• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.304-310
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• 2022

Background: The Boileau classification distinguishes three surgical neck fracture patterns: types A, B, and C. However, the reproducibility of this classification on plain radiographs is unclear. Therefore, we questioned what the interobserver agreement and accuracy of displaced surgical neck fracture patterns is categorized according to the modified Boileau classification. Does the reliability to recognize these fracture patterns differ between orthopedic residents and attending surgeons? Methods: This interobserver study consisted of a randomly retrieved series of 30 plain radiographs representing clinical practice in a level 1 and a level 2 trauma center. Radiographs were included from patients (≥18 years) who sustained an isolated displaced surgical neck fracture if they were taken ≤1 week after initial injury. A ground truth was established by consensus among three senior orthopedic surgeons. All images were assessed by 17 orthopedic residents and 17 attending orthopedic trauma surgeons. Results: Agreement for the modified Boileau classification was fair (κ=0.37; 95% confidence interval [CI], 0.36-0.38) with an accuracy of 62% (95% CI, 57%-66%). Comparison of interobserver variability between residents and attending surgeons revealed a significant but clinically irrelevant difference in favor of attending surgeons (0.34 vs. 0.39, respectively, Δκ=0.05, 95% CI, 0.02-0.07). Conclusions: The modified Boileau classification yields a low interobserver agreement with an unsatisfactory accuracy in a panel of orthopedic residents and attending surgeons. This supports the hypothesis that surgical neck fractures are challenging to categorize and that this classification should not be used to determine prognosis if only plain radiographs are available.

• Korean Journal of Radiology
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• 제22권4호
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• pp.612-623
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• 2021

Objective: To evaluate the diagnostic performance of a deep learning algorithm for the automated detection of developmental dysplasia of the hip (DDH) on anteroposterior (AP) radiographs. Materials and Methods: Of 2601 hip AP radiographs, 5076 cropped unilateral hip joint images were used to construct a dataset that was further divided into training (80%), validation (10%), or test sets (10%). Three radiologists were asked to label the hip images as normal or DDH. To investigate the diagnostic performance of the deep learning algorithm, we calculated the receiver operating characteristics (ROC), precision-recall curve (PRC) plots, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared them with the performance of radiologists with different levels of experience. Results: The area under the ROC plot generated by the deep learning algorithm and radiologists was 0.988 and 0.988-0.919, respectively. The area under the PRC plot generated by the deep learning algorithm and radiologists was 0.973 and 0.618-0.958, respectively. The sensitivity, specificity, PPV, and NPV of the proposed deep learning algorithm were 98.0, 98.1, 84.5, and 99.8%, respectively. There was no significant difference in the diagnosis of DDH by the algorithm and the radiologist with experience in pediatric radiology (p = 0.180). However, the proposed model showed higher sensitivity, specificity, and PPV, compared to the radiologist without experience in pediatric radiology (p < 0.001). Conclusion: The proposed deep learning algorithm provided an accurate diagnosis of DDH on hip radiographs, which was comparable to the diagnosis by an experienced radiologist.

• 치과방사선
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• 제27권1호
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• pp.189-201
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• 1997

