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García-Martínez D, Gil OG, Cambra-Moo O, Canillas M, Rodríguez MA, Bastir M, Martín AG. External and internal ontogenetic changes in the first rib. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 164:750-762. [DOI: 10.1002/ajpa.23313] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/24/2017] [Accepted: 08/29/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Daniel García-Martínez
- Paleoanthropology Group; Museo Nacional de Ciencias Naturales (MNCN-CSIC); 28006 Madrid Spain
| | - Orosia García Gil
- Laboratorio de Poblaciones del Pasado (LAPP). Departamento de Biología; Facultad de Ciencias, Universidad Autónoma de Madrid; 28049 Madrid Spain
| | - Oscar Cambra-Moo
- Laboratorio de Poblaciones del Pasado (LAPP). Departamento de Biología; Facultad de Ciencias, Universidad Autónoma de Madrid; 28049 Madrid Spain
- Grupo de Investigación en Arqueología Antigua y Medieval; Universidad de Oviedo; 33011 Oviedo Spain
| | - María Canillas
- Instituto de Cerámica y Vidrio (Consejo Superior de Investigaciones Científicas); 28049 Madrid Spain
| | - Miguel A. Rodríguez
- Instituto de Cerámica y Vidrio (Consejo Superior de Investigaciones Científicas); 28049 Madrid Spain
| | - Markus Bastir
- Paleoanthropology Group; Museo Nacional de Ciencias Naturales (MNCN-CSIC); 28006 Madrid Spain
| | - Armando González Martín
- Laboratorio de Poblaciones del Pasado (LAPP). Departamento de Biología; Facultad de Ciencias, Universidad Autónoma de Madrid; 28049 Madrid Spain
- Grupo de Investigación en Arqueología Antigua y Medieval; Universidad de Oviedo; 33011 Oviedo Spain
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The costal remains of the El Sidrón Neanderthal site (Asturias, northern Spain) and their importance for understanding Neanderthal thorax morphology. J Hum Evol 2017; 111:85-101. [PMID: 28874276 DOI: 10.1016/j.jhevol.2017.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 06/05/2017] [Accepted: 06/09/2017] [Indexed: 11/21/2022]
Abstract
The study of the Neanderthal thorax has attracted the attention of the scientific community for more than a century. It is agreed that Neanderthals have a more capacious thorax than modern humans, but whether this was caused by a medio-lateral or an antero-posterior expansion of the thorax is still debated, and is key to understanding breathing biomechanics and body shape in Neanderthals. The fragile nature of ribs, the metameric structure of the thorax and difficulties in quantifying thorax morphology all contribute to uncertainty regarding precise aspects of Neanderthal thoracic shape. The El Sidrón site has yielded costal remains from the upper to the lower thorax, as well as several proximal rib ends (frequently missing in the Neanderthal record), which help to shed light on Neanderthal thorax shape. We compared the El Sidrón costal elements with ribs from recent modern humans as well as with fossil modern humans and other Neanderthals through traditional morphometric methods and 3D geometric morphometrics, combined with missing data estimation and virtual reconstruction (at the 1st, 5th and 11th costal levels). Our results show that Neanderthals have larger rib heads and articular tubercles than their modern human counterparts. Neanderthal 1st ribs are smaller than in modern humans, whereas 5th and 11th ribs are considerably larger. When we articulated mean ribs (size and shape) with their corresponding vertebral elements, we observed that compared to modern humans the Neanderthal thorax is medio-laterally expanded at every level, especially at T5 and T11. Therefore, in the light of evidence from the El Sidrón costal remains, we hypothesize that the volumetric expansion of the Neanderthal thorax proposed by previous authors would mainly be produced by a medio-lateral expansion of the thorax.
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Holcombe SA, Wang SC, Grotberg JB. The effect of age and demographics on rib shape. J Anat 2017; 231:229-247. [PMID: 28612467 DOI: 10.1111/joa.12632] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 12/22/2022] Open
Abstract
Elderly populations have a higher risk of rib fractures and other associated thoracic injuries than younger adults, and the changes in body morphology that occur with age are a potential cause of this increased risk. Rib centroidal path geometry for 20 627 ribs was extracted from computed tomography (CT) scans of 1042 live adult subjects, then fitted to a six-parameter mathematical model that accurately characterizes rib size and shape, and a three-parameter model of rib orientation within the body. Multivariable regression characterized the independent effect of age, height, weight, and sex on the rib shape and orientation across the adult population, and statistically significant effects were seen from all demographic factors (P < 0.0001). This study reports a novel aging effect whereby both the rib end-to-end separation and rib aspect ratio are seen to increase with age, producing elongated and flatter overall rib shapes in elderly populations, with age alone explaining up to 20% of population variability in the aspect ratio of mid-level ribs. Age was not strongly associated with overall rib arc length, indicating that age effects were related to shape change rather than overall bone length. The rib shape effect was found to be more strongly and directly associated with age than previously documented age-related changes in rib angulation. Other demographic results showed height and sex being most strongly associated with rib size, and weight most strongly associated with rib pump-handle angle. Results from the study provide a statistical model for building rib shapes typical of any given demographic by age, height, weight, and sex, and can be used to help build population-specific computational models of the thoracic rib cage. Furthermore, results also quantify normal population ranges for rib shape parameters which can be used to improve the assessment and treatment of rib skeletal deformity and disease.
