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Sample records for bedside chest radiography

  1. Digital chest radiography

    DEFF Research Database (Denmark)

    Debess, Jeanne Elisabeth; Johnsen, Karen Kirstine; Thomsen, Henrik

    2015-01-01

    Background: Chest radiography is one of the most common examinations in radiology departments. In 2013 approximately 80,000 chest x-rays were performed on women in the fertile age. Even low dose for the examinationCorrect collimation Purpose: Quality improvement of basic radiography focusing...... collimations depending on side of radiograph. Results from dose reduction will be presented on the congress Conclusion: Correct positioning and collimation of digital chest radiographs can reduce the radiation dose significant to the patients and by that improve the quality of basic radiography....... on collimation and dose reduction in digital chest radiography Methods and Materials A retrospective study of digital chest radiography is performed to evaluate the primary x-ray tube collimation of the PA and lateral radiographs. Data from one hundred fifty self-reliant female patients between 15 and 55 years...

  2. Digital chest radiography

    DEFF Research Database (Denmark)

    Debess, Jeanne Elisabeth; Vejle-Sørensen, Jens Kristian; Thomsen, Henrik;

    2015-01-01

    of clinical supervisors. Optimal collimation is determined by European and Regional Danish guidelines. The areal between current and optimal collimation is calculated. The experimental research is performed in September - October 2014 Siemens Axiom Aristos digital radiography system DR using 150 kV, 1,25 -3......Purpose: Quality improvement of basic radiography focusing on collimation and dose reduction in digital chest radiography Methods and Materials:A retrospective study of digital chest radiography is performed to evaluate the primary x-ray tube collimation of the PA and lateral radiographs. Data from...... one hundred fifty self-reliant female patients between 15 and 55 years of age are included in the study. The clinical research is performed between September and November 2014 where 3rd year Radiography students collect data on four Danish x-ray departments using identical procedures under guidance...

  3. Bedside chest radiography of novel influenza A (H7N9) virus infections and follow-up findings after short-time treatment

    Institute of Scientific and Technical Information of China (English)

    SONG Feng-xiang; ZHOU Jun; SHI Yu-xin; ZHANG Zhi-yong; FENG Feng; ZHOU Jian-jun; WANG Qing-le

    2013-01-01

    Background Influenza A (H7Ng) virus infections were first observed in China in March 2013.This type virus can cause severe illness and deaths,the situation raises many urgent questions and global public health concerns.Our purpose was to investigate bedside chest radiography findings for patients with novel influenza A (H7Ng) virus infections and the followup appearances after short-time treatment.Methods Eight hospitalized patients infected with the novel influenza A (H7Ng) virus were included in our study.All of the patients underwent bedside chest radiography after admission,and all had follow-up bedside chest radiography during their first ten days,using AXIOM Aristos MX and/or AMX-Ⅳ portable X-ray units.The exposure dose was generally 90 kV and 5 mAs,and was slightly adjusted according to the weight of the patients.The initial radiography data were evaluated for radiological patterns (ground glass opacity,consolidation,and reticulation),distribution type (focal,multifocal,and diffuse),lung zones involved,and appearance at follow-up while the patients underwent therapy.Results All patients presented with bilateral multiple lung involvement.Two patients had bilateral diffuse lesions,three patients had unilateral diffuse lesions of the right lobe with multifocal lesions of the left lobe,and the remaining three had bilateral multifocal lung lesions.The lesions were present throughout bilateral lung zones in three patients,the whole right lung zone in three patients with additional involvement in the left middle and/or lower lung zone(s),both lower and middle lung zones in one patient,and the right middle and lower in combination with the left lower lung zones in one patient.The most common abnormal radiographic patterns were ground glass opacity (8/8),and consolidation (8/8).In three cases examined by CT we also found the pattern of reticulation in combination with CT images.Four patients had bilateral and four had unilateral pleural effusion.After a short

  4. 新生儿床旁X线胸片的临床应用%Clinical application of bedside chest radiography in neonates

    Institute of Scientific and Technical Information of China (English)

    田治海; 高超; 焦振华; 王联营; 张力维; 师勇

    2012-01-01

    目的 评价新生儿床头X线胸片的临床应用价值.方法回顾分析137例共224份新生儿床旁胸片及临床资料,观察其心肺疾病X线表现.结果 224份床旁胸片中212份符合诊断要求,占 94.6 %.其中209份显示有心肺疾病:新生儿感染性肺炎 21例,新生儿湿肺12例,胎粪吸入性肺炎(MAS) 37例,新生儿肺透明膜病(NRDS)23例,急性呼吸窘迫综合征(ARDS)11例,新生儿肺出血4例,新生儿气胸28例,急性肺水肿7例,肺不张4例,先天性心脏病6例及先天性肺发育不良 1 例.单发病例48例,占35%,伴有合并症89例,占65%.其中MAS、NRDS、ARDS、先天性心脏病的合并症多见,共69例,占78%.结合临床资料,床旁胸片对肺炎、湿肺、NRDSⅠ~Ⅱ型、ARDS、MAS、肺不张、肺水肿、中到大量气胸及胸腔积液的初诊的准确率达80%.误诊、漏诊共7例,占5%.肺水肿与ARDS及ARDS与MAS合并NRDS的鉴别存在一定困难,需要结合临床随访复查.结论 床旁胸片能满足新生儿危重病的检查需要.%Objective To evaluate the clinical application of neonatal bedside chest radiography. Methods 224 bedside chest radiographs and clinical data in 137 nconatcs were retrospectively analysed. X-ray features of cardiopulmonary disease were observed. Results Of 224 bedside chest X-ray films, 212 were consistent with the diagnosis of requirements(94. 6%). 209 chest films showed heart or lung disease: including neonatal infectious pneumonia in 21 cases, wet lung of newborn in 12 cases, mcconium aspiration pneumonia (MAS) in 37 cases, neonatal pulmonary hyaline membrane disease ( NRDS ) in 23 patients, acute respiratory distress syndrome (ARDS ) in 11 cases, neonatal pulmonary hemorrhage in 4 cases, pneumothorax in 28 cases, acute pulmonary edema in 7 cases, pulmonary atclcctasis in 4 cases, congenital heart disease in 6 cases and congenital pulmonary hypoplasia in 1 case. The lesions single in 4 8 cascs(35 % ) , complicated in 89 cases(65 % ) . The

  5. Digital chest radiography: collimation and dose reduction

    DEFF Research Database (Denmark)

    Debess, Jeanne; Johnsen, Karen Kirstine; Vejle-Sørensen, Jens Kristian

    Purpose: Quality improvement of basic radiography focusing on collimation and dose reduction in digital chest radiography Methods and Materials:A retrospective study of digital chest radiography is performed to evaluate the primary x-ray tube collimation of the PA and lateral radiographs. Data from...... of clinical supervisors. Optimal collimation is determined by European and Regional Danish guidelines. The areal between current and optimal collimation is calculated. The experimental research is performed in September - October 2014 Siemens Axiom Aristos digital radiography system DR using 150 kV, 1,25 -3...

  6. Interpretation of neonatal chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-05-15

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice.

  7. Bacteriological research for the contamination of equipment in chest radiography

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    Choi, Seung Gu; Song, Woon Heung; Kweon, Dae Cheol [Shinhan University, Uijeongbu (Korea, Republic of)

    2015-12-15

    The purpose is to determine the degree of contamination of the equipment for infection control in chest radiography of the radiology department. We confirmed by chemical and bacterial identification of bacteria of the equipment and established a preventive maintenance plan. Chest X-ray radiography contact area on the instrument patients shoulder, hand, chin, chest lateral radiography patient contact areas with a 70% isopropyl alcohol cotton swab were compared to identify the bacteria before and after sterilization on the patient contact area in the chest radiography equipment of the department. The gram positive Staphylococcus was isolated from side shoots handle before disinfection in the chest radiography equipment. For the final identification of antibiotic tested that it was determined by performing the nobobiocin to the sensitive Staphylococcus epidermidis. Chest radiography equipment before disinfecting the handle side of Staphylococcus epidermidis bacteria were detected using a disinfectant should be to prevent hospital infections.

  8. Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Chardoli Mojtaba

    2013-12-01

    Full Text Available 【Abstract】 Objective: Thoracic injuries are respon- sible for 25% of deaths of blunt traumas. Chest X-ray (CXR is the first diagnostic method in patients with blunt trauma. The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy (CT in hemodynami- cally stable patients with blunt chest trauma. Methods: Study was conducted at the emergency department of Sina Hospital from March 2011 to March 2012. Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included. All patients underwent the same diagnostic protocol which consisted of physical examination, CXR and CT scan respectively. Results: Two hundreds patients (84% male and 16% female were included with a mean age of (37.9±13.7 years. Chin J Traumatol 2013;16(6:351-354 Rib fracture was the most common finding of CXR (12.5% and CT scan (25.5%. The sensitivity of CXR for hemothorax, thoracolumbar vertebra fractures and rib fractures were 20%, 49% and 49%, respectively. Pneumothorax, foreign body, emphysema, pulmonary contusion, liver hematoma and ster- num fracture were not diagnosed with CXR alone. Conclusion: Applying CT scan as the first-line diag- nostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome. Key words: Radiography; Thoracic injuries; Tomography, X-ray computed

  9. Chest radiography and abdominal ultrasound in general practice

    NARCIS (Netherlands)

    Speets, Anouk Mariëlle

    2006-01-01

    Chest radiography (CXR) and abdominal ultrasound (US) are two widely used diagnostic imaging techniques in Western societies. General practitioners (GPs) in The Netherlands annually request approximately 500,000 CXRs and 200,000 abdominal US, and therefore clearly place a burden on health care. Besi

  10. Computer-aided diagnosis in chest radiography: Beyond nodules

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    Ginneken, Bram van [University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)], E-mail: bram@isi.uu.nl; Hogeweg, Laurens; Prokop, Mathias [University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2009-11-15

    Chest radiographs are the most common exam in radiology. They are essential for the management of various diseases associated with high mortality and morbidity and display a wide range of findings, many of them subtle. In this survey we identify a number of areas beyond pulmonary nodules that could benefit from computer-aided detection and diagnosis (CAD) in chest radiography. These include interstitial infiltrates, catheter tip detection, size measurements, detection of pneumothorax and detection and quantification of emphysema. Recent work in these areas is surveyed, but we conclude that the amount of research devoted to these topics is modest. Reasons for the slow pace of CAD development in chest radiography beyond nodules are discussed.

  11. Dose Reduction to the Thyroid Gland in Pediatric Chest Radiography

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    Vahid Karami

    2016-07-01

    Full Text Available Background  It is remain a main concern that pediatric chest radiographies contribute to the significant radiation exposure to the thyroid gland as a more susceptible organ to radiation induced cancer. The aim of this study was to evaluate the entrance surface dose (ESD of pediatric chest radiography compared to the diagnostic reference levels (DRL and evaluation the efficacy of the lead (Pb shield in radiation dose reduction to the thyroid gland.Materials and Methods After assessing each patient against specific inclusion-exclusion criteria, 40 pediatric patients who were undergoing anterior-posterior (AP projection of the chest x-ray were considered eligible for this study. The ESD of the chest and also ESD of thyroid gland with and without a 1 mm butterfly-shaped lead shield which placed on the thyroid gland were measured using high sensitive thermo luminescent dosimeters (TLD-GR 200.Results The average of ESD for chest radiography was 0.068+ 0.006 mGy (0.021 - 0.232 mGy. The unshielded average thyroid ESD was 0.065 + 0.003 mGy compared to the shielded average thyroid ESD of 0.001 + 0.0005 mGy. The use of Pb-shield produced a statistically significant decrease in the average thyroid dose by about 97% (P< 0.001. Conclusion The use of Pb-thyroid shield in the AP projection of pediatric chest radiography has potential to reduced radiation dose without compromising image quality.

  12. Chest radiography in the critically ill

    NARCIS (Netherlands)

    Kröner, A.

    2016-01-01

    Introduction: The chest radiograph (CXR) is a frequently obtained test to complement physical examination in ICU and post-surgery PACU patients. The opinion on indications for a CXR in these two patient categories varies worldwide. One approach is to obtain CXR on indication only, i.e., when there i

  13. Lung ultrasound versus chest radiography for the diagnosis of pneumothorax in critically ill patients: A prospective, single-blind study

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    W Abdalla

    2016-01-01

    Full Text Available Background: Radiologic data remains the gold standard for the diagnosis of pneumothorax (PTX. The use of ultrasonography (US has recently emerged as the method of choice with physicians who can perform bedside US. Purpose: To compare the diagnostic accuracy of lung US against bedside chest radiography (CR for the detection of PTX using thoracic computed tomography (CT as the gold standard. Materials and Methods: We conducted a prospective, single-blind study on 192 critically ill patients; each patient received lung US examination, bedside CR, followed by thoracic CT scan searching for PTX. Results: Of the studied patients, CT of the chest confirmed the diagnosis of PTX in 36 (18.75% patients of which 31 were diagnosed by thoracic US while CR detected only 19 cases. Overall lung US showed a considerable higher sensitivity than bedside CR (86.1% vs. 52.7%, lung US also showed higher, negative predictive values, and diagnostic accuracy against CR (96.8% vs. 90.1%, and (95.3% vs. 90.6%, respectively. CR had a slightly higher specificity than lung US (99.4% vs. 97.4%, and higher positive predictive values (95.0% vs. 88.6%. Conclusion: Lung US is an accurate modality more than anteroposterior bedside CR in comparison with CT scanning when evaluating critically ill mechanically ventilated patients, patients underwent thoracocentesis, central venous catheter insertion, or patients with polytrauma.

  14. Evaluation of new grids for bedside chest radiotherapy. Effects of X-ray beam misalignment

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    Hatemura, Masahiro; Ikeda, Ryuji; Katsuda, Noboru; Moribe, Nobuyuki; Takada, Takao; Takahashi, Mutsumasa [Kumamoto University (Japan). Hospital; Higashida, Yoshiharu

    1997-06-01

    We investigated the effects of different degrees of misalignment on the performance of new grids in bedside radiography. Two types of new grids (a conventional grid with a grid ratio of 3 : 1 and a parallel hole grid) designed for bedside radiography were compared with a conventional 5 : 1 grid. The effects of scatter fraction, contrast improvement factor, bucky factor, and tolerance to misalignment on grid performance were examined. The scatter rejection and contrast improvement of the new grids were significantly lower compared with a 5 : 1 grid at accurate alignment. However, the two new grids have much more tolerance to misalignment than the conventional grid. The two new grids may be used for bedside radiography without the need for accurate alignment. (author)

  15. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients

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    Ali Vafaei

    2016-01-01

    Full Text Available Introduction: Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. Methods: In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. Results: 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67, were enrolled (77.6% male. Chest CT scan showed pulmonary contusion in 48 (31.6% patients, hemothorax in 29 (19.1%, and pneumothorax in 55 (36.2% cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96, 0.86 (95% CI: 0.78‒0.94, and 0.80 (95% CI: 0.736‒0.88, respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87 for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86 for hemothorax, and 0.58 (95% CI: 0.5‒0.67 for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02 and pulmonary contusion (p < 0.001. However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08. Conclusion: The results of the present study showed that ultrasonography is preferable to radiography in the initial

  16. Performance of Bedside Lung Ultrasound by a Pediatric Resident

    DEFF Research Database (Denmark)

    Zhan, Chen; Grundtvig, Natalia; Klug, Bent Helmuth

    2017-01-01

    OBJECTIVES: Recent studies suggest that lung ultrasound is a good, radiation-free alternative to chest radiography in children with pneumonia. We investigated how bedside lung ultrasound performed by a pediatric resident compared with chest radiography in children with suspected pneumonia. METHODS......: This was a prospective study comparing bedside lung ultrasound to chest radiography as the reference standard. Children aged 0 to 15 years with suspected pneumonia at a pediatric emergency department were included and underwent chest radiography and lung ultrasound. A pediatric resident with minimal practical ultrasound...

  17. A method to optimize the processing algorithm of a computed radiography system for chest radiography.

    Science.gov (United States)

    Moore, C S; Liney, G P; Beavis, A W; Saunderson, J R

    2007-09-01

    A test methodology using an anthropomorphic-equivalent chest phantom is described for the optimization of the Agfa computed radiography "MUSICA" processing algorithm for chest radiography. The contrast-to-noise ratio (CNR) in the lung, heart and diaphragm regions of the phantom, and the "system modulation transfer function" (sMTF) in the lung region, were measured using test tools embedded in the phantom. Using these parameters the MUSICA processing algorithm was optimized with respect to low-contrast detectability and spatial resolution. Two optimum "MUSICA parameter sets" were derived respectively for maximizing the CNR and sMTF in each region of the phantom. Further work is required to find the relative importance of low-contrast detectability and spatial resolution in chest images, from which the definitive optimum MUSICA parameter set can then be derived. Prior to this further work, a compromised optimum MUSICA parameter set was applied to a range of clinical images. A group of experienced image evaluators scored these images alongside images produced from the same radiographs using the MUSICA parameter set in clinical use at the time. The compromised optimum MUSICA parameter set was shown to produce measurably better images.

  18. Impact of chest radiography for children with lower respiratory tract infection: a propensity score approach.

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    Emmanuelle Ecochard-Dugelay

    Full Text Available BACKGROUND: Management of acute respiratory tract infection varies substantially despite this being a condition frequently encountered in pediatric emergency departments. Previous studies have suggested that the use of antibiotics was higher when chest radiography was performed. However none of these analyses had considered the inherent indication bias of observational studies. OBJECTIVE: The aim of this work was to assess the relationship between performing chest radiography and prescribing antibiotics using a propensity score analysis to address the indication bias due to non-random radiography assignment. METHODS: We conducted a prospective study of 697 children younger than 2 years of age who presented during the winter months of 2006-2007 for suspicion of respiratory tract infection at the Pediatric Emergency Department of an urban general hospital in France (Paris suburb. We first determined the individual propensity score (probability of having a chest radiography according to baseline characteristics. Then we assessed the relation between radiography and antibiotic prescription using two methods: adjustment and matching on the propensity score. RESULTS: We found that performing a chest radiography lead to more frequent antibiotic prescription that may be expressed as OR = 2.3, CI [1.3-4.1], or as an increased use of antibiotics of 18.6% [0.08-0.29] in the group undergoing chest radiography. CONCLUSION: Chest radiography has a significant impact on the management of infants admitted for suspicion of respiratory tract infection in a pediatric emergency department and may lead to unnecessary administration of antibiotics.

  19. Optimisation of computed radiography systems for chest imaging

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    Alzimami, K. [Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom)], E-mail: k.alzimami@surrey.ac.uk; Sassi, S. [Royal Marsden NHS Foundation Trust, Sutton, Surrey SM2 5PT (United Kingdom); Alkhorayef, M. [Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom); Britten, A.J. [Department of Medical Physics, St George' s Hospital, London SW17 0QT (United Kingdom); Spyrou, N.M. [Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom)

    2009-03-01

    The main thrust of this study is to investigate methods of optimising the radiation dose-image quality relationship in computed radiography (CR) systems for chest imaging. Specifically, this study investigates the possibility of reducing the patient radiation exposure through an optimal selection of tube filtration, exposure parameters and air gap technique, in parallel with a study of the image quality, particularly low contrast detail detectability, signal-to-noise ratio (SNR) and scatter fraction (SF). The CDRAD phantom was used to assess the quality of the CR images. Tissue equivalent Polystyrene blocks were placed in the front of the phantom as scattering material with thicknesses of 5 and 15 cm to simulate an adult chest and heart/diaphragm regions, respectively. A series of exposure techniques were used, including Cu filtration with various thicknesses of Cu in the presence and absence of an air gap, whilst the exposure was kept as constant as possible throughout. The estimated patient effective dose and skin entrance dose were calculated using the NRPB-SR262 X-ray dose calculation software. The results have shown that the low contrast-detail detectability in the lung and the heart/diaphragm regions improves when using an air gap and no Cu filtration, particularly at low kilovoltage (kVp). However, there is no significant difference in low contrast-detail in the absence or presence of a 0.2 mm Cu filtration. SF values for the lung and heart regions decrease when using both, the air gap technique and a 0.2 mm Cu filtration, particularly at low kVp. SNR values for the lung and heart regions improve when using a small Cu thickness. In conclusion, this investigation has shown that the quality of chest CR images could be improved by using an air gap technique and a 0.2 mm Cu filtration at low kVp, particularly at 99 kVp.

  20. Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma

    Institute of Scientific and Technical Information of China (English)

    Mojtaba Chardoli; Toktam Hasan-Ghaliaee; Hesam Akbari; Vafa Rahimi-Movaghar

    2013-01-01

    Objective:Thoracic injuries are responsible for 25% of deaths of blunt traumas.Chest X-ray (CXR) is the first diagnostic method in patients with blunt trauma.The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy (CT) in hemodynamically stable patients with blunt chest trauma.Methods:Study was conducted at the emergency department of S ina Hospital from March 2011 to March 2012.Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included.All patients underwent the same diagnostic protocol which consisted of physical examination,CXR and CT scan respectively.Results:Two hundreds patients (84% male and 16% female) were included with a mean age of(37.9±13.7) years.Rib fracture was the most common finding of CXR (12.5%) and CT scan (25.5%).The sensitivity of CXR for hemothorax,thoracolumbar vertebra fractures and rib fractures were 20%,49% and 49%,respectively.Pneumothorax,foreign body,emphysema,pulmonary contusion,liver hematoma and sternum fracture were not diagnosed with CXR alone.Conclusion:Applying CT scan as the first-line diagnostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome.

