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Angel Sosa

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  1. Maybe you can learn more about it here: https://3dprintedultrasounds.com/blog/2018/09/10/convert-an-ultrasound-image-to-an-stl/
  2. Hello, check this tutorial out https://www.embodi3d.com/blogs/entry/345-a-ridiculously-easy-way-to-convert-ct-scans-to-3d-printable-bone-stl-models-for-free-in-minutes/
  3. Top Orbital and Skull 3D Model STL Files on embodi3D® In our day-to-day lives, we rely on vision more than any of the other four senses, so it only makes sense that human anatomy has adapted to include several features which keep our eyes safe: tear ducts, eyelids, and of course the orbital bone. The orbit (also known as the "eye socket") provides a rigid form of support and protection for some of the most sensitive parts of the eye including the central retinal artery, maeula, retina, choroid, and sclera. The orbit has such complex anatomical features that modeling can prove difficult, and in many instances, the finer features of the orbital bone have been simply been averaged out. The orbital structure isn't one bone, but seven: the frontal, lacrimal, ethmoid, zygomatic, maxillary, and palatine, and sphenoid bones. Can you think of any part of the human body where seven bones converge to fulfill a singular purpose? In recognition of this phenomenal feature of the human anatomy (and one of the most recognizable parts of the human skull), this week's embodi3D® Top Uploads articles, we are featuring several standout uploads — all of which can be used to create an orbital and skull 3D model. As detailed in the scholarly article "Clinical application of three-dimensional printing technology in craniofacial plastic surgery" 3D printing techniques are being used in craniofacial surgeries and especially in reconstruction procedures the require complex modeling. Using the latest 3D printing technology and the STL files converted using democratiz3D®, the contralateral orbit can serve as a point of reference for those in the medical field since the ipsilateral structures taken with a CT scan can be easily converted into an STL file and then fed to a 3D printer. These technologies improve patient consultations, increase the quality of diagnostic information while also helping to improve the planning stage of the surgical process. During surgery, a 3D-printed model of the orbital can be used to orient surgical staff and serve as a guide for surgical resectioning procedures. While these files are available for free on the website, you must register with embodi3D® before you can begin uploading and converting your own CT scans into STL files as well as downloading and 3D printing anatomical models from other users. Every day the collection of anatomical models grows on the embodi3D® website. This is but one of the many ways embodi3D® is seeking to revolutionize medical practices. #1. An Awesome Model of the Orbit's Acute Anatomy The orbits are conical structures dividing the upper facial skeleton from the middle face and surround the organs of vision. Seven bones conjoin to form the orbital structure as we can see in the example below. #2. A 3D Model of the Orbit's Surface in STL Format This excellent 3D model of embodi3D® shows the superficial bony margin of the orbit, which is rectangular with rounded corners. The margin is discontinuous at the lacrimal fossa. The supraorbital notch (seen in the image below) is within the supraorbital rim and is closed to form the supraorbital foramen in 25% of individuals. The supratrochlear notch is medial to the supraorbital notch. #3. A CT Scan of an Orbital Floor Fracture Hisham published this excellent ct scan on embodi3D®. Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim. Indications for repair of the orbital floor in these cases are the same as those for indirect (blowout) fractures. Indirect fractures of the orbital floor are not associated with fracture of the inferior orbital rim. #4. A 3D Model of an Orbital Fracture CT scans with coronal or sagittal views and 3D models help guide treatment. They allow evaluation of fracture size and extraocular muscle relationships, providing information that can be used to help predict enophthalmos and muscle entrapment. #5. 3D Model Showing an Orbital Fracture Dropbear upload this excellent example of a right orbit fracture. #6. An Orbit 3D Model (Printable) Showing Fibrous Dysplasia (FD) for Surgical Demonstration The FD is a benign slowly progressive disorder of bone, where normal cancellous bone is replaced by fibrous tissue and immature woven bone. This entity constitutes about 2.5 % of all bone tumors. #7. An Orbit tumor 57-year-old male patient with increase in left orbital volume and proptosis for 6 months related to headache. No relevant personal medical history. #8. Complex right facial bone fractures In this example we can evaluate a rotated tripod, orbital roof and floor, maxillary sinus, nasoorbitalethmoidal. References Choi, J. W., & Kim, N. (2015). Clinical application of three-dimensional printing technology in craniofacial plastic surgery. Archives of plastic surgery, 42(3), 267. Bibby, K., & McFadzean, R. (1994). Fibrous dysplasia of the orbit. British journal of ophthalmology, 78(4), 266-270.