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Affiliation(s)
- Sven A Holcombe
- Department of Biomechanical Engineering, University of Michigan, Ann Arbor, MI, USA.,International Center for Automotive Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Stewart C Wang
- International Center for Automotive Medicine, University of Michigan, Ann Arbor, MI, USA
| | - James B Grotberg
- Department of Biomechanical Engineering, University of Michigan, Ann Arbor, MI, USA
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Holcombe SA, Wang SC, Grotberg JB. Age-related changes in thoracic skeletal geometry of elderly females. TRAFFIC INJURY PREVENTION 2017; 18:S122-S128. [PMID: 28332867 DOI: 10.1080/15389588.2017.1309526] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/18/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Both females and the elderly have been identified as vulnerable populations with increased injury and mortality risk in multiple crash scenarios. Particularly in frontal impacts, older females show higher risk to the chest and thorax than their younger or male counterparts. Thoracic geometry plays a role in this increase, and this study aims to quantify key parts of that geometry in a way that can directly inform human body models that incorporate the concept of person age. METHODS Computed tomography scans from 2 female subject groups aged 20-35 and 65-99 were selected from the International Center for Automotive Medicine scan database representing young and old female populations. A model of thoracic skeletal anatomy was built for each subject from independent parametric models of the spine, ribs, and sternum, along with further parametric models of those components' spatial relationships. Parameter values between the 2 groups are directly compared, and average parameter values within each group are used to generate statistically average skeletal geometry for young and old females. In addition to the anatomic measures explicitly used in the parameterization scheme, key measures of rib cage depth and spine curvature are taken from both the underlying subject pool and from the resultant representative geometries. RESULTS Statistically significant differences were seen between the young and old groups' spine and rib anatomic components, with no significant differences in local sternal geometry found. Vertebral segments in older females had higher angles relative to their inferior neighbors, providing a quantification of the kyphotic curvature known to be associated with age. Ribs in older females had greater end-to-end span, greater aspect ratio, and reduced out-of-plane deviation, producing an elongated and overall flatter curvature that leads to distal rib ends extending further anteriorly in older individuals. Combined differences in spine curvature and rib geometry led to an 18-mm difference in anterior placement of the sternum between young and old subjects. CONCLUSIONS This study provides new geometric data regarding the variability in anthropometry of adult females with age and has utility in advancing the veracity of current human body models. A simplified scaffold representation of underlying 3-dimensional bones within the thorax is presented, and the reported young and old female parameter sets can be used to characterize the anatomic differences expected with age and to both validate and drive morphing algorithms for aged human body models. The modular approach taken allows model parameters to hold inherent and intuitive meaning, offering advantages over more generalized methods such as principal component analysis. Geometry can be assessed on a component level or a whole thorax level, and the parametric representation of thorax shape allows direct comparisons between the current study and other individuals or human body models.
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Affiliation(s)
- Sven A Holcombe
- a Department of Biomechanical Engineering , University of Michigan , Ann Arbor , Michigan
- b International Center for Automotive Medicine , University of Michigan , Ann Arbor , Michigan
| | - Stewart C Wang
- b International Center for Automotive Medicine , University of Michigan , Ann Arbor , Michigan
| | - James B Grotberg
- a Department of Biomechanical Engineering , University of Michigan , Ann Arbor , Michigan
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55
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Talbot BS, Gange CP, Chaturvedi A, Klionsky N, Hobbs SK, Chaturvedi A. Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and Treatment. Radiographics 2017; 37:628-651. [DOI: 10.1148/rg.2017160100] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Brett S. Talbot
- From the School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642
| | - Christopher P. Gange
- From the School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642
| | - Apeksha Chaturvedi
- From the School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642
| | - Nina Klionsky
- From the School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642
| | - Susan K. Hobbs
- From the School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642
| | - Abhishek Chaturvedi
- From the School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY 14642
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Heinrich D, Holzmann C, Wagner A, Fischer A, Pfeifer R, Graw M, Schick S. What are the differences in injury patterns of young and elderly traffic accident fatalities considering death on scene and death in hospital? Int J Legal Med 2017; 131:1023-1037. [PMID: 28180986 DOI: 10.1007/s00414-017-1531-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 01/03/2017] [Indexed: 11/28/2022]
Abstract
Older traffic participants have higher risks of injury than the population up to 65 years in case of comparable road traffic accidents and further, higher mortality rates at comparable injury severities. Rib fractures as risk factors are currently discussed. However, death on scene is associated with hardly survivable injuries and might not be a matter of neither rib fractures nor age. As 60% of traffic accident fatalities are estimated to die on scene, they are not captured in hospital-based trauma registries and injury patterns remain unknown. Our database comprises 309 road traffic fatalities, autopsied at the Institute of Legal Medicine Munich in 2004 and 2005. Injuries are coded according to Abbreviated Injury Scale, AIS© 2005 update 2008 [1]. Data used for this analysis are age, sex, site of death, site of accident, traffic participation mode, measures of injury severity, and rib fractures. The injury patterns of elderly, aged 65+ years, are compared to the younger ones divided by their site of death. Elderly with death on scene more often show serious thorax injuries and pelvic fractures than the younger. Some hints point towards older fatalities showing less frequently serious abdominal injuries. In hospital, elderly fatalities show lower Injury Severity Scores (ISSs) compared to the younger. The number of rib fractures is significantly higher for the elderly but is not the reason for death. Results show that young and old fatalities have different injury patterns and reveal first hints towards the need to analyze death on scene more in-depth.