  1. Evaluation of entrance surface air kerma in pediatric chest radiography

    Science.gov (United States)

    Porto, L.; Lunelli, N.; Paschuk, S.; Oliveira, A.; Ferreira, J. L.; Schelin, H.; Miguel, C.; Denyak, V.; Kmiecik, C.; Tilly, J.; Khoury, H.

    2014-11-01

    The objective of this study was to evaluate the entrance surface air kerma in pediatric chest radiography. An evaluation of 301 radiographical examinations in anterior-posterior (AP) and posterior-anterior (PA) (166 examinations) and lateral (LAT) (135 examinations) projections was performed. The analyses were performed on patients grouped by age; the groups included ages 0-1 y, 1-5 y, 5-10 y, and 10-15 y. The entrance surface air kerma was determined with DoseCal software (Radiological Protection Center of Saint George's Hospital, London) and thermoluminescent dosimeters. Two different exposure techniques were compared. The doses received by patients who had undergone LAT examinations were 40% higher, on average, those in AP/PA examinations because of the difference in tube voltage. A large high-dose “tail” was observed for children up to 5 y old. An increase in tube potential and corresponding decrease in current lead to a significant dose reduction. The difference between the average dose values for different age ranges was not practically observed, implying that the exposure techniques are still not optimal. Exposure doses received using the higher tube voltage and lower current-time product correspond to the international diagnostic reference levels.

  2. Chest radiography practice in critically ill patients: a postal survey in the Netherlands

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    Korevaar Johanna C

    2006-07-01

    Full Text Available Abstract Background To ascertain current chest radiography practice in intensive care units (ICUs in the Netherlands. Methods Postal survey: a questionnaire was sent to all ICUs with > 5 beds suitable for mechanical ventilation; pediatric ICUs were excluded. When an ICU performed daily-routine chest radiographs in any group of patients it was considered to be a "daily-routine chest radiography" ICU. Results From the number of ICUs responding, 63% practice a daily-routine strategy, in which chest radiographs are obtained on a daily basis without any specific reason. A daily-routine chest radiography strategy is practiced less frequently in university-affiliated ICUs (50% as compared to other ICUs (68%, as well as in larger ICUs (> 20 beds, 50% as compared to smaller ICUs (P > 0.05. Remarkably, physicians that practice a daily-routine strategy consider daily-routine radiographs helpful in guiding daily practice in less than 30% of all performed radiographs. Chest radiographs are considered essential for verification of the position of invasive devices (81% and for diagnosing pneumothorax, pneumonia or acute respiratory distress syndrome (82%, 74% and 69%, respectively. On demand chest radiographs are obtained after introduction of thoracic drains, central venous lines and endotracheal tubes in 98%, 84% and 75% of responding ICUs, respectively. Chest films are also obtained in case of ventilatory deterioration (49% of responding ICUs, and after cardiopulmonary resuscitation (59%, tracheotomy (58% and mini-tracheotomy (23%. Conclusion There is notable lack of consensus on chest radiography practice in the Netherlands. This survey suggests that a large number of intensivists may doubt the value of daily-routine chest radiography, but still practice a daily-routine strategy.

  3. No Value for Routine Chest Radiography in the Work-Up of Early Stage Cervical Cancer Patients

    NARCIS (Netherlands)

    Hoogendam, Jacob P.; Zweemer, Ronald P.; Verkooijen, Helena M.; de Jong, Pim A.; van den Bosch, Maurice A. A. J.; Verheijen, Rene H. M.; Veldhuis, WB

    2015-01-01

    Aim Evidence supporting the recommendation to include chest radiography in the work-up of all cervical cancer patients is limited. We investigated the diagnostic value of routine chest radiography in cervical cancer staging. Methods All consecutive cervical cancer patients who presented at our terti

  4. The Role of Bedside Troponin T Test for Identification of High Risk Patients With Acute Chest Pain

    Institute of Scientific and Technical Information of China (English)

    Guo xiaobi; Feng Jianzhan; Guo Hengshan

    2005-01-01

    Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure of patients with acute chest pain. Methods and Results 502 consecutive patients with chest pain for less than 24 hours were determined by troponin T test at bedside and quantitative troponin I test in lab. For bedside troponin T tests, there were 160 patients in positive and 323 in negative. During 30 days of followed-up. Myocardial infarction evolved in 139 patients among 160 patients in positive troponin T test, only 7 patients in negative one. Acute heart failure occurred in 51 patients among the positive group, but 37 occurred it at negative group.The odds ratio of acute heart failure of positive group vs.negative group was 3.6. Patients died 39 in positive group, 15 in negative group, the all-cause death odds ratio of positive group vs. negative group was 6.7; 31patients died with cardiac event in positive group, 5 in negative group only. Conclusions Bedside Troponin T test is a powerful and independent predictor of death and acute heart failure for patients with acute chest pain.

  5. Computed and conventional chest radiography: a comparison of image quality and radiation dose.

    Science.gov (United States)

    Ramli, K; Abdullah, B J J; Ng, K-H; Mahmud, R; Hussain, A F

    2005-12-01

    The aim of this study was to compare the image quality and entrance skin dose (ESD) for film-screen and computed chest radiography. Analysis of the image quality and dose on chest radiography was carried out on a conventional X-ray unit using film-screen, storage phosphor plates and selenium drum direct chest radiography. For each receptor, ESD was measured in 60 patients using thermoluminescent dosemeters. Images were printed on 35 x 43 cm films. Image quality was assessed subjectively by evaluation of anatomic features and estimation of the image quality, following the guidelines established by the protocols of the Commission of the European Communities. There was no statistically significant difference noted between the computed and conventional images (Wilcoxon rank sum test, P > 0.05). Imaging of the mediastinum and peripheral lung structures were better visualized with the storage phosphor and selenium drum technique than with the film-screen combination. The patients' mean ESD for chest radiography using the storage phosphor, film-screen combination and selenium drum was 0.20, 0.20 and 0.25 mGy, respectively, with no statistically significant difference with P > 0.05 (chi(2) tests).

  6. Bedside echo for chest pain: an algorithm for education and assessment

    Directory of Open Access Journals (Sweden)

    Amini R

    2016-05-01

    Full Text Available Richard Amini, Lori A Stolz, Jeffrey Z Kartchner, Matthew Thompson, Nicholas Stea, Nicolaus Hawbaker, Raj Joshi, Srikar Adhikari Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA Background: Goal-directed ultrasound protocols have been developed to facilitate efficiency, throughput, and patient care. Hands-on instruction and training workshops have been shown to positively impact ultrasound training.  Objectives: We describe a novel undifferentiated chest pain goal-directed ultrasound algorithm-focused education workshop for the purpose of enhancing emergency medicine resident training in ultrasound milestones competencies.  Methods: This was a cross-sectional study performed at an academic medical center. A novel goal-directed ultrasound algorithm was developed and implemented as a model for teaching and learning the sonographic approach to a patient with undifferentiated chest pain. This algorithm was incorporated into all components of the 1-day workshop: asynchronous learning, didactic lecture, case-based learning, and hands-on stations. Performance comparisons were made between postgraduate year (PGY levels.  Results: A total of 38 of the 40 (95% residents who attended the event participated in the chest pain objective standardized clinical exam, and 26 of the 40 (65% completed the entire questionnaire. The average number of ultrasounds performed by resident class year at the time of our study was as follows: 19 (standard deviation [SD]=19 PGY-1, 238 (SD=37 PGY-2, and 289 (SD=73 PGY-3. Performance on the knowledge-based questions improved between PGY-1 and PGY-3. The application of the novel algorithm was noted to be more prevalent among the PGY-1 class.  Conclusion: The 1-day algorithm-based ultrasound educational workshop was an engaging learning technique at our institution. Keywords: point-of care ultrasound, algorithm education, education, chest pain, bedside ultrasound, POCUS

  7. First experience with x-ray dark-field radiography for human chest imaging (Conference Presentation)

    Science.gov (United States)

    Noel, Peter B.; Willer, Konstantin; Fingerle, Alexander A.; Gromann, Lukas B.; De Marco, Fabio; Scherer, Kai H.; Herzen, Julia; Achterhold, Klaus; Gleich, Bernhard; Münzel, Daniela; Renz, Martin; Renger, Bernhard C.; Fischer, Florian; Braun, Christian; Auweter, Sigrid; Hellbach, Katharina; Reiser, Maximilian F.; Schröter, Tobias; Mohr, Jürgen; Yaroshenko, Andre; Maack, Hanns-Ingo; Pralow, Thomas; van der Heijden, Hendrik; Proksa, Roland; Köhler, Thomas; Wieberneit, Nataly; Rindt, Karsten; Rummeny, Ernst J.; Pfeiffer, Franz

    2017-03-01

    Purpose: To evaluate the performance of an experimental X-ray dark-field radiography system for chest imaging in humans and to compare with conventional diagnostic imaging. Materials and Methods: The study was institutional review board (IRB) approved. A single human cadaver (52 years, female, height: 173 cm, weight: 84 kg, chest circumference: 97 cm) was imaged within 24 hours post mortem on the experimental x-ray dark-field system. In addition, the cadaver was imaged on a clinical CT system to obtain a reference scan. The grating-based dark-field radiography setup was equipped with a set of three gratings to enable grating-based dark-field contrast x-ray imaging. The prototype operates at an acceleration voltage of up to 70 kVp and with a field-of-view large enough for clinical chest x-ray (>35 x 35 cm2). Results: It was feasible to extract x-ray dark-field signal of the whole human thorax, clearly demonstrating that human x-ray dark-field chest radiography is feasible. Lung tissue produced strong scattering, reflected in a pronounced x-ray dark-field signal. The ribcage and the backbone are less prominent than the lung but are also distinguishable. Finally, the soft tissue is not present in the dark-field radiography. The regions of the lungs affected by edema, as verified by CT, showed less dark-field signal compared to healthy lung tissue. Conclusion: Our results reveal the current status of translating dark-field imaging from a micro (small animal) scale to a macro (patient) scale. The performance of the experimental x-ray dark-field radiography setup offers, for the first time, obtaining multi-contrast chest x-ray images (attenuation and dark-field signal) from a human cadaver.

  8. Chest radiography in acute traumatic rupture of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Heystraten, F.M.; Rosenbusch, G.; Kingma, L.M.; Lacquet, L.K.; Boo, T. de; Lemmens, W.A.

    Of 123 patients who had suffered blunt trauma to the chest traumatic aortic rupture was eventually confirmed in 61 and absent in 62 patients. The chest radiographs of these patients were examined for 15 signs reported in the literature as being associated with traumatic aortic rupture. Although many individual signs were significantly more frequent in the aortic rupture group they were not useful in differentiating between patients with and those without rupture of the aorta. By using discriminant analysis combining 2 or 3 signs, patients were classified as having aortic rupture or not. The best discrimination between the two groups was obtained using the combined signs of a widened paratracheal stripe, and opacified pulmonary window, a widened right paraspinal interface and a displaced nasogastric tube.

  9. Association of Aortic Calcification on Plain Chest Radiography with Obstructive Coronary Artery Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yeong Han; Chang, Jeong Ho [Dept. of Diagnostic Radiology, Daegu Catholic University Hospital, Daegu (Korea, Republic of); Park, Jong Sam [Dept. of Radiologic Tecnology, Daegu Health College, Daegu (Korea, Republic of)

    2009-03-15

    This study was conducted to determine an association between aortic calcification viewed on plain chest radiography and obstructive coronary artery disease. Retrospective review of all chest radiography obtained from consecutive patients undergoing coronary angiography. Chest PA images were reviewed by technical radiologist and radiologist. Considering the presence of aortic arch calcification, images were compared with the results of coronary angiography. In addition, the size of aortic arch calcification were divided into two groups - the smaller and the larger than 10 mm. Among the total 846 patients, the number of the patients with obstructive coronary artery disease is total 417 (88.3%) in males and 312 (83.4%) in females. Considering the presence of aortic arch calcification, the positive predictive value of relation between aortic arch calcification and obstructive coronary artery disease was 91.4% and the relative risk of the group with aortic arch calcification to the opposite group was 1.10. According to the size of aortic arch calcification and obstructive coronary artery disease, the positive predictive value was 91.9% and the relative risk between two groups was 1.04. This study shows that aortic calcification was closely associated with obstructive coronary artery disease. If the aortic calcification is notified on plain chest radiography, we strongly recommend to consult with doctor.

  10. OPTIMIZATION OF RADIATION PROTECTION BY ELIMINATING WEEDS OUT RASTER DIGITAL RADIOGRAPHY OF THE CHEST

    Directory of Open Access Journals (Sweden)

    I. G. Kamyshanskaja

    2015-01-01

    Full Text Available An experimental study of the possibility of eliminating the raster digital radiography. On stationary digital x-ray machine produced 117 x-ray images of the test object and x-rays of the chest cavity with the gridand without him several patients-volunteers. Proven ability to eliminate grid digital radiography by digital processing of images, made without the grid that reduces dose radiation exposure of the patient more than in 3 times. «Virtual» grids enough improve the diagnostic quality of the photo to eliminate the pathology.

  11. Advantages and pitfalls of pocket ultrasound vs daily chest radiography in the coronary care unit: A single-user experience.

    Science.gov (United States)

    Phillips, Colin T; Manning, Warren J

    2017-05-01

    Pocket ultrasonography may enhance patient diagnosis and care. We sought to assess pocket ultrasound in detecting common conditions in the coronary care unit (CCU) compared to portable daily chest radiography (CXR) and conventional transthoracic echocardiography (TTE). An experienced pocket ultrasound user performed a pocket ultrasound examination for interstitial edema, pneumonia, central line seen in the right ventricle, pleural and pericardial effusions, left atrial enlargement, and cardiomegaly. Data were blindly compared to the radiologist CXR interpretation and cardiologist TTE interpretation. A total of 102 CXR and pocket ultrasound examinations were performed in 66 patients. The most common CXR indication was "interval change" (37%) and finding central line (65%). Pocket ultrasound demonstrated overall good concordance with CXR ranging from 77% for pleural effusion to 92% for pneumonia. Additionally, the pocket ultrasound examination appeared to anticipate resolution of pulmonary edema prior to the CXR. Compared to TTE, pocket ultrasound had excellent sensitivity for cardiac findings with values ranging from 85% for left atrial enlargement to 100% for cardiomegaly, but limited specificity of cardiomegaly at just 51%. In the CCU, bedside pocket ultrasound reliably diagnoses common conditions identified by CXR with the advantage of lack of ionizing radiation and the suggestion of detecting the resolution of pulmonary edema prior to CXR. Pitfalls include only modest concordance for pleural effusions and limited specificity for cardiomegaly. Larger, multicenter studies are needed to determine whether pocket ultrasound can reduce routine daily CXR in the CCU and other intensive care settings. © 2017, Wiley Periodicals, Inc.

  12. An investigation of automatic exposure control calibration for chest imaging with a computed radiography system.

    Science.gov (United States)

    Moore, C S; Wood, T J; Avery, G; Balcam, S; Needler, L; Beavis, A W; Saunderson, J R

    2014-05-07

    The purpose of this study was to examine the use of three physical image quality metrics in the calibration of an automatic exposure control (AEC) device for chest radiography with a computed radiography (CR) imaging system. The metrics assessed were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm), all measured using a uniform chest phantom. Subsequent calibration curves were derived to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated chest images with correct detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated chest images contained clinically realistic projected anatomy and anatomical noise and were scored by experienced image evaluators. Constant DDI and CNR curves do not appear to provide optimized performance across the diagnostic energy range. Conversely, constant eNEQm and SNR do appear to provide optimized performance, with the latter being the preferred calibration metric given as it is easier to measure in practice. Medical physicists may use the SNR image quality metric described here when setting up and optimizing AEC devices for chest radiography CR systems with a degree of confidence that resulting clinical image quality will be adequate for the required clinical task. However, this must be done with close cooperation of expert image evaluators, to ensure appropriate levels of detector air kerma.

  13. Routine chest radiography after permanent pacemaker implantation: Is it necessary?

    Directory of Open Access Journals (Sweden)

    Edwards N

    2005-01-01

    Full Text Available Background and Aims: Chest radiographs (CXRs are performed routinely after permanent pacemaker implantation to identify pacemaker lead position and exclude pneumothorax. We assessed the clinical value and need for this procedure. Design: Retrospective analysis of pacemaker data and CXRs following permanent pacemaker insertion between December 2002 and February 2004. Materials and Methods: Post-procedural CXRs were available in 125/126 consecutive patients after either first endocardial pacemaker implantation or insertion of at least one new lead. Subclavian vein puncture was used for venous access in all cases. CXRs were examined to establish the incidence of pneumothorax and assess pacing lead positions. The clinical records were examined in all patients who had subsequent CXRs or a further pacemaker procedure to identify the indication for these and to establish whether CXR had influenced patient management. Results: In total, 192 post-procedural CXRs were performed, either postero-anterior (PA and/or lateral views. Ventricular and/or atrial pacing lead contour and electrode position was considered radiographically appropriate in 86% CXRs. Fourteen per cent of post-procedural radiographs were considered to have radiologically sub-optimal pacemaker lead positioning. None of the patients with these "abnormal" radiographs experienced subsequent pacemaker complications or had further radiographs recorded at a later date. Later repeat CXRs were performed in 16 patients (13% but only 3 patients (2% had pacing abnormalities as the primary indication. All three had satisfactory pacing lead position on initial post-implantation and later radiographs, but required further procedures for lead re-positioning. Iatrogenic pneumothorax occurred in one patient (incidence 0.8% in our series. CXR confirmed the clinical diagnosis and allowed an assessment of size to guide treatment. Conclusion: Routine CXR after permanent pacemaker insertion is not necessary in

  14. Tropical pulmonary eosinophilia: a comparative evaluation of plain chest radiography and computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Sandhu Manavijit; Mukhopadhyay Sima; Sharma, S.K. [All India Inst. of Medical Sciences, New Delhi (India). Dept. of Nuclear Medicine

    1996-02-01

    Plain chest radiography and computed tomography (CT) of the chest were performed on 10 patients with tropical pulmonary eosinophilia (TPE). Chest radiographs revealed bilateral diffuse lesions in the lungs of all the patients with relative sparing of lower lobes in one patient. However, computed tomography revealed bilateral diffuse lung lesions in all of the patients with relative sparing of lower lobes in three patients. In seven (70%) of the 10 patients, CT provided additional information. Computed tomography was found to be superior for the detection of reticulonodular pattern, bronchiectasis, air trapping, calcification and mediastinal adenopathy. No correlation was found between pulmonary function and gas exchange data using CT densities. There was also no correlation between the absolute eosinophil count (AEC) and the radiological severity of lesions. In six patients, high-resolution CT (HRCT) was performed in addition to conventional CT (CCT), and nodularity of lesions was better appreciated in these patients. It is concluded from this study that CT is superior to plain radiography for the evaluation of patients with TPE. 17 refs., 2 tabs., 4 figs.

  15. Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok [Korea University Guro Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Ham, Soo-Youn [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Ki Yeol; Choo, Ji Yung [Korea University Ansan Hospital, Korea University College of Medicine, Department of Radiology, Ansan (Korea, Republic of)

    2014-12-15

    The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

  16. Detection of rib fractures in minor chest injuries: a comparison between ultrasonography and radiography performed on the same day

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Yong Soo; Back, Chang Hee; Lee, Kyung Rae; Shin, Yun Hack; Whang, Yeong Seop; Jeong, Ku Young [Yeosu Baek Hospital, Yeosu (Korea, Republic of); Chung, Soo Hyun [NamWon Medical Center, NamWon (Korea, Republic of); Whang, Cheol Mog [Konyang University Hospital, Daejeon (Korea, Republic of)

    2007-04-15

    We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries.

  17. Basic ultrasound training can replace chest radiography for safe tube thoracostomy removal.

    Science.gov (United States)

    Lavingia, Kedar S; Soult, Michael C; Collins, Jay N; Novosel, Timothy J; Weireter, Leonard J; Britt, L D

    2014-08-01

    An ultrasound (US) examination can be easily and rapidly performed at the bedside to aide in clinical decisions. Previously we demonstrated that US was safe and as effective as a chest x-ray (CXR) for removal of tube thoracostomy (TT) when performed by experienced sonographers. This study sought to examine if US was as safe and accurate for the evaluation of pneumothorax (PTX) associated with TT removal after basic US training. Patients included had TT managed by the surgical team between October 2012 and May 2013. Bedside US was performed by a variety of members of the trauma team before and after removal. All residents received, at minimum, a 1-hour formal training class in the use of ultrasound. Data were collected from the electronic medical records. We evaluated 61 TTs in 61 patients during the study period. Exclusion of 12 tubes occurred secondary to having incomplete imaging, charting, or death before having TT removed. Of the 49 remaining TT, all were managed with US imaging. Average age of the patients was 40 years and 30 (61%) were male. TT was placed for PTX in 37 (76%), hemothorax in seven (14%), hemopneumothorax in four (8%), or a pleural effusion in one (2%). Two post pull PTXs were correctly identified by residents using US. This was confirmed on CXR with appropriate changes made. US was able to successfully predict the safe TT removal and patient discharge at all residency levels after receiving a basic US training program.

