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Context: Computed tomography measurement of optic nerve sheath diameter (ONSD) is established for the indirect evaluation of intracranial pressure in traumatic brain injury (TBI). There is however a significant difference in the reported values across different techniques with no clear-cut range of values agreed upon. Objective: To measure the ONSD of patients with TBI and those with normal brains using different window settings and locations and compare with published values. Methodology: Comparative evaluation of 300 ONSD measurements obtained from cranial CT examinations at the Radiology department of a tertiary institution. Seventy-five patients had radiologic signs of TBI while 75 had normal findings (controls). For each subset, ONSD was measured at 3mm and 8mm retrobulbar regions using spine window (ww/wl 250/50). ONSD was measured using additional settings (mediastinal ww/wl 450/60 and soft tissue 380/40) for controls. Correlation between age, gender, and side of the ONS complex at different lengths and contrast settings were also evaluated. Results: The age range of the patients was 1-78 years, mean age of 40.4 years ± 21.7 with male: female ratio of 3:1. The mean ONSD was statistically different (p

Acute aortic dissection is one of the most life-threatening cardiovascular diseases, with a high mortality rate. Its prevalence ranges from 0.2% to 0.8% in humans, resulting in a significant number of deaths due to being missed in manual examinations. More importantly, the aortic diameter—a critical indicator for surgical selection—significantly influences the outcomes of surgeries post-diagnosis. Therefore, it is an urgent yet challenging mission to develop an automatic aortic dissection diagnostic system that can recognize and classify the aortic dissection type and measure the aortic diameter. This paper offers a dual-functional deep learning system called aortic dissections diagnosis-aiding system (DDAsys) that enables both accurate classification of aortic dissection and precise diameter measurement of the aorta. To this end, we created a dataset containing 61 190 computed tomography angiography (CTA) images from 279 patients from the Division of Cardiovascular Surgery at Tongji Hospital, Wuhan, China. The dataset provides a slice-level summary of difficult-to-identify features, which helps to improve the accuracy of both recognition and classification. Our system achieves a recognition F1 score of 0.984, an average classification F1 score of 0.935, and the respective measurement precisions for ascending and descending aortic diameters are 0.994 mm and 0.767 mm root mean square error (RMSE). The high consistency (88.6%) between the recommended surgical treatments and the actual corresponding surgeries verifies the capability of our system to aid clinicians in developing a more prompt, precise, and consistent treatment strategy.

Background and Objectives: Intracranial hypertension (IH) is associated with an unfavorable outcome in traumatic brain injury (TBI), and management strategies guided by intracranial pressure monitoring improve prognosis. Owing to the limitations of using invasive devices, measurement of optic nerve sheath diameter (ONSD) by ultrasonography is an alternative noninvasive method. However, its accuracy has not been validated in patients with TBI, so we aim to determine the diagnostic accuracy of measuring ONSD by ultrasonography in patients with TBI to estimate IH, compared with invasive monitoring., Methods: Systematic review of electronic databases and manual literature review from inception to June 2023. The analysis included diagnostic accuracy studies of ultrasonographic measurement of ONSD compared with invasive monitoring published in any language and with patients of any age. A qualitative synthesis was performed describing the clinical and methodological characteristics, strengths, limitations, and quality of evidence. In addition, a bivariate random effects model meta-analysis and a hierarchical summary receiver operating characteristics model were performed for the pediatric and adult population separately., Results: Five hundred and forty eight patients of 688 in 16 eligible studies were adults and 120 were children. Pooled sensitivity and specificity of ONSD measurement by ultrasonography were 84% (95% CI, 76%-89%) and 83% (95% CI, 73%-90%), respectively. During the sensitivity analysis, these parameters exhibited consistent values. Pooled area under the curve was 0.91 for adults and 0.76 for children. Optimal threshold for estimating IH was 5.76 mm for adults and 5.78 mm for children., Conclusion: Measurement of ONSD by ultrasonography is a reliable, low-cost, and safe alternative for the estimation of IH with TBI in adults. More robust studies are needed to overcome the high risk of bias and heterogeneity for this analysis., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Purpose: As one of the pathogenic factors of cerebral small vessel disease, venous collagenosis may result in the occlusion or stenosis of deep medullary veins (DMVs). Although numerous DMVs can be observed in susceptibility-weighted MRI images, their diameters are usually smaller than the MRI resolution, making it difficult to segment them and quantify their sizes. We aim to automatically segment DMVs and measure their diameters from gradient-echo images., Methods: A neural network model was trained for DMV segmentation based on the gradient-echo magnitude and phase images of 20 subjects at 7 T. The diameters of DMVs were obtained by fitting measured complex images with model images that accounted for the DMV-induced magnetic field and point spread function. A phantom study with graphite rods of different diameters was conducted to validate the proposed method. Simulation was carried out to evaluate the voxel-size dependence of measurement accuracy for a typical DMV size., Results: The automatically segmented DMV masks had Dice similarity coefficients of 0.68 ± 0.03 (voxel level) and 0.83 ± 0.04 (cluster level). The fitted graphite-rod diameters closely matched their true values. In simulation, the fitted diameters closely matched the true value when voxel size was ≤ 0.45 mm, and 92.2% of DMVs had diameters between 90 μm and 200 μm with a peak at about 120 μm, which agreed well with an earlier ex vivo report., Conclusion: The proposed methods enabled efficient and quantitative study of DMVs, which may help illuminate the role of DMVs in the etiopathogenesis of cerebral small vessel disease., (© 2024 International Society for Magnetic Resonance in Medicine.)