  4. If you are able to read this sentence, you not only have your English teacher to thank (as the popular bumper sticker suggests), but also your brain. The human brain — all of 3 pounds (1,350 grams) — consumes over 10% of the human body's total energy, yet most of its weight is water and makes up very little of the body's total mass. The recent explosion of 3D printing technologies in the field of neurosurgery has made creating a 3D brain model using CT-converted STL files easier than ever. This popularity has led to a number of medical authorities to further explore the technology's current utility and future potential. In a recent article titled "3D printing in neurosurgery: A systematic review," it was found that 3D printing techniques are not only practical, but also a viable means of creating anatomically correct models that can be applied to medical simulations, training, surgical planning, and secondary devices. 3D-printed models have also enabled neurosurgeons to explore structures in a way that is non-invasive. Amazingly, 3D models can be created using existing technologies, such as two-dimensional MRI, CT, and X-ray scans. These files are then converted into 3D printer-ready STL files using a program such as democratiz3D® from embodi3D®, a free tool that makes converting CT scans in 3D-printable files as easy as possible. Before you can make use the awesome medical 3D printing services offered by embodi3D®, you must become a registered embodi3D® member. It's absolutely free to join — sign up today! Once you've signed up, be sure to check out the tutorial demonstrating how easy it is to create your own 3D models. #1. 3D Printing a Brain Model with Stroke from an STL File This excellent 3D model of the brain circulation shows all the intracranial vessels. Stroke is a generic term that describes the clinical event of a sudden onset of neurologic deficit secondary to cerebrovascular disease. Stroke has 4 main etiologies, including cerebral infarction (80%), intraparenchymal hemorrhage (15%), nontraumatic subarachnoid hemorrhage (5%), and venous infarction (approximately 1%). Clinically, ischemic infarction is the most common etiology and will be the main topic of this introduction. The principal cause of cerebral infarction is atherosclerosis and its sequelae. Middle Cerebral Artery (MCA) distribution typically involves the majority of the lateral surface of the hemisphere, including the frontal, temporal, and parietal lobes. In addition, the majority of the lenticulostriate arteries arise from the M1 segment and supplies the basal ganglia. Anterior Cerebral Artery (ACA) supplies the medial anteroinferior frontal lobe, the anterior 2/3 of the medial hemisphere surface, and a variable amount of territory over the cerebral convexity. The corpus callosum is also typically supplied primarily by the ACA branches: Callosal perforating, pericallosal, and posterior splenial branches. Posterior Cerebral Artery (PCA) vascular territory, including the occipital lobes, inferior temporal lobes, and medial posterior 1/3 of the interhemispheric brain. Patients with PCA ischemia most commonly present with visual complaints. Large vessel/atherosclerotic strokes represent ~ 40% of strokes. The carotid bifurcation is the most common site of atherosclerotic plaque. Circle of Willis - A1-segment: Anterior cerebral artery from carotid bifurcation to anterior communicating artery gives rise to the medial lenticulostriate arteries. - A2-segment: Part of anterior cerebral artery distal to the anterior communicating artery. - P1-segment: Part of the posterior cerebral artery proximal to the posterior communicating artery. The posterior communicating artery is between the carotid bifurcation and the posterior cerebral artery) - P2-segment: Part of the posterior cerebral artery distal to the posterior communicating artery. - M1-segment: Horizontal part of the middle cerebral artery which gives rise to the lateral lenticulostriate arteries which supply most of the basal ganglia. - M2-segment: is the part in the sylvian fissure and the M3-segment is the cortical segment. - Horizontal M1-segment Gives rise to the lateral lenticulostriate arteries which supply part of head and body of caudate, globus pallidus, putamen and the posterior limb of the internal capsule. Notice that the medial lenticulostriate arteries arise from the A1-segment of the anterior cerebral artery. - Sylvian M2-segment Branches supply the temporal lobe and insular cortex (sensory language area of Wernicke), parietal lobe (sensory cortical areas) and inferolateral frontal lobe - Cortical M3-segment Branches supply the lateral cerebral cortex #2. A Brain Model Created from a High-Resolution MRI Scan This 3D model shows each of the cerebral hemispheres (the frontal lobe, the parietal lobe, the temporal lobe, and the occipital lobe, limbic lobe), sulcus, Silvian fissure and Rolandic fissure. Surgical education has undergone a recent paradigm shift toward simulation-based training as opposed to the traditional experience-based training program. This change reflects the need for a safe teaching environment separated from the risk-inherent operating room, thus enabling teaching faculty to focus on training during simulations and patient care during operations. Other factors have also contributed to the shift including instituted training restrictions that have limited patient interactions, which are essential for procedural learning. The capabilities of 3D printing are well suited for the development of these physical simulators, which is evident from the literature. #3. An MRI of the Brain This excellent MRI image of the brain shows all the anatomy structures with great detail. Current surgical planning for the resection of brain tumors involves using MRI technology to differentiate between tumor and surrounding brain tissue. Nonetheless, even when this distinction is clear, it can be difficult for surgeons to appreciate the relationships between adjacent anatomical landmarks during the procedure. 