  18. Detection of lung nodules. New opportunities in chest radiography; Detektion pulmonaler Rundherde. Neue Moeglichkeiten der Thoraxradiographie

    Energy Technology Data Exchange (ETDEWEB)

    Poetter-Lang, S. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Department of Biomedical Imaging and Image-Guided Therapy, Wien (Austria); Schalekamp, S. [Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Schaefer-Prokop, C. [Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Meander Medical Center Amersfoort, Amersfoort (Netherlands); Uffmann, M. [Landesklinikum Neunkirchen, Abteilung fuer Radiodiagnostik, Neunkirchen (Germany)

    2014-05-15

    Chest radiography still represents the most commonly performed X-ray examination because it is readily available, requires low radiation doses and is relatively inexpensive. However, as previously published, many initially undetected lung nodules are retrospectively visible in chest radiographs. The great improvements in detector technology with the increasing dose efficiency and improved contrast resolution provide a better image quality and reduced dose needs. The dual energy acquisition technique and advanced image processing methods (e.g. digital bone subtraction and temporal subtraction) reduce the anatomical background noise by reduction of overlapping structures in chest radiography. Computer-aided detection (CAD) schemes increase the awareness of radiologists for suspicious areas. The advanced image processing methods show clear improvements for the detection of pulmonary lung nodules in chest radiography and strengthen the role of this method in comparison to 3D acquisition techniques, such as computed tomography (CT). Many of these methods will probably be integrated into standard clinical treatment in the near future. Digital software solutions offer advantages as they can be easily incorporated into radiology departments and are often more affordable as compared to hardware solutions. (orig.) [German] Das Thoraxroentgen mit den Vorteilen der schnellen Verfuegbarkeit, geringen Strahlendosis und geringen Kosten ist unveraendert die haeufigste radiologische Untersuchung. Es wurde jedoch vielfach publiziert, dass primaer im Thoraxroentgen uebersehene Lungenrundherde retrospektiv sichtbar waren. Die grossen Fortschritte der Detektortechnologie mit verbesserter Dosiseffizienz und Ortsaufloesung der Systeme fuehren zu einer gesteigerten Bildqualitaet bei geringerem Dosisbedarf. Die Dual-energy-Aufnahmetechnik sowie auch Bildverarbeitungsmethoden wie die digitale Knochensubtraktion und die ''temporal subtraction'' reduzieren das &apos

  19. Bone images from dual-energy subtraction chest radiography in the detection of rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Szucs-Farkas, Zsolt, E-mail: zsolt.szuecs@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Lautenschlager, Katrin, E-mail: katrin@students.unibe.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ott, Daniel, E-mail: daniel.ott@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Strautz, Tamara, E-mail: tamara.strautz@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Vock, Peter, E-mail: peter.vock@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ruder, Thomas D., E-mail: thomas.ruder@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland)

    2011-08-15

    Objective: To assess the sensitivity and image quality of chest radiography (CXR) with or without dual-energy subtracted (ES) bone images in the detection of rib fractures. Materials and methods: In this retrospective study, 39 patients with 204 rib fractures and 24 subjects with no fractures were examined with a single exposure dual-energy subtraction digital radiography system. Three blinded readers first evaluated the non-subtracted posteroanterior and lateral chest radiographs alone, and 3 months later they evaluated the non-subtracted images together with the subtracted posteroanterior bone images. The locations of rib fractures were registered with confidence levels on a 3-grade scale. Image quality was rated on a 5-point scale. Marks by readers were compared with fracture localizations in CT as a standard of reference. Results: The sensivity for fracture detection using both methods was very similar (34.3% with standard CXR and 33.5% with ES-CXR, p = 0.92). At the patient level, both sensitivity (71.8%) and specificity (92.9%) with or without ES were identical. Diagnostic confidence was not significantly different (2.61 with CXR and 2.75 with ES-CXR, p = 0.063). Image quality with ES was rated higher than that on standard CXR (4.08 vs. 3.74, p < 0.001). Conclusions: Despite a better image quality, adding ES bone images to standard radiographs of the chest does not provide better sensitivity or improved diagnostic confidence in the detection of rib fractures.

  20. Image quality for five modern chest radiography techniques: a modified FROC study with an anthropomorphic chest phantom.

    Science.gov (United States)

    Månsson, L G; Kheddache, S; Lanhede, B; Tylén, U

    1999-01-01

    The purpose of the study was to compare the image quality for one conventional and four digital chest radiography techniques. Three storage phosphor systems, one selenium drum system, and one film-screen system were compared using a modified receiver-operating-characteristics method. Simulated pathology was randomly positioned over the parenchymal regions and the mediastinum of an anthropomorphic phantom. Eight observers (four chest radiologists, one specialist in general radiology, one hospital physicist, and two radiographers) evaluated 60 images for each technique. The selenium drum system (Philips, Eindhoven, The Netherlands) rated best for the detection of parenchymal nodules. Together with the storage phosphor system of generation IIIN (Philips/Fuji), the selenium drum system also rated best for detection of thin linear structures. The storage phosphor system of generation V (Fuji) rated best for the detection of mediastinal nodules. The first generation of the storage phosphor system from Agfa (Mortsel, Belgium) rated worst for the detection of parenchymal nodules and thin linear structures. These differences were significant (p drum system and the storage phosphor system of generation V were significantly better than the other systems tested. The film/screen system performed significantly better than the first-generation storage phosphor system from Agfa, equal to the generation IIIN storage phosphor system (Philips/Fuji) and significantly worse than the selenium drum system (Philips) and the generation-V storage phosphor system (Fuji). The conclusion is therefore that the image quality of selenium-based digital technique and of the more recent generations of storage phosphor systems is superior to both conventional technique and storage phosphor systems using image plates of older types.

  1. Pulmonary ultrasound and pulse oximetry versus chest radiography and arterial blood gas analysis for the diagnosis of acute respiratory distress syndrome: a pilot study.

    Science.gov (United States)

    Bass, Cameron M; Sajed, Dana R; Adedipe, Adeyinka A; West, T Eoin

    2015-07-21

    In low-resource settings it is not always possible to acquire the information required to diagnose acute respiratory distress syndrome (ARDS). Ultrasound and pulse oximetry, however, may be available in these settings. This study was designed to test whether pulmonary ultrasound and pulse oximetry could be used in place of traditional radiographic and oxygenation evaluation for ARDS. This study was a prospective, single-center study in the ICU of Harborview Medical Center, a referral hospital in Seattle, Washington, USA. Bedside pulmonary ultrasound was performed on ICU patients receiving invasive mechanical ventilation. Pulse oximetric oxygen saturation (SpO2), partial pressure of oxygen (PaO2), fraction of inspired oxygen (FiO2), provider diagnoses, and chest radiograph closest to time of ultrasound were recorded or interpreted. One hundred and twenty three ultrasound assessments were performed on 77 consecutively enrolled patients with respiratory failure. Oxygenation and radiographic criteria for ARDS were met in 35 assessments. Where SpO2 ≤ 97%, the Spearman rank correlation coefficient between SpO2/FiO2 and PaO2/FiO2 was 0.83, p arterial blood gas testing and chest radiography are not readily available.

  2. Exploration of exposure conditions with a novel wireless detector for bedside digital radiography

    Science.gov (United States)

    Bosmans, Hilde; Nens, Joris; Delzenne, Louis; Marshall, Nicholas; Pauwels, Herman; De Wever, Walter; Oyen, Raymond

    2012-03-01

    We propose, apply and validate an optimization scheme for a new wireless CsI based DR detector in combination with a regular mobile X-ray system for bedside imaging applications. Three different grids were tested in this combination. Signal-difference-to-noise was investigated in two ways, using a 1mm Cu piece in combination with different thicknesses of PMMA and by means of the CDRAD phantom using 10 images per condition and an automated evaluation method. A Figure of Merit (FOM), namely SDNR2/Imparted Energy, was calculated for a large range of exposure conditions, without and with grid in place. Misalignment of the grids was evaluated via the same FOMs. This optimization study was validated with comparative X-ray acquisitions performed on dead bodies. An experienced radiologist scored the quality of several specific aspects for all these exposures. Signal difference to noise ratios measured with the Cu method correlated well with the threshold contrasts from the CDRAD analysis (R2 > 0.9). The analysis showed optimal FOM with detector air kerma rates as typically used in clinical practice. Lower tube voltages provide higher FOM than the higher values but their practical use depends on the limitations of X-ray tubes, linked to patient motion artefacts. The use of high resolution grids should be encouraged, as the FOM increases with 47% at 75kV. These scores from the Visual grading study confirmed the results obtained with the FOM. The switch to (wireless) DR technology for bedside imaging could benefit from devices to improve grid positioning or any scatter reduction technique.

  3. TU-CD-BRA-11: Application of Bone Suppression Technique to Inspiratory/expiratory Chest Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, R; Sanada, S [Kanazawa University, Kanazawa, Ishikawa (Japan); Sakuta, K; Kawashima, H [Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Kishitani, Y [TOYO Corporation, Chuoh-ku, Tokyo (Japan)

    2015-06-15

    Purpose: The bone suppression technique based on advanced image processing can suppress the conspicuity of bones on chest radiographs, creating soft tissue images normally obtained by the dual-energy subtraction technique. This study was performed to investigate the usefulness of bone suppression technique in quantitative analysis of pulmonary function in inspiratory/expiratory chest radiography. Methods: Commercial bone suppression image processing software (ClearRead; Riverain Technologies) was applied to paired inspiratory/expiratory chest radiographs of 107 patients (normal, 33; abnormal, 74) to create corresponding bone suppression images. The abnormal subjects had been diagnosed with pulmonary diseases, such as pneumothorax, pneumonia, emphysema, asthma, and lung cancer. After recognition of the lung area, the vectors of respiratory displacement were measured in all local lung areas using a cross-correlation technique. The measured displacement in each area was visualized as displacement color maps. The distribution pattern of respiratory displacement was assessed by comparison with the findings of lung scintigraphy. Results: Respiratory displacement of pulmonary markings (soft tissues) was able to be quantified separately from the rib movements on bone suppression images. The resulting displacement map showed a left-right symmetric distribution increasing from the lung apex to the bottom region of the lung in many cases. However, patients with ventilatory impairments showed a nonuniform distribution caused by decreased displacement of pulmonary markings, which were confirmed to correspond to area with ventilatory impairments found on the lung scintigrams. Conclusion: The bone suppression technique was useful for quantitative analysis of respiratory displacement of pulmonary markings without any interruption of the rib shadows. Abnormal areas could be detected as decreased displacement of pulmonary markings. Inspiratory/expiratory chest radiography combined

  4. Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yakun [Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Li, Xiang [Medical Physics Graduate Program, Department of Physics, Cleveland State University, Cleveland, Ohio 44115 (United States); Segars, W. Paul [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Samei, Ehsan, E-mail: samei@duke.edu [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Departments of Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University Medical Center, Durham, North Carolina 27705 (United States)

    2014-02-15

    Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI{sub vol} and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose

  5. Localized Energy-Based Normalization of Medical Images: Application to Chest Radiography.

    Science.gov (United States)

    Philipsen, R H H M; Maduskar, P; Hogeweg, L; Melendez, J; Sánchez, C I; van Ginneken, B

    2015-09-01

    Automated quantitative analysis systems for medical images often lack the capability to successfully process images from multiple sources. Normalization of such images prior to further analysis is a possible solution to this limitation. This work presents a general method to normalize medical images and thoroughly investigates its effectiveness for chest radiography (CXR). The method starts with an energy decomposition of the image in different bands. Next, each band's localized energy is scaled to a reference value and the image is reconstructed. We investigate iterative and local application of this technique. The normalization is applied iteratively to the lung fields on six datasets from different sources, each comprising 50 normal CXRs and 50 abnormal CXRs. The method is evaluated in three supervised computer-aided detection tasks related to CXR analysis and compared to two reference normalization methods. In the first task, automatic lung segmentation, the average Jaccard overlap significantly increased from 0.72±0.30 and 0.87±0.11 for both reference methods to with normalization. The second experiment was aimed at segmentation of the clavicles. The reference methods had an average Jaccard index of 0.57±0.26 and 0.53±0.26; with normalization this significantly increased to . The third experiment was detection of tuberculosis related abnormalities in the lung fields. The average area under the Receiver Operating Curve increased significantly from 0.72±0.14 and 0.79±0.06 using the reference methods to with normalization. We conclude that the normalization can be successfully applied in chest radiography and makes supervised systems more generally applicable to data from different sources.

  6. Initial quality performance results using a phantom to simulate chest computed radiography

    Directory of Open Access Journals (Sweden)

    Muhogora Wilbroad

    2011-01-01

    Full Text Available The aim of this study was to develop a homemade phantom for quantitative quality control in chest computed radiography (CR. The phantom was constructed from copper, aluminium, and polymenthylmethacrylate (PMMA plates as well as Styrofoam materials. Depending on combinations, the literature suggests that these materials can simulate the attenuation and scattering characteristics of lung, heart, and mediastinum. The lung, heart, and mediastinum regions were simulated by 10 mm x 10 mm x 0.5 mm, 10 mm x 10 mm x 0.5 mm and 10 mm x 10 mm x 1 mm copper plates, respectively. A test object of 100 mm x 100 mm and 0.2 mm thick copper was positioned to each region for CNR measurements. The phantom was exposed to x-rays generated by different tube potentials that covered settings in clinical use: 110-120 kVp (HVL=4.26-4.66 mm Al at a source image distance (SID of 180 cm. An approach similar to the recommended method in digital mammography was applied to determine the CNR values of phantom images produced by a Kodak CR 850A system with post-processing turned off. Subjective contrast-detail studies were also carried out by using images of Leeds TOR CDR test object acquired under similar exposure conditions as during CNR measurements. For clinical kVp conditions relevant to chest radiography, the CNR was highest over 90-100 kVp range. The CNR data correlated with the results of contrast detail observations. The values of clinical tube potentials at which CNR is the highest are regarded to be optimal kVp settings. The simplicity in phantom construction can offer easy implementation of related quality control program.

  7. Coronary calcium visualization using dual energy chest radiography with sliding organ registration

    Science.gov (United States)

    Wen, Di; Nye, Katelyn; Zhou, Bo; Gilkeson, Robert C.; Wilson, David L.

    2016-03-01

    Coronary artery calcification (CAC) is the lead biomarker for atherosclerotic heart disease. We are developing a new technique to image CAC using ubiquitously ordered, low cost, low radiation dual energy (DE) chest radiography (using the two-shot GE Revolution XRd system). In this paper, we proposed a novel image processing method (CorCalDx) based on sliding organ registration to create a bone-image-like, coronary calcium image (CCI) that significantly reduces motion artifacts and improves CAC conspicuity. Experiments on images of a physical dynamic cardiac phantom showed that CorCalDx reduced 73% of the motion artifact area as compared to standard DE over a range of heart rates up to 90 bpm and varying x-ray radiation exposures. Residual motion artifact in the phantom CCI is greatly suppressed in gray level and area (0.88% of the heart area). In a Functional Measurement Test (FMT) with 20 clinical exams, image quality improvement of CorCalDx against standard DE (measured from -10 to +10) was significantly suggested (p<0.0001) by three radiologists for cardiac motion artifacts (7.2+/-2.1) and cardiac anatomy visibility (6.1+/-3.5). CorCalDx was always chosen best in every image tested. In preliminary assessments of 12 patients with 18 calcifications, 90% of motion artifact regions in standard DE results were removed in CorCalDx results, with 100% sensitivity of calcification detection, showing great potential of CorCalDx to improve CAC detection and grading in DE chest radiography.

  8. Pneumothorax and the Value of Chest Radiography after Ultrasound-Guided Thoracocentesis

    Energy Technology Data Exchange (ETDEWEB)

    Pihlajamaa, K.; Bode, M.K.; Puumalainen, T.; Lehtimaeki, A.; Marjelund, S.; Tikkakoski, T. [Keski-Pohjanmaan sairaanhoitopiiri, Kokkola (Finland). Rontgenosasto

    2004-12-01

    Purpose: To determine the incidence, the operator's experience, and other variables that may influence the development of pneumothorax or re-expansion edema after ultrasound (US)-guided thoracocentesis. Material and Methods: The medical records of 264 procedures in 212 patients who had undergone US-guided thoracocentesis in our radiology department or intensive care unit during the period 1996-2001 were retrospectively reviewed. Results: Post-thoracocentesis pneumothorax occurred in 11 cases, the incidence being 4.2% (11/264). None of the pneumothoraces occurred in the 10 mechanically ventilated patients. All but one patient with pneumothorax were asymptomatic or had only minor symptoms. Chest tube drainage was needed in one patient with a large pneumothorax. No re-expansion edema was recorded, although 1500 ml or more pleural fluid was aspirated in 29 patients. The operator's experience had no effect on the complication rate. Needle size was the only significant variable that contributed to the pneumothorax rate. Conclusion: US-guided thoracocentesis can be done equally as safely by residents as by senior radiologists. The safety and feasibility of the method are evident among mechanically ventilated intensive care patients. Our results do not support the routine use of post-thoracocentesis chest radiography.

  9. Image quality of a digital chest radiography system based on a selenium detector.

    Science.gov (United States)

    Neitzel, U; Maack, I; Günther-Kohfahl, S

    1994-04-01

    A digital chest radiography system has been developed, with a detector based on the photoelectric properties of amorphous selenium. The selenium layer is deposited on a cylindrical aluminium drum, large enough to cover the full field of view for chest imaging. The electrostatic charge image which is formed on the selenium surface after x-ray exposure is read out by electrometer probes using fast drum rotation. For a physical evaluation of the attainable image quality, the characteristic curve, the modulation transfer function, and the noise spectra were measured. From these measurements, the signal-to-noise properties of the detector in terms of detective quantum efficiency (DQE) and noise equivalent quanta (NEQ) were derived. The results show that the selenium-based detector has a wide dynamic range and a significantly better DQE than screen-film and storage phosphor systems for spatial frequencies below the Nyquist limit (2.7 lp/mm). As a consequence, the detectability of small, low-contrast details is considerably improved.

  10. Large hiatal hernia at chest radiography in a woman with cardiorespiratory symptoms.

    Science.gov (United States)

    Torres, Daniele; Parrinello, Gaspare; Cardillo, Mauro; Pomilla, Marina; Trapanese, Caterina; Michele, Bellanca; Lupo, Umberto; Schimmenti, Caterina; Cuttitta, Francesco; Pietrantoni, Rossella; Vogiatzis, Danai; Licata, Giuseppe

    2012-11-01

    Hiatal hernia (HH) is a frequent entity. Rarely, it may exert a wide spectrum of clinical presentations mimicking acute cardiovascular events such as angina-like chest pain until manifestations of cardiac compression that can include postprandial syncope, exercise intolerance, respiratory function, recurrent acute heart failure, and hemodynamic collapse. A 69-year-old woman presented to the emergency department complaining of fatigue on exertion, cough, and episodes of restrosternal pain with less than 1 hour of duration. Her medical history only included some episodes of bronchitis and no history of hypertension. The 12-lead electrocardiogram demonstrated sinus rhythm with right bundle-branch block. Laboratory tests, including cardiac troponin I, were within normal reference values. Chest radiography showed no significant pulmonary alterations and revealed in mediastinum a huge abnormal shadow overlapping the right heart compatible with a gastric bubble.The gastroscopy confirmed a large HH. A 2-dimensional transthoracic echocardiogram, using all standard and modified apical and parasternal views, revealed an echolucent mass, compatible with HH, compressing the right atrium. Also, it showed an altered left ventricular relaxation and a mild increase of pulmonary artery pressure (35 mm Hg). Spirometry showed a mild obstruction of the small airways, whereas coronary angiography showed normal coronary arteries. We concluded that the patient's symptomatology was related to the compressive effects of the large hiatal ernia, a neglected cause of cardiorespiratory symptoms. The surgical repair of HH was indicated.

  11. Clinical evaluation of irreversible image compression: analysis of chest imaging with computed radiography.

    Science.gov (United States)

    Ishigaki, T; Sakuma, S; Ikeda, M; Itoh, Y; Suzuki, M; Iwai, S

    1990-06-01

    To implement a picture archiving and communication system, clinical evaluation of irreversible image compression with a newly developed modified two-dimensional discrete cosine transform (DCT) and bit-allocation technique was performed for chest images with computed radiography (CR). CR images were observed on a cathode-ray-tube monitor in a 1,024 X 1,536 matrix. One original and five reconstructed versions of the same images with compression ratios of 3:1, 6:1, 13:1, 19:1, and 31:1 were ranked according to quality. Test images with higher spatial frequency were ranked better than those with lower spatial frequency and the acceptable upper limit of the compression ratio was 19:1. In studies of receiver operating characteristics for scoring the presence or absence of nodules and linear shadows, the images with a compression ratio of 25:1 showed a statistical difference as compared with the other images with a compression ratio of 20:1 or less. Both studies show that plain CR chest images with a compression ratio of 10:1 are acceptable and, with use of an improved DCT technique, the upper limit of the compression ratio is 20:1.

  12. Retrodiaphragmatic portion of the lung: how deep is the posterior costophrenic sulcus on posteroanterior chest radiography?

    Energy Technology Data Exchange (ETDEWEB)

    Oh, J.K. [Department of Radiology, Kangnam St Mary' s Hospital, Seoul (Korea, Republic of); Ahn, M.I. [Department of Radiology, Kangnam St Mary' s Hospital, Seoul (Korea, Republic of)], E-mail: ami@catholic.ac.kr; Kim, H.L.; Park, S.H. [Department of Radiology, Kangnam St Mary' s Hospital, Seoul (Korea, Republic of); Shin, E. [Department of Preventive Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-08-15

    Aim: To determine the depth of the posterior costophrenic sulcus (CPS) on posteroanterior (PA) chest radiography in relation to the diaphragmatic dome and lateral CPS. Materials and methods: Five hundred and forty consecutive PA chest radiographs that were performed for general health screenings were retrospectively reviewed. Among them 282 radiographs were selected that met the following criteria: visualization of the inferior boundary of the posterior CPS behind the right hemidiaphragm; and no abnormal findings that affected the shape and level of the diaphragm. The selected chest radiographs were from 155 men and 127 women with a mean age of 40.7 {+-} 8.4 years. On 282 PA chest radiographs, the distances between the right diaphragmatic dome and posterior CPS (total diaphragmatic height), the diaphragmatic dome and lateral CPS (diaphragmatic dome height), and the lateral and posterior CPS (posterior CPS depth) were measured. In addition levels of the right lateral and posterior CPS were scored in relation to levels of the thoracic and lumbar spines. The relationships between the posterior CPS depth and demographic and physical data and other radiographic measurements were analysed. Results: The mean right posterior CPS depth was 29.2 {+-} 15.6 mm. The average level of the posterior CPS in relation to the spine was 13.5 {+-} 0.6, i.e., the level of lower half of the L1 vertebral body. The posterior CPS depth had a tendency to be deeper in those participants who were taller (r = 0.17, p < 0.01), had a higher body mass index (BMI; r = 0.25, p < 0.01), longer total diaphragmatic height (r = 0.55, p < 0.01), and shorter diaphragmatic dome height (r = -0.18, p < 0.01). Conclusion: As the posterior CPS is deeper than the lateral CPS by approximately 3 cm, and reaches, on average, to L1, the standard chest PA radiograph must include >3 cm below the level of lateral CPS, or should include the L1 spine.