Abstract Ocular Point of Care Ultrasound (PoCUS) is emerging as a valuable utility within emergency medicine. Optic nerve sheath diameter (ONSD) has been demonstrated to correlate closely with intracranial pressure (ICP) and an elevated measurement can detect raised ICP readily, where fundoscopy may not, owing to both technical challenges and insufficient clinical skills. A previously fit and well 10-year-old girl presented to the paediatric emergency department with worsening headache, fever and lethargy. On examination, her left pupil was large, and not reactive to light. Initially, her GCS was 15 but suddenly dropped to 8/15. Her blood tests showed raised inflammatory markers. A CT head was reported as possible pansinusitis and MRI of her brain was initially reported as showing evidence of meningeal irritation only. Due to her drop in GCS PoCUS of optic nerve sheath was conducted which showed evidence of increased ICP with increased optic nerve sheath diameter of 6.8mm. This led to a reassessment of the MRI imaging by the neurosurgical team who felt there was evidence of subdural empyema. The patient was transferred to the tertiary neurosurgical centre, where an emergency evacuation of subdural empyema was carried out. Staphylococcus aureus and Streptococcus pyogenes were grown from pus samples. Early detection of raised ICP is of paramount importance in terms of being able to instigate neuroprotective measures and prevent adverse neurological outcomes. PoCUS is a readily available, non-irradiating, easily repeatable, well-tolerated and readily teachable ultrasound modality and a useful tool which should be employed in paediatric and adult emergency departments.

Detailed anamnesis and systematic physical examination are often relevant in the diagnostic routine of acute appendicitis. However, physicians are increasingly motivated to obtain radiological approval. Inherent limitations due to radiologists' experience and the presenting anatomy may result in contradictory outcomes between the described and intraoperative findings. In this study, a comparison of anthropometric measurements of the appendix vermiformis obtained by radiologists and surgeons in children with acute appendicitis is discussed. The external appendiceal diameter in 53 patients who underwent surgery between April 2022 and January 2024 was measured at three different anatomical locations during preoperative ultrasound and intraoperatively with the help of Vernier calipers. Appendectomy materials were classified into negative, acute, and complicated appendicitis subgroups on the basis of histopathological results. The widest median diameter, expressed in millimeters, was analyzed statistically in terms of diagnostic accuracy. Histopathological analysis revealed negative appendectomy in 15.1%, acute appendicitis in 66%, and complicated appendicitis in 18.8% of the patients. The median age at presentation was 11.4 years (4-17.3 years), and 45.3% of the patients were females. The average median appendiceal diameter was 7.8 ± 2.4 mm according to the caliper and 7.9 ± 2.7 mm according to ultrasound (p > 0.05). The evaluation by the caliper revealed a much smaller diameter in 19 patients than did ultrasound. The appendiceal diameter of eight documented negative appendectomy samples was 7 mm or greater. US failed to identify the presence of an appendicolith in 11 cases (20.8%), all of which were disclosed during histopathological evaluation. It is possible to conclude that ultrasound and intraoperative anthropometric measurements correlate according to our study. Diagnostic accuracy, however, which is individually based on ultrasound appendix diameter values greater than 6 mm, is controversial. It is clear that comparison and further reinterpretation of such anthropometric measurements in light of histopathological consequences may help diminish the frequency of negative and perforated appendectomies., (© 2024 American Association of Clinical Anatomists and British Association of Clinical Anatomists.)

