01) and 21-30 (p<0.01) years age categories. Conclusions: The maxillary sinus sizes and volume showed sexual dimorphism at most age categories. Gender consideration should be taken into account in clinical assessment and procedures which may affect the maxillary sinus.

Asilah Yusof

Papers

A three-dimensional computed tomographic analysis of the cervical spine in unoperated infants with cleft lip and palate.

Bilateral persistent sciatic arteries with unilateral complicating aneurysm.

Size and Morphology of Sella Turcica in Malay populations: A 3D CT Study

Relationship between Hounsfield unit in CT scan and gray scale in CBCT

A Three Dimensional Computed Tomography (3D-CT): A Study of Maxillary Sinus in Malays