30 research outputs found
Application of rapid prototyping techniques for modelling of anatomical structures in medical training and education
Rapid prototyping has become an innovative method of fast and cost-effective
production of three-dimensional models for manufacturing. Wide access to
advanced medical imaging methods allows application of this technique for
medical training purposes. This paper presents the feasibility of rapid prototyping
technologies: stereolithography, selective laser sintering, fused deposition
modelling, and three-dimensional printing for medical education. Rapid prototyping
techniques are a promising method for improvement of anatomical education
in medical students but also a valuable source of training tools for medical
specialists. (Folia Morphol 2011; 70, 1: 1-4
Quadricuspid pulmonary valve complicated with aneurysm of pulmonary trunk diagnosed with ECG-gated computed tomography
Quadricuspid pulmonary valve (QPV) is an uncommon congenital defect reported
in the general population with a frequency of up to 0.25%. The defect
usually does not cause severe clinical complications and its presence frequently
remains clinically silent. Moreover, there are several difficulties in visualization
of pulmonary valve using basic diagnostic modalities such as echocardiography.
Therefore, in the majority of cases, QPV is detected accidentally during cardiac
procedures or post mortem.
The authors present a case of QPV complicated with aneurysm of the pulmonary
trunk, diagnosed with computed tomography in 70-year-old woman.
Although the patient had undergone transthoracic echocardiography examinations
several times in the past, only computed tomography allowed the detection
of the anomalous valve. In addition, the examination confirmed aneurysm
of the pulmonary trunk.
To the best of our knowledge, this is the first case of QPV diagnosed in vivo
with computed tomography
An unusual crossed course of separately originating left circumflex and left anterior descending arteries with concomitant anomalies found in multi-slice computed tomography
Coronary artery anomalies occur in approximately in 1-2% of the population.
The split origin of branches of the left coronary artery is a relatively common
anomaly, usually with no significant observable impairment of cardiac function.
The application of multi-slice computed tomography (MSCT) for cardiac imaging
is increasing and becoming, along with other techniques, a recognised
method of examination of the coronary arteries.
In the case presented we observed in an ECG-gated MSCT the anomalous origin
and proximal course of the arteries of the left sinus of Valsalva. The ostiae of
both coronary arteries were located unusually: the ostium of the LAD was found
posterior to the ostium of the LCx. Because of this, the proximal part of the LAD
crossed the proximal part of the LCx superiorly. Furthermore, muscular bridges
were found in the middle part and in the first diameter branch of the LAD. To
our knowledge, this is the first case of a crossed course of the LCx and the LAD
to be presented in the literature.
Applications of MSCT in coronary imaging are presented in comparison with
other diagnostic imaging methods. The advantages and limitations of MSCT as
a diagnostic tool for anomalies of the coronary arteries are discussed
Arteria lusoria in patients with a normal and a right-sided aortic arch diagnosed with multi-slice computed tomography: a report of two cases
A retro-oesophageal course of the right subclavian artery is referred to as "arteria lusoria". It may be related to severe compression of the trachea and oesophagus, typically resulting in impaired swallowing. The paper presents two patients with arteria lusoria, which in one patient was an aberrant right subclavian artery and in the other an aberrant left subclavian artery, originating from the right-sided aortic arch. In both cases the diagnosis was made with multi-slice computed tomography. The embryology of the anomalies and clinical status of
the patients is discussed. Arteria lusoria should be considered in differential diagnosis in patients with dyspnoea and dysphagia. Multi-slice computed tomography allows this anatomical variant to be reliably visualised
Supernumerary renal vessels: analysis of frequency and configuration in 996 computed tomography studies
Background: Number, course and division pattern of renal vessels is highly variable. Variant renal vasculature is of high interest in nephrectomy for the renal transplantations, both in deceased and living donors. The purpose of the study was to analyse the frequency of supernumerary renal vessels in a large cohort of patients undergoing the multiphase abdominopelvic computed tomography (CT), as well as analyse the possible patterns of coexisting supernumerary arteries in veins.
Materials and methods: A retrospective analysis of abdominopelvic CT studies within 1 year period was performed. In each study, number of renal arteries and veins was recorded. Course of left renal vein was classified into normal, retro- or periaortic. For statistical analysis of normal distribution data, t-Student test was used. Chi-square test was used for frequency of variant vessel distribution. Pearson correlation coefficient was used for the analysis of coexistence of supernumerary vessels.
Results: 996 patients were included in the analysis, male to female ratio: 481:515 (48%:52%). Mean age was 57.9 ± 14.7 years. Single renal arteries were observed in 73% of cases, while single renal veins in 95%. Circumaortic or retroaortic courses of left renal veins were observed in 10% of cases. Number of renal vessels has been compared in patients with and without supernumerary vessels. In patients with supernumerary left renal artery, significantly more right renal vessels were observed. In patients with supernumerary right renal vein, mean number of all remaining vessels was significantly higher.
Conclusions: Supernumerary renal vessels are a frequent finding in abdominal CT studies. Finding a supernumerary vessel should increase awareness of possible other supernumerary renal vessels.