3D printing technology has enabled MRI data to be translated into patient-specific models depicting the associations between tumor, skull, vasculature, and surrounding nonpathologic brain tissue. Therefore, surgeons can recognize the location and extent of the tumor relative gyral/sulcal patterns and skull features. Models have then been further utilized to simulate realistic surgical approaches under microscopic observation. Spottiswoode et al. additionally included printed regions of functional MRI (fMRI) activation determined from presurgical mapping paradigms in the model to demarcate areas of eloquent cortex that should be avoided in resection. #4. A Brain CTA (nrrd file) This is an illustrative case of a normal CT angiography obtained with contrast administration. #5. A Fronto-Parietal Brain Tumor from an MRI Printed head models have also had a role in the planning and development of novel treatments for brain tumors. Phantoms that replicate the properties of the skull and cerebral tissue were produced to evaluate the potential for MRI-guided focused ultrasound to be used in the noninvasive thermocoagulation of brain tumors. #6. A 55-Year-Old Male's Brain (from an MRI Scan) The neocortex is the most phylogenetically developed structure of the human brain as compared with the brains of other species. The complex pattern of folding allows an increased cortical surface to occupy a smaller cranial volume. The pattern of folding that forms the sulcal and gyral patterns remains highly preserved across individuals. This enables a nomenclature for the cortical anatomy. #7. A Post-Traumatic Brain Injury Pneumocephalus refers to the presence of intracranial gas, and in the vast majority of cases the gas is air. The term encompasses gas in any of the intracranial compartments, and is most commonly encountered following trauma or surgery. Gas on CT will have a very low density (~ -1000HU) but care needs to be taken in ensuring that it is not fat which although of much higher density (-90HU) also appear completely black on routine brain windows. #8. A 3d printable model of the brain: An example This brain model was printed for a customer in white PLA. It turned out great! #9. Dilated Ventricles with Colpocephaly Colpocephaly is a congenital brain abnormality in which the occipital horns - the posterior or rear portion of the lateral ventricles (cavities) of the brain -- are larger than normal because white matter in the posterior cerebrum has failed to develop or thicken. #10. Full Sized Brain with marked cerebellar atrophy Diffuse atrophy of the cerebellum refers to a progressive and irreversible reduction in cerebellar volume. It is a relatively common finding and found in a wide variety of clinical scenarios. References 1. Randazzo, M., Pisapia, J. M., Singh, N., & Thawani, J. P. (2016). 3D printing in neurosurgery: a systematic review. Surgical neurology international, 7(Suppl 33), S801. 2. Radiology assistant web. 3 Radiopaedia.org 4. Osborn´s Brain Imaging. 5. Medscape
  5. We encourage you to check out the Abdomen and Pelvis CTs forum for more great CT scans of the abdomen and pelvis. Also, we invite you to become an embodi3D® member. It's free and all you have to do is choose a screen name, enter your email address and preferred password, answer CAPTCHA, and you'll have access to a number of tissue conversion algorithms and other great democratiz3D® tools.
  6. This week's embodi3D® blog post is inspired by a recently published article titled "Three-Dimensional Printing Surgical Applications". The scholarly article goes in depth on the current state of biomedical 3D-printing applications, with a special focus on how the technology may affect the ever-growing list of patients on the organ transplant waiting list, which numbers over 150,000 in the United States alone. While medical 3D printing has been used to create 3D-printed models for training, educational, and inter-surgical reference applications, 3D-printed organs are still not viable in many types of procedures. This is especially true of organs found within the abdominal cavity (such as the gastric mucosa of the stomach lining), which rely on a mucous membrane layer in order to function properly. But, surgeons point to the progression of technology and see 3D-printed organs in the horizon. For these reasons, the staff of embodi3D® remain relentless advocates of this technology; for the present applications and also where medical 3D printing from STL files will take the medical community as we head into a new age of less-invasive, more ethical surgery. For years, embodi3D® has provided a anatomically correct, 3D-printed organ models for the purpose of medical device testing and research. These models are made from CT scans, converted into STL files, with the final result being a highly detailed 3D-printed model. It is our hope that someday we