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Affiliation(s)
- Daniela Heinrich
- Ludwig-Maximilians-University (LMU) Munich, Institute of Legal Medicine, Nussbaumstrasse 26, D-80336, Munich, Germany.
| | - Christopher Holzmann
- Department of Accident and Reconstructive Surgery, Hospital of the RWTH University Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
| | - Anja Wagner
- Ludwig-Maximilians-University (LMU) Munich, Institute of Legal Medicine, Nussbaumstrasse 26, D-80336, Munich, Germany
| | - Anja Fischer
- Ludwig-Maximilians-University (LMU) Munich, Institute of Legal Medicine, Nussbaumstrasse 26, D-80336, Munich, Germany
| | - Roman Pfeifer
- Department of Accident and Reconstructive Surgery, Hospital of the RWTH University Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany
| | - Matthias Graw
- Ludwig-Maximilians-University (LMU) Munich, Head of the Institute of Legal Medicine, Nussbaumstrasse 26, D-80336, Munich, Germany
| | - Sylvia Schick
- Ludwig-Maximilians-University (LMU) Munich, Institute of Legal Medicine, Nussbaumstrasse 26, D-80336, Munich, Germany
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Yamauchi-Kawaura C, Fujii K, Akahane K, Yamauchi M, Obara S, Narai K, Katsu T, Imai K, Ikeda M. DEVELOPMENT OF AGE-SPECIFIC JAPANESE PHYSICAL PHANTOMS FOR DOSE EVALUATION IN INFANT CT EXAMINATIONS. RADIATION PROTECTION DOSIMETRY 2016; 171:483-502. [PMID: 26420904 DOI: 10.1093/rpd/ncv420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 06/05/2023]
Abstract
Secondary to the previous development of age-specific Japanese head phantoms, the authors designed Japanese torso phantoms for dose assessment in infant computed tomography (CT) examinations and completed a Japanese 3-y-old head-torso phantom. For design of age-specific torso phantoms (0, 0.5, 1 and 3 y old), anatomical structures were measured from CT images of Japanese infant patients. From the CT morphometry, it was found that rib cages of Japanese infants were smaller than those in Europeans and Americans. Radiophotoluminescence glass dosemeters were used for dose measurement of a 3-y-old head-torso phantom. To examine the validity of the developed phantom, organ and effective doses by the in-phantom dosimetry system were compared with simulation values in a web-based CT dose calculation system (WAZA-ARI). The differences in doses between the two systems were <20 % at the doses of organs within scan regions and effective doses in head, chest and abdominopelvic CT examinations.
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Affiliation(s)
- C Yamauchi-Kawaura
- Department of Radiological Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daikominami, Higashi-ku, Nagoya 461-8673, Japan
| | - K Fujii
- Department of Radiological Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daikominami, Higashi-ku, Nagoya 461-8673, Japan
| | - K Akahane
- Medical Exposure Research Promotion Section, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - M Yamauchi
- Division of Radiology, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan
| | - S Obara
- Medical Exposure Research Promotion Section, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - K Narai
- Techno-Rad, Inc., 50-8, Higashi Arami, Tai, Miyama-cho, Kuze-gun, Kyoto 613-0036, Japan
| | - T Katsu
- Division of Radiology, Nagoya University Hospital, Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - K Imai
- Department of Radiological Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daikominami, Higashi-ku, Nagoya 461-8673, Japan
| | - M Ikeda
- Department of Radiological Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daikominami, Higashi-ku, Nagoya 461-8673, Japan
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Bastir M, García-Martínez D, Torres-Tamayo N, Sanchis-Gimeno JA, O'Higgins P, Utrilla C, Torres Sánchez I, García Río F. In Vivo 3D Analysis of Thoracic Kinematics: Changes in Size and Shape During Breathing and Their Implications for Respiratory Function in Recent Humans and Fossil Hominins. Anat Rec (Hoboken) 2016; 300:255-264. [PMID: 27762077 DOI: 10.1002/ar.23503] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/16/2016] [Accepted: 07/18/2016] [Indexed: 11/05/2022]
Abstract
The human ribcage expands and contracts during respiration as a result of the interaction between the morphology of the ribs, the costo-vertebral articulations and respiratory muscles. Variations in these factors are said to produce differences in the kinematics of the upper thorax and the lower thorax, but the extent and nature of any such differences and their functional implications have not yet been quantified. Applying geometric morphometrics we measured 402 three-dimensional (3D) landmarks and semilandmarks of 3D models built from computed tomographic scans of thoraces of 20 healthy adult subjects in maximal forced inspiration (FI) and expiration (FE). We addressed the hypothesis that upper and lower parts of the ribcage differ in kinematics and compared different models of functional compartmentalization. During inspiration the thorax superior to the level of the sixth ribs undergoes antero-posterior expansion that differs significantly from the medio-lateral expansion characteristic of the thorax below this level. This supports previous suggestions for dividing the thorax into a pulmonary and diaphragmatic part. While both compartments differed significantly in mean size and shape during FE and FI the size changes in the lower compartment were significantly larger. Additionally, for the same degree of kinematic shape change, the pulmonary thorax changes less in size than the diaphragmatic thorax. Therefore, variations in the form and function of the diaphragmatic thorax will have a strong impact on respiratory function. This has important implications for interpreting differences in thorax shape in terms of respiratory functional differences within and among recent humans and fossil hominins. Anat Rec, 300:255-264, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Markus Bastir
