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Biomedical subjects

D R Ney

Publications and source records attributed to D R Ney.

At least 19 recordsLinked to original sources
PubMed1992

Three-dimensional display of hepatic venous anatomy generated from spiral computed tomography data: preliminary results.

A new method is presented for generating three-dimensional images of the hepatic venous anatomy from helical computed tomography (CT) scans using volumetric rendering. The helical CT scans were obtained using peripheral injection of intravenous contrast via a power injector. Five patients with suspected liver tumors were studied from which one sample case was selected for illustration. Surgical planning of hepatic resection from three-dimensional images will soon become a practical part of patient care.

Adult↗
PubMed1992

Examination of the pathologic anatomy of ankle fractures.

A prospective study of the translational and rotational displacement of the lateral malleolus in ankle fractures was carried out utilizing roentgenographic techniques. Twenty-six ankle fractures in 25 patients were studied using both routine plain films and CT scanning with two- and three-dimensional multiplanar reconstruction. Eighty-one percent were Lauge-Hansen supination-external rotation type injuries. Overall, 21 fractures did not involve the medial malleolus. Initial talar shift was less than or equal to 2 mm in 15 fractures. Although all patients exhibited external rotation deformities of the lateral malleolus on plain films, only one fracture was found to possess any degree of external rotation relative to the talus. The proximal fibula was seen on CT scans to have increased internal rotation with respect to the tibia in 19 cases. One patient had a slightly externally rotated proximal fibula; the remainder appeared normally aligned. The displacements measured by the CT scans at the talofibular articulation were compared with the standard plain film measurements. The displacements at the distal lateral malleolus were consistently overestimated by the plain roentgenograms, presumably because the capsular and ligamentous attachments to the distal fibula limit malleolar displacement. The talocrural angle, determined on both plain films and CT scans, was also not found to be a sensitive measure of fibular shortening nor of the severity of the fracture. The results of this study suggest that, in an isolated lateral malleolar ankle fracture, the apparent external rotation of the fracture fragment is relative only to the proximal fibula and is not associated with derangement of the talofibular articulation. Based on these mechanical considerations, surgical intervention for such fractures may not be necessary. This hypothesis is consistent with previous long-term clinical studies.

Adolescent↗
PubMed1992

Comparison of helical and serial CT with regard to three-dimensional imaging of musculoskeletal anatomy.

To test the hypothesis that helical computed tomographic (CT) scans provide three-dimensional images as good as or better than those provided by serial CT, two objects were used to study the effects of helical CT: an angled cylindrical bone phantom and a human cadaveric femur specimen with a simulated fracture 1 mm wide. Both objects were immersed in a water bath, and a series of helical and serial CT scans were obtained with various parameters. Volumetric rendering was applied to the resultant data sets to create three-dimensional images, which three radiologists reviewed in a blinded manner to rate their fidelity, accuracy, and diagnostic usefulness. As expected, the images obtained with thin collimation and small intersection spacing or slow table movement were considered superior. Helical and serial CT data acquired with similar parameters were similar in quality, but helical CT is approximately five times faster than serial CT; hence, it is possible to use thinner collimation and obtain more sectional data with helical CT.

Femur↗
PubMed1992

Spiral CT of the pancreas with multiplanar display.

This essay illustrates the findings obtained with spiral CT imaging in pancreatic disease. Features of spiral CT--fast scanning, dynamic injection of contrast material allowing optimal vessel opacification, and supplemental multiplanar imaging--promise to provide increased accuracy in the diagnosis and staging of pancreatic disease. With further development of continuous (spiral/helical) scanning technology, this technology should expand to cover a wider range of applications.

Adolescent↗
PubMed1992

Computer-based radiological teaching programs: the challenge and trauma of development and implementation.

Computers are becoming an invaluable part of the radiologist's environment whether they are used as a source of the patient's clinical or laboratory information, to store x-ray or pathologic reports or as a viewing station for films. The use of computers in the educational environment is but a natural extension of the increased computerization of the radiologic department. This article reviews the use of personal computers in a teaching environment via the construction of the computed tomography teaching program entitled "CT: The Game." The decisions that must be made in terms of hardware and software prior to program development as well as the actual development are discussed. The potential of computers in terms of continuing education as well as in residency training programs is discussed with the potential for the future addressed.

Computer Systems↗
PubMed1991

The use of graphic design in an interactive computer teaching program.

The widespread diffusion of affordable computers into the scientific and educational community has provided the opportunity to design medical and scientific teaching programs illustrated either by hand or by utilizing commercially available software and manipulating existing computer generated images. The medical illustrator can provide the ideal aesthetic link between text format information and the visual representation of such knowledge in a concise presentation format. The availability of interactive multimedia programs has given the medical illustrator an environment to create and enhance Hypermedia designed specifically for the purpose of medical education. This paper will focus on the incorporation of illustration and screen design into "CT The Game," an experimental medical teaching program currently being developed in the Johns Hopkins Body CT Imaging Laboratory. The program is designed to provide an enjoyable approach to learning Computed Tomography (CT), and is directed toward an audience of medical students, residents, and fellows.

Computer Graphics↗
PubMed1991

Data base management in radiology: a simplified approach.

The increasing availability of personal and departmental computers in radiology departments has led to increasing interest in data management. Data base management software must be system compatible, simple, and flexible to insure its acceptance and constant use. Once in place, such a system streamlines the daily documentation of interesting cases for conference, follow-up, research, and quality assurance. The authors have developed such a data base program for tracking computed body tomography cases in their department, which can be run as a portable computer to maximize ease of access and therefore usage.

