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1 online ML Comm Head and Neck Korean J Otorhinolaryngol-Head Neck Surg 2014;57(4): / pissn / eissn Clinical pplication of 3 Dimensional Reconstruction of CT from Fish one Foreign ody Model Kuk Sung Woo 1, Young Sam Yoo 1, Han ee Lee 2, Dong Won Kim 3, Ji-Min Chang 3, Joong Hyun Park 1, and Kyoung Ho Park 1 1 Departments of Otolaryngology-Head and Neck Surgery, 2 Radiology, 3 Thoracic and Cardiovascular Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea 생선뼈이물모델의전산화단층촬영에서도출한삼차원재구성방법의임상적응용 우국성 1 유영삼 1 이한비 2 김동원 3 장지민 3 박중현 1 박경호 1 인제대학교의과대학상계백병원이비인후과학교실, 1 영상의학과학교실, 2 흉부외과학교실 3 Received October 27, 2013 Revised December 9, 2013 ccepted December 10, 2013 ddress for correspondence Young Sam Yoo, MD Department of Otolaryngology- Head and Neck Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul , Korea Tel Fax ackground and ObjectivesZZThis study aimed to gather three-dimensional data to detect fish bones as an esophageal foreign body model and to assess the possibility that this method could be applied for cases of real fish bone foreign body (FF). Materials and MethodZZFish bones from two species were collected and sizes were measured. Pork meat loaf was placed flat into a plastic box containing plaster cast and bones were laid over the meat layer. nother layer of meat was placed on the bones, then another layer of plaster cast, and the final layer of meat were placed. The meat-bone sandwich was regarded as a fish bone foreign body model of esophagus. The model was imaged using computed tomography (CT) scan and the CT data were reconstructed three-dimensionally making multi-planar reconstruction, maximal intensity projection, and volume rendering images. We tried to find tools to detect the shape and lying position of the FF model. The above tools were applied to 3 FF cases to verify effectiveness of the tools. ResultsZZMulti-planar reconstruction, maximal intensity projection, and volume rendering images were reconstructed easily. fter single or more processing, all of the bones could be detected. The shape and lying positions could be detected using tools made from FF models. ConclusionZZReconstructed images of CT data readily enabled the detection of fish bone in the esophageal model and real cases. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(4): Key WordsZZFish bone foreign body ㆍ 3D reconstruction of CT. 서론 244 Copyright 2014 Korean Society of Otorhinolaryngology-Head and Neck Surgery

2 3D Reconstruction of CT from FF Model Woo KS, et al. 재료및방법 C D Fig. 1. Meat-fish bone sandwich foreign body model viewed from above. The fish bones are placed over the meat layer before covering with additional meat-plaster-meat layer (). Plaster layed on the plastic box (). Meat-plaster layers added (C). Meat layer added and complete fish bone foreign body model (D). Fig. 2. Meat-fish bone sandwich foreign body model, cross sectional view. Red bar: meat layer, purple bar: fish bone, clear bar: plastic box, blue bar: plaster mimicking soft tissue, foreign bodies, body and surrounding bones respectively

3 Korean J Otorhinolaryngol-Head Neck Surg 2014;57(4): MPR MIP VR C D E F Fig. 3. The 3D reconstructed images of fish bones used as foreign body model. Fish bones, axial MPR images, coronal MIP images, volume rendered images from left to right respectively. Maxilla and mandible of sea bream ( and ). Mandible of stingfish (C). Gill cover of stingfish (D). Skull bones of stingfish (E and F). MPR: multiplanar reconstruction, MIP: maximum intensity projection, VR: volume rendering, 3D: 3 dimensional. 246

4 3D Reconstruction of CT from FF Model Woo KS, et al. 결과 C D - - E C D E Fig. 4. Case 1. Fish bone impacted in esophagus removed under flexible fiberscopy. Fish bone removed (), endoscopic view (), axial MPR image (C), coronal MIP image (D), and VR cube image respectively (E). MPR: multiplanar reconstruction, MIP: maximum intensity projection, VR: volume rendering. Fig. 5. Case 2. Fish bone impacted in esophagus removed by thoracotomy. Fish bone removed (), endoscopic view (), axial MPR image (C), axial MIP image (D), and VR cube image respectively (E). MPR: multiplanar reconstruction, MIP: maximum intensity projection, VR: volume rendering

5 Korean J Otorhinolaryngol-Head Neck Surg 2014;57(4): C D E Fig. 6. Case 3. Shell of mussel impacted in esophagus removed under flexible fiberscopy. Shell removed (), endoscopic view (), sagittal MPR image (C), coronal MIP image (D), and VR image respectively (E). MPR: multiplanar reconstruction, MIP: maximum intensity projection, VR: volume rendering. 고찰 - 248