can look back to the present era and wonder how we ever relied on human donations for organ transplantation. After you browse through this group of uploads, we encourage you to check out the Abdomen and Pelvis CTs forum for more great CT scans of the abdomen and pelvis. Also, we invite you to become an embodi3D® member. It's free and all you have to do is choose a screen name, enter your email address and preferred password, answer CAPTCHA, and you'll have access to a number of tissue conversion algorithms and other great democratiz3D® tools. #1. A Whole-Body CT Scan in DICOM and NRRD File Formats First place: A Ridiculously Easily Way to Convert CT Scans to 3D Printable Bone STL Models for Free in Minutes which allows you to follow along with the tutorial. Included is an anonymized chest abdomen pelvis CT in both DICOM and NRRD formats. Take a look to this CT model of whole body. #2. Pelvis CT scan Showing Osseous Disruption of the Right Posterior Portion of the Pelvic Ring Pelvis forms ring surrounding and protecting pelvic organs. The anterior ring: Pubic bones, acetabula, ilium to level of ischial spines and posterior ring: Ilium from ischial spines posteriorly + sacrum - Not all disruptions of pelvic ring are unstable. - Integrity of ring dependent on ligaments; can infer ligament injury based on bone & joint displacement. #3. A Contrast-Enhanced CT Scan of the Abdomen and Pelvis This CT scan with contrast shows scoliosis of the lumbar spine, the intra abdominal organs are normal. #4. Pelvis CT Scan Showing Postoperative Changes of the Osseous Disruption (#2) Follow-up: Staging, Grading, & Classification • Young-Burgess classification: Most widely used. Focuses on degree of injury and direction of force. APC: Symphyseal diastasis or sagittal pubic ramus fractures – I: Symphyseal diastasis < 2.5 cm or bilateral pubic ramus fractures (superior and inferior); sacrotuberous and sacroiliac ligaments and SIJ intact (stable). – II: Symphyseal diastasis > 2.5 cm, anterior SIJ diastasis; posterior SIJ normal width (partially stable). – III: Symphyseal diastasis > 2.5 cm, anterior + posterior SIJ diastasis or separated sacral alar fracture (unstable). LC: Oblique/coronal/transverse ramus fractures plus – I: Sacral impaction fracture on side of impact (stable). – II: Iliac wing fracture extending through ring (crescent fracture) on side of impact with SIJ disruption (partially unstable). Ilium usually internally rotated with fulcrum in or adjacent to sacroiliac joint. – III: Type I or II injury on side of impact with contralateral APC injury = windswept pelvis (unstable). VS: Symphyseal diastasis or sagittal ramus fractures with complete disruption of posterior arch and vertical displacement of hemipelvis (unstable) – Highest mortality rate. Combined mechanism https://www.embodi3d.com/files/file/7142-pelvis-whitneys-project/ 5. CT scan with contrast of thorax and abdomen. A CT scan with contrast showing all the structures of the thorax and abdomen. #6. CT Scan without Contrast of Thorax and Abdomen, Converted into 3D-Printable STL File A whole body NRRD file converted from CT Scan for Medical 3D Printing includes the chest, abdomen and pelvis. #7. CT Scan (with Contrast) Showing Postoperative Changes in a Segmentation and Fusion Anomaly (SFA) of Lumbar Spine This ct scan also shows osteodegenerative changes and osteophytes. Coronal MR, AP radiography best for detecting and characterizing SFAs, "counting" abnormal vertebral levels. #8. A 3D printing model of the gastrointestinal tract from a CT Scan (with Oral Contrast) In this example we can evaluate the stomach, small intestine and large intestine anatomy with exquisite detail. #9. An skin 3D model of the surface anatomy of abdomen The abdominal area is the region between the chest and the pelvis. Arterial supply of the abdominal wall comes from the following: Superior epigastric artery, a branch of the internal thoracic artery. Inferior epigastric artery, a branch of the external iliac artery. Superficial circumflex iliac and superficial epigastric arteries, the branches of the femoral artery. The skin of the front of the abdomen is thin as we can see this great example. #10. Another 3D printing model of the gastrointestinal tract from a CT Scan (with Oral Contrast) showing the relations with vascular vessels In this example we can evaluate some branches of the Abdominal Aorta. References 1. AlAli, A. B., Griffin, M. F., & Butler, P. E. (2015). Three-dimensional printing surgical applications. Eplasty, 15.
  7. It's an exciting time in medical 3D printing and we would like you to be a part of it. Register on embodi3D® and take advantage of the many conversion algorithms registered users can utilize. The kidney is crucial to human health. Visualize, for a moment, the human body as a city; the veins, the highway transporting nutrients; the brain, the urban planners, and of course, the kidneys would be the waste management department. Kidneys don't have a glorious role, but like a city waste department, you quickly realize something is amiss when they aren't doing their official duties.
  8. The embodi3D® website hosts a section dedicated to CT scans of the head, neck, and spine, but this is the first blog post devoted to the neck. In this week's embodi3D® blog post, we will take a look at some of the most compelling files uploaded to the embodi3D® website. All of these can be used to explore the anatomy of the neck in a 3D model.
