|
|||||
|
|
Strengths and Weaknesses of Non-enhanced and Contrast-enhanced Cadaver Computed Tomography Scans in the Teaching of Gross Anatomy in an Integrated Curriculum |
|
| Authors: | Daniel Paech Kerstin Klopries Ralph Nawrotzki Heinz-Peter Schlemmer Frederik L Giesel Joachim Kirsch Jobst-Hendrik Schultz Thomas Kuner Sara Doll |
| Institution: | 1. Institute of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany;2. Institute of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
Department of Radiology, University Hospital Essen, Essen, Germany Contribution: Conceptualization (supporting), Data curation (equal), Formal analysis (equal), ?Investigation (equal), Methodology (supporting), Validation (equal), Visualization (supporting), Writing - original draft (equal);3. Institute of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany Contribution: Supervision (supporting), Writing - original draft (supporting);4. Division of Radiology, German Cancer Research Center, Heidelberg, Germany Contribution: Resources (supporting), Writing - original draft (supporting);5. Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany Contribution: Supervision (supporting), Writing - original draft (supporting);6. Institute of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany Contribution: Resources (lead), Supervision (supporting), Writing - original draft (supporting);7. Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany Contribution: Supervision (supporting), Writing - original draft (supporting);8. Institute of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany Contribution: Conceptualization (supporting), Formal analysis (supporting), Project administration (supporting), Resources (equal), Supervision (supporting), Writing - original draft (supporting) |
| Abstract: | Cadaver-specific postmortem computed tomography (PMCT) has become an integral part in anatomy teaching at several universities. Recently, the feasibility of contrast-enhanced (CE)-PMCT has been demonstrated. The purpose of this study was to identify particular strengths and weaknesses of both non-enhanced and contrast-enhanced PMCT compared to conventional cadaver dissection. First, the students’ perception of the learning effectiveness of the three different modalities have been assessed using a 34-item survey (five-point Likert scale) covering all anatomy course modules. Results were compared using the nonparametric Friedman Test. Second, the most frequent artifacts in cadaver CT scans, were systematically analyzed in 122 PMCT and 31 CE-PMCT data sets to quantify method-related limitations and characteristics. Perfusion quality was assessed in 57 vascular segments (38 arterial and 19 venous). The survey was answered by n = 257/320 (80.3%) students. Increased learning benefits of PMCT/ CE-PMCT compared to cadaver dissection were found in osteology (2/3 categories, P < 0.001), head and neck (2/5 categories, P < 0.01), and brain anatomy (3/3 categories, P < 0.01). Contrast-enhanced-PMCT was perceived particularly useful in learning vascular anatomy (10/10 categories, P < 0.01). Cadaver dissection received significantly higher scores compared to PMCT and CE-PMCT in all categories of the abdomen and thorax (7/7 categories, P < 0.001), as well as the majority of muscular anatomy (5/6 categories, P < 0.001). Frequent postmortem artifacts (total n = 28, native-phase n = 21, contrast injection-related n = 7) were identified and assessed. The results of this work contribute to the understanding of the value of integrating cadaver-specific PMCT in anatomy teaching. |
| Keywords: | Gross anatomy education medical education radiology education computed tomography angiography postmortem imaging cross-sectional anatomy |