22세에서 25세의 남녀 각각 100명씩 200명을 대상으로 표준 위치에서 촬영된 파노라마 방사선사진상에서 이공의 정상적 형태 및 위치를 분석하고, 다시 남녀 각각 50명씩 100명을 선별하여 두부를 10mm 전방 이동, 10mm 후방 이동, 10° 하방 이동, 그리고 10° 상방 이동시킨 후 촬영된 각각의 파노라마 방사선사진상에서 피사체의 위치 변화에 따른 이공의 형태 및 수평, 수직적 위치의 변화를 평가하여 다음과 같은 결과를 얻었다. 1. 이 공의 형 태 는 elliptic질형 (43.3％), round 또는 oval형 (42.5％), unidentified형 (7.5％), diffuse형(6.7％)의 순으로 관찰되었다. 2. 이공이 치아에 대한 수평적 위치는 제2소구치 부위(54.2％)와 제1소구치와 제2소구치 사이 (43.1％)에서 대부분 관찰되었으며, 제2소구치와 제1대구치 사이(2.7％)의 순으로 관찰되었고, 제1소구치 부위, 견치와 제1소구치 사이, 제1대구치 부위에서는 관찰되지 않았다. 3. 이공의 수직적 위치는 치근단 하방(88.2％)에서 대부분 관찰되었으며, 치근단에 접하는 경우(9.7％), 치근단과 겹쳐 나타난 경우(1.9％), 치근단에 비해 상방에 위치하는 경우(0.2％)의 순으로 관찰되었다. 4. 피사체 두부 위치의 변화에 따른 이공의 형태 변화는 표준 위치에서 나타난 결과와 비교해 볼 때 표준 위치에서 두부를 10mm전방 이동시킨 위치에서 unidentified형(9.0％)이 증가하였고, 두부를 10mm 후방 이동시 킨 위치와 피사체의 턱을 10° 상방 이동시킨 위치에서는round 또는 oval형(57.5％, 52.5％)이 각각 증가하였으며, 피사체의 턱을 10° 하방 이동시킨 위치에서는 diffuse형(3.5％)이 감소한 것 외에는 표준 위치에서 나타난 결과와 유사하였다. 5. 피사체 두부 위치의 변화에 따른 이공의 수평적 위치의 변화는 표준 위치에서 두부를 10mm 전방 이동시킨 위치에서 제1소구치와 제2소구치 사이에 위치한 경우(35.2％)가 감소한 반면 제2소구치와 제1대구치 사이에 위치한 경우(8.8％)는 더 많이 관찰되었으며, 두부를 10mm후방 이동시킨 위치와 피사체의 턱을 10° 상방 이동시킨 위치에서는 제2소구치와 제1대구치 사이에 위치한 경우(6.1％, 7.5％)가 더 많이 관찰되었으며, 피사체의 턱을 10° 하방 이동시킨 위치에서는 표준 위치에서 나타난 결과와 유사하였다. 6. 피사체 두부 위치의 변화에 따른 이공의 수직적 위치 변화는 치근단에 비해 하방에 위치한 경우가 약 90％로 대부분이었으며, 치근단에 접하는 경우, 치근단과 겹쳐 나타난 경우의 순으로 관찰되었으며, 치근단에 비해 상방에 위치하는 경우는 관찰되지 않았다.

• Imaging Science in Dentistry
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• 제37권4호
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• pp.185-189
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• 2007

Purpose: This study was intended to estimate the prevalence of cemento-osseous dysplasia (COD) in the Korean population and to assess the clinical and radiographic characteristics of this condition. Materials and Methods: Panoramic radiographs from 10,646 patients (4,982 males and 5,664 females, age range from 6 to 91 years) were reviewed for evidence of COD. Their demographics, clinical characteristics, and radiographic features were retrospectively assessed. Results: Of 10,646 panoramic radiographs, 33 radiographs (0.31 %) exhibited evidence of COD. The prevalence of COD increased to over 1 % in women over 40-years old. Of these 33 patients, 16 had florid cemento-osseous dysplasia (FCOD) and 17 had focal COD. Due to the multiplicity of FCOD, a total of 63 COD lesions were assessed. These lesions were most common in the mandibular molar area. Most of the COD lesions examined (61.9%) were less than 10 mm and the majority (82.5%) showed radiopacity. Conclusion : COD has a predilection for the mandibular molar area of middle-aged and older women.

• 대한치과의사협회지
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• 제56권10호
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• pp.548-554
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• 2018

Choristoma is a growth of normal tissue that occurs at an abnormal region. In the oral cavity, osseous choristoma that has a normal bone feature mainly has been appeared. It is mainly occurred on the tongue. So, It can be found in dental practice or in discomfort in the mouth. Osseous choristoma in the oral cavity is extremely rare. But It can be treated excisional biopsy under local anesthesia. The prognosis is very good. This case is a report of osseous choristoma on the dorsal surface of the tongue. A 17-year-old female patient presented with a foreign body sensation of the tongue. A diameter of the mass is 0.7cm, and there is no pain. Panoramic radiographs showed a radiopaque image in the form of a double image. An excisional biopsy was performed and diagnosed as an osseous choristoma. 12 months after the resection, there were no signs of recurrence. Intraoral osseous choristoma is very rare, but it is clinically very simple and can be found in dental radiographs. We present this case because of Dentists who examine the oral cavity of the patient can easily diagnose the lesion and treat it by simple resection.