  13. Effect of External Quality Assurance Evaluation for Chest Radiography: 3-Year Follow-Up in the Medical Institution for Pneumoconiosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Jeong; Choi, Soon Byung [Clinical Research Team, Occupational Lung Diseases Institute, Korea Worker' s Compensation and Welfare Service, Ansan (Korea, Republic of)

    2012-04-15

    The aim of this study was to determine the effect of external quality assurance (QA) evaluation for chest radiography in the medical institution for pneumoconiosis (MIP). The chest radiography of the MIPs were evaluated for a radiological technique (RT), image quality (IQ), and reading environment (RE), during a 3-year follow up according to the Korean guidelines. Same methods were implemented each year to ensure that the results are reliable. RT, IQ, and RE were compared between examination and medical care (EMP), and only medical care (MCP) for pneumoconiosis, film-screen (FSR) and digital (DR) radiography. Uneducated and educated for QA during a 3-year follow up referencing with 2008 were realized. RT and IQ of the MIPs showed a significantly higher score in 2009 and 2010 compared with 2008 (p < 0.01). However, RE was not significantly improved. The score of RT, IQ, and RE of the EMPs were higher than those of MCPs every year, and FSR showed a lower score in all evaluations, although, more improvement was seen than the DR. The chest radiography of the MIPs showed a significant effect as a result of a repeated external QA evaluation. However, the MIPs need to transfer from FSR to DR, and maintain a continuous QA evaluation for the MCPs.

  14. Digital radiography of the chest in pediatric patients; Die digitale Thoraxradiographie beim paediatrischen Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Puig, S. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2003-12-01

    The hopes placed in digital radiography have been fulfilled only partly in pediatric radiology. Specifically, the option of gaining reduced radiation exposure in combination with a similar or even improved image quality was hard to realize. The only portable digital system available for a long time were storage phosphors which were disadvantaged by an extremely limited dose-quantum-efficiency (DQE) in comparison to digital flat panel detectors. New developments and the introduction of the dual-reading system led to image qualities comparable to film-screen-systems with high resolution and achievable without dose increase, sometimes even with dose reduction. A study using an animal model suggests that these systems can even be used in preterm infants with very low birth weights. A new portable flat panel detector by Canon may improve digital chest radiography in pediatric patients. (orig.) [German] Erwartungen, die man anfaenglich in die digitale Projektionsradiographie gesetzt hat, haben sich in der Kinderradiologie erst verzoegert oder teilweise gar nicht erfuellt. Insbesondere Hoffnungen, dass man die Strahlenbelastung bei gleich bleibender oder gar verbesserter Bildqualitaet reduzieren koennte, wurden bald enttaeuscht. Das einzige portable digitale System waren lange Zeit Phosphorplatten, die aber im Vergleich zu den Festplattendetektoren eine aeusserst limitierte Dosisquanteneffizienz (DQE) hatten. Durch neue Entwicklungen und v. a. durch die Einfuehrung des Dual-reading-Systems kann eine Bildqualitaet erreicht werden, die an hochaufloesende Film-Folien-Systeme heranreicht, ohne die Dosis erhoehen zu muessen. Teilweise ist nun auch eine Dosisreduktion moeglich. In einem Tiermodell konnte gezeigt werden, dass diese Systeme auch bei Fruehgeborenen mit einem sehr niedrigen Geburtgewicht einsetzbar sind. Hoffnung wird in ein neues portables Festplattendetektorsystem gesetzt, welches in der paediatrischen digitalen Thoraxradiographie evtl. neue Massstaebe setzen

  15. Bedside ultrasound diagnosis of pulmonary contusion.

    Science.gov (United States)

    Stone, Michael B; Secko, Michael A

    2009-12-01

    A 10-year-old boy presented to the emergency department after being struck by a van while crossing the street. He complained of right side chest pain, and a chest radiography was suggestive of pulmonary contusion. The treating physician performed a bedside ultrasound that revealed a right-sided pulmonary contusion that was subsequently confirmed on computed tomography of the thorax. The sonographic features of pulmonary contusion are described, and the possible role of lung sonography in the assessment of pediatric thoracic trauma is discussed.

  16. Chest radiography and thoracic computed tomography findings in children who have family members with active pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Uzum, Kazim; Karahan, Okkes I.; Dogan, Sukru; Coskun, Abdulhakim E-mail: coskuna@erciyes.edu.tr; Topcu, Faik

    2003-12-01

    Objective: The chest radiography and TCT findings in children who had contacted with adult family members with active pulmonary tuberculosis were compared. The contributions of thoracic computed tomography to the diagnosis of tuberculosis were investigated. Methods and material: The children who were 0-16 years old (n=173) and children of families with an adult member which was diagnosed as pulmonary tuberculosis were evaluated. The children were considered in two groups based on the absence (n=125) or presence (n=48) of complaints and/or ambiguous symptoms such as lack of appetite, mild cough, sweating, history of lung infection, low body weight and those with suspicious chest radiography findings (12 cases) were included in this study. Asymptomatic patients (n=125) did not undergo TCT. Patients who had positive PPD skin tests only received isoniazid. If the TCT demonstrated enlarged lymph nodes or parenchymal lesions, minimally active pulmonary tuberculosis was diagnosed and antituberculous treatment was given. Results and discussions: TCT revealed lymph node enlargement or parenchymal lesions in 39 children (81.2%). Of the 12 children whose CXRs revealed suspicious lymph node enlargement and/or infiltration, five had normal findings in TCT whereas the initial findings were confirmed in the remaining seven. These data suggest that there is a correlation between the presence of ambiguous symptoms in exposed children and TCT findings; chest radiography and TCT findings do not yield parallel findings. All the patients who received anti-TB treatment were resolved in the control examinations. Conclusion: In this study there is a correlation between presence of ambiguous symptoms and TCT findings, but the chest radiography and TCT findings do not yield harmony in exposed children with ambiguous symptoms (suspicious tuberculosis cases). These observations should be considered in children with symptoms similar to those of exposed children, but with no definite history of

  17. Physical imaging properties of a new screen-film system for chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Higashida, Yoshiharu [Kumamoto Univ. (Japan). Coll. of Medical Science; Yoshida, Akira; Katsuda, Noboru [and others

    1996-04-01

    To evaluate the clinical usefulness of a new screen-film system (advanced screen-film system; AD system) for chest radiography, its fundamental imaging properties were investigated. The basic imaging properties were evaluated by measuring characteristic (H and D) curves, relative speeds, MTFs (modulation transfer functions), WS (Wiener spectra), and x-ray attenuation of screens. The film gradient of the AD system was slightly lower at low radiographic density. and higher at high density. The screen speed of the AD system was 112% greater than that of the conventional system, and the film speed was 47% lower. As the result, the total speed of the AD system was slightly higher compared with the conventional system. Resolution property of the AD system was comparable to or slightly lower than that of the conventional system. However, the noise level of the AD system was considerably lower than that of the conventional system at low and middle photographic density levels. X-ray attenuation of the HG-M screens was about 10% higher than that of the conventional screens. We conclude that the AD system has superior imaging properties than the conventional system. (author).

  18. Assessment and optimisation of the image quality of chest-radiography systems.

    Science.gov (United States)

    Redlich, U; Hoeschen, C; Doehring, W

    2005-01-01

    A complete evaluation strategy had been developed for thoracic X-ray imaging. It has been validated by investigating five chest-radiography systems, two of these systems after optimising image processing. The systems were a screen-film combination, a selenium drum, a conventional and a transparent imaging plate and a Cs/I-based flat panel detector (the two latter ones have been optimised using different post processing). At first all detectors have been characterised using physical parameters like DQE and MTF. After that all systems have been evaluated by human observer studies using anatomy in clinical images (VGA, ICS) and added pathological structures in thoracic phantom images (ROC). The ranking of the image quality of the systems was nearly the same in all studies. There was a similar assessment of main image quality parameters like spatial resolution, dynamic range and MTF. The modification of image post processing changed the visibility of pathological structures more than the visualisation of the anatomical criteria. The assessment of the clinical image quality has to be done for anatomical structures, and the recognition of pathological structures has to be evaluated.

  19. Evaluation of cancer detection efficiency by means of hybrid and inverse filter in chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Youn Young; Kim, Tae Young; Kim, Hyun Ji; Kim, Jung Min [Dept. of Radiological Science, Korea university, Seoul (Korea, Republic of); Park, Min Seock [Radiation Safety and Section, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2013-12-15

    The purpose of this study is to evaluate usefulness of Hybrid image and Inverse image about detection of tumor shadow in chest radiography using ROC analysis. Original images of 60 cases are selected from Standards digital image date base issued by the Japanese Society of Radiological Technology. Through computer language of C, Inverse images of 60 cases and Hybrid image of 30 cases are made. The continues reading experiment was conducted. In the case of inverse image were observed by 5 radiographer and 2 radiologist. In the case of In case of Hybrid image were observed by 3 student radiographer and 2 experienced radiographer. ROC curve are constructed using ROCKIT Program made by Metz. In Inverse image, a Az of average ROC curve was increases from 0.742 of original image to 0.775 of inverse image. In normal cases, the effect of the detrimental is same to that of the beneficial, however In abnormal cases, the beneficial effect is greater than detrimental effect. However in Hybrid image, a Az of average ROC curve was decreases from 0.5253 of original image to 0.4868 of Hybrid image. In Normal cases, the effect of the detrimental is greater than that of the Beneficial, however In abnormal cases, the Beneficial effect is greater than detrimental effect. The inverse image can be more positively considered for the detecting of tumor than the hybrid image.

  20. Investigation of optimum energies for chest imaging using film-screen and computed radiography.

    Science.gov (United States)

    Honey, I D; Mackenzie, A; Evans, D S

    2005-05-01

    The purpose of the study was to compare the image quality of film-screen (FS) and computed radiography (CR) for adult chest examinations across a range of beam energies. A series of images of the CDRAD threshold contrast detail detection phantom were acquired for a range of tube potential and exposure levels with both CR and FS. The phantom was placed within 9 cm of Perspex to provide attenuation and realistic levels of scatter in the image. Hardcopy images of the phantom were scored from a masked light-box by two scorers. Threshold contrast indices were used to calculate a visibility index (VI). The relationships between dose and image quality for CR and for FS are fundamentally different. The improvements in VIs obtained using CR at 75 kVp and 90 kVp were found to be statistically significant compared with 125 kVp at matched effective dose levels. The relative performance of FS and CR varies as a function of energy owing to the different k-edges of each system. When changing from FS to CR, the use of lower tube potentials may allow image quality to be maintained whilst reducing effective dose. A tube voltage of 90 kVp is indicated by this work, but may require clinical verification.

  1. Chest radiography versus chest CT in the evaluation for pulmonary metastases in patients with Wilms' tumor: a retrospective review

    Energy Technology Data Exchange (ETDEWEB)

    Wootton-Gorges, S.L.; Albano, E.A.; Riggs, J.M.; Ihrke, H.; Rumack, C.M.; Strain, J.D. [Colorado Univ., Denver, CO (United States). Dept. of Radiology

    2000-08-01

    Background. Determination of the presence of pulmonary metastases in children with Wilms' tumor is an important part of staging and treatment. We sought to compare the efficacy of chest radiography (CXR) and chest CT in the evaluation for pulmonary metastases in patients with Wilms' tumor. Materials and methods. This retrospective study included 83 children with Wilms' tumor diagnosed between 1980 and 1993. All patients with pulmonary nodules (n = 12) as well as 14 Wilms' tumor patients without pulmonary metastases (control group) had blinded review of the CXR and chest CTs by three pediatric radiologists. Presence, size, and certainty of metastatic diagnosis were recorded. Medical records were reviewed. The remaining 57 patients had review of their medical and imaging records to confirm the absence of pulmonary metastases. Results. Ten of the 12 with pulmonary masses had imaging available for review. Eight had both positive CXR and chest CT examinations. Two patients had pulmonary nodules seen by CT only: one had a right cardiophrenic angle mass and died as a result of liver metastases. The other had a solitary nodule, which proved to be a plasma-cell granuloma. Overall, the CXR and chest CT data concur in 79/81 (98 %). Conclusion. CXR alone appears adequate for the diagnosis or exclusion of pulmonary metastases in patients with Wilms' tumor. (orig.)

  2. Screening strategies for tuberculosis prevalence surveys: the value of chest radiography and symptoms.

    Science.gov (United States)

    van't Hoog, Anna H; Meme, Helen K; Laserson, Kayla F; Agaya, Janet A; Muchiri, Benson G; Githui, Willie A; Odeny, Lazarus O; Marston, Barbara J; Borgdorff, Martien W

    2012-01-01

    We conducted a tuberculosis (TB) prevalence survey and evaluated the screening methods used in our survey, to assess if screening in TB prevalence surveys could be simplified, and to assess the accuracy of screening algorithms that may be applicable for active case finding. All participants with a positive screen on either a symptom questionnaire, chest radiography (CXR) and/or sputum smear microscopy submitted sputum for culture. HIV status was obtained from prevalent cases. We estimated the accuracy of modified screening strategies with bacteriologically confirmed TB as the gold standard, and compared these with other survey reports. We also assessed whether sequential rather than parallel application of symptom, CXR and HIV screening would substantially reduce the number of participants requiring CXR and/or sputum culture. Presence of any abnormality on CXR had 94% (95%CI 88-98) sensitivity (92% in HIV-infected and 100% in HIV-uninfected) and 73% (95%CI 68-77) specificity. Symptom screening combinations had significantly lower sensitivity than CXR except for 'any TB symptom' which had 90% (95%CI 84-95) sensitivity (96% in HIV-infected and 82% in HIV-uninfected) and 32% (95%CI 30-34) specificity. Smear microscopy did not yield additional suspects, thus the combined symptom/CXR screen applied in the survey had 100% (95%CI 97-100) sensitivity. Specificity was 65% (95%CI 61-68). Sequential application of first a symptom screen for 'any symptom', followed by CXR-evaluation and different suspect criteria depending on HIV status would result in the largest reduction of the need for CXR and sputum culture, approximately 36%, but would underestimate prevalence by 11%. CXR screening alone had higher accuracy compared to symptom screening alone. Combined CXR and symptom screening had the highest sensitivity and remains important for suspect identification in TB prevalence surveys in settings where bacteriological sputum examination of all participants is not feasible.

  3. What is the yield of routine chest radiography following tube thoracostomy for trauma?

    Science.gov (United States)

    Kong, Victor Y; Oosthuizen, George V; Clarke, Damian L

    2015-01-01

    Routine chest radiography (CXR) following tube thoracostomy (TT) is a standard practice in most trauma centres worldwide. Evidence supporting this routine practice is lacking and the actual yield is unknown. We performed a retrospective review of 1042 patients over a 4-year period who had a routine post-insertion CXR performed in accordance with current ATLS® recommendations. A total 1042 TTs were performed on 1004 patients. Ninety-one per cent of patients (913/1004) were males, and the median age for all patients was 24 years. Seventy-five per cent of all injuries (756/1004) were from penetrating trauma, and the remaining 25% (248/1004) were from blunt. The initial pathologies requiring TT were: haemopneumothorax: 34% (339/1042), haemothroax: 31% (314/1042), simple pneumothorax: 25% (256/1042), tension pneumothorax: 8% (77/1042) and open pneumothorax: 5% (54/1042). One hundred and three patients had TTs performed on clinical grounds alone without a pre-insertion CXR [Group A]. One hundred and ninety-one patients had a pre-insertion CXR but had persistent clinical concerns following insertion [Group B]. Seven hundred and ten patients had pre-insertion CXR but no clinical concerns following insertion [Group C]. Overall, 15% (152/1004) [9 from Group A, 111 from Group B and 32 from Group C] of all patients had their clinical management influenced as a direct result of the post-insertion CXR. Despite the widely accepted practice of routine CXR following tube thoracostomy, the yield is relatively low. In many cases, good clinical examination post tube insertion will provide warnings as to whether problems are likely to result. However, in the more rural setting, and in resource challenged environments, there is a relatively high yield from the CXR, which alters management. Further prospective studies are needed to establish or refute the role of the existing ATLS® guidelines in these specific environments. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Chest radiography patterns in 75 adolescents with vertically-acquired human immunodeficiency virus (HIV) infection

    Energy Technology Data Exchange (ETDEWEB)

    Desai, S.R., E-mail: sujal.desai@nhs.ne [King' s College London, King' s Health Partners, Department of Radiology, King' s College Hospital NHS Foundation Trust (United Kingdom); Copley, S.J. [Department of Radiology, Hammersmith Hospital (United Kingdom); Barker, R.D.; Elston, C.M. [King' s College London, King' s Health Partners, Department of Respiratory Medicine, King' s College Hospital NHS Foundation Trust (United Kingdom); Miller, R.F. [Research Department of Infection and Public Health, Division of Population Health, University College London (United Kingdom); Clinical Research Unit, London School of Hygiene and Tropical Medicine, London (United Kingdom); Wells, A.U. [The Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Trust, London (United Kingdom); Munyati, S. [Biomedical Research and Training Institute, Samora Machel Avenue (Zimbabwe); Nathoo, K. [Department of Paediatrics, University of Zimbabwe (Zimbabwe); Harare Central Hospital, Lobengula Road, Harare (Zimbabwe); Corbett, E.L.; Ferrand, R.A. [Clinical Research Unit, London School of Hygiene and Tropical Medicine, London (United Kingdom); Biomedical Research and Training Institute, Samora Machel Avenue (Zimbabwe)

    2011-03-15

    Aim: To evaluate lung disease on chest radiography (CR), the relative frequency of CR abnormalities, and their clinical correlates in adolescents with vertically-acquired human immunodeficiency virus (HIV) infection. Materials and methods: CRs of 75 patients [59 inpatients (33 males; mean age 13.7 {+-} 2.3 years) and 16 outpatients (eight males; mean age 14.1 {+-} 2.1 years)] were retrospectively reviewed by three independent observers. The overall extent of disease (to the nearest 5%), its distribution, and the proportional extents (totalling 100%) of different radiographic patterns (including ring/tramline opacities and consolidation) were quantified. CR features and clinical data were compared. Results: CRs were abnormal in 51/75 (68%) with 'extensive' disease in 38/51 (74%). Ring/tramline opacities and consolidation predominated (i.e., proportional extent >50%) in 26 and 21 patients, respectively. Consolidation was significantly more common in patients hospitalized primarily for a respiratory illness than patients hospitalized for a non-respiratory illness or in outpatients (p < 0.005, {chi}{sup 2} for trend); by contrast, ring/tramline opacities did not differ in prevalence across the groups. On stepwise logistic regression, predominant consolidation was associated with progressive dyspnoea [odds ratio (OR) 5.60; 95% confidence intervals (CI): 1.60, 20.1; p < 0.01] and was associated with a primary respiratory cause for hospital admission (OR: 22.0; CI: 2.7, 181.1; p < 0.005). Ring/tramline opacities were equally prevalent in patients with and without chronic symptoms and in those admitted to hospital with respiratory and non-respiratory illness. Conclusion: In HIV-infected adolescents, evaluated in secondary practice, CR abnormalities are prevalent. The presence of ring/tramline opacities, believed to reflect chronic airway disease, is not linked chronic respiratory symptoms.

  5. Quantitative evaluation of anatomical noise in chest digital tomosynthesis, digital radiography, and computed tomography

    Science.gov (United States)

    Lee, D.; Choi, S.; Lee, H.; Kim, D.; Choi, S.; Kim, H.-J.

    2017-04-01

    Lung cancer is currently the worldwide leading cause of death from cancer. Thus, detection of lung cancer at its early stages is critical for improving the survival rate of patients. Chest digital tomosynthesis (CDT) is a recently developed imaging modality, combining many advantages of digital radiography (DR) and computed tomography (CT). This method has the potential to be widely used in the clinical setting. In this study, we introduce a developed CDT R/F system and compare its image quality with those of DR and CT, especially with respect to anatomical noise and lung nodule conspicuity, for LUNGMAN phantoms. The developed CDT R/F system consists of a CsI scintillator flat panel detector, X-ray tube, and tomosynthesis data acquisition geometry. For CDT R/F imaging, 41 projections were acquired at different angles, over the ± 20° angular range, in a linear translation geometry. To evaluate the clinical effectiveness of the CDT R/F system, the acquired images were compared with CT (Philips brilliance CT 64, Philips healthcare, U.S.) and DR (ADR-M, LISTEM, Korea) phantom images in terms of the anatomical noise power spectrum (aNPS). DR images exhibited low conspicuity for a small-size lung nodule, while CDT R/F and CT exhibited relatively high sensitivity for all lung nodule sizes. The aNPS of the CDT R/F system was better than that of DR, by resolving anatomical overlapping problems. In conclusion, the developed CDT R/F system is likely to contribute to early diagnosis of lung cancer, while requiring a relatively low patient dose, compared with CT.