The abrage fault inspection and bobbin diameter measurement are very important processes in yarn manufacturing industry. These processes are performed manually, and so they are difficult, low efficient, time-consuming processes. The abrage faults are seen as colour or shade difference on the dyed fabric. This happens when the bobbins including abrage are converted to the fabric form, mistakes in colour differences are seen after dyeing process. An automatic machine vision system was developed for detecting abrage fault, and bobbin diameter from yarn bobbin cross-section view. Image processing software was developed and applied on different sizes of bobbin samples including different types of abrage fault. The success of vision system was statistically evaluated by detecting the bobbin abrage faults with 95.83% accuracy. In addition, the bobbin diameters obtained from the developed image processing algorithm were statistically analysed and the correlation coefficient (R²=0.99) was calculated. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury is a disease with high mortality with increased intracranial pressure included in the emergency department. Neuroimaging and intracranial pressure monitoring are limited in resource-limited settings. Optic nerve sheath diameter measurement to assess intracranial pressure indirectly using point-of-care ultrasound is appealing in diagnostics and decision-making. Objectives: We plan to evaluate the utility of point-of-care ultrasound on optic nerve sheath diameter role in traumatic brain injury patients. In these patients, optic nerve sheath diameter measurement was performed immediately postoperatively and 24 h later by trained residents. The procedure was repeated if any change in clinical status was observed. Results: A total of 50 patients were enrolled. Twenty-one patients underwent neurosurgical intervention. Three patients died in hospital. Eighteen patients had optic nerve sheath diameters less than 5 mm, 20 patients had optic nerve sheath diameter between 5 mm and 6 mm, and 12 patients had optic nerve sheath diameter > 6 mm. In 2 patients with changes in clinical condition, the repeat optic nerve sheath diameter assessment showed an increase in optic nerve sheath diameter. Conclusion: Despite limitations, trained health care providers can perform optic nerve sheath diameter. Longer training time and quality assurance are needed to appreciate the impact.

Aim: In our study, we investigated whether there is any relationship between fetal abdominal circumference measurement and shoulder dystocia. Materials and Methods: Our study is retrospective. Patients who gave birth in our hospital between 2013 and 2023 were included in the study. A total of 200 patients, 100 cases, and 100 control groups who had a vaginal delivery were included in the study. The relationship between fetal abdominal circumference and shoulder dystocia was examined. SPSS (IBM SPSS for Windows, Ver.26) statistical package program was used for statistical analysis of our study. Results: The average age of the patients is 28.1±5.6. The average ultrasound measurement value of the fetal abdomen circumference of pregnant women is 36.3+1.3 cm. In the group with shoulder dystocia, the ultrasound measurement of fetal abdominal circumference was found to be 37.27±0.5 cm and above. Fetal abdominal circumference measurement was found to be statistically significantly higher in the group with shoulder dystocia compared to the control group (p=0.000). In our study, no statistically significant relationship was found between fetal weight and shoulder dystocia (p=0.235). Fetal complication rates were found to be statistically significantly higher in pregnant women with shoulder dystocia (p=0.000). The rates of maternal complications in pregnant women with shoulder dystocia were found to be statistically significantly higher (p=0.001). When additional parameters were examined, shoulder dystocia was statistically higher in the high parity, high body mass index, and diabetic patient groups. Conclusion: In our study, the average fetal abdomen circumference measurement in the group with shoulder dystocia was found to be 37.27±0.5 cm and was statistically significantly higher than the control group. [ABSTRACT FROM AUTHOR]

Abstract Background Measuring stem diameter (SD) is a crucial foundation for forest resource management, but current methods require expert personnel and are time-consuming and costly. In this study, we proposed a novel device and method for automatic SD measurement using an image sensor and a laser module. Firstly, the laser module generated a spot on the tree stem that could be used as reference information for measuring SD. Secondly, an end-to-end model was performed to identify the trunk contour in the panchromatic image from the image sensor. Finally, SD was calculated from the linear relationship between the trunk contour and the spot diameter in pixels. Results We conducted SD measurements in three natural scenarios with different land cover types: transitional woodland/shrub, mixed forest, and green urban area. The SD values varied from 2.00 cm to 89.00 cm across these scenarios. Compared with the field tape measurements, the SD data measured by our method showed high consistency in different natural scenarios. The absolute mean error was 0.36 cm and the root mean square error was 0.45 cm. Our integrated device is low cost, portable, and without the assistance of a tripod. Compared to most studies, our method demonstrated better versatility and exhibited higher performance. Conclusion Our method achieved the automatic, efficient and accurate measurement of SD in natural scenarios. In the future, the device will be further explored to be integrated into autonomous mobile robots for more scenarios.