• Imaging Science in Dentistry
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• 제30권1호
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• pp.80-86
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• 2000

A 37-year-old male with the complaint of intermittent gingival swelling and dull pain associated with the food impaction of the mandibular third molar area was referred to our department of Chonbuk National University Hospital. The dental history of the patient showed that he had extracted the maxillary left third molar without complications two years ago. Intraoral and panoramic radiographs showed diffuse increased radiopacity of the maxilla and mandible. The trabecular pattern was obliterated. Postero-anterior skull and lateral skull radiographs showed thickening of cortical bone and diffuse increased radiopacity of the skull. Additional radiographs showed similar changes in the lumbar spine, clavicles, iliac bone and femur. However, no evidence of osteomyelitis was observed clinically and radiographically. Laboratory findings showed normal values of serum calcium, phosphorus, and alkaline phosphatase. Based on the radiographic examinations and the laboratory findings, final diagnosis was made as a benign osteopetrosis.

• 대한관절경학회지
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• 제2권1호
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• pp.80-84
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• 1998

The isometric position for the graft is important in the anterior cruciate ligament reconstruction surgery. It is well known that the femoral position is more critical than tibial side. But, there is few deciding method of proper graft position after the anterior cruciate ligament reconstruction surgery. So we planned to evaluate the ideal femoral isometric position with 6 adult cadavaric femurs and exact radiographs. After the insertion of femoral interference screw on ideal isometric position, we obtained roentgenograms of true lateral view and 10, 20, 30, 45 degree internal and external rotation views. Then we measured the shortest distance from the posterior cortical margin of lateral femoral condyle to posterior border of interference screw on the radiographs. We also measured true distance between posterior cortical margin of lateral femoral condyle to the posterior margin of femoral tunnel after cutting of distal femur. Based on this study, we could not determine the permissible rotation degree of radiographs. But we concluded that if the distance between posterior cortical margin of lateral femoral condyle and posterior border of interference screw ranges 4.5-6.5mm on the lateral view, the femoral position is considered as a relatively ideal isometric good position.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권4호
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• pp.323-330
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• 2011

Purpose: The present study examined the reproducibility of an operation plan by comparing the jaw position of STO with the postoperative mandibular set back measurement in sagittal split ramus osteotomy. Methods: Thirty patients with class III dental and skeletal malocclusion and who were treated with BSSRO were reviewed. Three plain radiographs such as the panoramic view, the lateral cephalogram and the submentovertex view were taken before and after operation. Also, paper surgery for STO and model surgery were used to evaluate the amount of mandibular set back. Results: On the panoramic view, the amount of mandibular set back in STO was similar to the postoperative results of model surgery, but the amount of mandibular set back on the lateral cephalogram was smaller than the postoperative result of model surgery and then the amount of set back on submentovertex view was similar to the postoperative result of model surgery. Conclusion: Precise tracing and paper surgery should be performed for a combined expected STO in order to predict the exact amount of preoperative mandibular set back.

• 대한방사선기술학회지:방사선기술과학
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• 제25권1호
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• pp.35-37
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• 2002

To assess the new multichannel cochlear implant by radiography in Stenver's projection, because MRI generates artifacts, inducing an electrical current and causing device magnetization. CT is relatively expensive and the metal electrodes scatter the image. Multichannel cochlear implant insertion using the multichannel cochlear implant device. Patients underwent postoperative radiography of their implants. The radiographs were obtained in a Stenver's. The insertion depth of the implant was measured on the radiographs and the results were correlated with the surgical results of insertion depth and with audiometric tests. Patients a correct inserted electrode was found, while in patient complications concerning the electrode were noticed. Radiographs in the Stenver's projection are sufficient for the postoperative assessment of the multichannel cochlear implant device and an exact evaluation of the insertion depth.

• 대한치과교정학회지
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• 제45권2호
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• pp.82-88
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• 2015

Objective: The aim of this study was to evaluate the reliability of measurements obtained after the superimposition of three-dimensional (3D) digital models by comparing them with those obtained from lateral cephalometric radiographs and photocopies of plaster models for the evaluation of upper molar distalization. Methods: Data were collected from plaster models and lateral cephalometric radiographs of 20 Class II patients whose maxillary first molars were distalized with an intraoral distalizer. The posterior movements of the maxillary first molars were evaluated using lateral cephalometric radiographs (group CP), photocopies of plaster models (group PH), and digitized 3D models (group TD). Additionally, distalization and expansion of the other teeth and the degrees of molar rotation were measured in group PH and group TD and compared between the two groups. Results: No significant difference was observed regarding the amount of molar distalization among the three groups. A comparison of the aforementioned parameters between group PH and group TD did not reveal any significant difference. Conclusions: 3D digital models are reliable to assess the results of upper molar distalization and can be considered a valid alternative to conventional measurement methods.