- Department of Paleobiology, Paleoanthropology Group, Museo Nacional de Ciencias Naturales, CSIC, Madrid, Spain
| | - Daniel García-Martínez
- Department of Paleobiology, Paleoanthropology Group, Museo Nacional de Ciencias Naturales, CSIC, Madrid, Spain.,Department of Biology, Science Faculty, Autónoma University of Madrid, Madrid, Spain
| | - Nicole Torres-Tamayo
- Department of Paleobiology, Paleoanthropology Group, Museo Nacional de Ciencias Naturales, CSIC, Madrid, Spain
| | | | - Paul O'Higgins
- Department of Archaeology and Hull York Medical School, The University of York, York, United Kingdom
| | - Cristina Utrilla
- Hospital Universitario La Paz Biomedical Research Institute (Idipaz), Madrid, Spain
| | | | - Francisco García Río
- Hospital Universitario La Paz Biomedical Research Institute (Idipaz), Madrid, Spain
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Risk factors for thoracic and spinal deformities following lung resection in neonates, infants, and children. Surg Today 2016; 47:810-814. [PMID: 27783148 PMCID: PMC5486598 DOI: 10.1007/s00595-016-1434-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/10/2016] [Indexed: 11/17/2022]
Abstract
Purpose We aimed to identify the risk factors for thoracic and spinal deformities following lung resection during childhood and to elucidate whether thoracoscopic surgery reduces the risk of complications after lung resection. Methods We retrospectively examined the medical records of all pediatric patients who underwent lung resection for congenital lung disease at our institution between 1989 and 2014. Results Seventy-four patients underwent lung resection during the study period and were followed-up. The median age of the patients at the time of surgery was 5 months (range 1 day–13 years), and 22 were neonates. Thoracotomy and thoracoscopy were performed in 25 and 49 patients, respectively. Thoracic or spinal deformities occurred in 28 of the 74 patients (37%). Univariate analyses identified thoracotomy, being a neonate (age: <1 month) at the time of surgery, and being symptomatic at the time of surgery as risk factors for these deformities. However, a multivariate analysis indicated that only thoracotomy and being a neonate were risk factors for deformities. Conclusions Thoracoscopic surgery reduced the risk of thoracic and spinal deformities following lung resection in children. We suggest that, where possible, lung resection should be avoided until 2 or 3 months of age.
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Wang Y, Cao L, Bai Z, Reed MP, Rupp JD, Hoff CN, Hu J. A parametric ribcage geometry model accounting for variations among the adult population. J Biomech 2016; 49:2791-2798. [DOI: 10.1016/j.jbiomech.2016.06.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 06/14/2016] [Accepted: 06/18/2016] [Indexed: 11/29/2022]
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Holcombe SA, Wang SC, Grotberg JB. Modeling female and male rib geometry with logarithmic spirals. J Biomech 2016; 49:2995-3003. [PMID: 27497501 DOI: 10.1016/j.jbiomech.2016.07.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/17/2016] [Accepted: 07/20/2016] [Indexed: 11/18/2022]
Abstract
In this study we present a novel six-parameter shape model of the human rib centroidal path using logarithmic spirals. It provides a reduction in parameter space from previous models of overall rib shape, while simultaneously reducing fitting error by 34% and increasing curvature continuity. Furthermore, the model directly utilizes geometric properties such as rib end-to-end span, aspect ratio, rib "skewness", and inner angle with the spine in its parameterization, making the effects of each parameter on overall shape intuitive and easy to visualize. The model was tested against 2197 rib geometries extracted from CT scans from a population of 100 adult females and males of uniformly distributed ages between 20 and 70. Significant size and shape differences between genders were identified, and shape model utility is demonstrated by the production of statistically average male and female rib shapes for all rib levels. Simulated mechanical loading of the resulting model rib shapes showed that the stiffness of statistically average male and female ribs matched well with the average rib stiffness from each separate population. This in-plane rib shape model can be used to characterize variation in human rib geometry seen throughout the population, including investigation of the overall changes in shape and resultant mechanical properties that ribs undergo during aging or disease progression.