The course of the cystic artery during laparoscopic cholecystectomy
Proper recognition of the particular structures that form the triangle of Calot is
essential for the proper and safe performance of laparoscopic cholecystectomy.
Proper recognition, ligation, and cut of the cystic duct and cystic artery
with branches (dorsal and ventral) remain an integral condition for the removal
of the gallbladder. Calot’s triangle, as an orientation structure, determines the
most common location of the cystic artery. The triangle of Calot is one of the
most variable regions of the abdomen in terms of anatomy. The aim of this
study was to evaluate how important for surgery is the detailed anatomical
recognition of the main branches of the cystic artery in Calot’s triangle during
laparoscopic cholecystectomy.
Relations of the main branches of the cystic artery were evaluated in 88 patients
that underwent laparoscopic cholecystectomy at the Department of General
Surgery of the District Specialistic Hospital of Lublin. The anatomical relations
of cystic duct and artery were classified into typical and variant types.
Significantly more frequently variants of cystic artery were observed in women.
However, the time of the procedure was not significantly related with the type
of cystic artery
Anatomical variations of the coeliac trunk in the homogeneous Polish population
Background: The abdominal vessels show a number of abnormalities and pathologies knowledge of which is important during open as well as laparoscopic surgeries. One of the most common vessels which pattern has many variations is the coeliac trunk. The present study was undertaken on homogeneous population to assess morphology of the coeliac trunk and to evaluate the possible variability of its branches. Materials and methods: Standard abdominal multidetector computed tomography examinations were performed on a total of 1569 patients diagnosed by 2 radiologists independently; in case of doubts common assessment was performed. Results: The coeliac trunk followed the classic pattern in 92.7% of the cases (1455/1569 of patients). The gastrosplenic trunk was detected in 4.1% of cases (64/1569); the hepatosplenic trunk in 2.2% of cases (34/1569); the coeliac-mesenteric trunk was observed in 0.5% of cases (8/1569); the hepatogastric trunk in 0.2% of cases (4/1569); the splenomesenteric trunk was detected in 0.1% of cases (2/1569). In the next 0.1% the coeliac trunk was absent. The hepatosplenomesenteric and the coeliac-colic trunk were not observed in the study population. Conclusions: Vascular anatomical abnormality is usually asymptomatic hovewer, its preoperative knowledge is helpful to reduce complications like vascular bleeding when dissecting the hapato-pancreatic region. The coeliac trunk and its branches can be fast and easy evaluated in computed tomography exams performed due to various symptoms from abdominal cavity
Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism
Bowing of the interventricular septum (IVS) is a sign of severe pulmonary embolism(PE); however, it is affected by high interobserver variability. The aim of thestudy was to evaluate the application of volumetric reconstructions of the rightventricle for assessment of IVS position regarding its accuracy in identifying rightventricular dysfunction, as well as interobserver agreement in evaluating this sign.IVS bowing was evaluated with multiplanar reformations (MPR) and volumetricreconstruction (VR, volume rendering) by 2 observers. The accuracy of IVS bowingsign was better for VR-based assessment; however, it was not significantlybetter than the MPR-based evaluation. Interobserver agreement was found tobe fair (kappa = 0.381) for the MPR-based grading of IVS position as normal orabnormal, while it was significantly better for the VR method (kappa = 0.629,p < 0.001). The VR-based method may improve utilisation of IVS bowing sign inpatients with PE
The body constitution of patients and intubation scales as predictors of difficult intubation considered in relation to the experience of the intubator
The aims of the study were to identify factors that may result in difficulties in
intubation, and to compare the results obtained when an experienced and
when a less experienced anaesthesiologist was involved. The 96 patients included
in the study were evaluated for difficult intubation according to the
following scales: Mallampati, upper lip bite test (ULBT) and Patil. The mobility
of the cervical segments of the vertebral column, the distance between the
jugular notch of the sternum and the chin and the anatomical constitution of
the body were other factors that were taken into consideration. Statistical analysis
was performed in order to identify factors that may result in difficulties in intubation
for an experienced and for a less experienced anaesthesiologist
What do clinicians think of the anatomical knowledge of medical students? Results of a survey
Human anatomy is one of basic courses in medical education. It usually takes place during the first year of the medical school syllabus. However, the results of the course, if defined as profound anatomical knowledge, are not applied by the students until several years after the final anatomy examination. The aim of the study was to evaluate the anatomical knowledge of senior medical students. For this reason a survey was distributed among teachers responsible for clinical rotas. The results of the study were intended to give the answer to the question, "What do students remember several years after the anatomy examination?" as expressed by their clinical teachers. The
questionnaire included four closed questions and one open question. The closed questions concerned general anatomical knowledge, whether the anatomy course should be extended and whether additional courses should be introduced and included a question about student knowledge of particular systems. The open question concerned ways of improving anatomical education.
As a result of the survey it was observed that surgical specialists had a significantly lower opinion of the medical knowledge of their students than had medical specialists. Most of the suggestions for improving anatomical education were related to introducing clinical applications of anatomical knowledge