  6. Screening strategies for tuberculosis prevalence surveys: the value of chest radiography and symptoms.

    Directory of Open Access Journals (Sweden)

    Anna H van't Hoog

    Full Text Available BACKGROUND: We conducted a tuberculosis (TB prevalence survey and evaluated the screening methods used in our survey, to assess if screening in TB prevalence surveys could be simplified, and to assess the accuracy of screening algorithms that may be applicable for active case finding. METHODS: All participants with a positive screen on either a symptom questionnaire, chest radiography (CXR and/or sputum smear microscopy submitted sputum for culture. HIV status was obtained from prevalent cases. We estimated the accuracy of modified screening strategies with bacteriologically confirmed TB as the gold standard, and compared these with other survey reports. We also assessed whether sequential rather than parallel application of symptom, CXR and HIV screening would substantially reduce the number of participants requiring CXR and/or sputum culture. RESULTS: Presence of any abnormality on CXR had 94% (95%CI 88-98 sensitivity (92% in HIV-infected and 100% in HIV-uninfected and 73% (95%CI 68-77 specificity. Symptom screening combinations had significantly lower sensitivity than CXR except for 'any TB symptom' which had 90% (95%CI 84-95 sensitivity (96% in HIV-infected and 82% in HIV-uninfected and 32% (95%CI 30-34 specificity. Smear microscopy did not yield additional suspects, thus the combined symptom/CXR screen applied in the survey had 100% (95%CI 97-100 sensitivity. Specificity was 65% (95%CI 61-68. Sequential application of first a symptom screen for 'any symptom', followed by CXR-evaluation and different suspect criteria depending on HIV status would result in the largest reduction of the need for CXR and sputum culture, approximately 36%, but would underestimate prevalence by 11%. CONCLUSION: CXR screening alone had higher accuracy compared to symptom screening alone. Combined CXR and symptom screening had the highest sensitivity and remains important for suspect identification in TB prevalence surveys in settings where bacteriological sputum

  7. Needle image plates compared to conventional CR in chest radiography: Is dose reduction possible?

    Energy Technology Data Exchange (ETDEWEB)

    Berger-Kulemann, Vanessa, E-mail: vanessa.berger-kulemann@meduniwien.ac.at [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Pötter-Lang, Sarah; Gruber, Michael [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Berger, Rudolf [Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Vonbank, Karin [Department of Internal Medicine II, Division of Pneumology, Medical University of Vienna Waehringer Guertel 18-20, 1090 Vienna (Austria); Weber, Michael [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Rabitsch, Werner [Department of Internal Medicine I, Bone Marrow Transplantation, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Uffmann, Martin [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Department of Radiology, KH Neunkirchen, Peischinger Straße 19, 2620 Neunkirchen (Austria)

    2012-12-15

    Purpose: To compare image quality of standard-dose computed radiography and dose reduced needle-technology CR for supine CXR in a clinical setting. Materials and methods: We prospectively evaluated 128 radiographs of 32 immunocompromised patients. For each patient four clinical CXR were performed within one week, two with powder image plates (PIP; Fuji ST-V) and two with needle image plates (NIP; Agfa DXS) at standard and half dose, respectively. One experienced radiologist and two residents blinded to dose level and kind of imaging system rated different anatomical structures, image noise, tubes/lines and abnormalities on a image quality scale from 1 to 10 (1 = poor, 10 = excellent). The rating scores were tested for statistical differences using analysis of variance with repeated measures. Results: A statistical difference (p < 0.05) was found for the two systems as well as for the two dose levels. Overall rating scores were 6.5 for PIP with full dose, 6.2 for PIP with half dose, 7.6 for NIP with full dose and 7.4 for NIP with half dose. There was a significant difference in favour of the NIP system at the same dose level. Also the NIP images obtained at half dose were ranked significantly better compared to the PIP images at standard dose. The differences in ranking of anatomical structures and abnormalities were more pronounced in low absorption areas (pulmonary vessels, parenchyma) than in high absorption areas (mediastinum, spine). Conclusion: For supine chest radiograms the NIP technology allows for a dose reduction of 50% while providing higher image quality.

  8. 婴儿床边摄影图像伪影排除与研究%Study and elimination of artifacts on infant bed-side chest radiograph

    Institute of Scientific and Technical Information of China (English)

    聂世琨; 陈小军; 王柏烨; 文翠昆

    2013-01-01

    Objective: To analyze and understand the artifacts on infant bed-side chest radiograph, and to prevent their occurring to reduce diagnostic errors. Methods: Infant bedside chest radiograph were obtained randomly for quality control. Artifacts with regular shape but different location were found on the above images. Measures to eliminate the artifacts were taken as the followings: Firstly, digital panel, X-ray tube window and collimator were observed to eliminate fixed foreign body; secondly, the digital panel was collimated, and finally, collimator must be dismantled and cleaned up. Results: The machine problem was solved and the image artifacts disappeared after the above measures were taken. Conclusions: It is easy to produce image artifacts on infant bed-side chest radiograph due to low exposure conditions for infant chest and high low-contrast resolution.%目的:通过分析少见的婴儿床边胸部图像,掌握其伪影形成的原因及排除方法,以防止因此图像伪影的产生而造成诊断的错误.方法:随机抽取6~7张有形状固定且位置不固定的伪影的婴儿床边胸片.检查摄影时数字平板和X射线管窗口及束光器有无固定异物,对数字平板进行校正,拆开束光器清洁束光器内部四周灰尘及尘渣.结果:故障排除,图像伪影消失.结论:由于婴儿胸部摄影曝光条件弱,加之DR图像低对比分辨率高,故在婴儿胸片上容易产生图像伪影.

  9. Development of new imaging system for chest radiography; Investigation of basic imaging properties and improvement of signal detection

    Energy Technology Data Exchange (ETDEWEB)

    Higashida, Yoshiharu (Kumamoto Univ. (Japan). Coll. of Medical Science); Kariya, Kohmyo

    1991-09-01

    A new imaging system for chest radiography which has higher sensitivity in the mediastinum area than in the lung area has been developed. Through use of this new system for routine clinical examinations, the mediastinum area and lung areas are simultaneously displayed with a single exposure in optimal contrast. We investigated the fundamental physical properties of this system by comparing such items as its relative speed, modulation transfer functions (MTFs), density dependence on X-ray spectra, and low-contrast signal detections, with those of the conventional standard screen-film system. (author).

  10. Development of New Imaging System for Chest Radiography: Investigation of Basic Imaging Properties and Improvement of Signal Detection

    Science.gov (United States)

    Higashida, Yoshiharu; Kariya, Kohmyo

    1991-09-01

    A new imaging system for chest radiography which has higher sensitivity in the mediastinum area than in the lung area has been developed. Through use of this new system for routine clinical examinations, the mediastinum area and lung areas are simultaneously displayed with a single exposure in optimal contrast. We investigated the fundamental physical properties of this system by comparing such items as its relative speed, modulation transfer functions (MTFs), density dependence on X-ray spectra, and low-contrast signal detections, with those of the conventional standard screen-film system.

  11. A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography.

    Science.gov (United States)

    Faraone, Antonio; Fortini, Alberto

    2015-01-01

    We describe the case of a 23-year-old man presenting with recurrent pleuritic chest pain and prolonged fever after electrophysiology testing and placement of an implantable cardioverter-defibrillator because of a suspected arrhythmogenic right ventricular dysplasia. The clinical suspicion was initially directed toward pneumonia with pleural effusion and later toward an infection of the cardiac device complicated by septic pulmonary embolism. The definitive diagnosis of pulmonary embolism and infarction was suggested by a point-of-care thoracic sonography, performed at the bedside by a clinician caring for the patient, and then confirmed by contrast enhanced computed tomography, which also showed thrombosis of the left iliofemoral vein, site of percutaneous puncture for cardiac catheterization. Prolonged fever was attributable to a concomitant Epstein-Barr virus primary infection that acted as confounding factor. The present report confirms the value of bedside thoracic sonography in the diagnostic evaluation of patients with nonspecific respiratory symptoms.

  12. A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography

    Directory of Open Access Journals (Sweden)

    Antonio Faraone

    2015-01-01

    Full Text Available We describe the case of a 23-year-old man presenting with recurrent pleuritic chest pain and prolonged fever after electrophysiology testing and placement of an implantable cardioverter-defibrillator because of a suspected arrhythmogenic right ventricular dysplasia. The clinical suspicion was initially directed toward pneumonia with pleural effusion and later toward an infection of the cardiac device complicated by septic pulmonary embolism. The definitive diagnosis of pulmonary embolism and infarction was suggested by a point-of-care thoracic sonography, performed at the bedside by a clinician caring for the patient, and then confirmed by contrast enhanced computed tomography, which also showed thrombosis of the left iliofemoral vein, site of percutaneous puncture for cardiac catheterization. Prolonged fever was attributable to a concomitant Epstein-Barr virus primary infection that acted as confounding factor. The present report confirms the value of bedside thoracic sonography in the diagnostic evaluation of patients with nonspecific respiratory symptoms.

  13. Analysis of image quality according to BMI of digital chest radiography: Focusing on bureau of radiological health evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Seong Jin [Gammaknife center, Inje University Haeundae Paik Hospital, Busan (Korea, Republic of); Im, In Chul [Dept. of Radiological Science, Dongeui University, Busan (Korea, Republic of); Cho, Ji Hwan [Dept. of Health Care Clinic, Inje University Busan Paik Hospital, Busan (Korea, Republic of)

    2017-03-15

    Visual evaluation of chest radiograph images is the most practical and effective method. This study compared the Body Mass Index, waist circumference, and mAs with chest radiographs of 351 women. The Bureau of Radiological Health method was used to evaluate the image quality of chest X-ray images by anatomical and physical methods. The average age of the subjects was 30.17±4.73 and the average waist circumference was 66.91±4.67 cm. The mean Body Mass Index value was 20.21±2.23, the mean value of mAs was 3.04±0.78, and the mean value of Bureau of Radiological Health was 79.83±8.45. When the Body Mass Index value increased, waist circumference and mAs mean value increased. The mean value of Body Mass Index was statistically significant(p<0.05) in Group 4 compared to Groups 1 and 2, with increasing Body Mass Index. Exposure control of the automatic exposure control system is considered to be well performed according to body thickness or Body Mass Index at the time of chest radiography. As the Body Mass Index increases, the thickness of the body increases and the breast thickness of the woman also increases. Therefore, it is considered that the exposure amount is changed by the automatic exposure control device to affect the image quality.

  14. Three-contrast, metal test pattern (Snellen E-plate) in evaluation of imaging techniques in clinical chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Manninen, H.

    A metal test pattern based on a minified Snellen-type E-plate was evaluated in testing six imaging techniques for chest radiography. The device consisted of three contrast zones and it was attached to the patient's back over the right lung during chest radiography. The values for visual detectability of the E-figures were compared with the film scores obtained by grading the radiographs with respect to visibility of diagnostically important anatomic details. The test plate proved to be a simple, quick and reproducible tool for testing several imaging techniques at the same time. The E-plate results were similar to those of the visual grading analysis in most respects. A few discrepancies existed, which were probably due to the inability of the test pattern to fully consider the effect of motion unsharpness and varying scattering conditions within the human thorax, as well as to great differences in roentgen ray absorption properties between Au and tissues. (orig.).

  15. Comparison of visual grading analysis and determination of detective quantum efficiency for evaluating system performance in digital chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Sund, Patrik; Baath, Magnus; Maansson, Lars Gunnar [Department of Radiation Physics, Goeteborg University, 41345 Goeteborg (Sweden); Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, 41345 Goeteborg (Sweden); Kheddache, Susanne [Department of Radiology, Goeteborg University, 41345 Goeteborg (Sweden); Department of Radiology, Sahlgrenska University Hospital, 41345 Goeteborg (Sweden)

    2004-01-01

    A study was conducted to compare physical and clinical system performance in digital chest radiography. Four digital X-ray modalities, two storage-phosphor based systems and two generations of a CCD-based system, were evaluated in terms of both their imaging properties (determination of presampling MTF and DQE) and clinical image quality (grading of the reproduction of anatomical details of 23 healthy volunteers using both absolute and relative visual grading analysis). One of the two storage-phosphor systems performed best in both evaluations and the first generation of the CCD-based system was rated worst; however, the other two systems were ranked differently with the two methods. The newest CCD-based system yielded a higher clinical image quality than the second storage-phosphor system, although the latter presented a DQE substantially higher than the former. The results show that clinical performance cannot be predicted from determinations of DQE alone, and that a system with lower DQE, under the quantum-saturated conditions in chest radiography, can outperform a system with higher DQE if the image processing used on the former is more effective in presenting the information in the image to the radiologist. (orig.)

  16. Dynamic dual-energy chest radiography: a potential tool for lung tissue motion monitoring and kinetic study.

    Science.gov (United States)

    Xu, Tong; Ducote, Justin L; Wong, Jerry T; Molloi, Sabee

    2011-02-21

    Dual-energy chest radiography has the potential to provide better diagnosis of lung disease by removing the bone signal from the image. Dynamic dual-energy radiography is now possible with the introduction of digital flat-panel detectors. The purpose of this study is to evaluate the feasibility of using dynamic dual-energy chest radiography for functional lung imaging and tumor motion assessment. The dual-energy system used in this study can acquire up to 15 frames of dual-energy images per second. A swine animal model was mechanically ventilated and imaged using the dual-energy system. Sequences of soft-tissue images were obtained using dual-energy subtraction. Time subtracted soft-tissue images were shown to be able to provide information on regional ventilation. Motion tracking of a lung anatomic feature (a branch of pulmonary artery) was performed based on an image cross-correlation algorithm. The tracking precision was found to be better than 1 mm. An adaptive correlation model was established between the above tracked motion and an external surrogate signal (temperature within the tracheal tube). This model is used to predict lung feature motion using the continuous surrogate signal and low frame rate dual-energy images (0.1-3.0 frames per second). The average RMS error of the prediction was (1.1 ± 0.3) mm. The dynamic dual energy was shown to be potentially useful for lung functional imaging such as regional ventilation and kinetic studies. It can also be used for lung tumor motion assessment and prediction during radiation therapy.

  17. Evaluation of the effective detective quantum efficiency for various tube voltages with digital radiography for chest imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyo-Min; Kim, Hee-Joung; Park, Hye-Suk; Kim, Dae-Hong; Lee, Chang-Lae; Choi, Yu-Na; Lee, Seung-Wan [Yonsei University, Wonju (Korea, Republic of)

    2011-03-15

    The concept of effective detective quantum efficiency (eDQE) has recently been developed and introduced. The purpose of this study was to use the eDQE to evaluate the effect of tube voltage and grid for chest imaging with a direct flat-panel-based digital radiographic system. The exposure factors that we considered were the tube potential and an anti-scatter moving grid. The incident air kerma was adjusted for each tube potential to yield an effective dose of 34 {mu}Sv. The scatter fraction (SF), transmission fraction (TF), effective modulation transfer function (eMTF), and effective normalized noise power spectrum (eNNPS) were measured using a phantom that simulate the attenuation and scatter properties of the human chest. Our results showed that the resolution properties measured by using eMTFs were independent of the tube potential regardless of whether or not a grid was used. The noise properties through the phantom were greater with the use of an anti-scatter grid than without while the eDQE was largest at a lower tube potential, which we tested without a grid. In conclusion, we measured a high efficiency at a low tube potential without an anti-scatter grid for digital radiography (DR) in chest imaging. The eDQE reflected the real exam environment better than the general DQE because it better reflected the effect of the total X-ray system.

  18. Survey of the Satisfaction and Dissatisfaction of Referring Physicians Concerning the Radiologic Report of Plain Radiography Except for Chest Plain Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Soon Young; Park, Noh Hyuck; Kim, Mi Sung; Park, Chan Sub; Park, Ji Yeon [Dept. of Radiology, Myongji Hospital, Kwandong University College of Medicine, Goyang (Korea, Republic of); Park, Hee Jin [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Sam Soo [Dept. of Radiology, Kangwon National University School of Medicine, Chuncheon (Korea, Republic of); Jeon, Hyun Jun [Dept. of Occupational Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2011-09-15

    To assess the satisfaction, attitude, dissatisfaction and general opinion of radiologic reports on the plain radiography, except for chest plain radiographs. A questionnaire was distributed to the 63 physicians of our hospital. The questionnaire aimed to investigate physician's general attitude, dissatisfaction and opinions. The responses elicited, as well as discrepancies among residents, staff, medical clinicians and surgical clinicians were assessed. Chi-square and t-tests were used to determine the value of the data. The mean rate of satisfaction for the reading report by medical clinicians (64%) was higher than surgical clinicians (25%) (p < 0.001). The mean satisfaction score was 3.1 (2.8-3.61). The main cause for dissatisfaction was the absence of reports when they were needed, especially for residents. The medical clinician's dependence on radiologic reports was higher than that of the surgical clinicians. The satisfaction score was in the middle range and the main cause of dissatisfaction was absence of the reports when they were needed.

  19. The relationship of over density to overexposure each film/screen systems in chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Min; Huo Joon [Korea University, Seoul (Korea, Republic of); Taro, Hayash; Yuji, Ishida; Tatsuya, Sakurai [The Chemotherapeutic Istitute Hospital, Tokyo (Japan)

    1999-06-01

    This study is to calculate the exposed radiation dose using Bit method, NDD calculation method and monogram method without dosimeter. In addition,we can calculate the radiation dose from x-ray film density as a film badge. The authors examined the entrance skin dose from 2 {approx} 3 intercostal chest x-ray film density. We also studied the relationship between film density and equivalent dose in the each screen film system under the different radiation quality and the poor geometry condition of grid ratio. As results, we established the deductive method to define the entrance skin dose from chest x-ray film density. The error range was found in the range -13 percent {approx} +17 percent for between deductive entrance skin dose and the 2 {approx} 3 inter coastal chest x-ray film density to actual detective radiation dose with dosimeter. (author)

  20. Survey of the Use of X-ray Beam Collimator and Shielding Tools during Infant Chest Radiography

    Directory of Open Access Journals (Sweden)

    Vahid Karami

    2016-04-01

    Full Text Available Background The use of shielding tools and X-ray beam collimator has extensively been advocated as effective methods to reduce radiation exposure to patients underwent radiological procedures. The aim of this study was to address the use of these protection measures during infant chest radiography. Material and Methods 348digital and/or analogue infant chest radiographs were reviewed that performed between October-  and December 2015 at four main hospitals of Khuzestan-Iran province to assessment the beam collimation. For each radiograph the area between current and acceptable collimation was calculated. Thirty eight radiographers were deeply interviewed to investigate the actual use of shielding tools and the main reasons for not using of them. Results Only 54 (15.5% radiographs [33(61% analogues and 21(39% digital] have satisfactory collimation. The total means area of diagnostic interest (ADI and the region outside ADI for each radiograph was estimated 171 and 86 cm2, respectively. The irradiated region outside the ADI was significantly larger in digital than in analogue images (mean of 103 cm2 vs. 54 cm2; P < 0.05. Shielding tools were used regularly only by 5% of radiographers. Conclusion The radiosensitive organs of infants located outside of ADI in hospitals investigated are at risk. Adherence to safety guideline urgently recommends.

  1. Comparison of Computed Tomography and Chest Radiography in the Detection of Rib Fractures in Abused Infants

    Science.gov (United States)

    Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; Walton, John W.; Rosas, Angela J.; Coulter, Kevin P.; Rogers, Kristen K.

    2008-01-01

    Purpose: Chest radiographs (CXR) are the standard method for evaluating rib fractures in abused infants. Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants. Methods: This retrospective study included all 12 abused infants…

  2. Detection of tuberculosis with digital chest radiography: automatic reading versus interpretation by clinical officers

    NARCIS (Netherlands)

    Maduskar, P.; Muyoyeta, M.; Ayles, H.; Hogeweg, L.E.; Peters-Bax, L.; Ginneken, B. van

    2013-01-01

    SETTING: A busy urban health centre in Lusaka, Zambia. OBJECTIVE: To compare the accuracy of automated reading (CAD4TB) with the interpretation of digital chest radiograph (CXR) by clinical officers for the detection of tuberculosis (TB). DESIGN: A retrospective analysis was performed on 161

  3. Sensitivity and specificity of perfusion scintigraphy combined with chest radiography for acute pulmonary embolism in PIOPED II.