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Affiliation(s)
- Sven A Holcombe
- Department of Biomechanical Engineering, University of Michigan, Ann Arbor, MI, USA; International Center for Automotive Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - Stewart C Wang
- International Center for Automotive Medicine, University of Michigan, Ann Arbor, MI, USA
| | - James B Grotberg
- Department of Biomechanical Engineering, University of Michigan, Ann Arbor, MI, USA
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García-Martínez D, Torres-Tamayo N, Torres-Sanchez I, García-Río F, Bastir M. Morphological and functional implications of sexual dimorphism in the human skeletal thorax. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 161:467-477. [DOI: 10.1002/ajpa.23051] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/20/2016] [Accepted: 07/01/2016] [Indexed: 01/05/2023]
Affiliation(s)
- Daniel García-Martínez
- Paleoanthropology Group; Paleobiology Department, Museo Nacional de Ciencias Naturales (MNCN-CSIC); Madrid Spain
- Biology Department; Faculty of Sciences, Universidad Autónoma De Madrid; Madrid Spain
| | - Nicole Torres-Tamayo
- Paleoanthropology Group; Paleobiology Department, Museo Nacional de Ciencias Naturales (MNCN-CSIC); Madrid Spain
| | | | - Francisco García-Río
- Hospital Universitario La Paz, Biomedical Research Institute (IdiPAZ); Madrid Spain
| | - Markus Bastir
- Paleoanthropology Group; Paleobiology Department, Museo Nacional de Ciencias Naturales (MNCN-CSIC); Madrid Spain
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63
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Planning of mandibular reconstructions based on statistical shape models. Int J Comput Assist Radiol Surg 2016; 12:99-112. [PMID: 27393280 DOI: 10.1007/s11548-016-1451-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The reconstruction of large continuity defects of the mandible is a challenging task, especially when the shape of the missing part is not known prior to operation. Today, the surgical planning is based mainly on visual judgment and the individual skills and experience of the surgeons. The objective of the current study was to develop a computer-based method that is capable of proposing a reconstruction shape from a known residual mandible part. METHODS The volumetric data derived from 60 CT scans of mandibles were used as the basis for the novel numerical procedure. To find a standardized representation of the mandible shapes, a mesh was elaborated that follows the course of anatomical structures with a specially developed topology of quadrilaterals. These standard meshes were transformed with defined mesh modifications toward each individual mandible surface to allow for further statistical evaluations. The data were used to capture the inter-individual shape variations that were considered as random field variations and mathematically evaluated with principal component analysis. With this information of the mandibular shape variations, an algorithm was developed that proposes shapes for reconstruction planning based on given residual mandible geometry parts. RESULTS The accuracy of the novel method was evaluated on six different virtually defined continuity defects that were each created on three mandibles that were not part of the initial database. Virtual reconstructions showed sufficient accuracy of the algorithm for the planning of surgical reconstructions, with average deviations toward the actual geometry of [Formula: see text] mm for small missing parts and 5 mm for large hemi-lateral defects. CONCLUSIONS The presented algorithm may be a valuable tool for the planning of mandibular reconstructions. The proposed shapes can be used as templates for computer-aided manufacturing, e.g., with 3D printing devices that use biocompatible materials.
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Bugaev N, Breeze JL, Alhazmi M, Anbari HS, Arabian SS, Rabinovici R. Displacement Patterns of Blunt Rib Fractures and Their Relationship to Thoracic Coinjuries: Minimal Displacements Count. Am Surg 2016. [DOI: 10.1177/000313481608200311] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Displacement patterns of rib fractures (RF) and their association with thoracic coinjuries and outcomes are unknown. This is a retrospective review of adult patients with blunt closed RF who underwent chest CT at a Level I trauma center (2007–2012). Displacement patterns of RF were compared among the three-dimensional planes using CT images. An analysis of receiver operating characteristic (ROC) curves was performed to identify displacements in each plane most strongly associated with chest coinjuries. Univariate analysis was used to find association of displaced RF with hospital course and outcome. There were 1127 RF (245 patients, most in ribs 3–9, 45 per cent displaced). Axial displacement was the most common, with odds ratios 7.20 and 2.13 compared with cranio-caudal, and impaction-separation (along rib axis) movement, respectively. Axial displacement thresholds performed well with hemothorax (2.8 mm, ROC = 0.74), pneumothorax (2.6 mm, ROC = 0.70), hemopneumothorax (3.1 mm, ROC = 0.77), flail chest (3.4 mm, ROC = 0.80), and chest tube placement (2.8 mm, ROC = 0.75). RF displacement was associated with increased days on mechanical ventilation and hospital length of stay. In conclusion, even minimal RF displacement is associated with increased risk of chest coinjuries and chest tube placement, and displacements correlated with increased days on mechanical ventilation and hospital length of stay. Future studies are required to investigate these associations, especially in relationship to the indications for rib plating.
