It has not yet been proven whether sepsis affects the tissue around the anal canal. To address this issue, we established three-dimensional models for various types of anorectal abscesses and utilize 3D reconstruction of Magnetic Resonance Imaging scans to assess the extent of muscle damage caused by anorectal abscesses. Patients diagnosed with anorectal abscess, selected from January 2019 to January 2022 underwent pre- and post-operative scanning of pelvic floor and perianal tissues. The aforementioned structures were segmented for the reconstruction of a three-dimensional visual model and measurement of volumes for the abscess as well as the internal and external sphincters and levator ani muscle. The study included a total of 42 patients. Three-dimensional visualization models were created for different types of anorectal abscesses, including perianal, intersphincteric, ischiorectal, and supralevator abscesses. No statistically significant differences were observed in the volume of the internal sphincter, external sphincter, and levator ani muscle between pre- and post-operative patients. The 3D model of anorectal abscess, reconstructed from MRI data, offers a precise and direct visualization of the anatomical structures associated with various types of anorectal abscesses. The infection did not result in any damage to the internal and external anal sphincter and levator ani muscle.

UNASSIGNED: Preoperative three-dimensional (3D) lung reconstructions can reduce intraoperative blood loss, conversion rate, and operation duration. These 3D reconstructions are predominantly provided by commercial expensive products, hence we aimed to assess the usability and performance of preoperative 3D lung reconstructions created with open-source software.
UNASSIGNED: Patients were invited to participate in this prospective pilot study if they were planned for uniportal video-assisted thoracoscopic surgery (VATS) lobectomy or segmentectomy between January and February 2023. Participants were excluded if a two-dimensional (2D) late-arterial-phase computed tomography (CT) scan contained motion artifacts, another surgical procedure was performed, or the surgery was canceled. After informed consent was obtained, 3D lung reconstructions were constructed using open-source 3D Slicer software. The system usability score (SUS) questionnaire assessed the usability of these reconstructions, whilst performance was evaluated based on anatomical validity compared to prior 2D CT assessment as well as operative findings. Descriptive statistics were reported.
UNASSIGNED: Thirteen patients were included, of whom one underwent a segmentectomy. Eighty-three percent of the 3D lung reconstructions scored above average (SUS >68). Compared to 2D CT scans, 38% of lung nodule segmental locations were detected more accurately through 3D lung reconstructions. Furthermore, 3D lung reconstructions revealed anatomical variations in 62%, which were not recognized on 2D CT scans, and provided surgeons with insights that would change the procedure and/or transection planes in 62%. One 3D lung reconstruction failed to demonstrate an intraoperative recognized segmental pulmonary artery (A6) branch.
UNASSIGNED: Three-dimensional lung reconstructions created with open-source software were usable and effective for uniportal VATS anatomical resections.
UNASSIGNED: ClinicalTrials.gov/NCT06132607.

UNASSIGNED: Due to the complex anatomy of the spine and the intricate surgical procedures involved, spinal surgery demands a high level of technical expertise from surgeons. The clinical application of image-guided spinal surgery has significantly enhanced lesion visualization, reduced operation time, and improved surgical outcomes.
UNASSIGNED: This article reviews the latest advancements in deep learning and artificial intelligence in image-guided spinal surgery, aiming to provide references and guidance for surgeons, engineers, and researchers involved in this field.
UNASSIGNED: Our analysis indicates that image-guided spinal surgery, augmented by artificial intelligence, outperforms traditional spinal surgery techniques. Moving forward, it is imperative to collect a more expansive dataset to further ensure the procedural safety of such surgeries. These insights carry significant implications for the integration of artificial intelligence in the medical field, ultimately poised to enhance the proficiency of surgeons and improve surgical outcomes.

