Anat Cell Biol.  2022 Dec;55(4):507-511. 10.5115/acb.22.092.

Revisiting diaphragmatic hernia of Joseon period Korean mummy by three-dimensional liver and heart segmentation and model reconstruction

• Koh E
• Lee DY
• Yoo D
• Kim MJ
• Lee IS
• Hong JH
• Park SJ
• Kim J
• Cha SC
• Lee H
• Oh CS
• Shin DH

• KMID: 2537472
• DOI: http://doi.org/10.5115/acb.22.092

Abstract

A three-dimensional (3D) segmentation and model reconstruction is a specialized tool to reveal spatial interrelationship between multiple internal organs by generating images without overlapping structures. This technique can also be applicable to mummy studies, but related reports have so far been very rare. In this study, we applied 3D segmentation and model reconstruction to computed tomography images of a Korean mummy with congenital diaphragmatic hernia. As originally revealed by the autopsy in 2013, the current 3D reconstruction reveals that the mummy’s heart is shifted to the left due to the liver pushing up to thoracic cavity thorough diaphragmatic hernial defect. We can generate 3D images by calling up the data exclusively from mummy’s target organs, thus minimizing the confusion of diagnosis that could be caused by overlapping organs.

Keyword

Computed tomography; Congenital diaphragmatic hernia; Image reconstruction; Korea; Joseon dynasty

Figure

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  Fig. 1 Autopsy view in 2013. Mediastinal shift to the left. Left border of heart (Ht) marked by a yellow broken line. Liver (Lv) is found in right thoracic cavity. Posterolateral defect of diaphragm marked by arrows. Lu, lung.

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  Fig. 2 Three-dimensional reconstructed heart (Ht) and liver (Lv) viewed from various angles. In brief, columns: (A) the view from the front; (B) the view from the left 45-degree angle; (C) the view from the left 90-degree angle; and (D) the view from the back.

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  Fig. 3 Three-dimensional segmentation and model reconstruction of heart (A, C) and liver (B, D). The views from the front (A, B) and caudal (C, D). Mediastinal shift to the left could be seen (A, C). Liver can be found in right thoracic cavity due to diaphragmatic hernia (B, D).

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  Fig. 4 (A) Autopsy (2013) and (B) three-dimensional segmentation and model reconstruction view of Andong mummy’s thoracic cavity. Liver is present below the right lung. Heart is encapsulated by pericardium. (B) Heart and liver is visible without overlapping organs by calling up the data exclusively from the target organs.

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  Fig. 5 Heart (red) and liver (yellow) in the thorax are viewed from different angles. (A) the view from the front; (B) the view from the left 45-degree angle; (C) the view from the left 90-degree angle; and (D) the view from the back.

Reference

References

1. Hughes SW. Higgins T, Main P, Lang J, editors. 1996. Three-dimensional reconstruction of an ancient Egyptian mummy. Imaging the Past: Electronic Imaging and Computer Graphics in Museums and Archaeology. British Museum;London: p. 211–26.

2. Melcher AH, Holowka S, Pharoah M, Lewin PK. 1997; Non-invasive computed tomography and three-dimensional reconstruction of the dentition of a 2,800-year-old Egyptian mummy exhibiting extensive dental disease. Am J Phys Anthropol. 103:329–40. DOI: 10.1002/(SICI)1096-8644(199707)103:3<329::AID-AJPA3>3.0.CO;2-L. PMID: 9261496.

3. Gerloni A, Cavalli F, Costantinides F, Costantinides F, Bonetti S, Paganelli C. 2009; Dental status of three Egyptian mummies: radiological investigation by multislice computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107:e58–64. DOI: 10.1016/j.tripleo.2009.02.031. PMID: 19464646.

4. Hoffman H, Torres WE, Ernst RD. 2002; Paleoradiology: advanced CT in the evaluation of nine Egyptian mummies. Radiographics. 22:377–85. DOI: 10.1148/radiographics.22.2.g02mr13377. PMID: 11896227.

5. Cesarani F, Martina MC, Ferraris A, Grilletto R, Boano R, Marochetti EF, Donadoni AM, Gandini G. 2003; Whole-body three-dimensional multidetector CT of 13 Egyptian human mummies. AJR Am J Roentgenol. 180:597–606. DOI: 10.2214/ajr.180.3.1800597. PMID: 12591661.

6. Pelo S, Correra P, Danza FM, Amenta A, Gasparini G, Marianetti TM, Moro A. 2012; Evaluation of the dentoskeletal characteristics of an Egyptian mummy with three-dimensional computer analysis. J Craniofac Surg. 23:1159–62. DOI: 10.1097/SCS.0b013e31824e25c2. PMID: 22801114.

7. Cavka M, Janković I, Sikanjić PR, Ticinović N, Rados S, Ivanac G, Brkljacić B. 2010; Insights into a mummy: a paleoradiological analysis. Coll Antropol. 34:797–802. PMID: 20977064.

8. Kim YS, Lee IS, Jung GU, Kim MJ, Oh CS, Yoo DS, Lee WJ, Lee E, Cha SC, Shin DH. 2014; Radiological diagnosis of congenital diaphragmatic hernia in 17th century Korean mummy. PLoS One. 9:e99779. DOI: 10.1371/journal.pone.0099779. PMID: 24988465. PMCID: PMC4079512.

9. Musculoskeletal Key. c2017. Screening for hepatic and biliary disease [Internet]. UFO Themes;Available from: https://musculoskeletalkey.com/screening-for-hepatic-and-biliary-disease/. cited 2022 Apr 20.