악교정 수술에서 모의 조종된 3차원 전산화 단층촬영상의 응용

김형돈,이경상,유선국,박창서 大韓口腔顎顔面 放射線學會 1998 Imaging Science in Dentistry Vol.28 No.2

In orthodontics and orthognathic surgery, cephalogram has been routine practice in diagnosis and treatment evaluation of craniofacial deformity. But its inherent distortion of actual length and angles during projecting three dimensional object to two dimensional plane might cause errors in quantitative analysis of shape and size. Therefore, it is desirable that three dimensional object is diagnosed and evaluated three dimensionally and three dimensional CT image is best for three dimensional analysis. Development of clinic necessitates evaluation of result of treatment and comparison before and after surgery. It is desirable that patient that was diagnosed and planned by three dimensional computed tomography before surgery is evaluated by three dimensional computed tomography after surgery, too. But Because there is no standardized normal values in three dimension now and three dimensional Computed Tomography needs expensive equipments and because of its expenses and amount of exposure to radiation, limitations still remain to be solved in its application to routine practice. If postoperative three dimensional image is constructed by pre and postoperative lateral and postero-anterior cephalograms and preoperative three dimensional computed tomogram, pre and postoperative image will be compared and evaluated three dimensionally without three dimensional computed tomography after surgery and that will contribute to standardize normal values in three dimension. This study introduced new method that computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms, and for validation of new method, in four cases of dry skull that position of mandible was displaced and four patients of orthognathic surgery, computer-simulated three dimensional image and actual postoperative three dimensional image were compared. The results were as follows. 1. In four cases of dry skull that position of mandible was displaced, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -1.8 mm to 1.8 mm and 94% in displacement of all co-ordinates values was from -1.0 mm to 1.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). 2. In four cases of orthognathic surgery patients, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in coordinates values was from -6.7 mm to 7.7 mm and 90% in displacement of all co-ordinates values was from -4.0 to 4.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). Conclusively, computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. Therefore, potentiality that can construct postoperative three dimensional image without three dimensional computed tomography after surgery was presented.

흉부 외상 골절에 있어서 3차원 재구성 영상의 유용성

고경훈,김동훈,김영숙,변주남 대한영상의학회 2006 대한영상의학회지 Vol.55 No.3

Purpose: We wanted to evaluate the usefulness of three-dimensional reconstructive images using multidetector computed tomography (MDCT) for thoracic traumatic patients visiting emergency room. Materials and Methods: 76 patients with fractures of the 105 patients who visited our emergency room with complaints of thoracic trauma were analyzed retrospectively. All the patients had thoracic MDCT performed and the three-dimensional reconstructive images were taken. The fractures were confirmed by axial CT, the clinical information, whole body bone scanning and the multiplanar reformation images. Plain x-ray images were analyzed by the fractured sites in a blind comparison of two radiologists’readings, and then that finding was compared with the axial CT scans and the three-dimensional reconstructive images. Results: The fracture sites were rib (n=68), sternum (n=14), clavicle (n=6), scapula (n=3), spine (n=5) and combined fractures (n=14). Plain x-ray and axial CT scans had a correspondency of 0.555 for the rib fractures. Axial CT scans and the three-dimensional reconstructive images had a correspondency of .952. For sternal fractures, those values were 0.692 and 0.928, respectively. The axial CT scans and three-dimensional reconstructive images showed sensitivities of 94% and 91% for rib and other fractures, respectively, and 93% and 100% for sternal fracture, respectively. Three-dimensional reconstructive image had an especially high sensitivity for the diagnosis of sternal fracture. Conclusion: While evaluating thoracic trauma at the emergency room, the three-dimensional reconstructive image was useful to easily diagnose the extent of fracture and it was very sensitive for detecting sternal fracture. 목적: 응급실에 내원한 흉부 외상 골절 환자에 있어서 다절편 흉부 전산화단층촬영(이하 CT)을 이용한 3차원 재구성 영상의 유용성에 대하여 알아보고자 하였다. 대상과 방법: 흉부 외상을 받아 응급실로 내원한 105명의 환자 중 골절이 확인된 76명의 환자를 대상으로 후향적으로 연구하였다. 모든 환자에서 다절편 흉부 CT와 함께 3차원 영상을 재 구성하였다. 골절은 축상 CT, 임상소견과 전신 골 주사(whole body bone scan), 다면 구성영상(multiplanar reformation: MPR)을 포함한 영상검사 소견을 종합하여 판단하였다. 두 명의 영상의학과 의사가 임상적 결과를 모르는 상태에서 단순촬영 영상을 보고 골절을 발생부위별로 분석하였으며 CT 축상 영상과 3차원 재구성 영상의 결과와 비교하였다. 결과: 진단된 부위별 골절은 늑골(68명), 흉골(14명), 쇄골(6명), 견갑골(3명), 척추(5명)였으며 두 부위 이상의 복합골절은 14명이었다. CT 축상 영상을 기준으로 늑골 골절에 대한 단순촬영 영상과 다절편 흉부 CT의 축상 영상의 진단 일치도는 0.555이었고, 3차원 재구성 영상과 CT 축상 영상과의 진단 일치도는 0.952이었다. 흉골 골절에서는 각각 0.692와 0.928였다. CT축상 영상과 3차원 재구성 영상간의 늑골 및 기타 골절 진단의 예민도는 94% 와 91%로 축상 영상이 높았으나 흉골 골절에 대해서는 93%와 100%로 3차원 재구성 영상이 더욱 예민하였다. 결론: 흉부 외상으로 응급실에 내원한 환자에 있어서 다절편 흉부 CT의 3차원 재구성 영상은 골절 병변의 범위를 쉽게 인지할 수 있게 해주며 특히 흉골 골절의 진단에 유용할 것으로 생각한다.