    Science.gov (United States)

    Sostman, H Dirk; Miniati, Massimo; Gottschalk, Alexander; Matta, Fadi; Stein, Paul D; Pistolesi, Massimo

    2008-11-01

    We used the archived Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) data and images to test the hypothesis that reading perfusion scans with chest radiographs but without ventilation scans, and categorizing the perfusion scan as "pulmonary embolism (PE) present" or "PE absent," can result in clinically useful sensitivity and specificity in most patients. Patients recruited into PIOPED II were eligible for the present study if they had a CT angiography (CTA) or digital subtraction angiography (DSA) diagnosis, an interpretable perfusion scan and chest radiographs, and a Wells' score. Four readers reinterpreted the perfusion scans and chest radiographs of eligible patients. Two readers used the modified PIOPED II criteria and 2 used the Prospective Investigative Study of Pulmonary Embolism Diagnosis (PISAPED) criteria. The chest radiographs were read as "normal/near normal," "abnormal," or "nondiagnostic," and the perfusion scans were read as "PE present," "PE absent," or "nondiagnostic." The primary analysis used a composite reference standard: the PIOPED II DSA result or, if there was no definitive DSA result, CTA results that were concordant with the Wells' score as defined in PIOPED II (CTA positive and Wells' score > 2, or CTA negative and Wells' score PIOPED II criteria, the sensitivity of a "PE present" perfusion scan was 84.9% (95% confidence interval [CI], 80.1%-88.8%), and the specificity of "PE absent" was 92.7% (95% CI, 91.1%-94.1%), excluding "nondiagnostic" results, which occurred in 20.6% (95% CI, 18.8%-22.5%). Using PISAPED criteria, the sensitivity of a "PE present" perfusion scan was 80.4% (95% CI, 75.9%-84.3%) and the specificity of "PE absent" was 96.6% (95% CI, 95.5%-97.4%), whereas the proportion of patients with "nondiagnostic" scans was 0% (95% CI, 0.0%-0.2%). Perfusion scintigraphy combined with chest radiography can provide diagnostic accuracy similar to both CTA and ventilation-perfusion scintigraphy, at lower cost

  4. Application of off-line image processing for optimization in chest computed radiography using a low cost system.

    Science.gov (United States)

    Muhogora, Wilbroad E; Msaki, Peter; Padovani, Renato

    2015-03-08

     The objective of this study was to improve the visibility of anatomical details by applying off-line postimage processing in chest computed radiography (CR). Four spatial domain-based external image processing techniques were developed by using MATLAB software version 7.0.0.19920 (R14) and image processing tools. The developed techniques were implemented to sample images and their visual appearances confirmed by two consultant radiologists to be clinically adequate. The techniques were then applied to 200 chest clinical images and randomized with other 100 images previously processed online. These 300 images were presented to three experienced radiologists for image quality assessment using standard quality criteria. The mean and ranges of the average scores for three radiologists were characterized for each of the developed technique and imaging system. The Mann-Whitney U-test was used to test the difference of details visibility between the images processed using each of the developed techniques and the corresponding images processed using default algorithms. The results show that the visibility of anatomical features improved significantly (0.005 ≤ p ≤ 0.02) with combinations of intensity values adjustment and/or spatial linear filtering techniques for images acquired using 60 ≤ kVp ≤ 70. However, there was no improvement for images acquired using 102 ≤ kVp ≤ 107 (0.127 ≤ p ≤ 0.48). In conclusion, the use of external image processing for optimization can be effective in chest CR, but should be implemented in consultations with the radiologists.

  5. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    Energy Technology Data Exchange (ETDEWEB)

    Alandete Germán, Salvador Pascual, E-mail: salaiger@gmail.com; Isarria Vidal, Santiago, E-mail: isarria@comv.es; Domingo Montañana, María Luisa, E-mail: domingo.luimon@gmail.com; De la vía Oraá, Esperanza, E-mail: esviao82@gmail.com; Vilar Samper, José, E-mail: vilarsamper@gmail.com

    2015-03-15

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning.

  6. Measurement of entrance skin dose and estimation of organ dose during pediatric chest radiography.

    Science.gov (United States)

    Kumaresan, M; Kumar, Rajesh; Biju, K; Choubey, Ajay; Kantharia, S

    2011-06-01

    Entrance skin dose (ESD) was measured to calculate the organ doses from the anteroposterior (AP) and posteroanterior (PA) chest x-ray projections for pediatric patients in an Indian hospital. High sensitivity tissue-equivalent thermoluminescent dosimeters (TLD, LiF: Mg, Cu, P chips) were used for measuring entrance skin dose. The respective organ doses were calculated using the Monte Carlo method (MCNP 3.1) to simulate the examination set-up and a three-dimensional mathematical phantom for representing an average 5-y-old Indian child. Using this method, conversion coefficients were derived for translating the measured ESD to organ doses. The average measured ESDs for the chest AP and PA projections were 0.305 mGy and 0.171 mGy, respectively. The average calculated organ doses in the AP and the PA projections were 0.196 and 0.086 mSv for the thyroid, 0.167 and 0.045 mSv for the trachea, 0.078 and 0.043 mSv for the lungs, 0.110 and 0.013 mSv for the liver, 0.002 and 0.016 mSv for the bone marrow, 0.024 and 0.002 mSv for the kidneys, and 0.109 and 0.023 mSv for the heart, respectively. The ESD and organ doses can be reduced significantly with the proper radiological technique. According to these results, the chest PA projection should be preferred over the AP projection in pediatric patients. The estimated organ doses for the chest AP and PA projections can be used for the estimation of the associated risk.

  7. [Conventional radiology, digital radiology with photostimulable phosphor, laser digitalization of thoracic radiographic films at the bedside. A comparative study].

    Science.gov (United States)

    Miceli, M; Stamati, R; Burci, P; Guidarelli, G; Sartoni Galloni, S

    1992-10-01

    The bedside chest images obtained with conventional radiology and with "on line" and "off line" digital modalities were compared to evaluate the respective capabilities in visualizing chest anatomical structures. Seventy patients were submitted to bedside chest examinations with a portable unit; both a conventional film and a digital system (PCR Graphics 1, Philips) with photostimulable phosphor imaging plate were fitted in the radiographic cassette. The former was digitized using an "off line" laser beam unit (FD 2000, Dupont); the latter was subsequently postprocessed by modifying contrast, optical density and spatial frequencies. Thus, 4 different viewing modalities were obtained for each examination: a) conventional radiography; b) standard digital radiography; c) postprocessed digital radiography; d) digitized conventional radiography. Detectability rates of chest anatomical structures were analyzed by 4 independent radiologists on the different images and expressed by a score 1-4. The values were always higher with digital modalities than with the conventional one and the differences were statistically significant (Student's t-test modified by Bonferroni). In particular, the greatest difference was found between c) and a) in retrocardiac lung parenchyma and in skeletal structures, in favour of c). Concerning the comparative adequacy of the various digital modalities, higher detectability rates of chest anatomical structures were obtained with c), but also with b), than with d).

  8. Computerized Classification of Pneumoconiosis on Digital Chest Radiography Artificial Neural Network with Three Stages.

    Science.gov (United States)

    Okumura, Eiichiro; Kawashita, Ikuo; Ishida, Takayuki

    2017-01-20

    It is difficult for radiologists to classify pneumoconiosis from category 0 to category 3 on chest radiographs. Therefore, we have developed a computer-aided diagnosis (CAD) system based on a three-stage artificial neural network (ANN) method for classification based on four texture features. The image database consists of 36 chest radiographs classified as category 0 to category 3. Regions of interest (ROIs) with a matrix size of 32 × 32 were selected from chest radiographs. We obtained a gray-level histogram, histogram of gray-level difference, gray-level run-length matrix (GLRLM) feature image, and gray-level co-occurrence matrix (GLCOM) feature image in each ROI. For ROI-based classification, the first ANN was trained with each texture feature. Next, the second ANN was trained with output patterns obtained from the first ANN. Finally, we obtained a case-based classification for distinguishing among four categories with the third ANN method. We determined the performance of the third ANN by receiver operating characteristic (ROC) analysis. The areas under the ROC curve (AUC) of the highest category (severe pneumoconiosis) case and the lowest category (early pneumoconiosis) case were 0.89 ± 0.09 and 0.84 ± 0.12, respectively. The three-stage ANN with four texture features showed the highest performance for classification among the four categories. Our CAD system would be useful for assisting radiologists in classification of pneumoconiosis from category 0 to category 3.

  9. Aspects of radiation protection during chest X-radiography; Strahlenhygienische Aspekte bei der Roentgenuntersuchung des Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Seidenbusch, M.C.; Schneider, K. [Dr. von Haunersches Kinderspital, Klinikum der Universitaet Muenchen, Institut fuer Klinische Radiologie - Kinderradiologie, Muenchen (Germany)

    2015-07-15

    Radiation safety in conventional X-ray diagnostics is based on the concepts of justification, optimization of an X-ray examination and limitation of the radiation exposure achieved during the examination. Optimization of an X-ray examination has to be considered as a multimodal process in which all technical components of the X-ray equipment have to be adapted to each other and also have to be adapted to the anthropometric characteristics of patients and the clinical indications. In this article the technical components of a conventional pediatric chest X-radiograph are presented, and recommendations for optimizing chest X-rays in children are provided. The following measures are of prime importance: correct x-ray beam limitation, using the posteroanterior projection when possible and not using anti-scatter grids in children under approximately 8 years old. In pediatric radiology chest x-rays that are taken not at the peak of inspiration can also be of some diagnostic significance. Optimization of an X-ray examination inevitably results in the limitation of radiation exposure. (orig.) [German] Die Strahlenhygiene in der konventionellen radiologischen Diagnostik basiert auf der Trias Rechtfertigung, Optimierung bzw. Limitierung der Roentgenuntersuchung bzw. Strahlenexposition. Die Optimierung einer Roentgenuntersuchung ist als multimodaler Prozess aufzufassen, in welchem saemtliche technische Komponenten der Roentgeneinrichtung sowohl miteinander als auch mit den anthropometrischen Eigenschaften des Patienten und der klinischen Fragestellung abzustimmen sind. Im vorliegenden Beitrag werden die technischen Komponenten bei der konventionellen Roentgenuntersuchung des paediatrischen Thorax in ihrer Beziehung zueinander dargestellt und Empfehlungen fuer eine Optimierung der konventionellen Thoraxaufnahme bei Kindern ausgesprochen. Die wichtigsten Massnahmen bestehen in einer korrekten Einblendung, in der Anfertigung der Aufnahmen im posteroanterioren Strahlengang und im

  10. Bone marrow dose in chest radiography: the posteroanterior vs. anteroposterior projection

    Energy Technology Data Exchange (ETDEWEB)

    Archer, B.R.; Whitmore, R.C.; North, L.B.; Bushong, S.C.

    1979-10-01

    The dose to active bone marrow resulting from anteroposterior (AP) and posteroanterior (PA) chest examinations was estimated using an Alderson Rando phantom and extruded lithium fluoride dosimeters. The AP projections resulted in a mean marrow dose range of 1.9 to 2.6 mrad (0.019 to 0.026 mGy) as compared to doses for PA projections of 3.4 to 3.8 mrad (0.034 to 0.038 mGy) for optimally diagnostic exposures taken at 70, 90, and 120 kVp.

  11. Is HELICS the right way? Lack of chest radiography limits ventilator-associated pneumonia surveillance in Wales

    Directory of Open Access Journals (Sweden)

    Richard Pugh

    2016-08-01

    Full Text Available Introduction: The reported incidence of ventilator-associated pneumonia (VAP in Wales is low compared with surveillance data from other European regions. It is unclear whether this reflects success of the Welsh healthcare-associated infection prevention measures or limitations in the application of European VAP surveillance methods. Our primary aim was to investigate episodes of ventilator-associated respiratory tract infection (VARTI, to identify episodes that met established criteria for VAP, and to explore reasons why others did not, according to the Hospitals in Europe Link for Infection Control through Surveillance (HELICS definitions. Materials and methods: During two 14-day study periods 2012-2014, investigators reviewed all invasively ventilated patients in all 14 Welsh Intensive Care Units (ICUs. Episodes were identified in which the clinical team had commenced antibiotic therapy because of suspected VARTI. Probability of pneumonia was estimated using a modified Clinical Pulmonary Infection Score (mCPIS. Episodes meeting HELICS definitions of VAP were identified, and reasons for other episodes not meeting definitions examined. In the second period, each patient was also assessed with regards to the development of a ventilator-associated event (VAE, according to recent US definitions. Results: The study included 306 invasively ventilated patients; 282 were admitted to ICU for 48 hours or more. 32 (11.3% patients were commenced on antibiotics for suspected VARTI. 10 of these episodes met HELICS definitions of VAP, an incidence of 4.2 per 1000 intubation days. In 48% VARTI episodes, concurrent chest radiography was not performed, precluding the diagnosis of VAP. Mechanical ventilation (16.0 vs. 8.0 days; p=0.01 and ICU stay (25.0 vs. 11.0 days; p=0.01 were significantly longer in patients treated for VARTI compared to those not treated. There was no overlap between episodes of VARTI and of VAE. Discussion: HELICS VAP surveillance

  12. The value of digital tomosynthesis of the chest as a problem-solving tool for suspected pulmonary nodules and hilar lesions detected on chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Galea, Angela, E-mail: galeaangie@gmail.com [Peninsula Radiology Academy, William Prance Road, Plymouth PL65WR (United Kingdom); Dubbins, Paul, E-mail: Paul.dubbins@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Riordan, Richard, E-mail: richardriordan@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Adlan, Tarig, E-mail: tarig.adlan@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Roobottom, Carl, E-mail: carl.roobotoom@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Gay, David, E-mail: davegay@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom)

    2015-05-15

    Graphical abstract: When compared to CXR, DTS has: • Superior resolution • Better assessment of location in the AP dimension (better at locating a pleural or intrapulmonary lesion) • Better characterisation (better at distinguishing between calcified plaque and soft tissue) • Removes composite artefact caused by overlying anatomical structures (such as the ribs or pulmonary vessels) DTS has improved sensitivity, specificity and accuracy when compared to CXR. - Highlights: • DTS is a type of limited angle tomography. Sixty coronal reconstructed images of the chest are produced that combine the superior resolution of radiography with the tomographic benefits of computed tomography. • The sensitivity for detecting a suspected lung lesions is 0.65 with CXR and 0.91 for DTS. • The high specificity of DTS (1) and the high negative predictive value (0.94) are similar to CT and suggest that if the DTS is normal patients do not need further assessment with CT with significant potential dose savings. • 50% of suspected lesions were resolved with CXR, this improved to 96% with DTS. - Abstract: Objectives: To assess the capability of digital tomosynthesis (DTS) of the chest compared to a postero-anterior (PA) and lateral chest radiograph (CXR) in the diagnosis of suspected but unconfirmed pulmonary nodules and hilar lesions detected on a CXR. Computed tomography (CT) was used as the reference standard. Materials and method: 78 patients with suspected non-calcified pulmonary nodules or hilar lesions on their CXR were included in the study. Two radiologists, blinded to the history and CT, prospectively analysed the CXR (PA and lateral) and the DTS images using a picture archiving and communication workstation and were asked to designate one of two outcomes: true intrapulmonary lesion or false intrapulmonary lesion. A CT of the chest performed within 4 weeks of the CXR was used as the reference standard. Inter-observer agreement and time to report the modalities

  13. An artificial neural network for estimating scatter exposures in portable chest radiography.

    Science.gov (United States)

    Lo, J Y; Floyd, C E; Baker, J A; Ravin, C E

    1993-01-01

    An adaptive linear element (Adaline) was developed to estimate the two-dimensional scatter exposure distribution in digital portable chest radiographs (DPCXR). DPCXRs and quantitative scatter exposure measurements at 64 locations throughout the chest were acquired for ten radiographically normal patients. The Adaline is an artificial neural network which has only a single node and linear thresholding. The Adaline was trained using DPCXR-scatter measurement pairs from five patients. The spatially invariant network would take a portion of the image as its input and estimate the scatter content as output. The trained network was applied to the other five images, and errors were evaluated between estimated and measured scatter values. Performance was compared against a convolution scatter estimation algorithm. The network was evaluated as a function of network size, initial values, and duration of training. Network performance was evaluated qualitatively by the correlation of network weights to physical models, and quantitatively by training and evaluation errors. Using DPCXRs as input, the network learned to describe known scatter exposures accurately (7% error) and estimate scatter in new images (< 8% error) slightly better than convolution methods. Regardless of size and initial shape, all networks adapted into radial exponentials with magnitude of 0.75, perhaps implying an ideal point spread function and average scatter fraction, respectively. To implement scatter compensation, the two-dimensional scatter distribution estimated by the neural network is subtracted from the original DPCXR.

  14. High-resolution computed tomography in silicosis: correlation with chest radiography and pulmonary function tests

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Agnaldo Jose [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Pedro Ernesto Univ. Hospital. Dept. of Respiratory Function]. E-mail: phel.lop@uol.com.br; Mogami, Roberto; Capone, Domenico; Jansen, Jose Manoel [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). School of Medical Sciences; Tessarollo, Bernardo [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Dept. of Radiology and Diagnostic Image; Melo, Pedro Lopes de [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. of Biology

    2008-05-15

    Objective: To correlate tomographic findings with pulmonary function findings, as well as to compare chest X-ray findings with high-resolution computed tomography (HRCT) findings, in patients with silicosis. Methods: A cross-sectional study was conducted in 44 non-smoking patients without a history of tuberculosis. Chest X-ray findings were classified according to the International Labour Organization recommendations. Using a semiquantitative system, the following HRCT findings were measured: the full extent of pulmonary involvement; parenchymal opacities; and emphysema. Spirometry and forced oscillation were performed. Pulmonary volumes were evaluated using the helium dilution method, and diffusing capacity of the lung for carbon monoxide was assessed. Results: Of the 44 patients studied, 41 were male. The mean age was 48.4 years. There were 4 patients who were classified as category 0 based on X-ray findings and as category 1 based on HRCT findings. Using HRCT scans, we identified progressive massive fibrosis in 33 patients, compared with only 23 patients when X-rays were used. Opacity score was found to correlate most closely with airflow, DLCO and compliance. Emphysema score correlated inversely with volume, DLCO and airflow. In this sample of patients presenting a predominance of large opacities (75% of the individuals), the deterioration of pulmonary function was associated with the extent of structural changes. Conclusions: In the early detection of silicosis and the identification of progressive massive fibrosis, HRCT scans are superior to X-rays. (author)

  15. An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients.

    Science.gov (United States)

    Rahman, Md Toufiq; Codlin, Andrew J; Rahman, Md Mahfuzur; Nahar, Ayenun; Reja, Mehdi; Islam, Tariqul; Qin, Zhi Zhen; Khan, Md Abdus Shakur; Banu, Sayera; Creswell, Jacob

    2017-05-01

    Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved.A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73-0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses.Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software. More studies are needed to evaluate CAR using different screening approaches. Copyright ©ERS 2017.

  16. Analysis of the impact of digital tomosynthesis on the radiological investigation of patients with suspected pulmonary lesions on chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Quaia, Emilio; Baratella, Elisa; Cernic, Stefano; Lorusso, Arianna; Casagrande, Federica; Cioffi, Vincenzo; Cova, Maria Assunta [University of Trieste (Italy), Department of Radiology, Cattinara Hospital, Trieste (Italy)

    2012-09-15

    To assess the impact of digital tomosynthesis (DTS) on the radiological investigation of patients with suspected pulmonary lesions on chest radiography (CXR). Three hundred thirty-nine patients (200 male; age, 71.19 {+-} 11.9 years) with suspected pulmonary lesion(s) on CXR underwent DTS. Two readers prospectively analysed CXR and DTS images, and recorded their diagnostic confidence: 1 or 2 = definite or probable benign lesion or pseudolesion deserving no further diagnostic workup; 3 = indeterminate; 4 or 5 = probable or definite pulmonary lesion deserving further diagnostic workup by computed tomography (CT). Imaging follow-up by CT (n = 76 patients), CXR (n = 256) or histology (n = 7) was the reference standard. DTS resolved doubtful CXR findings in 256/339 (76 %) patients, while 83/339 (24 %) patients proceeded to CT. The mean interpretation time for DTS (mean {+-} SD, 220 {+-} 40 s) was higher (P < 0.05; Wilcoxon test) than for CXR (110 {+-} 30 s), but lower than CT (600 {+-} 150 s). Mean effective dose was 0.06 mSv (range 0.03-0.1 mSv) for CXR, 0.107 mSv (range 0.094-0.12 mSv) for DTS, and 3 mSv (range 2-4 mSv) for CT. DTS avoided the need for CT in about three-quarters of patients with a slight increase in the interpretation time and effective dose compared to CXR. (orig.)

  17. Utility of Chest Radiography in Emergency Department Patients Presenting with Syncope

    Directory of Open Access Journals (Sweden)

    Matthew L Wong

    2016-11-01

    Full Text Available Introduction Syncope has myriad etiologies, ranging from benign to immediately life threatening. This frequently leads to over testing. Chest radiographs (CXR are among these commonly performed tests despite their uncertain diagnostic yield. The objective is to study the distribution of normal and abnormal chest radiographs in patients presenting with syncope, stratified by those who did or did not have an adverse event at 30 days. Methods We performed a post-hoc analysis of a prospective cohort of consecutive patients presenting to an urban tertiary care academic medical center with a chief complaint of syncope from 2003–2006. The frequency and findings for each CXR were reviewed, as well as emergency department and hospital discharge diagnoses, and 30-day outcome. Results There were 575 total subjects, 39.7% were male, and the mean age was 57.2 (SD 24.6. Of the 575 subjects, 403 (70.1% had CXRs performed, and 116 (20.2% had an adverse event after their syncope. Of the 116 people who had an adverse event, 15 (12.9% had a positive CXR, 81 (69.8% had a normal CXR, and 20 (17.2% did not have a CXR as part of the initial evaluation. Among the 459 people who did not have an adverse event, 3 (0.7% had a positive CXR, 304 (66.2% had a normal CXR, and 152 (33.1% did not have a CXR performed. Fifteen of the 18 patients (83.4% with an abnormal CXR had an adverse event. Eighty-one of the 385 patients (21.0% with a normal CXR had an adverse event. Among those who had a CXR performed, an abnormal CXR was associated with increased odds of adverse event (OR: 18.77 (95% CI= [5.3–66.4]. Conclusion Syncope patients with abnormal CXRs are likely to experience an adverse event, though the majority of CXRs performed in the work up of syncope are normal.

  18. Detection of tuberculosis using digital chest radiography: automated reading vs. interpretation by clinical officers.

