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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 entyoo@empal.com 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

3D Reconstruction of CT from FF Model Woo KS, et al. 재료및방법 - - - - - C D Fig. 1.

The fish bones are placed over the meat layer before covering with additional

Meat-fish bone sandwich foreign body model, cross sectional view.

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

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