외상에 의한 흉곽 골절에 유용한 다절편 CT의 재구성 영상

김승국(Seung Kook Kim),노지숙(Ji Sook Noh),전재두(Jea Doo Jeon),전진만(Jin Man Jeon),김동훈(Dong Hoon Kim) 대한CT영상기술학회 2007 대한CT영상기술학회지 Vol.9 No.1

Purpose This article evaluate the usefulness of three-dimensional reconstructive images using multi detector computed tomography (MDCT) in thoracic traumatic patients visiting emergency room clinics for out-patients. Materials and methods 76 patients with fractures of 105 patients who visited our emergency room complaining of thoracic trauma were analyzed retrospectively. All patients performed thoracic MDCT and three-dimensional reconstructive images were taken. Fractures were confirmed by axial CT, clinical information, whole body bone scan, and multi planar reformation images. Plain x-ray was analyzed by fractured sites in a blind comparison of two radiologists’ readings, and then that finding was compared with them of axial CT scans and three-dimensional reconstructive images. Results The fracture sites were rib (n=68), sternum (n=14), clavicle (n=6), scapula (n=3), spine (n=5) and combined fractures (n=14). Plain x-ray and axial CT scans had correspondency of 0.555 for rib fractures. Axial CT scans and three-dimensional reconstructive images had 0.952. For sternal fracture, those were 0.692 and 0.928 each. Axial CT scans and three-dimensional reconstructive images showed sensitivities for rib and other fractures, 94 % and 91 % and for sternal fracture, 93 % and 100 % each. Three-dimensional reconstructive image had high sensitivity in the diagnosis of sternal fracture especially. Conclusion While evaluating thoracic trauma at emergency room, three-dimensional reconstructive image was useful to diagnose extent of fracture easily and very sensitive to detect sternal fracture.

Three-dimensional imaging modalities in endodontics

Mao, Teresa,Neelakantan, Prasanna Korean Academy of Oral and Maxillofacial Radiology 2014 Imaging Science in Dentistry Vol.44 No.3

Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of periradicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome.

Three-dimensional imaging modalities in endodontics

Teresa Mao,Prasanna Neelakantan 대한영상치의학회 2014 Imaging Science in Dentistry Vol.44 No.3

Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of peri-radicular lesions,diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome.

Difference in glenoid retroversion between two-dimensional axial computed tomography and three-dimensional reconstructed images