    Science.gov (United States)

    Maduskar, P; Muyoyeta, M; Ayles, H; Hogeweg, L; Peters-Bax, L; van Ginneken, B

    2013-12-01

    A busy urban health centre in Lusaka, Zambia. To compare the accuracy of automated reading (CAD4TB) with the interpretation of digital chest radiograph (CXR) by clinical officers for the detection of tuberculosis (TB). A retrospective analysis was performed on 161 subjects enrolled in a TB specimen bank study. CXRs were analysed using CAD4TB, which computed an image abnormality score (0-100). Four clinical officers scored the CXRs for abnormalities consistent with TB. We compared the automated readings and the readings by clinical officers against the bacteriological and radiological results used as reference. We report here the area under the receiver operating characteristic curve (AUC) and kappa (κ) statistics. Of 161 enrolled subjects, 97 had bacteriologically confirmed TB and 120 had abnormal CXR. The AUCs for CAD4TB and the clinical officers were respectively 0.73 and 0.65-0.75 in comparison with the bacteriological reference, and 0.91 and 0.89-0.94 in comparison with the radiological reference. P values indicated no significant differences, except for one clinical officer who performed significantly worse than CAD4TB (P < 0.05) using the bacteriological reference. κ values for CAD4TB and clinical officers with radiological reference were respectively 0.61 and 0.49-0.67. CXR assessment using CAD4TB and by clinical officers is comparable. CAD4TB has potential as a point-of-care test and for the automated identification of subjects who require further examinations.

  19. Pulmonary infections in the late period after allogeneic bone marrow transplantation: chest radiography versus computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Schueller, Gerd [Department of Radiology, University Hospital Vienna, Waehringer Guertel 18-20/7F, A-1090 Vienna (Austria)]. E-mail: gerd.schueller@univie.ac.at; Matzek, Wolfgang [Department of Radiology, University Hospital Vienna, Waehringer Guertel 18-20/7F, A-1090 Vienna (Austria); Kalhs, Peter [Department of Internal Medicine I, University of Vienna Medical School (Austria); Schaefer-Prokop, Cornelia [Department of Radiology, University Hospital Vienna, Waehringer Guertel 18-20/7F, A-1090 Vienna (Austria)

    2005-03-01

    Purpose: To analyze the capabilities of chest roentgenogram (CXR) and computed tomography (CT) in the evaluation of pulmonary infectious disease in the late period (>100 days) after allogeneic bone marrow transplantation (BMT). Methods: Ninety-four matched CXR and CT examinations were performed for clinical suspicion of infectious lung disease. The time gap between CXR and CT was 48 h at maximum. The image pairs were correlated with the patients' clinical course and with the results of diagnostic bronchoalveolar lavage (BAL). An unremarkable clinical course over the subsequent seven days after imaging and/or negative microbiological culture served as the basis for excluding infectious lung disease. Positive microbiological culture and/or improvement of symptoms after antibiotic therapy were considered as evidence of infectious disease. Results: The correlation with the clinical course and/or BAL revealed a significantly higher sensitivity, negative predictive value, and accuracy for CT than for CXR (89% versus 58%, P < 0.0001; 78% versus 47%, P < 0.0001; 90% versus 68%, P < 0.0001, respectively). CT was significantly more diagnostic in BAL verified fungal and bacterial infections (P < 0.05). Conclusion: CT is significantly superior to CXR in the evaluation of infectious pulmonary disease in the late phase after BMT. Therefore, an unremarkable CXR should be followed by a CT scan to reliably detect or to accurately exclude early pulmonary infection in these patients.

  20. Sex determination based on a thoracic vertebra and ribs evaluation using clinical chest radiography.

    Science.gov (United States)

    Tsubaki, Shun; Morishita, Junji; Usumoto, Yosuke; Sakaguchi, Kyoko; Matsunobu, Yusuke; Kawazoe, Yusuke; Okumura, Miki; Ikeda, Noriaki

    2017-07-01

    Our aim was to investigate whether sex can be determined from a combination of geometric features obtained from the 10th thoracic vertebra, 6th rib, and 7th rib. Six hundred chest radiographs (300 males and 300 females) were randomly selected to include patients of six age groups (20s, 30s, 40s, 50s, 60s, and 70s). Each group included 100 images (50 males and 50 females). A total of 14 features, including 7 lengths, 5 indices for the vertebra, and 2 types of widths for ribs, were utilized and analyzed for sex determination. Dominant features contributing to sex determination were selected by stepwise discriminant analysis after checking the variance inflation factors for multicollinearity. The accuracy of sex determination using a combination of the vertebra and ribs was evaluated from the selected features by the stepwise discriminant analysis. The accuracies in each age group were also evaluated in this study. The accuracy of sex determination based on a combination of features of the vertebra and ribs was 88.8% (533/600). This performance was superior to that of the vertebra or ribs only. Moreover, sex determination of subjects in their 20s demonstrated the highest accuracy (96.0%, 96/100). The features selected in the stepwise discriminant analysis included some features in both the vertebra and ribs. These results indicate the usefulness of combined information obtained from the vertebra and ribs for sex determination. We conclude that a combination of geometric characteristics obtained from the vertebra and ribs could be useful for determining sex. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Evaluation of Image According to Exposure Conditions using Contrast-Detail Phantom for Chest Digital Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Ja [Dept. of Radiologic Tecnology, Dongnam Health College, Suwon (Korea, Republic of); Kim, You Hyun; Kim, Chang Nam [Dept. of Radiological Science, College of Health Science, Korea University, Seoul (Korea, Republic of); Kim, Chang Nam; Lee, Chang Yeob; Park, Kye Yeon [Dept. of Diagnostic Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2009-03-15

    To find out proper photographing conditions in the chest DR imaging, the evaluation of images using the C-D phantom was carried out on relationship of identification capability, graininess, and exposure ratio. The conclusions were obtained as follows. 1. The patient's entrance skin Exposure (ESE) was decreased as tube voltage was increased. 2. According to the tube voltage change, the C-D phantom's identification capability of the exposure conditions was most visible at 110 kVp. 3. The identification capability according to the exposure ratio (mAs) change was most visible at 90 kVp for 0.5 times of low exposure ratio and at 110 kVp for 1.5 times. Therefore, it is known that the images were able to be better identified at a high exposure than a low exposure. 4. The graininess according to the exposure ratio at tube voltage of 110 kVp resulted in the best thing at 1.5 times of ratio when the exposure ratio was 1.5 times increased and the tube voltage was changed, the graininess showed the best result at 110 kVp. Therefore, the patient's exposure dose was low when kVp was increased and the adequate kVp was found to be 110. The image was better identified when exposure ratio was 1.5 times compared to 1.0 times. The graininess was also good when the exposure ratio became 1.5 times. The tube voltage was good at 110 kVp. However, once the exposure ratio is increased, the amount of radiation dose that the patients received get increased, so that the exposure condition has to be thoroughly considered.

  2. Basic imaging properties of an indirect flat-panel detector system employing irradiation side sampling (ISS) technology for chest radiography: comparison with a computed radiographic system.

    Science.gov (United States)

    Tanaka, Nobukazu; Yano, Yuki; Yabuuchi, Hidetake; Akasaka, Tsutomu; Sasaki, Masayuki; Ohki, Masafumi; Morishita, Junji

    2013-01-01

    The image quality and potential usefulness for patient skin-dose reduction of a newly developed flat-panel detector (FPD) system employing irradiation side sampling (ISS) were investigated and compared to a conventional computed radiography (CR) system. We used the X-ray beam quality of RQA 9 as noted in the standard evaluation method by the International Electrotechnical Commission 62220-1 to evaluate the image quality of the detector for chest radiography. The presampled modulation transfer function (MTF) of the ISS-FPD system was slightly higher than that of the CR system in the horizontal direction at more than 2.2 cycles/mm. However, the presampled MTF of the ISS-FPD system was slightly lower than that of the CR system in the vertical direction. The Wiener spectrum of the ISS-FPD system showed a 50-65 % lesser noise level than that of the CR system under the same exposure condition. The detective quantum efficiency of the ISS-FPD system was at least twice as great as that of the CR system. We conclude that the ISS-FPD system has the potential to reduce the patient skin dose compared to a conventional CR system for chest radiography.

  3. Assessing the role of routine chest radiography in asymptomatic students during registration at a university in an endemic area of tuberculosis

    Directory of Open Access Journals (Sweden)

    Moifo Boniface

    2012-01-01

    Full Text Available Context: Routine chest radiographs are usually obtained from asymptomatic individuals during routine medical visits probably to detect the presence of occult disease. In sub-Saharan countries tuberculosis is endemic among young individuals; primary tuberculosis might be the most probable occult disease sought for. Aims: The aim was to determine the diagnostic yield and cost-effectiveness of routine chest radiography in an asymptomatic student population in Yaounde during registration at a university. Settings and Design: A cross-sectional descriptive study carried out in a University-affiliated hospital in Yaounde, Cameroon. Materials and Methods: Postero-anterior (PA chest radiographs were obtained from students during a routine medical visit before university admission. Radiographic results were coded as normal, minor, or major findings. The estimated cost per radiograph was that of the study setting at the time of the study. Statistical Analysis Used: Epi Info software version 3.3.2 of February 9 2005 (CDC Atlanta was used for statistical analysis. Results: Of 758 students enrolled, there were 280 males and 478 females (sex ratio 1:2. The mean age of the study population was 21 years (age range 15-33 years. All enrolled cases were asymptomatic. There were 739 normal radiographs (97.5%, while 19 radiographs (2.5 % showed minor abnormalities. No major abnormality was seen. The estimated direct cost of all the radiographs obtained was 3,941,600 F CFA ($ 8,760. Conclusions: Routine chest radiography has a low diagnostic yield in asymptomatic students even in a setting where tuberculosis is endemic, and is therefore not cost-effective.

  4. Comparative evaluation of chest radiography, low-field MRI, the Shwachman-Kulczycki score and pulmonary function tests in patients with cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Anjorin, Angela; Vogl, Thomas J. [Johann Wolfgang Goethe University, Institute for Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Schmidt, Helga [Johann Wolfgang Goethe University, Department of Pediatric Radiology, Institute for Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Posselt, Hans-Georg [Johann Wolfgang Goethe University, Clinics for Pediatry, Gastroenterology, Frankfurt am Main (Germany); Smaczny, Christina [Johann Wolfgang Goethe University, Medical Clinics I, Pneumology, Frankfurt am Main (Germany); Ackermann, Hanns [Johann Wolfgang Goethe University, Department of Biomathematics, Frankfurt am Main (Germany); Deimling, Michael [Siemens Medical Solutions, Erlangen (Germany); Abolmaali, Nasreddin [Dresden University of Technology, OncoRay - Molecular Imaging, Medical Faculty Carl Gustav Carus, Dresden (Germany)

    2008-06-15

    The aim of this study was to investigate whether the parenchymal lung damage in patients suffering from cystic fibrosis (CF) can be equivalently quantified by the Chrispin-Norman (CN) scores determined with low-field magnetic resonance imaging (MRI) and conventional chest radiography (CXR). Both scores were correlated with pulmonary function tests (PFT) and the Shwachman-Kulczycki method (SKM). To evaluate the comparability of MRI and CXR for different states of the disease, all scores were applied to patients divided into three age groups. Seventy-three CF patients (mean SKM score: 62 {+-} 8) with a median age (range) of 14 years (7-32) were included. The mean CN scores determined with both imaging methods were comparable (CXR: 12.1 {+-} 4.7; MRI: 12.0 {+-} 4.5) and showed high correlation (P < 0.05, R = 0.97). Only weak correlations were found between imaging, PFT, and SKM. Both imaging modalities revealed significantly more severe disease expression with age, while PFT and SKM failed to detect early signs of disease. We conclude that imaging of the lung in CF patients is capable of detecting subtle and early parenchymal destruction before lung function or clinical scoring is affected. Furthermore, low-field MRI revealed high consistency with chest radiography and may be used for a thorough follow-up while avoiding radiation exposure. (orig.)

  5. Development of Portable Digital Radiography System with a Device for Monitoring X-ray Source-Detector Angle and Its Application in Chest Imaging

    Directory of Open Access Journals (Sweden)

    Tae-Hoon Kim

    2017-03-01

    Full Text Available This study developed a device measuring the X-ray source-detector angle (SDA and evaluated the imaging performance for diagnosing chest images. The SDA device consisted of Arduino, an accelerometer and gyro sensor, and a Bluetooth module. The SDA values were compared with the values of a digital angle meter. The performance of the portable digital radiography (PDR was evaluated using the signal-to-noise (SNR, contrast-to-noise ratio (CNR, spatial resolution, distortion and entrance surface dose (ESD. According to different angle degrees, five anatomical landmarks were assessed using a five-point scale. The mean SNR and CNR were 182.47 and 141.43. The spatial resolution and ESD were 3.17 lp/mm (157 μm and 0.266 mGy. The angle values of the SDA device were not significantly difference as compared to those of the digital angle meter. In chest imaging, the SNR and CNR values were not significantly different according to the different angle degrees. The visibility scores of the border of the heart, the fifth rib and the scapula showed significant differences according to different angles (p < 0.05, whereas the scores of the clavicle and first rib were not significant. It is noticeable that the increase in the SDA degree was consistent with the increases of the distortion and visibility score. The proposed PDR with a SDA device would be useful for application in the clinical radiography setting according to the standard radiography guidelines.

  6. Follow-up chest radiography in surgical breast cancer patients; La radiografia del torace nel controllo delle pazienti operate per neoplasia della mammella

    Energy Technology Data Exchange (ETDEWEB)

    Coppola, V.; Brunese, L.; Gatta, G. [Neapel Univ., Neapel (Italy). Ist. di Scienze Radiologiche; Coppola, M.; Alfano, L. [Azienda Sanitaria Locale, Salerno (Italy). Unita' Operativa di Chirurgia; Cariello, S. [Azienda Sanitaria Locale, Salerno (Italy). Unita' Operativa di Oncologia Medica; Maioli, A. [Azienda Sanitaria Locale, Salerno (Italy). Unita' Operativa di Radiologia

    1999-10-01

    In this report is investigated to what extent the diagnostic findings of chest radiography can improve prognosis and treatment in surgical breast cancer patients. It is also reviewed the literature and the personal findings to choose the optima follow-up frequency to meet therapeutical and management needs, including radiation protection. [Italian] Scopo dello studio e' verificare l'utilita' e l'efficacia diagnostica della radiografia del torace ai fini del miglioramento prognostico e terapeutico delle pazienti operate per neoplasia mammaria proponendo, anche sulla base dei dati della letteratura, la cadenza di controllo preferibile che consenta di contemperare le esigenze terapeutiche e gestionali, ivi compresi gli obblighi radioprotezionistici.

  7. 精神疾病患者CR胸部CR质量控制方案%Quality Control Program in CR Chest Radiography of Mental Illness Patients

    Institute of Scientific and Technical Information of China (English)

    许光凯; 陈永红; 王斌

    2011-01-01

    Objective To explore CR chest photography of mental illness patients and master the CR technology, and to evaluate the response program function for chest radiographic image quality of menial disorders. Methods 1000 cases of CR chest images of inpatients in brain department in 2009 were collected and evaluated by the four radiologists with more than 5 years of work experience, Results In 1000 cases of mental disorders patients with chest radiography image, class A was 923 leaves, A rate was 92.3%, class B was 62 leaves, B rate was 6.2%, class waste was 15 leaves, and the rale was 1.5%. Coclusion By quality control of CR, characteristics of various types of mental illness condition are identified, and the response program can improve the chest radiographic image quality effectively.%目的:探索精神疾病患者CR胸部CR技术,掌握CR技巧,评价应对方案对精神疾病患者胸部影像图像质量的作用.方法:收集整理某医院2009年度1000例脑科住院患者CR胸片图像,由4位具有5年以上工作经验放射科医师分组进行读片评析.结果:1 000例精神疾病患者胸部CR图像中,甲级片923张,甲级片率92.3%;乙级片62张,乙级片率6.2%;废片巧张,废片率1.5%.结论:通过CR质量控制,明确各类精神疾病患者病情特点,制定的应对方案能有效提高胸部CR影像质量,值得借鉴.

  8. Accuracy of Lung Ultrasonography versus Chest Radiography for the Diagnosis of Adult Community-Acquired Pneumonia: Review of the Literature and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Xiong Ye

    Full Text Available Lung ultrasonography (LUS is being increasingly utilized in emergency and critical settings. We performed a systematic review of the current literature to compare the accuracy of LUS and chest radiography (CR for the diagnosis of adult community-acquired pneumonia (CAP. We searched in Pub Med, EMBASE dealing with both LUS and CR for diagnosis of adult CAP, and conducted a meta-analysis to evaluate the diagnostic accuracy of LUS in comparison with CR. The diagnostic standard that the index test compared was the hospital discharge diagnosis or the result of chest computed tomography scan as a "gold standard". We calculated pooled sensitivity and specificity using the Mantel-Haenszel method and pooled diagnostic odds ratio using the DerSimonian-Laird method. Five articles met our inclusion criteria and were included in the final analysis. Using hospital discharge diagnosis as reference, LUS had a pooled sensitivity of 0.95 (0.93-0.97 and a specificity of 0.90 (0.86 to 0.94, CR had a pooled sensitivity of 0.77 (0.73 to 0.80 and a specificity of 0.91 (0.87 to 0.94. LUS and CR compared with computed tomography scan in 138 patients in total, the Z statistic of the two summary receiver operating characteristic was 3.093 (P = 0.002, the areas under the curve for LUS and CR were 0.901 and 0.590, respectively. Our study indicates that LUS can help to diagnosis adult CAP by clinicians and the accuracy was better compared with CR using chest computed tomography scan as the gold standard.

  9. Three-dimensional reconstructed magnetic resonance imaging for diagnosing persistent left superior vena cava. Comparison with magnetic resonance angiography and plain chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Koito, Hitoshi; Suzuki, Junichi; Ohkubo, Naohiko; Ishiguro, Yuka; Iwasaka, Toshiji; Inada, Mitsuo; Nakano, Yoshihisa [Kansai Medical Univ., Moriguchi, Osaka (Japan)

    1996-09-01

    The usefulness of low-cost, three-dimensional (3D) images reconstructed from magnetic resonance (MR) imaging for investigating persistent left superior vena cava was assessed and compared to the diagnostic accuracy of chest radiography. MR imaging by the spin-echo technique and MR angiography were performed in 10 patients with this anomaly diagnosed previously by contrast echocardiography and radionuclide angiocardiography. Four patients had complicating cardiac anomalies, one with postoperative atrial septal defect, one with postoperative ventricular septal defect, one with atrial septal defect and partial anomalous pulmonary venous return, and one with aortic coarctation and patent ductus arteriosus. Multisectional and multiphasic MR images were used for the 3D-reconstruction of the cardiovascular and mediastinal structures with a NeXT workstation and a 3D-kit. The 3D-reconstructed MR imaging clearly showed the persistent left superior vena cava and the anatomical relationship with the other cardiovascular and mediastinal structures in all 10 patients. Vascular shadows were observed outside the upper left border of the aortic arch on the chest radiographs in seven patients, and the 3D-reconstructed MR images revealed these shadows to be compatible with superior caval vein. The ratios of the diameter between the left and right superior venae cavae with and without the left innominate vein were 0.63{+-}0.14 (mean{+-}SD) and 0.94{+-}0.08, respectively. Three-dimensional reconstructed MR imaging is a useful method for recognizing persistent left superior vena cava and precise examination of the chest radiographs often allowed detection of the vascular shadows caused by this anomaly. (author)

  10. Lung Cancer Risk Following Detection of Pulmonary Scarring by Chest Radiography in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

    Science.gov (United States)

    Yu, Ying-Ying; Pinsky, Paul F.; Caporaso, Neil E.; Chatterjee, Nilanjan; Baumgarten, Mona; Langenberg, Patricia; Furuno, Jon P.; Lan, Qing; Engels, Eric A.