  9. Creating a Kidney Free and Downloadable Models Using the Latest Medical 3D Printing Technologies At embodi3D®, we see the utility of creating a kidney model using 3D printing technologies as a way to better understand this complex and utterly vital organ. Through CT-converted STL files, researchers, students, and medical practitioners can examine the kidney in 3D form and in a state that is more natural. An average kidney has a peripheral cortex, central medulla, vessels, urothelial structures, and renal sinus fat. All of these features work together to properly eliminate toxins from the body, ensuring excess creatinine and urea are expelled and not concentrated in the bloodstream. The kidney is crucial to human health. Visualize, for a moment, the human body as a city; the veins, the highway transporting nutrients; the brain, the urban planners, and of course, the kidneys would be the waste management department. Kidneys don't have a glorious role, but like a city waste department, you quickly realize something is amiss when they aren't doing their official duties. Kidneys work by regulating the amount of water retained in the body. The amount of water retained is based on the body's hydration needs and the kidneys' need to expel toxins, namely urea and creatinine. When a kidney doesn't operate as it should, these toxins can build up in the bloodstream, leading to a range of health complications. A common blood test can reveal these byproducts. Currently, there is no cure for chronic kidney disease (CKD), only methods to slow its progression and provide some relief through dialysis and kidney transplants, respectively. A recent investigative inquiry into the impact of 3D-printed pelvicalyceal system models on patient information prior to surgeries related to percutaneous nephrolithotripsy found that it is highly feasible to generate models of the pelvicalyceal, and also helps patients to better understand the disease and the surgical process in treating it. Although 3D-printed models of the kidney continue to be used in patient education and as reference tools during complex surgical procedures. Although, more recently, a young patient in the United Kingdom received a kidney transplant during a procedure aided by a 3D-printed reference model. The last 5 to 10 years have seen dramatic changes in the ability of CT scanners to image faster with greater resolution. Using this new technology, CT has aided in the evaluation of urinary lithiasis, renal masses, and adrenal lesions. It's an exciting time in medical 3D printing and we would like you to be a part of it. Register on embodi3D® and take advantage of the many conversion algorithms registered users can utilize. #1. Left kidney in an STL (3D Printer-Ready File) Dr. Mike uploads this amazing 3d model of the left kidney. The kidneys are generally symmetric in size and appearance, but the left kidney may also be slightly longer than the right kidney. The kidneys are usually larger in male patients and should reach full size by the late teens. The normal range of the kidney size is variable based on patient height with median length 11 cm, and most are within a range of 9.8 to 12.3 cm. #2. 3D Model of a Right Renal Cortex (Kidney) Processed Using 3D Slicer The cortical thickness of the kidneys is usually symmetric. The mean thickness of the cortex is approximately 10 mm, based on sonographic studies #3. 3D Model of the Left Kidney with Hydronephrosis Hydronephrosis is a dilatation of collecting system. demonstrate the full length of the ureters and pyelocaliectasis. Grading: ○ Mild: Mild dilatation of renal pelvis ± dilatation of calyces. ○ Moderate: Moderate dilatation of renal pelvis and dilatation of calyces. ○ Severe: Severe dilatation of renal pelvis and calyces and parenchymal thinning. Thank you valchanov for this excellent example. #4. CT Angiogram of Normal Kidneys (from a Whole-Body CTA) When the cortex has enhanced but the medulla is nearly unenhanced, the nephrographic phase. We can see the renal vessels with exquisite detail. Beyond the renal capsule is the perinephric space, which contains fat and thin fibrous septations. The perinephric fat is contained within Gerota’s fascia. Gerota’s fascia also surrounds the adrenal, which is separated from the kidney by a transverse septum. The anterior and posterior renal fascias separate the kidney and adrenal from other adjacent spaces. If the fascia becomes thickened due to fluid or other causes, it may be visible. #5. Another CT Angiogram of Normal Kidneys (from a Whole-Body CTA) in a Coronal View This example of CTA shows normal kidneys. When the cortex and medulla are more similarly enhanced, and the urographic or excretory phase. Because of its high contrast sensitivity, CT allows differentiation of tissues with much less attenuation difference than can be identified with radiography; thus, there is greater sensitivity for detection of small or faint calcifications than is possible with radiography. #6. 3D Model of the Great Abdominal Vessels In this excellent 3D model we can see the great vessels of the abdomen. The kidneys are located within the retroperitoneal space to each side of the vertebral bodies at the level of T10-L2. The left kidney is often located slightly more cranial than the right kidney. Each kidney is supplied by one or more renal arteries, which originate from the aorta below the level of the superior mesenteric artery or rarely from the iliac arteries. Single bilateral renal arteries are the most common configuration and the renal arteries course anterior and medial to the kidney. However, in approximately 24% to 30% of kidneys, there will be multiple renal arteries. The right main renal artery typically passes posterior to the IVC, but precaval arteries are present in 5% of patients. The main renal artery typically divides at the renal hilum to form a dorsal and ventral branch. The dorsal and ventral branches subsequently divide into segmental renal arteries. In approximately one fifth of renal arteries, there may be early branching of the renal arteries within 2 cm of the origin of the main renal arteries. The renal arteries may also be in close association with the collecting system or proximal ureter. #7. CT Angiogram Showing Left Kidney with a Tumor In this CTA we can see a tumor localized in posterior pole of the left kidney. #8. T1-Weighted MRI Showing the Normal Anatomy of the Kidneys Normal T1-weighted MRI appearance of the kidney. The renal parenchyma is similar to other soft tissues and there is T1 bright fat in the renal hilum References 1. Atalay, H. A., Canat, H. L., Ülker, V., Alkan, İ., Özkuvanci, Ü., & Altunrende, F. (2017). Impact of personalized three-dimensional (3D) printed pelvicalyceal system models on patient information in percutaneous nephrolithotripsy surgery: a pilot study. International braz j urol, 43(3), 470-475. 2. Soliman, Y., Feibus, A. H., & Baum, N. (2015). 3D printing and its urologic applications. Reviews in urology, 17(1), 20. 3. Lee, J. K. (Ed.). (2006). Computed body tomography with MRI correlation (Vol. 1). Lippincott Williams & Wilkins.