Hyungsuk Kim,Chang Hyun Yoo,Soo Bin Park,송현석 대한견주관절학회 2020 대한견주관절학회지 Vol.23 No.2

Background: The glenoid version of the shoulder joint correlates with the stability of the glenohumeral joint and the clinical results of total shoulder arthroplasty. We sought to analyze and compare the glenoid version measured by traditional axial two-dimensional (2D) computed tomography (CT) and three-dimensional (3D) reconstructed images at different levels. Methods: A total of 30 cases, including 15 male and 15 female patients, who underwent 3D shoulder CT imaging was randomly selected and matched by sex consecutively at one hospital. The angular difference between the scapular body axis and 2D CT slice axis was measured. The glenoid version was assessed at three levels (midpoint, upper one-third, and center of the lower circle of the glenoid) using Friedman’s method in the axial plane with 2D CT images and at the same level of three different transverse planes using a 3D reconstructed image. Results: The mean difference between the scapular body axis on the 3D reconstructed image and the 2D CT slice axis was 38.4°. At the level of the midpoint of the glenoid, the measurements were 1.7° ± 4.9° on the 2D CT images and −1.8° ± 4.1° in the 3D reconstructed image. At the level of the center of the lower circle, the measurements were 2.7° ± 5.2° on the 2D CT images and −0.5° ± 4.8° in the 3D reconstructed image. A statistically significant difference was found between the 2D CT and 3D reconstructed images at all three levels. Conclusions: The glenoid version is measured differently between axial 2D CT and 3D reconstructed images at three levels. Use of 3D reconstructed imaging can provide a more accurate glenoid version profile relative to 2D CT. The glenoid version is measured differently at different levels.

Determination of midsagittal plane for evaluation of facial asymmetry using three-dimensional computed tomography

김태영,백지선,박주영,채화성,허경회,최순철 대한구강악안면방사선학회 2011 Imaging Science in Dentistry Vol.41 No.2

Purpose : The aim of the present study was to investigate the disagreement of cephalometric analysis depending on the reference determination of midsagittal plane on three-dimensional computed tomography. Materials and Methods : A total of 102 young women with class III dentofacial deformity were evaluated using three-dimensional computed tomography. The cranial and facial midsagittal planes were defined and the amounts of jaw deviation were calculated. The amounts of jaw deviation were compared with paired t-test (2-tailed) and Bland-Altman plot was drawn. Results : The landmark tracing were reproducible (r?.978). The jaws relative to the cranial midsagittal plane were 10-17 times more significantly deviated than to the facial midsagittal plane (P⁄.001). Bland-Altman plot demonstrated that the differences between the amounts of jaw deviation from two midsagittal planes were not normally distributed versus the average of the amounts of jaw deviation from two midsagittal planes. Conclusion : The cephalometric analyses of facial asymmetry were significantly inconsistent depending on the reference determination of midsagittal plane. The reference for midsagittal plane should be carefully determined in three-dimensional cephalometric analysis of facial asymmetry of patients with class III dentofacial deformity.

Determination of midsagittal plane for evaluation of facial asymmetry using three-dimensional computed tomography

Kim, Tae-Young,Baik, Jee-Seon,Park, Joo-Young,Chae, Hwa-Sung,Huh, Kyung-Hoe,Choi, Soon-Chul Korean Academy of Oral and Maxillofacial Radiology 2011 Imaging Science in Dentistry Vol.41 No.2

Purpose : The aim of the present study was to investigate the disagreement of cephalometric analysis depending on the reference determination of midsagittal plane on three-dimensional computed tomography. Materials and Methods : A total of 102 young women with class III dentofacial deformity were evaluated using three-dimensional computed tomography. The cranial and facial midsagittal planes were defined and the amounts of jaw deviation were calculated. The amounts of jaw deviation were compared with paired t-test (2-tailed) and Bland-Altman plot was drawn. Results : The landmark tracing were reproducible ($r{\ge}.978$). The jaws relative to the cranial midsagittal plane were 10-17 times more significantly deviated than to the facial midsagittal plane (P<.001). Bland-Altman plot demonstrated that the differences between the amounts of jaw deviation from two midsagittal planes were not normally distributed versus the average of the amounts of jaw deviation from two midsagittal planes. Conclusion : The cephalometric analyses of facial asymmetry were significantly inconsistent depending on the reference determination of midsagittal plane. The reference for midsagittal plane should be carefully determined in three-dimensional cephalometric analysis of facial asymmetry of patients with class III dentofacial deformity.