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Affiliation(s)
- Nikolay Bugaev
- Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts and
| | - Janis L. Breeze
- Tufts Clinical and Translational Science Institute, Tufts University, and Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Majid Alhazmi
- Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts and
| | - Hassan S. Anbari
- Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts and
| | - Sandra S. Arabian
- Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts and
| | - Reuven Rabinovici
- Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts and
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65
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García-Martínez D, Recheis W, Bastir M. Ontogeny of 3D rib curvature and its importance for the understanding of human thorax development. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 159:423-31. [PMID: 26890054 DOI: 10.1002/ajpa.22893] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 10/26/2015] [Accepted: 10/29/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Sagittal and axial rib orientation relative to the spine are two factors that modify rib cage morphology during ontogeny. Some studies suggest that these factors do not operate in the same way at the upper (ribs 1-5) and lower thorax (ribs 6-10) during postnatal growth, but it is unknown if the ontogenetic thoracic changes are produced by morphological changes of the ribs (intrinsic rib factors) or by external factors related to costal joints (extrinsic rib factors). MATERIAL AND METHODS To clarify these questions, we applied 3D geometric morphometrics of landmarks and sliding semilandmarks (N = 20/rib) to 280 individual ribs (1-10) of Homo sapiens comprising the entire human ontogeny and growth simulations were carried out. RESULTS PCA shows that intrinsic rib factors (rib torsion and axial rib curvature) are ontogenetic factors of variability that contribute to configuring the adult thorax shape. Moreover, growth simulations and regression slopes suggest that the upper thorax unit is comprised by ribs 1-7 and the lower unit at least by ribs 8-10. DISCUSSION These results suggest anatomical constraints for ontogenetic rib variation, since ribs 1-7 (true ribs) are directly linked to the sternum. Moreover, these results are supported by functional anatomy because pulmonary kinematics would influence the upper unit and diaphragmatic kinematics would influence the lower one. Our findings are relevant not only to understanding how changes at individual ribs contribute to the adult thorax morphology, but also to the development and evolution of the modern human rib cage.
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Affiliation(s)
- Daniel García-Martínez
- Paleoanthropology Group, Paleobiology Department, Museo Nacional de Ciencias Naturales (MNCN-CSIC), JG. Abascal 2, Madrid, 28006, Spain.,Biology Department, Faculty of Sciences, Universidad Autónoma De Madrid. Darwin 2, Madrid, 28049, Spain
| | - Wolfgang Recheis
- Department of Radiology, Medizinische Universität Innsbruck, 6020, Austria
| | - Markus Bastir
- Paleoanthropology Group, Paleobiology Department, Museo Nacional de Ciencias Naturales (MNCN-CSIC), JG. Abascal 2, Madrid, 28006, Spain
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66
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Weaver AA, Nguyen CM, Schoell SL, Maldjian JA, Stitzel JD. Image segmentation and registration algorithm to collect thoracic skeleton semilandmarks for characterization of age and sex-based thoracic morphology variation. Comput Biol Med 2015; 67:41-8. [PMID: 26496701 DOI: 10.1016/j.compbiomed.2015.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 10/04/2015] [Accepted: 10/05/2015] [Indexed: 11/20/2022]
Abstract
Thoracic anthropometry variations with age and sex have been reported and likely relate to thoracic injury risk and outcome. The objective of this study was to collect a large volume of homologous semilandmark data from the thoracic skeleton for the purpose of quantifying thoracic morphology variations for males and females of ages 0-100 years. A semi-automated image segmentation and registration algorithm was applied to collect homologous thoracic skeleton semilandmarks from 343 normal computed tomography (CT) scans. Rigid, affine, and symmetric diffeomorphic transformations were used to register semilandmarks from an atlas to homologous locations in the subject-specific coordinate system. Homologous semilandmarks were successfully collected from 92% (7077) of the ribs and 100% (187) of the sternums included in the study. Between 2700 and 11,000 semilandmarks were collected from each rib and sternum and over 55 million total semilandmarks were collected from all subjects. The extensive landmark data collected more fully characterizes thoracic skeleton morphology across ages and sexes. Characterization of thoracic morphology with age and sex may help explain variations in thoracic injury risk and has important implications for vulnerable populations such as pediatrics and the elderly.
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Affiliation(s)
- Ashley A Weaver
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Medical Center Blvd, Winston-Salem, NC 27103, USA; Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27103, USA.
| | - Callistus M Nguyen
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27103, USA.
| | - Samantha L Schoell
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Medical Center Blvd, Winston-Salem, NC 27103, USA; Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27103, USA.
| | - Joseph A Maldjian
- Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27103, USA.
| | - Joel D Stitzel
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Medical Center Blvd, Winston-Salem, NC 27103, USA; Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27103, USA.