  10. Magnetic resonance imaging (MRI) allows for the delineation between normal and abnormal tissue on a macroscopic scale, sampling an entire tissue volume three-dimensionally. While MRI is an extremely sensitive tool for detecting tissue abnormalities, association of signal changes with an underlying pathological process is usually not straightforward. This digital model can then be used to create a 3D-printed custom holder for the brain. (1,2,3) An MRI sequence is a number of radiofrequency pulses and gradients that result in a set of images with a particular appearance. When describing most MRI sequences we refer to the shade of grey of tissues or fluid with the word intensity, leading to the following absolute terms: - high signal intensity = white - intermediate signal intensity = grey - low signal intensity = black Often we refer to the appearance by relative terms: - hyperintense = brighter than the thing we are comparing it to. - isointense = same brightness as the thing we are comparing it to. - hypointense = darker than the thing we are comparing it to. This week we´d like to share the best MRI images from embodi3d. Also, we invite you to become an embodi3D® member and get full access, it´s easy and free! 1. Aortic type III MRI 3D reconstruction This excellent 3D model was uploaded by valchanov. The aortic arch type III is described using as criterion the vertical distance from the origin of the brachiocephalic trunk (BT) to the top of the arch in the parasagittal ‘stretched-out’ projection. This distance is < 2 diameter of the left common carotid artery (LCA). This can influence the feasibility and difficulty of interventional and/or surgical maneuvers. 2. An head´s MRI pmcpartlan uploads this brain´s MRI, T1 sequence. In the context of neurosurgical planning, one can lay implantable devices on the skull or brain to see precise ultimate spatial fits, as well as anticipate surgical approaches such as any bone windows. The 3D models can also be excellent educational tools that are more robust and less toxic than fixed tissue. 3. An MRI of 25 year old male In this 3D model reconstruction we can see we exquisite detail all the structures of the face. Excellent for surgical planning. 4. A left knee MRI after an injury This MRI shows patella´s osteophytes. The cruciate ligaments and meniscus are normal. 5. Left hemisphere´s brain tumor. Contrast enhancement visualized. Homogeneous enhancement can be seen in: Metastases, Lymphoma, Germinoma and other pineal gland tumors Pituitary macroadenoma, Pilocytic astrocytoma and hemangioblastoma (only the solid component), Ganglioglioma, Meningioma and Schwannoma. Three-dimensional models and navigation systems for neurosurgery can be combined to improve surgical planning and surgeon training. An study titled: New Directions in 3D Medical Modeling: 3D-Printing Anatomy and Functions in Neurosurgical Planning reported herein demonstrates that preoperative planning using diffusion tensor imaging (DTI) tractography and 3D models is feasible and can be employed in the preparation of complex operations. Additionally, it is likely that this process can shorten operation times, contribute to better patient safety, and be used for training surgeons. 6. Right anterior cruciate ligament´s injury This knee MRI without contrast shows an anterior cruciate ligament´s injury. Most tears occur in proximal or mid portion of ligament. Staging, Grading, & Classification • Complete tear: Ligament functionally incompetent ○ Some fibers may remain morphologically intact • Partial tear ○ High grade (unstable): Abnormal Lachman but not completely disrupted – Usually ≥ 50% of ligamentous cross section disrupted. – Tears involving 50-75% of ligament → high likelihood of progression to complete tear. ○ Low grade (stable): Some laxity on exam but defined endpoint on anterior drawer test. Image Interpretation Pearls • Use axial MR images to determine partial vs. complete 7. Lumbar spine´s MRI In this MRI we can see L4-L5 bulging and osteodegenerative changes. Thanks Dr. Pablo Andres Rodriguez Covili, Medico Neurorradiólogo/Chile. 8. Normal hand finger anatomy by MRI Hand´s MRI can provide important information for diagnosis and evaluation of soft-tissue trauma in the fingers. An optimal imaging technique should include proper positioning, dedicated surface coils, and specific protocols for the suspected abnormalities. Familiarity with the fine anatomy of the normal finger is crucial for identifying pathologic entities. MR imaging is a powerful method for evaluating acute and chronic lesions of the stabilizing articular elements (volar plate and collateral ligaments) of the fingers and thumbs, particularly in the frequently affected proximal interphalangeal and metacarpophalangeal joints. In the palmar aspect of the hand, the flexor digitorum superficialis (FDS) tendons of the lesser (second-fifth) digits insert onto the palmar aspects of the bases of the middle phalanges. Prior to their insertion, they briefly split at the level of the proximal phalanges then reunite at the level of the proximal interphalangeal (PIP) joints to create ring apertures for passage of the flexor digitorum profundus (FDP) tendons. In the dorsal aspect of the hand, the digital branches of the extensor digitorum (ED) tendon trifurcate distal to the metacarpophalangeal (MCP) joint. A central band from each ED branch inserts on the dorsal aspects of the bases of the lesser middle phalanges. Radial and ulnar bands continue more distally to insert on the dorsal aspects of the bases of the distal phalanges. The MCP joint collateral ligaments of the thumb and lesser digits extend with slight obliquity from shallow depressions on the radial and ulnar aspects of the metacarpal heads to the bases of the proximal phalanges. 9. Left foot MRI An incredible foot´s MRI showing the normal anatomy with exquisite detail. Excellent for surgical assessment. 10. Another Lumbar spine´s MRI This MRI shows normal anatomy. References 1. Demertzis, S., Hurni, S., Stalder, M., Gahl, B., Herrmann, G., & Van den Berg, J. (2010). Aortic arch morphometry in living humans. Journal of anatomy, 217(5), 588-596. 2. Jones, J. (2018). MRI | Radiology Reference Article | Radiopaedia.org. Radiopaedia.org. 3. Luciano, N. J., Sati, P., Nair, G., Guy, J. R., Ha, S. K., Absinta, M., ... & Reich, D. S. (2016). Utilizing 3D printing technology to merge mri with histology: a protocol for brain sectioning. Journal of visualized experiments: JoVE, (118). 4. Naftulin, J. S., Kimchi, E. Y., & Cash, S. S. (2015). Streamlined, inexpensive 3D printing of the brain and skull. PLoS One, 10(8), e0136198. 5. Bahadure, N. B., Ray, A. K., & Thethi, H. P. (2017). Image analysis for MRI based brain tumor detection and feature extraction using biologically inspired BWT and SVM. International journal of biomedical imaging, 2017. 6. Mirvis, S. E. (2016). Diagnostic Imaging: Musculoskeletal: Trauma.
