Herz- und thorakale Gefässchirurgie: Therapie der koronaren Herzkrankheit: «je länger, desto besser für die Chirurgie»
In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, Band 12, Heft 3
ISSN: 1424-4020
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In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, Band 12, Heft 3
ISSN: 1424-4020
In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, Band 8, Heft 51
ISSN: 1424-4020
In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum
ISSN: 1424-4020
In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, Band 9, Heft 39
ISSN: 1424-4020
In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, Band 7, Heft 20
ISSN: 1424-4020
In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, Band 10, Heft 18
ISSN: 1424-4020
PURPOSE: To prospectively evaluate an automated volume of interest (VOI)-fitting algorithm for quantitative computed tomography (CT) of proximal femur specimens, correlate bone mineral density (BMD) with biomechanically determined bone strength in vitro, and compare that correlation with those observed at dual-energy x-ray absorptiometry (DXA) measurement of BMD. MATERIALS AND METHODS: The study was compliant with institutional and legislative requirements; donors had dedicated their body for education and research before death. Multidetector CT and DXA scans were acquired in 178 proximal femur specimens harvested from human cadavers (91 women, 87 men; mean age at death, 79 years +/- 10.2; range, 52-100 years). An automated VOI-fitting algorithm was used to calculate BMD and bone mineral content (BMC) in the head, neck, and trochanter from CT findings and pixel distribution parameters. The femur failure load (FL) was determined by using a mechanical test. Quantitative CT BMD, quantitative CT pixel distribution parameters, DXA BMD, and FL were correlated at multiple regression analysis. RESULTS: Mean precision errors in quantitative CT BMD measurements at segmentation with repositioning were 0.56%, 2.26%, and 0.61% for the head, neck, and trochanter, respectively. For the head, neck, and trochanter, respectively, r values were 0.77, 0.53, and 0.59 for the correlation between quantitative CT BMD and FL and 0.74, 0.55, and 0.65 for the correlation between quantitative CT BMC and FL (P< .001). Values ranged from 0.77 to 0.80 for correlations between DXA BMD and FL and from 0.73 to 0.82 for correlations between DXA BMC and FL (P< .001). In a multiple regression model that included quantitative CT pixel distributions, adjusted multivariate correlation coefficient values for correlations with FL increased to up to 0.88. CONCLUSION: Regional BMD of the proximal femur can be determined in vitro from quantitative CT data with high precision by using an automated VOI-fitting algorithm. The best multiple regression model for predicting FL included DXA BMD and regional quantitative CT BMD measurements.
BASE
PURPOSE: To investigate in vitro the calcaneal trabecular bone structure in elderly human donors with high spatial resolution magnetic resonance (MR) imaging at 3.0 T and 1.5 T, to quantitatively compare MR measures of bone microarchitecture with those from micro-computed tomography (CT), and to compare the performance of 3.0-T MR imaging with that of 1.5-T MR imaging in differentiating donors with spinal fractures from those without spinal fractures. MATERIALS AND METHODS: The study was performed in line with institutional and legislative requirements; all donors had dedicated their body for educational and research purposes prior to death. Sagittal MR images of 49 human calcaneus cadaveric specimens were obtained (mean age of donors, 79.5 years +/- 11 [standard deviation]; 26 male donors, 23 female donors). After the spatial coregistering of images acquired at 3.0-T and 1.5-T MR imaging, the signal-to-noise-ratios and structural parameters obtained at each magnetic field strength were compared in corresponding sections. Micro-CT was performed on calcaneus cores obtained from corresponding regions in 40 cadaveric specimens. Vertebral deformities of the thoracic and lumbar spine were radiographically classified by using the spinal fracture index. Diagnostic performance of the structural parameters in differentiating donors with vertebral fractures from those without was assessed by using receiver operator characteristic (ROC) analysis, including area under the ROC curve (A(z)). RESULTS: Correlations between structural parameters at 3.0-T MR imaging and those at micro-CT were significantly higher (P .05). CONCLUSION: MR imaging at 3.0 T provided a better measure of the trabecular bone structure than did MR imaging at 1.5 T. There was a trend for better differentiation of donors with from those without osteoporotic vertebral fractures at 3.0 T than at 1.5 T.
BASE
In: Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, Band 10, Heft 24
ISSN: 1424-4020