Abstract Objective To determine the effectiveness of pelvis diameters in determining postoperative outcomes in men who underwent open radical cystectomy + urinary diversion, it is aimed to predict the factors that may affect the operative difficulty and possible surgical outcomes before the operation. Methods A total of 79 radical cystectomy patients operated in our institution with preoperative computed tomography (CT) were included the study. Pelvic dimensions; symphysis angle (SA), upper conjugate, lower conjugate, pelvic depth, apical depth (AD), interspinous distance (ISD), bone femoral width and soft tissue width were measured by preoperative CT. ISD index were defined as ISD/AD. Postoperative outcomes and indicators of operative difficulty were recorded. Regression analyses were used to predict perioperative and postoperative outcomes. Results Total of 96 complications were observed in 52 of the 79 patients in ninety days (65,8%) with a mean age of 68.25 years. There were significant correlations between SA and body mass index (BMI) with operative time (p = 0.006, p

BACKGROUND: Several studies show that gestational age estimation during the third trimester of pregnancy using fetal transcerebellar diameter is superior to that measured using fetal biometry (biparietal diameter, head circumference, abdominal circumference, and femur diaphysis length). However, the conclusion of the studies stemmed from findings of correlation and regression statistical tests, which are not the recommended statistical analysis methods for comparing the values of 1 variable as measured by 2 different methods. OBJECTIVE: This study aimed to compare the accuracy of gestational age estimation using transcerebellar diameter to that using fetal biometry during the third trimester of pregnancy using Bland-Altman statistical analysis. STUDY DESIGN: This was a cross-sectional study on pregnant women who presented for routine antenatal care follow-up in the third trimester of pregnancy (28–41 weeks of gestation) at St. Paul's Hospital Millennium Medical College (Ethiopia) between November 1, 2020, and February 28, 2021. Data were collected prospectively using a structured questionnaire on the Open Data Kit. The primary outcome of our study was the mean bias of gestational age estimation (error in estimating gestational age) using transcerebellar diameter and composite fetal biometry (composite gestational age). Data were analyzed using Stata (version 15; StataCorp, College Station, TX). Simple descriptive analysis, Bland-Altman analysis, and the Kendall τa discordance measurement were performed as appropriate. The mean bias (error) and limits of agreement were used to present the significance of the finding. RESULTS: A total of 104 pregnant women in the third trimester were included in the study. The mean error (bias) when transcerebellar diameter was used to estimate the gestational age was 0.65 weeks vs a bias of 1.1 weeks using composite biometry, compared with the gold standard method from crown-lump length (in both cases). The calculated estimated limit of agreement was narrower in the case of transcerebellar diameter than in the case of composite fetal biometry (−3.56 to 2.25 vs −4.73 to 2.53). The Kendall τa discordance measurement revealed that gestational age estimations using composite biometry and crown-lump length were 51% to 70%, respectively, more likely to agree than disagree and that gestational age estimations using transcerebellar diameter and crown-lump length were 62% to 77%, respectively, more likely to agree than to disagree (P≤.001). CONCLUSION: Gestational age estimation using transcerebellar diameter is more accurate than gestational age estimation using composite gestational age (biparietal diameter, head circumference, femur diaphysis length, and abdominal circumference). Transcerebellar diameter should be used to date third-trimester pregnancies with unknown gestational age (unknown last normal menstrual period with no early ultrasound milestone).

Background Hair diameter is a crucial element in deciding the treatment and predicting the prognosis of hair transplantation in patients with hair loss. Methods Ten female volunteers participated in this study. Three sites at different horizontal positions of the scalp were chosen for measurement: midoccipital, mastoid, and temporal. Three boxes of 1 cm2 were marked from superior to inferior along the midline of each site, and five anagen hairs ≥10 cm long were randomly sampled from each box. The thickness of each collected hair was measured at three positions along the hair length: 1 cm, 5 cm, and 10 cm from the surface of the skin. The diameters of the hairs were measured using a micrometer caliper and a Folliscope phototrichogram, and the measurements were compared. Results The average thickness of all hairs was 76.90±12.29 μm when measured with the caliper and 108.78±19.97 μm when measured with the phototrichogram. There was a statistically significant difference between the two measurement methods (P