OBJECTIVE: To compare the clinical value of multi-slice spiral computed tomography (MSCT) low-dose three-dimensional reconstruction and traditional X-ray in the auxiliary diagnosis of distal radius epiphyseal injury in children.
METHODS: A retrospective analysis was performed on 105 children with distal radius bone scale injury (classified by Salter-Harris classification) admitted from March 2020 to June 2022. All children underwent MSCT three-dimensional reconstruction examination and traditional X-ray examination. The detection rate of epiphyseal injury of the distal radius was compared, along with the resolution, sensitivity and specificity. The image clarity and display degree of bone structure were analyzed. The radiation dose-related indicators and the time required for diagnosis were compared.
RESULTS: The detection rate and diagnostic accuracy of MSCT (100%, 92.38%) was significantly higher than that of X-ray (76.19%, 64.76%). In terms of radiation dose index, the volume dose index CTDI of MSCT ranged from 1-5 mGy while the X-ray group ranged from 5-10 mGy. The dose length product (DLP) value of the MSCT group was lower than in the X-ray group (20-100 mGy·cm vs. 50-150 mGy·cm). The diagnostic scan time for MSCT was shorter than that of conventional X-ray. The acceptance rate with MSCT was 99%, significantly higher than that with conventional X-ray (85%).
CONCLUSIONS: Low-dose three-dimensional reconstruction of MSCT in the diagnosis of epiphyseal injury of distal radius in children shows significant advantages over traditional CT in the detection rate, diagnostic accuracy, postoperative reduction quality evaluation, and radiation dose.

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a superficial sarcoma characterized by infiltrative growth with tentacle-like borders. Mohs micrographic surgery (MMS) is the preferred treatment option for DFSP. However, the imprecise boundary localization in MMS leads to an increased number of Mohs layers required and a longer surgery time. High-frequency ultrasound has excellent tissue recognition capability for DFSP, allowing for precise boundary marking.
METHODS: In this study, we retrospectively analyzed 14 cases of DFSP treated with MMS using preoperative ultrasound localization and three-dimensional reconstruction at Xiangya Hospital over the past 5 years. We also reviewed previous studies on MMS for DFSP treatment.
RESULTS: It was found that the average number of Mohs layers for patients after preoperative ultrasound localization was 1.57, ranging from 1 to 3, which was less than the previously reported 1.86 layers, ranging from 1 to 12. This effectively reduced the number of Mohs layers required.
CONCLUSIONS: By utilizing preoperative high-frequency ultrasound to determine the boundaries and depth of DFSP, the number of Mohs layers can be effectively reduced, leading to less workload for pathological examination, shorter operation time, and reduced surgical risks for patients. Ultrasound imaging data can be used for three-dimensional reconstruction, enabling less experienced Mohs surgeons to have a visual understanding of the morphology and extent of infiltration of the lesions. This aids in developing optimal surgical plans, smoothing the learning curve, and promoting the wider adoption of MMS.

UNASSIGNED: We present a case of idiopathic azygos vein aneurysm (AVA) and describe its radiological features. Clinicians should be aware of the imaging findings to avoid the risk of bleeding caused by biopsy.
METHODS: An asymptomatic 46-year-old woman was found to have an abnormal shadow on a chest computed tomography (CT) scan during a medical checkup. Plain CT revealed a well-defined, homogeneous mass on the posterior side of the right main bronchus. Contrast-enhanced CT revealed a mass with marked enhancement pointing to a vascular structure. Three-dimensional reconstruction showed that the mass was connected to the azygos arch, and inflow to and outflow from the azygos vein was detected. Subsequently, video-assisted thoracic surgery was performed.
UNASSIGNED: Patients with idiopathic AVA often present with accidental findings of a mediastinal or lung mass on a chest radiographs or CT scans, which can be mistakenly diagnosed as a paratracheal tumor, bronchial cyst, or posterior mediastinal tumor. Needle biopsy should be avoided due to the risk of massive bleeding. During the evaluation of thoracic malignancies, AVAs should be considered in the differential diagnosis, especially in area of the right tracheobronchial angle or right upper or posterior mediastinum. Three-dimensional reconstruction can help surgeons to clarify the disease diagnosis.
CONCLUSIONS: Imaging findings combined with enhanced CT and three-dimensional reconstruction are useful for diagnosing AVAs.