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67
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Bruno AG, Bouxsein ML, Anderson DE. Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage. J Biomech Eng 2015; 137:081003. [PMID: 25901907 DOI: 10.1115/1.4030408] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Indexed: 11/08/2022]
Abstract
We developed and validated a fully articulated model of the thoracolumbar spine in opensim that includes the individual vertebrae, ribs, and sternum. To ensure trunk muscles in the model accurately represent muscles in vivo, we used a novel approach to adjust muscle cross-sectional area (CSA) and position using computed tomography (CT) scans of the trunk sampled from a community-based cohort. Model predictions of vertebral compressive loading and trunk muscle tension were highly correlated to previous in vivo measures of intradiscal pressure (IDP), vertebral loading from telemeterized implants and trunk muscle myoelectric activity recorded by electromyography (EMG).
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68
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Quantitative Validation of a Human Body Finite Element Model Using Rigid Body Impacts. Ann Biomed Eng 2015; 43:2163-74. [DOI: 10.1007/s10439-015-1286-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/19/2015] [Indexed: 11/26/2022]
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69
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Lee EL, Craig M, Scarboro M. Real-World Rib Fracture Patterns in Frontal Crashes in Different Restraint Conditions. TRAFFIC INJURY PREVENTION 2015; 16 Suppl 2:S115-S123. [PMID: 26436220 DOI: 10.1080/15389588.2015.1062888] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The purpose of this study was to use the detailed medical injury information in the Crash Injury Research and Engineering Network (CIREN) to evaluate patterns of rib fractures in real-world crash occupants in both belted and unbelted restraint conditions. Fracture patterns binned into rib regional levels were examined to determine normative trends associated with belt use and other possible contributing factors. METHODS Front row adult occupants with Abbreviated Injury Scale (AIS) 3+ rib fractures, in frontal crashes with a deployed frontal airbag, were selected from the CIREN database. The circumferential location of each rib fracture (with respect to the sternum) was documented using a previously published method (Ritchie et al. 2006) and digital computed tomography scans. Fracture patterns for different crash and occupant parameters (restraint use, involved physical component, occupant kinematics, crash principal direction of force, and occupant age) were compared qualitatively and quantitatively. RESULTS There were 158 belted and 44 unbelted occupants included in this study. For belted occupants, fractures were mainly located near the path of the shoulder belt, with the majority of fractures occurring on the inboard (with respect to the vehicle) side of the thorax. For unbelted occupants, fractures were approximately symmetric and distributed across both sides of the thorax. There were negligible differences in fracture patterns between occupants with frontal (0°) and near side (330° to 350° for drivers; 10° to 30° for passengers) crash principal directions of force but substantial differences between groups when occupant kinematics (and contacts within the vehicle) were considered. Age also affected fracture pattern, with fractures tending to occur more anteriorly in older occupants and more laterally in younger occupants (both belted and unbelted). CONCLUSIONS Results of this study confirmed with real-world data that rib fracture patterns in unbelted occupants were more distributed and symmetric across the thorax compared to belted occupants in crashes with a deployed frontal airbag. Other factors, such as occupant kinematics and occupant age, also produced differing patterns of fractures. Normative data on rib fracture patterns in real-world occupants can contribute to understanding injury mechanisms and the role of different causation factors, which can ultimately help prevent fractures and improve vehicle safety.
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Affiliation(s)
- Ellen L Lee
- a National Highway Traffic Safety Administration (NHTSA), Human Injury Research Division , Washington , DC
| | - Matthew Craig
- a National Highway Traffic Safety Administration (NHTSA), Human Injury Research Division , Washington , DC
| | - Mark Scarboro
- a National Highway Traffic Safety Administration (NHTSA), Human Injury Research Division , Washington , DC
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70
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Schoell SL, Weaver AA, Vavalle NA, Stitzel JD. Age- and sex-specific thorax finite element model development and simulation. TRAFFIC INJURY PREVENTION 2015; 16 Suppl 1:S57-S65. [PMID: 26027976 DOI: 10.1080/15389588.2015.1005208] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The shape, size, bone density, and cortical thickness of the thoracic skeleton vary significantly with age and sex, which can affect the injury tolerance, especially in at-risk populations such as the elderly. Computational modeling has emerged as a powerful and versatile tool to assess injury risk. However, current computational models only represent certain ages and sexes in the population. The purpose of this study was to morph an existing finite element (FE) model of the thorax to depict thorax morphology for males and females of ages 30 and 70 years old (YO) and to investigate the effect on injury risk. METHODS Age- and sex-specific FE models were developed using thin-plate spline interpolation. In order to execute the thin-plate spline interpolation, homologous landmarks on the reference, target, and FE model are required. An image segmentation and registration algorithm was used to collect homologous rib and sternum landmark data from males and females aged 0-100 years. The Generalized Procrustes Analysis was applied to the homologous landmark data to quantify age- and sex-specific isolated shape changes in the thorax. The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant model was morphed to create age- and sex-specific thoracic shape change models (scaled to a 50th percentile male size). To evaluate the thoracic response, 2 loading cases (frontal hub impact and lateral impact) were simulated to assess the importance of geometric and material property changes with age and sex. RESULTS Due to the geometric and material property changes with age and sex, there were observed differences in the response of the thorax in both the frontal and lateral impacts. Material property changes alone had little to no effect on the maximum thoracic force or the maximum percent compression. With age, the thorax becomes stiffer due to superior rotation of the ribs, which can result in increased bone strain that can increase the risk of fracture. For the 70-YO models, the simulations predicted a higher number of rib fractures in comparison to the 30-YO models. The male models experienced more superior rotation of the ribs in comparison to the female models, which resulted in a higher number of rib fractures for the males. CONCLUSION In this study, age- and sex-specific thoracic models were developed and the biomechanical response was studied using frontal and lateral impact simulations. The development of these age- and sex-specific FE models of the thorax will lead to an improved understanding of the complex relationship between thoracic geometry, age, sex, and injury risk.