  11. Explore the Neck Anatomy in a free and downloadable 3D Model The "neck"—colloquially speaking—is the section of human anatomy between the head and the rest of the body. The word "cervical" is derived from Latin and simply translates to "of the neck." The neck has a huge responsibility in supporting the head, while also allowing enough flexibility to change the position of the head—a full 60 to 80 degrees of rotation in most healthy adults. Because of its versatility and utility, the neck is simply one of the most fascinating parts of the human form. One of the best ways to explore neck anatomy is in a 3D model. In this week's post, the staff at embodi3D® have put together a number of exciting examples demonstrating the usefulness of 3D printing in modeling the head, neck, and upper torso. These days, physicians, radiologists, and those within the medical community are using DICOM CT scans converted into STL files in order to create 3D-printed models of this fascinating region of the human body. These 3D-printed models are then used in medical training, as references during patient consultations, as well as guides during complicated surgeries. In a recent issues of the Journal of Spine Surgery, they explored 3D-printed models' use in complex neck and spine surgeries, with a particular emphasis on how neurosurgeons are using the technology. The embodi3D® website hosts a section dedicated to CT scans of the head, neck, and spine, but this is the first blog post devoted to the neck. In this week's embodi3D® blog post, we will take a look at some of the most compelling files uploaded to the embodi3D® website. All of these can be used to explore the anatomy of the neck in a 3D model. Before you can begin printing your own 3D models, you must first become a registered member. It is absolutely free to join embodi3D® and take advantage of our many industry-leading tools and conversion algorithms. Register with embodi3D® today! #1. A CTA Scan of the Neck in NRRD Format Dr. Mike uploaded this excellent CT scan showing all the intricate structures of the neck in beautiful detail, including spaces of the infrahyoid neck. Spaces of the infrahyoid neck The infrahyoid neck is divided into 5 major anatomical compartments or spaces by the various layers of the cervical fascia. These spaces are well recognized in the axial plane and therefore suited for analysis on axial CT or MR. - Visceral space Central compartment containing several viscera like the larynx, thyroid, hypopharynx and cervical esophagus. - Carotid space Paired space just lateral to the visceral compartment which contains the internal carotid artery, internal jugular vein and several neural structures. - Retropharyngeal space A small virtual space containing only fat continuous with the suprahyoid space and the middle mediastinum. - Posterior Cervical Space Paired space posterolateral to the carotid space. It contains fat, lymph nodes and neural elements. - Perivertebral space This large space completely encircles the vertebral body including the pre- and paravertebral muscles. #2. A 3D Model Showing Skin of the Neck (in 3D-Printable STL Format) This awesome 3d model of the neck shows the surgical triangles. The infrahyoid neck is the region of the neck extending from the hyoid bone to the thoracic inlet. Traditionally the anatomy of the infrahyoid neck has been subdivided into a group of surgical triangles whose borders are readily palpable bones and muscles. These triangles have a cranial-caudal orientation and therefore are difficult to correlate with cross-sectional imaging. Another approach to the anatomy of the neck is the so-called 'spatial approach', which we shall use in this review. #3. MRI of the neck This dicom image shows the neck and head without contrast. T1 sequence allows evaluate the normal anatomy. #4. CT of the Neck in a Coronal View This model shows the muscles in the front of the neck are the suprahyoid and infrahyoid muscles and the anterior vertebral muscles (see the images below). The suprahyoid muscles are the digastrics, stylohyoid, mylohyoid, and geniohyoid. The infrahyoid muscles are the sternohyoid, sternothyroid, thyrohyoid, and omohyoid. #5. CT Scan of the Neck in a Patient with Craniotomy This ct scan shows the neck muscles and spaces. #6. 3D Model of the Cervical Spine from an STL File This 3d model shows all the bony structures of the neck with some important vessels. The cervical spine is made of 7 cervical vertebrae deemed C1 to C7. The cervical portion of the spine has a gentle forward curve called the cervical lordosis. Certain cervical vertebrae have atypical features and differ from the general form of a typical vertebra. C1 is also called the atlas because it bears the head, "the globe." It has 2 concave superior facets that articulate with the occipital condyles of the skull. This important articulation provides 50% of the flexion and extension of the neck. C1 has no vertebral body and no spinous process. #7. CT of the Neck in a Sagittal View In this ct scan we can evaluate all the lateral vertebral muscles, which are the scalenus anterior, scalenus medius, and scalenus