OBJECTIVE: Segmentectomy has been widely performed in clinical practice, which required a comprehensive understanding of anatomical structure. In right lower lobe, studies of superior segment (S6) were relatively small-sized. And only one study focusing on subsuperior segment (S∗) was published, which showed different results with previous ones. As the close relationship between S6 and S∗, variation types and their prevalence rate were reported, aiming to providing larger-size study of S6 and showing new evidence on anatomical structure of S∗.
METHODS: 800 CT imaging data were collected from patients in our hospital. Three-dimensional reconstruction was performed after quality check. All images were screened according to the definition of corresponding segment and anatomical variations were analyzed.
RESULTS: The proportion of S6 variation types in the largest scale (718 patients) was reported with no significant difference compared to previous studies and newly classified subtypes of two-stem V6. The prevalence rate for S∗ in right lower lobe reached 28.3 % (203/718) with similar proportion of three types. Variation types and origins of pulmonary artery were analyzed in detail, finding two-stem A∗ only be observed in type III B∗.
CONCLUSIONS: Through this study, the variation types and incidence rate of S6 were confirmed, and a different result of S∗ has been provided as well. The feasibility of the current classification standards and proposed new subclassifications were verified. The results would be a supplement to lung segmental anatomy and could advance researches in the future.

The quality of underwater bridge piers significantly impacts bridge safety and long-term usability. To address limitations in conventional inspection methods, this paper presents a sonar-based technique for the three-dimensional (3D) reconstruction and visualization of underwater bridge piers. Advanced MS1000 scanning sonar is employed to detect and image bridge piers. Automated image preprocessing, including filtering, denoising, binarization, filling, and morphological operations, introduces an enhanced wavelet denoising method to accurately extract the foundation contour coordinates of bridge piers from sonar images. Using these coordinates, along with undamaged pier dimensions and sonar distances, a model-driven approach for a 3D pier reconstruction algorithm is developed. This algorithm leverages multiple sonar data points to reconstruct damaged piers through multiplication. The Visualization Toolkit (VTK) and surface contour methodology are utilized for 3D visualization, enabling interactive manipulation for enhanced observation and analysis. Experimental results indicate a relative error of 13.56% for the hole volume and 10.65% for the spalling volume, demonstrating accurate replication of bridge pier defect volumes by the reconstructed models. Experimental validation confirms the method\'s accuracy and effectiveness in reconstructing underwater bridge piers in three dimensions, providing robust support for safety assessments and contributing significantly to bridge stability and long-term safety assurance.

OBJECTIVE: The anatomy of the skeletal muscles located between the vagina and anus is important during complex obstetric laceration reconstructions. We aimed to clarify the composition of skeletal muscles located between the vagina and anal canal and their three-dimensional configuration relevant to perineum repair.
METHODS: This observational study involved ten female cadavers. An anatomical dissection was performed to observe the muscles around the vagina and anal canal. Immunohistological analysis of the midsagittal section was performed to clarify the composition of the muscles, and dissection was performed to correspond to the cross-section. Wide-range serial sectioning and three-dimensional reconstruction were used to support these findings histologically and visualize the three-dimensional arrangement.
RESULTS: The region between the vagina and anal canal included the anterior part of the external anal sphincter, superficial transverse perineal muscle approaching from the lateral side, and levator ani, located cranially. They converge three-dimensionally in the median from each direction, forming a muscle complex between the vagina and anal canal.
CONCLUSIONS: The medial region between the vagina and anal canal in those giving birth includes a skeletal muscle complex formed by the confluence of the external anal sphincter, anterior bundle of the levator ani, and superficial transverse perineal muscle. In cases of severe perineal lacerations, these muscles could be injured. The anatomical knowledge that a part of the levator ani forms a muscle sling anterior to the anal canal is particularly important for obstetricians and gynecologists repairing obstetric lacerations and treating pelvic floor disorders.

Early bifurcation of the common hepatic artery (EBCHA) is a rare anatomical variation (1%), that is often overlooked but can lead to accidental ligation of the right branch of the hepatic artery with consequent arterial ischemia of the right liver and potentially very serious complications during pancreaticoduodenectomy, partial hepatectomy, or liver harvesting for transplantation. It may be difficult to diagnose EBCHA using transverse imaging sections. However, on standard CT sections with intravenous contrast injection, three warning signs should allow the image reader to suspect it: presence of two hepatic arteries to the right of the celiac trunk, presence of a retro-portal hepatic artery, and absence of a right hepatic artery arising from the superior mesenteric artery. Analysis of the CT with reconstruction then allows for definitive diagnosis and limits the risk of accidental arterial injury or ligation.