Database Management Systems↗
PubMed1991

Sacral foramina: view at CT.

Conventional transaxial computed tomography (CT) is superior to plain radiography in depicting the sacrum. Because of the shape and orientation of the sacrum, CT provides oblique views of the structures of interest. With easily reproducible landmarks and standard transaxial CT data, orthogonal image sets can be produced that provide a true en face orientation matching the obliquity of the sacrum. This allows optimal visualization of the paired foramina and of the sacroiliac joints for better assessment of trauma, tumor, or inflammatory disease.

Humans↗
PubMed1990

Three-dimensional CT-volumetric reconstruction and display of the bronchial tree.

We applied a refined version of our volumetric rendering technique for three-dimensional (3-D) computed tomographic (CT) imaging to display the cadaveric lung and the major components of the bronchial tree. We report details of the technical aspects of 3-D imaging of the lung, and four representative case studies of lung specimens from our initial experience.

Bronchography↗
PubMed1990

Adult ankle fractures: comparison of plain films and interactive two- and three-dimensional CT scans.

Thirteen patients with 15 ankle fractures potentially requiring surgical reduction according to plain film criteria were studied with transaxial CT, from which static and animated interactive two-dimensional (2-D) images and animated volumetric three-dimensional (3-D) images were generated. CT criteria believed to parallel well-accepted plain film criteria for triage of ankle fractures were developed and applied. The tibiofibular, talofibular, and tibiotalar articulations were characterized and, where possible (nine cases), compared with the (presumably normal) contralateral ankle. Talocrural angle measurements were made on interactive coronal measurements and compared with standard plain film measurements. Fracture fragment displacement, rotation, and impaction were noted. Posterior tibial lip disruption was quantified. Information derived from the 2-D/3-D CT study led to cancellation of proposed surgery in three of the distal fibular fractures and in two distal tibial fractures. There was far less variation than anticipated between the talocrural angles of the injured and normal ankles, and both injured and normal ankles deviated significantly from the accepted standard of 84 degrees. Displacement at the level of the fibular fracture was a poor predictor of more distal disruption. Two-dimensional CT was found to provide anatomic detail and information superior to either plain film or 3-D CT; 3-D CT was preferred by the surgeons for final surgical planning and for integration of the 2-D data. CT altered management in five of the 13 patients studied, supporting our belief that 2-D/3-D CT can be of significant value in assessing ankle fractures.

Adolescent↗
PubMed1990

Computer-based learning in radiology: a hypermedia application in CT.

Multimedia is a form of computer data presentation that uses multiple formats (text, illustration, sound, and animation) to enhance attention to and retention of presented information. Hypermedia is a nonlinear, branched access version of this that allows the user to pursue information more freely and variably than a linear format does. We used the hypermedia format to create an interactive medical teaching program that we believe holds the user's interest and attention better than a straight-text style does.

Computer-Assisted Instruction↗
PubMed1989

Nonunion of acetabular fractures: evaluation with interactive multiplanar CT.

Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool (copyright and trademark of the Body CT Imaging Laboratory, Department of Radiology, The Johns Hopkins Medical Institutions) that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion.

Acetabulum↗
PubMed1989

Interactive real-time multiplanar CT imaging.

A new software program provides the real-time display of high-resolution computed tomographic reformation in the axial, coronal, sagittal, or oblique views. The advantages of this new technique over the standard multiplanar format include (a) larger image display format, (b) reconstruction of entire dataset for each of up to 192 sections, (c) real-time viewing, (d) interactive real-time oblique imaging, and (e) on-screen correlation of multiplanar and three-dimensional images.

Adult↗
PubMed1989

Two-and three-dimensional imaging of the painful shoulder.

Fifty-six patients with musculoskeletal disorders involving the shoulder were examined using two-dimensional computed tomography multiplanar reconstruction and volumetric three-dimensional (3D) image processing. Two- and three-dimensional imaging of the shoulder demonstrated advantages over conventional radiography in clarifying areas of complex anatomy. The techniques were found most beneficial for (1) delineating complex fractures; (2) evaluating joint instability; (3) localizing foreign bodies; (4) detecting lytic lesions; (5) assessing soft tissue pathology; and (6) identifying causes for decreased range of motion. Two-dimensional multiplanar reconstruction provided superior views of the scapula and permitted a better understanding of the orientation of the glenoid. Multiplanar reconstruction displayed deep soft tissue anatomy more clearly, including the course of important neurovascular structures. Volumetric 3D imaging added several unique perspectives, providing a more comprehensive representation of the shoulder and its articulating surfaces. The ability to rotate the shoulder about he vertical and horizontal axes in an animated video loop and to edit away confusing, overlying structures provided a "real-time" 3D model of the shoulder for planning treatment.

Humans↗
PubMed1988

Complex shoulder trauma: three-dimensional CT imaging.

Volumetric three-dimensional imaging is a new technique for CT image processing which generates realistic, three-dimensional models of complex musculoskeletal anatomy from routine transaxial CT data. Volumetric three-dimensional imaging is particularly helpful in evaluating complex shoulder trauma, demonstrating significant advantages over plain film radiography. Multipartite fractures involving the shoulder girdle are displayed in a comprehensive fashion with 3D imaging. With volumetric imaging as implemented on a Pixar Imaging Computer, a 3D model of the injured shoulder can be generated with overlapping structures removed from view, and then rotated about the vertical and horizontal axis for better understanding of abnormal anatomy prior to surgical correction.

Humans↗