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Affiliation(s)
- Samantha L Schoell
- a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Wake Forest University School of Medicine , Winston-Salem , North Carolina
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71
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Perz R, Toczyski J, Subit D. Variation in the human ribs geometrical properties and mechanical response based on X-ray computed tomography images resolution. J Mech Behav Biomed Mater 2015; 41:292-301. [DOI: 10.1016/j.jmbbm.2014.07.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/28/2014] [Accepted: 07/30/2014] [Indexed: 11/24/2022]
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72
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Agnew AM, Schafman M, Moorhouse K, White SE, Kang YS. The effect of age on the structural properties of human ribs. J Mech Behav Biomed Mater 2015; 41:302-14. [DOI: 10.1016/j.jmbbm.2014.09.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/28/2014] [Accepted: 09/02/2014] [Indexed: 10/24/2022]
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73
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Urban JE, Weaver AA, Lillie EM, Maldjian JA, Whitlow CT, Stitzel JD. Evaluation of morphological changes in the adult skull with age and sex. J Anat 2014; 229:838-846. [PMID: 25406956 DOI: 10.1111/joa.12247] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 11/27/2022] Open
Abstract
The morphology of the brain and skull are important in the evaluation of the aging human; however, little is known about how the skull may change with age. The objective of this study was to evaluate the morphological changes of the adult skull using three-dimensional geometric morphometric analysis of thousands of landmarks with the focus on anatomic regions that may be correlated with brain atrophy and head injury. Computed tomography data were collected between ages 20 and 100. Each scan was segmented using thresholding techniques. An atlas image of a 50th percentile skull was registered to each subject scan by computing a series of rigid, affine, and non-linear transformations between atlas space and subject space. Landmarks on the atlas skull were transformed to each subject and partitioned into the inner and outer cranial vault and the cranial fossae. A generalized Procrustes analysis was completed for the landmark sets. The coordinate locations describing the shape of each region were regressed with age to generate a model predicting the landmark location with age. Permutation testing was performed to assess significant changes with age. For the males, all anatomic regions reveal significant changes in shape with age except for the posterior cranial fossa. For the females, only the middle cranial fossa and anterior cranial fossa were found to change significantly in shape. Results of this study are important for understanding the adult skull and how shape changes may pertain to brain atrophy, aging, and injury.
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Affiliation(s)
- Jillian E Urban
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston Salem, NC, USA.,Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Ashley A Weaver
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston Salem, NC, USA.,Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Elizabeth M Lillie
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston Salem, NC, USA.,Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Joseph A Maldjian
- Wake Forest School of Medicine, Winston Salem, NC, USA.,Department of Radiology (Neuroradiology), Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Christopher T Whitlow
- Wake Forest School of Medicine, Winston Salem, NC, USA.,Department of Radiology (Neuroradiology), Wake Forest School of Medicine, Winston Salem, NC, USA.,Translational Science Institute, Wake Forest University, Winston Salem, NC, USA
| | - Joel D Stitzel
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston Salem, NC, USA.,Wake Forest School of Medicine, Winston Salem, NC, USA
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74
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Weaver AA, Schoell SL, Nguyen CM, Lynch SK, Stitzel JD. Morphometric analysis of variation in the sternum with sex and age. J Morphol 2014; 275:1284-99. [DOI: 10.1002/jmor.20302] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 05/01/2014] [Accepted: 05/28/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Ashley A. Weaver
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Department of Biomedical Engineering; Winston-Salem North Carolina
- Wake Forest University School of Medicine, Department of Biomedical Engineering; Winston-Salem North Carolina
| | - Samantha L. Schoell
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Department of Biomedical Engineering; Winston-Salem North Carolina
- Wake Forest University School of Medicine, Department of Biomedical Engineering; Winston-Salem North Carolina
| | - Callistus M. Nguyen
- Wake Forest University School of Medicine, Department of Biomedical Engineering; Winston-Salem North Carolina
| | - Sarah K. Lynch
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Department of Biomedical Engineering; Winston-Salem North Carolina
- Wake Forest University School of Medicine, Department of Biomedical Engineering; Winston-Salem North Carolina
| | - Joel D. Stitzel
- Virginia Tech-Wake Forest University Center for Injury Biomechanics, Department of Biomedical Engineering; Winston-Salem North Carolina
- Wake Forest University School of Medicine, Department of Biomedical Engineering; Winston-Salem North Carolina
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