척골 경상돌기 골절의 중심와 침범 여부의 판정: 단순방사선 사진과 Three-Dimensional 단층 촬영의 비교

강진우,신승한,이용석,성용규,김동현,김도열,임진형,정양국 대한수부외과학회 2016 대한수부외과학회지 Vol.21 No.4

Purpose: There remains uncertain whether to fix or not an ulnar styloid fracture acommpanied by distal radius fracture. Fixation might be required in cases of the fracture involving a fovea of ulnar head, an attachment site of deep triangular fibrocartilage, which is thought to be important to distal radioulnar joint stability. We analyzed a fovea involvement of an accompanied ulnar styloid fracture in patients with distal radius fracture by simple radiograph and three-dimensional computed tomography (3D CT). Methods: We retrospectively reviewed 168 patients who underwent surgery with volar locking plate for distal radius fracture in our hospital from January 2005 to March 2015 and evaluated a fovea involvement of ulnar head by simple radiographs and 3D CT respectively, and compared. Results: On simple X-ray, 64 cases (38%) were ulnar styloid fovea fractures; however, 21 cases of these revealed non-fovea fractures by 3D CT. And 7 out of 104 cases determined as non-fovea fracture by simple radiographs were diagnosed as fovea fractures by 3D CT. Sensitivity, specificity and accuracy of evaluation by simple radiograph were 86%, 82% and 83% respectively, when compared with those of 3D CT based evaluation. Conclusion: Accuracy of evaluating an accompanied ulnar styloid fovea fracture in patients with distal radius fracture by simple radiograph, when compared with 3D CT, was 83%; therefore, we recommend using the 3D CT based evaluation instead of simple radiograph based one for determination of fovea involvement of ulnar head. 목적: 원위 요골골절에 동반된 척골 경상돌기 골절에 대한 수술적 치료가 필요한가에 대한 논란이 있으나, 삼각섬유연골복합체의 심부인대 부착부인 와(fovea)를 포함한 골절의 경우 원위 요척관절 불안정성을 동반할 수 있어 수술적 치료를 고려해야 한다. 저자들은 단순방사선 사진만으로 와 부위의 침범 여부를 정확히 판단할 수 있는 지를 알아보기 위해 원위 요골골절에 동반된 척골 경상돌기 골절에 대하여 단순방사선 사진과 three-dimensional computed tomography (3D CT)에서 경상돌기 기저부, 와 부위의 침범 여부를 비교 분석하였다. 방법: 2005년 1월부터 2015년 3월 사이에 수장판 내고정술로 치료했던 원위 요골골절에 동반된 척골 경상돌기 골절에대하여 수술 전 단순방사선 사진촬영과 3D CT를 모두 시행한 168명의 환자에서 척골 경상돌기 와 부위 침범 여부를 비교 평가하였다. 결과: 단순방사선 사진을 이용한 평가에서 64예, 38%에서 척골 경상돌기 와 부를 침범한 골절을 보였으나 3D CT 영상을 이용한 평가에서는 이들 중 21예가 와 부를 침범하지 않은 것으로 평가되었으며, 단순방사선 사진상 와 부를 침범하지 않은 것으로 평가되었던 104예 중 7예에서는 3D CT 영상을 이용한 평가에서 와 부를 침범한 골절로 확인되었다. 3D CT 영상 소견을 기준으로 평가할 때 단순방사선 사진상의 평가는 86%의 민감도, 82%의 특이도 및 83%의 정확도를 나타내었다. 결론: 3D CT 영상 평가를 기준으로 판단할 때 단순방사선 사진을 이용한 경상돌기 와 부위 침범 여부에 대한 평가는83%의 정확도를 보였다. 척골 경상돌기 골절 시 와 부위 침범여부를 판단하기 위해서는 단순방사선 사진보다 3D CT 영상에 근거한 평가가 요망된다.

Three-Dimensional Reconstruction Computed Tomography Evaluation of the Tunnel Location and Angle in Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction: A Comparison of the Anteromedial Portal and Outside-in Techniques

김강일,이상학,배찬일,배성혜 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.1

purpose: The purpose of this study was to compare the geometry and position of the femoral tunnel between the anteromedial portal (AMP) and outside-in (OI) techniques after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods: We evaluated 82 patients undergoing single-bundle ACL reconstruction with hamstring autografts using either the AMP (n=40) or OI (n=42) technique. The locations of the tunnel apertures were assessed by postoperative 3-dimensional computed tomography imaging. The femoral graft bending angle, femoral tunnel aperture shape, femoral tunnel length, and posterior wall breakage were also measured. results: The mean femoral tunnel position parallel to the Blumensaat line was more caudally positioned in the AMP group than in the OI group (p=0.025) The mean femoral graft angle in the OI group (99.6°±7.1°) was significantly more acute than that of the AMP group (108.9°±10.2°, p<0.001). The mean height/width ratio of the AMP group (1.21±0.20) was significantly more ellipsoidal than that of the OI group (1.07±0.09, p<0.001). conclusions: The mean femoral tunnel position was significantly shallower in the AMP technique than in the OI technique. The OI technique might be more disadvantageous than the AMP technique in terms of the more acute bending angle.