posterior. Scalenus anterior lies at the side of the neck, behind the sternocleidomastoid. It arises from the anterior tubercles of the transverse processes of the third, fourth, fifth, and sixth cervical vertebrae, and descending, almost vertically, is inserted by a narrow, flat tendon into the scalene tubercle on the inner border of the first rib and into the ridge on the upper surface of the rib in front of the subclavian groove. Scalenus medius the largest and longest of the three scaleni, arises from the posterior tubercles of the transverse processes of the lower 6 cervical vertebrae, and descending along the side of the vertebral column, is inserted by a broad attachment into the upper surface of the first rib, between the tubercle and the subclavian groove. Scalenus posterior, the smallest and most deeply seated of the 3 scaleni, arises, by 2 or 3 separate tendons, from the posterior tubercles of the transverse processes of the lower 2 or 3 cervical vertebrae and is inserted by a thin tendon into the outer surface of the second rib, behind the attachment of the serratus anterior. It is occasionally blended with the scalenus medius. The scaleni are supplied by branches from the second to the seventh cervical nerves. When the scaleni act from above, they elevate the first and second ribs, and are, therefore, inspiratory muscles. Acting from below, they bend the vertebral column to one or other side; if the muscles of both sides act, the vertebral column is slightly flexed. #8. 3D model of the neck´s muscles This incredible 3d model shows all the muscles groups with detail. The muscles of the neck can be grouped according to their location. Those immediately in front and behind the spine are the prevertebral, postvertebral, and lateral vertebral muscles and on the side the neck are the lateral cervical muscles. In addition, a unique superficial muscle, the platysma, exists. The platysma muscles are paired broad muscles located on either side of the neck. The platysma arises from a subcutaneous layer and fascia covering the pectoralis major and deltoid at the level of the first or second rib and is inserted into the lower border of the mandible, the risorius, and the platysma of the opposite side. It is supplied by the cervical branch of the facial nerve. The platysma depresses the lower lip and forms ridges in the skin of the neck and upper chest when the jaws are "clenched" denoting stress or anger. It also serves to draw down the lower lip and angle of the mouth in the expression of melancholy. The sternocleidomastoid is the prominent muscle on the side of the neck. It arises from the sternum and clavicle by 2 heads. The medial or sternal head arises from the upper part of the anterior surface of the manubrium sterni and is directed upward, lateralward, and backward. #9. 3D model of the neck´s muscles You can see the supravicular fossa in this example and its relations. It´s limited anteromedially by the sternocleidomastoid muscle, posteromedially by the trapezius muscle and superiorly by the omohyoid muscle. Its pavement is formed by the middle scalene muscle and the first fasciculation of the anterior serratus muscle, involved by the deep layer of the deep cervical fascia. Its roof is formed by skin, superficial fascia and platysma muscle. Its content includes a series of structures that intersect this region, separated from each other by connective and adipose tissue, such as: the subclavian, suprascapular and transverse cervical arteries and veins; the terminal portions of internal and external jugular veins; lymph nodes; the thoracic duct on the left side; the lymphatic duct on the right side; the brachial plexus trunk; the phrenic nerve; and scalene muscles! #10. MRI of the skull and neck In this last example uploaded by Axel Foley you can evaluate with more detail the neck muscles. Tip: Nodes less than 1 cm in size can still be malignant and should be carefully evaluated for other abnormal features, particularly if in expected drainage sites of the primary tumor. References 1. The Radiology Assistant : Infrahyoid neck. (2009). Radiologyassistant.nl. Retrieved 23 September 2018, from http://www.radiologyassistant.nl/en/p49c603213caff/infrahyoid-neck.html 2. Li, H., Chen, R. K., Tang, Y., Meurer, W., & Shih, A. J. (2018). An experimental study and finite element modeling of head and neck cooling for brain hypothermia. Journal of thermal biology, 71, 99-111. 3. Kaye, R., Goldstein, T., Zeltsman, D., Grande, D. A., & Smith, L. P. (2016). Three dimensional printing: A review on the utility within medicine and otolaryngology. International Journal of Pediatric Otorhinolaryngology, 89, 145-148. 4. Neck Anatomy: Overview, Quadrangular Area, Osteology: The Cervical Spine. (2018). Reference.medscape.com. Retrieved 23 September 2018, from https://reference.medscape.com/article/1968303-overview#a5 5. Hoang JK, Vanka J, Ludwig BJ, Glastonbury CM. Evaluation of cervical lymph nodes in head and neck cancer with CT and MRI: tips, traps, and a systematic approach. American Journal of Roentgenology. 2013 Jan;200(1):W17-25.
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