6 3D Reconstruction of CT from FF Model Woo KS, et al. - - REFERENCES 1) Irfan M, hmad Helmy K, Wan Shah Jihan WD. Radio-opacity of commonly consumed bony fish in kelantan, malaysia. Med J Malaysia 2012;67(5): ) Wang CP, Jiang SL. Migrating fish bone presenting as acute onset of neck lump. J Formos Med ssoc 2009;108(2): ) Pinto, Muzj C, Gagliardi N, Pinto F, Setola FR, Scaglione M, et al. Role of imaging in the assessment of impacted foreign bodies in the 249

7 Korean J Otorhinolaryngol-Head Neck Surg 2014;57(4): hypopharynx and cervical esophagus. Semin Ultrasound CT MR 2012;33(5): ) Siu WT, Yau KK, Law K, Li MK. Fish bone embedded in cervical esophagus. uris Nasus Larynx 2005;32(3): ) Palme CE, Lowinger D, Petersen J. Fish bones at the cricopharyngeus: a comparison of plain-film radiology and computed tomography. Laryngoscope 1999;109(12): ) Eliashar R, Dano I, Dangoor E, raverman I, Sichel JY. Computed tomography diagnosis of esophageal bone impaction: a prospective study. nn Otol Rhinol Laryngol 1999;108(7 Pt 1): ) Kim HU, Song HJ. Clinical characteristics of an esophageal fish bone foreign body from chromis notata. J Korean Med Sci 2012;27(10): ) Lo WC, Hsin CH, Lee SY, Cheng PW. Radiology quiz case 1. Migrating esophageal fish bone complicating a right paraesophageal abscess. rch Otolaryngol Head Neck Surg 2008;134(9):1008, ) Das D, May G. est evidence topic report. Is CT effective in cases of upper oesophageal fish bone ingestion? Emerg Med J 2007;24(1): ) kazawa Y, Watanabe S, Nobukiyo S, Iwatake H, Seki Y, Umehara T, et al. The management of possible fishbone ingestion. uris Nasus Larynx 2004;31(4): ) Kumar M, Joseph G, Kumar S, Clayton M. Fish bone as a foreign body. J Laryngol Otol 2003;117(7): ) riz C, Horton KM, Fishman EK. 3D CT evaluation of retained foreign bodies. Emerg Radiol 2004;11(2): ) Evans S, Jones C, Plassmann P. 3D imaging in forensic odontology. J Vis Commun Med 2010;33(2): ) Heo G, Yoo YS, Kim SW. Virtual endoscopy of impacted foreign bodies in tracheal and esophageal model. Korean J Otorhinolaryngol- Head Neck Surg 2011;54(5): ) Yoo YS, Kim DW. Detection of simulative foreign body using three dimensional reconstruction technique, introduction and application. Korean J ronchoesophagol 2011;17(1): ) Watanabe K, mano M, Nakanome, Saito D, Hashimoto S. The prolonged presence of a fish bone in the neck. Tohoku J Exp Med 2012;227(1): ) Park S, Choi DS, Shin HS, Cho JM, Jeon KN, ae KS, et al. Fish bone foreign bodies in the pharynx and upper esophagus: evaluation with 64-slice MDCT. cta Radiol 2014;55(1): ) Yang J, Zheng G, Zhou Z, Guo W. pplication of MPR in sacral nerve injury during sacral fracture. J Trauma 2011;70(6): ) Isogai S, Takehara Y, Isoda H, Kaneko M. [Maximum intensity projection (MIP) and multiplanar reformation (MPR) for postprocessing cholangiopancreatographic data set--clinical application and pitfalls]. Nihon Rinsho 1998;56(11): ) Sahel M, Ourrad E, Zouaoui, Marro, Sourour N, iondi, et al. [3D-CT angiography with volume rendering technique in the intracerebral aneurysms]. J Radiol 2000;81(2): ) Prokesch RW, Goerzer HG, Killer M, Dorffner R, Schima W, Schindler EG. Pseudoaneurysm of the internal carotid artery after shrapnel injury in World War II: demonstration by CT angiography with 3D MIP reconstruction. Eur Radiol 1999;9(7): ) Rodt T, artling SO, Zajaczek JE, Vafa M, Kapapa T, Majdani O, et al. Evaluation of surface and volume rendering in 3D-CT of facial fractures. Dentomaxillofac Radiol 2006;35(4):

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