    2010-01-01

    Background Fibrotic scars are frequently found in proximity to lung cancer at the time of cancer diagnosis. However, the nature of the relationship between pulmonary scarring and lung cancer remains uncertain. Our objective was to test whether localized pulmonary scarring is associated with increased lung cancer risk. Methods Cohort analysis of data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. We included 66 863 cancer-free trial participants aged 55 to 74 years, who received a baseline chest radiographic examination and were followed up subsequently for up to 12 years. We used proportional hazards models to estimate hazard ratios (HRs) for lung cancer associated with scarring, adjusting for age, sex, race, and cigarette smoking, and in relation to laterality of scarring. The main outcome measure was incident lung cancer. Results Scarring was present on the baseline chest radiograph for 5041 subjects (7.5%). Scarring was associated with elevated lung cancer risk (809 lung cancer cases [HR, 1.5; 95% confidence interval {CI}, 1.2-1.8]). This association was specific for cancer in the lung ipsilateral to the scar (HR, 1.8; 95% CI, 1.4-2.4) and absent for contralateral cancer (HR, 0.9; 95% CI, 0.7-1.2). Ipsilateral lung cancer risk was elevated throughout the follow-up period (interval-specific HRs, 1.6, 2.0, 2.1, and 1.7 during 0.01-2.00, 2.01-4.00, 4.01-6.00, and 6.01-12.00 years after baseline chest radiography, respectively). Conclusions The relationship between pulmonary scarring and lung cancer was specific to the same lung and extended over time. These findings are consistent with the hypothesis that localized inflammatory processes associated with scarring promote the subsequent development of lung cancer. PMID:19029496

  11. High-resolution computed tomography versus chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis; Avaliacao da tomografia de alta resolucao versus radiografia de torax na doenca intersticial pulmonar na esclerose sistemica

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, Ana Beatriz Cordeiro de; Calderaro, Debora; Moreira, Caio [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Hospital das Clinicas. Servico de Reumatologia; Guimaraes, Silvana Mangeon Meirelles [Gerais Univ., Belo Horizonte, MG (Brazil). Hospital das Clinicas. Secao de Tomografia Computadorizada; Tavares Junior, Wilson Campos; Leao Filho, Hilton Muniz; Andrade, Diego Correa de [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Hospital das Clinicas. Servico de Radiologia e Diagnostico por Imagem]. E-mail: wilsontavaresjrmd@yahho.fr; Ferreira, Cid Sergio; Vieira, Jose Nelson Mendes [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Faculdade de Medicina. Dept. de Radiologia

    2005-04-01

    Objective: To compare the accuracy of high-resolution computed tomography (HRCT) with chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis (SSc). Materials And Methods: HRCT scans and chest radiographs in postero-anterior and lateral views were performed in 34 patients with systemic sclerosis, according to the American College of Rheumatology preliminary criteria for the diagnosis of SSc. The prevalence of radiological findings suggestive of interstitial lung disease in SSc seen on both imaging methods was compared. Results: Interstitial disease was observed on HRCT images of 31 patients (91%) and in the chest radiographs of 16 patients (47%). The most frequent findings observed on HRCT were septal lines (74%), honeycombing (56%) and parenchymal bands (26%). Chest radiographs showed reticular areas of attenuation in 11 patients (32%) and parenchymal distortion in 12% of the patients. In 18 patients (53%) with normal chest radiographs HRCT showed septal lines in 55%, ground glass in 44%, honeycombing in 38.5% and cysts in 33%. Conclusion: HRCT is more sensitive than chest radiography in the evaluation of incipient interstitial lung involvement in patients with SSc and can provide a justification for immunosuppressive therapy in patients with early disease. (author)

  12. Ventilation-perfusion-chest radiography match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent.

    Science.gov (United States)

    Kim, C K; Worsley, D F; Alavi, A

    2000-09-01

    The authors' goal was to determine whether the prevalence of pulmonary embolism in patients with matching ventilation-perfusion (V-Q) defects and chest radiographic opacities differs depending on the degree of perfusion deficit (absent versus decreased). The authors performed a retrospective analysis of the data obtained from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study. In 233 patients, angiograms were of diagnostic quality for 275 lung zones that showed matching V-Q defects and chest radiographic opacities (triple matches). Of these, V-Q scans and chest radiographs from 217 patients with triple matches in 255 lung zones were retrieved and reviewed. Areas corresponding to chest radiographic opacities were scored as having either decreased perfusion or absent perfusion by consensus. Information regarding the presence or absence of pulmonary embolism in corresponding lung zones was obtained from the PIOPED database. The overall prevalence of pulmonary embolism in all lung zones with triple matches was 27% (69 of 255). Of the 255 areas of triple matches, the perfusion was decreased in 153 (60%) and absent in 102 (40%). The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion was 13% (20 of 153) and 48% (49 of 102), respectively (P = 0.0001 by the chi-square test). When these were divided further by lung zones, triple matches with decreased perfusion and triple matches with absent perfusion in the upper-middle lung zone were associated with a prevalence of 0% (O of 44), and 25% (9 of 36), respectively. The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion in the lower lung zone was 18% (20 of 109), and 61% (40 of 66), respectively. A V-Q/chest radiographic match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent. The overall prevalence of pulmonary

  13. The influence of liquid crystal display monitors on observer performance for the detection of interstitial lung markings on both storage phosphor and flat-panel-detector chest radiography

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    Sung, Yon Mi [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-ku, Seoul 135-710 (Korea, Republic of); Department of Radiology, Gachon University Gil Hospital, 1198, Guwol-dong, Namdong-gu, Incheon 405-760 (Korea, Republic of); Chung, Myung Jin [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-ku, Seoul 135-710 (Korea, Republic of)], E-mail: mj1.chung@samsung.com; Lee, Kyung Soo [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-ku, Seoul 135-710 (Korea, Republic of); Choe, Bong-Keun [Department of Preventive Medicine, School of Medicine, Kyunghee University, Seoul (Korea, Republic of)

    2010-04-15

    Purpose: To compare observer performance with a flat-panel liquid crystal display (LCD) monitor and with a high-resolution gray-scale cathode ray tube (CRT) monitor in the detection of interstitial lung markings using a silicon flat-panel-detector direct radiography (DR) and storage phosphor computed radiography (CR) in a clinical setting. Materials and methods: We displayed 39 sets of posteroanterior chest radiographs from the patients who were suspected of interstitial lung disease. Each sets consisted of DR, CR and thin-section CT as the reference standard. Image identities were masked, randomly sorted, and displayed on both five mega pixel (2048 x 2560 x 8 bits) LCD and CRT monitors. Ten radiologists independently rated their confidence in detection for the presence of linear opacities in the four fields of the lungs; right upper, left upper, right lower, and left lower quadrant. Performance of a total 6240 (39 sets x 2 detector systems x 2 monitor system x 4 fields x 10 observers) observations was analyzed by multi-reader multi-case receiver operating characteristic (ROC) analysis. Differences between monitor systems in combinations of detector systems were compared using ANOVA and paired-samples t-test. Results: Area under curves (AUC) for the presence of linear opacities measured by ROC analysis was higher on the LCDs than CRTs without statistical significance (p = 0.082). AUC was significantly higher on the DR systems than CR systems (p = 0.006). AUC was significantly higher on the LCDs than CRTs for DR systems (p = 0.039) but not different for CR systems (p = 0.301). Conclusion: In clinical conditions, performance of the LCD monitor appears to be better for detecting interstitial lung markings when interfaced with DR systems.

  14. To Screen or not to Screen: Low Dose Computed Tomography in Comparison to Chest Radiography or Usual Care in Reducing Morbidity and Mortality from Lung Cancer

    Science.gov (United States)

    Kamdar, Jay; Moats, Austin; Nguyen, Brenda

    2016-01-01

    Lung cancer has the highest mortality rate of all cancers. This paper seeks to address the question: Can the mortality of lung cancer be decreased by screening with low-dose computerized tomography (LDCT) in higher risk patients compared to chest X-rays (CXR) or regular patient care? Currently, CXR screening is recommended for certain high-risk patients. Several recent trials have examined the effectiveness of LDCT versus chest radiography or usual care as a control. These trials include National Lung Screening Trial (NLST), Detection And screening of early lung cancer with Novel imaging TEchnology (DANTE), Lung Screening Study (LSS), Depiscan, Italian Lung (ITALUNG), and Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON study). NLST, the largest trial (n=53, 454), demonstrated a decrease in mortality from lung cancer in the LDCT group (RRR=20%, P=0.004). LSS demonstrated a greater sensitivity in detecting both early stage and any stage of lung cancer in comparison to traditional CXR. Although the DANTE trial yielded data consistent with findings in LSS, it also showed that via LDCT screening a greater proportion of patients were placed under unnecessary surgical procedures. The Depiscan trial yielded a high nodule detection rate at the cost of a high false-positive rate compared to CXR screening. The ITALUNG and NELSON trials demonstrated the early detection capabilities of LDCT for lung cancers compared to usual care without surveillance imaging. False-positive findings with unnecessary workup, intervention, and radiation exposure remain significant concerns for routine LDCT screening. However, current data suggests LDCT may provide a highly sensitive and specific means for detecting lung cancers and reducing mortality. PMID:27375974

  15. 成人胸部适当高电压数字X线摄影试验研究%Optimisation of tube voltage for adult chest digital radiography

    Institute of Scientific and Technical Information of China (English)

    赵永霞; 秦维昌; 黄玲; 张晓晶; 亓恒涛; 刘传亚; 王巍

    2010-01-01

    Objective To explore the optimum voltage for digital chest radiography in adult. Methods PMMAs of Different thickness (7.2, 9.0, 10. 8 and 12. 6 cm) were used to simulate chest of different depth ( 17. 5, 22. 5, 27.0 and 32. 5 cm). The combinants of contrast-detail Cdrad 2.0 phantom and above PMMAs were exposed with automatic exposure control (AEC) and different tube voltages. The images of these combinants were obtained and the entrance surface dose (ESD) was recorded. The imaging quality factor (IQF) was calculated and the curves were drawn between the ESD,IQF and kV. The PMMAs of different thickness, on which a contrast object ( PMAA of 5 cm diameter and 1.8 cm thickness ) was placed, were exposed with the same condition used for above test. Their images were obtained and SNRs were calculated. Results The ESD, SNR and IQFinv of different chest depth decreased with increase of kV.When tube voltages of 70, 100 and 140 kV were used, for 17. 5 cm chest depth, the ESD was 0. 22, 0. 09 and 0. 06 mGy, the IQF was 43.3, 58. 8 and 72. 0, the SNR was 7.5, 6. 2 and 5.0; for 22. 5 cm chest depth, the ESD was 0.37, 0.12 and 0.06 mGy, the IQF was 56. 0, 61.4 and 65.3, the SNR was 6. 4, 5.2 and 3. 8; for 27. 0 cm chest depth, the ESD was 0. 52, 0. 20 and 0. 09 mGy, the IQF was 54. 2, 64. 3 and 91. 0, the SNR was 6. 0, 4. 8 and 3. 5; for 31.5 cm chest depth, the ESD was 0.53, 0.24 and 0. 10 mGy,the IQF was 53.2, 66. 8 and 95.3, the SNR was 5. 7, 4. 5 and 3. 0. Conclusion To balance ESD, SNR and IQF, proper tube voltage should be chosen for chest radiography according to thickness and constitution of patients.%目的 探讨成人胸部不同厚度高千伏DR的适当电压千伏值.方法 用不同厚度的聚甲基丙烯酸甲酯(PMMA)模拟不同成人胸部厚度,用不同电压、自动曝光控制(AEC)摄影,记录入射体表剂量(ESD)、获取模体影像并计算影像质量因子(IQF),绘制ESD和IQF之间的曲线.将一块厚度为1.8 cm(5 cm×5 cm)的PMMA作为对

  16. Efficacy of Increasing Focus to Film Distance (FFD for Patient’s Dose and Image Quality in Pediatric Chest Radiography

    Directory of Open Access Journals (Sweden)

    Vahid Karami

    2016-09-01

    Full Text Available Background: Increasing the x-ray focus to film distance (FFD has been advocated as an effective method to reduce the patients’ radiation dose. The aim of this study was to investigate the efficacy of this technique in patients' dose and image quality in pediatric chest x-ray.Material and methods: Sixty pediatric patients were x-ray imaged at FFDs of 100 and 130 cm. Dose measurements were performed using thermo-luminescent dosimeters (GR200. The quality of images was independently assessed using the anatomical criteria recommended by the European guidelines.Results: Increasing the FFD from 100 to 130 cm has reduced the entrance skin dose (ESD of patients by 32.2% (p 0.05.Conclusion: Increased FFD to 130 cm reduce the pediatric radiation dose with no significant changes in image quality.

  17. Development of profession and quality in radiography with focus on evaluation criteria and image quality of chest x-rays

    DEFF Research Database (Denmark)

    Debess, Jeanne; Thomsen, Henrik; Conradsen, Jacob

    2011-01-01

    Learning Objectives: Learning Objectives: To improve quality of chest xrays by Education Conferences for radiographers and evaluation of image quality. Background: Introduction of digital imaging technology and picture archiving and communication system (PACS) has changed the workflow in the x......-ray department including evaluation of image quality and feedback from radiologist to radiographer. Imaging Findings or Procedure Details: Procedure Details: Data for evaluation of image quality was collected by questionnaires aimed at: anatomy, image-focusing, image-collimation, exposure and body habitus...... collection were found. Evaluation results from anatomy, image-focusing, image-collimation and exposure from first data collection shows variations from 7 % to 37 % between evaluation at primary monitor by the radiographers and diagnostic monitor by the radiologist. In relation to anatomy, the quality...

  18. Effective DQE (eDQE) for monoscopic and stereoscopic chest radiography imaging systems with the incorporation of anatomical noise

    Energy Technology Data Exchange (ETDEWEB)

    Boyce, Sarah J. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 and Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27695 (United States); Choudhury, Kingshuk Roy [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Samei, Ehsan [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Biomedical Engineering, Duke University, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Physics, Duke University, Durham, North Carolina 27705 (United States)

    2013-09-15

    Purpose: Stereoscopic chest biplane correlation imaging (stereo/BCI) has been proposed as an alternative modality to single view chest x-ray (CXR). The metrics effective modulation transfer function (eMTF), effective normalized noise power spectrum (eNNPS), and effective detective quantum efficiency (eDQE) have been proposed as clinically relevant metrics for assessing clinical system performance taking into consideration the magnification and scatter effects. This study compared the metrics eMTF, eNNPS, eDQE, and detectability index for stereo/BCI and single view CXR under isodose conditions at two magnifications for two anthropomorphic phantoms of differing sizes.Methods: Measurements for the eMTF were taken for two phantom sizes with an opaque edge test device using established techniques. The eNNPS was measured at two isodose conditions for two phantoms using established techniques. The scatter was measured for two phantoms using an established beam stop method. All measurements were also taken at two different magnifications with two phantoms. A geometrical phantom was used for comparison with prior results for CXR although the results for an anatomy free phantom are not expected to vary for BCI.Results: Stereo/BCI resulted in improved metrics compared to single view CXR. Results indicated that magnification can potentially improve the detection performance primarily due to the air gap which reduced scatter by ∼20%. For both phantoms, at isodose, eDQE(0) for stereo/BCI was ∼100 times higher than that for CXR. Magnification at isodose improved eDQE(0) by ∼10 times for stereo/BCI. Increasing the dose did not improve eDQE. The detectability index for stereo/BCI was ∼100 times better than single view CXR for all conditions. The detectability index was also not improved with increased dose.Conclusions: The findings indicate that stereo/BCI with magnification may improve detectability of subtle lung nodules compared to single view CXR. Results were improved

  19. Computed Radiography and Computed Tomography of Chest Wall Diseases%胸壁病变的计算机X线摄影和CT检查

    Institute of Scientific and Technical Information of China (English)

    洪庆坚; 李惠民; 肖湘生; 王晨光; 胡爱妹

    2000-01-01

    Purpose: To analyze computed radiography (CR) and computed tomography (CT) findings of diseases of chest wall and to investigate the value of CR and CT in diagnosis of these diseases. Materials and Methods: The findings and diagnoses of 39 cases with proved (by fina needle biopsy, or surgory and/or pathology, of clinical follow up) chest wall disease were analysed retrospectively. Resulte: In 12 infective lesions, including purulent infection (4 cases) and tuberculosis (8 cases), the correct dignosis was made in 4cases by CR and in 11 cases by CT. In 16 soft tissue tumors, including lipoma (7 cases), fibrosarcoma (4 cases), hemangioma (1 case), neurofibroma (1 case), malignant fibrous histocytoma (1case), aggressive fibromatosis (1 case) and liposarcoma (1 case), the correct diagnosis was made in 3cases by CR and in 14 cases by CT. In 11 bone lesions, including fibrous dysplasia (7 cases), chondroma (2 cases), myeloma (lcase) and cosinophilic granuloma (1 case), the correct diagnosis was made in 8cases by CR and in 10 cases by CT. Conclusion: CR is useful in the dignosis of chest wall bone diseases. CT is obviously superior to CR for demonstration of all chest wall diseases espacially for soft tissue lesions. CT has definite value for the differentiation of malignant from benign tumore of chest wall, but still has certain limit.%目的:探讨胸壁病变的计算机X线摄影(CR)和CT表现及其诊断价值,提高对胸壁病变的认识。材料和方法:回顾分析经手术病理、穿刺细胞学检查或临床随访资料证实的39例CR和CT资料。结果:感染组12例中(包括化脓性感染4例,胸壁结核8例),CR准确诊断4例,CT诊断11例;软组织肿瘤组16例中(包括脂肪瘤7例,纤维肉瘤4例,血管瘤、神经纤维瘤、恶性纤维组织细胞瘤、侵袭性纤维瘤病和脂肪肉瘤各l例),CR准确诊断3例,CT诊断14例;骨肿瘤和肿瘤样病变组11例中(包括骨纤维异常增殖症7例,软骨瘤2

  20. Modified Chrispin-Norman chest radiography score for cystic fibrosis: observer agreement and correlation with lung function

    Energy Technology Data Exchange (ETDEWEB)

    Jong, P.A. de; Achterberg, J.A.; Kessels, O.A.M.; Beek, F.J. [Department of Radiology, University Medical Center Utrecht, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Ginneken, B. van; Hogeweg, L. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Image Sciences Institute, University Medical Center Utrecht, Utrecht (Netherlands); Terheggen-Lagro, S.W.J. [University Medical Center Utrecht, Wilhelmina Children' s Hospital, Department of Pediatric Pulmonology, Utrecht (Netherlands)

    2011-04-15

    To test observer agreement and two strategies for possible improvement (consensus meeting and reference images) for the modified Chrispin-Norman score for children with cystic fibrosis (CF). Before and after a consensus meeting and after developing reference images three observers scored sets of 25 chest radiographs from children with CF. Observer agreement was tested for line, ring, mottled and large soft shadows, for overinflation and for the composite modified Chrispin-Norman score. Correlation with lung function was assessed. Before the consensus meeting agreement between observers 1 and 2 was moderate-good, but with observer 3 agreement was poor-fair. Scores correlated significantly with spirometry for observers 1 and 2 (-0.72

  1. Comparison of chest radiography and high-resolution computed tomography findings in early and low-grade coal worker's pneumoconiosis.

    Science.gov (United States)

    Savranlar, Ahmet; Altin, Remzi; Mahmutyazicioğlu, Kamran; Ozdemir, Hüseyin; Kart, Levent; Ozer, Tülay; Gündoğdu, Sadi

    2004-08-01

    High-resolution computed tomography (HRCT) is more sensitive than chest X-ray (CXR) in the depiction of parenchymal abnormalities. We aimed to present and compare CXR and HRCT findings in coal workers with and without early and low-grade coal worker's pneumoconiosis (CWP). 71 coal workers were enrolled in this study. All workers were male. The CXR and HRCT of those workers were obtained and graded by two trained readers. HRCT's were graded according to Hosoda and Shida's Japanese classification. After grading, 67 workers with CXR profusion 0/0-2/2 were included in the study. Four patients with major opacity were excluded. Profusion 0/1 to 1/1 cases were accepted as early and profusion 1/2 and 2/2 cases as low-grade pneumoconiosis. Discordance between CXR and HRCT was high. Discordance rate was found higher in the early pneumoconiosis cases with negative CXR than low-grade pneumoconiosis (60, 36 and 8%, respectively). When coal miners with normal CXR were evaluated by HRCT, six out of 10 cases were diagnosed as positive. In low-grade pneumoconiosis group, the number of patients with positive CXR but negative HRCT were low in comparison to patients with CXR negative and early pneumoconiosis findings. Most of the CXR category 0 patients (10/16) were diagnosed as category 1 by HRCT. Eleven cases diagnosed as CXR category 1 were diagnosed as category 0 (7/11) and category 2 (4/11) by HRCT. In CXR category 2 (eight cases), there were four cases diagnosed as category 1 by HRCT. Discordance between CXR and HRCT was high, especially for CXR negative and early pneumoconiosis cases. The role of CXR in screening coal workers to detect early pneumoconiosis findings should be questioned. We suggest using HRCT as a standard screening method instead of CXR to distinguish between normal and early pneumoconiosis.

  2. Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos Accuracy of chest radiography plus electrocardiogram in diagnosis of hypertrophy in hypertension

    Directory of Open Access Journals (Sweden)

    Sergio Marrone Ribeiro

    2012-09-01

    Full Text Available FUNDAMENTO: A radiografia de tórax e o eletrocardiograma (ECG tem sido criticados em razão de sua baixa sensibilidade no diagnóstico da Hipertrofia Ventricular Esquerda (HVE quando comparada ao ecocardiograma. Entretanto, esse exame não está disponível nos centros de atendimento primário para toda a população de hipertensos. OBJETIVO: Avaliar se a radiografia de tórax associada ao eletrocardiograma apresenta acurácia que justifique seu uso na detecção de HVE em hipertensos, bem como a utilidade do índice cardiotorácico e das radiografias oblíquas na avaliação das dimensões das câmaras cardíacas esquerdas. MÉTODOS: Estudo prospectivo realizado em 177 pacientes hipertensos consecutivos, através da radiografia do tórax, eletrocardiograma e ecocardiograma. Testes de acurácia foram utilizados para comparar esses métodos utilizando a ecocardiografia convencional como padrão de referência. RESULTADOS: O índice cardiotorácico mostrou sensibilidade de 17% para o diagnóstico de HVE, somente detectando alterações cardíacas mais acentuadas. As incidências póstero-anterior e perfil tiveram sensibilidade de 52%, aumentando para 54% quando a radiografia de tórax foi associada ao eletrocardiograma. As incidências oblíquas não melhoraram significativamente a acurácia da radiografia de tórax que, por sua vez, apresentou alta especificidade e boa sensibilidade para a detecção do aumento da aorta. Foi interessante notar que essa alteração estava presente em metade dos hipertensos com HVE. CONCLUSÃO: A associação da radiografia de tórax com eletrocardiograma é útil na avaliação inicial de hipertensos para o diagnóstico de hipertrofia ventricular esquerda, especialmente se a ecocardiografia não estiver disponível. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0BACKGROUND: Chest radiography and electrocardiogram have been criticized due to their low sensitivity for Left Ventricular Hypertrophy diagnosis

  3. Chest X-Ray (Chest Radiography)

    Science.gov (United States)

    ... clothing that might interfere with the x-ray images. Women should always inform their physician and x-ray ... small burst of radiation that passes through the body, recording an image on photographic film or a special detector. Different ...

  4. S100A12 is up-regulated in pulmonary tuberculosis and predicts the extent of alveolar infiltration on chest radiography: an observational study

    Science.gov (United States)

    Berrocal-Almanza, Luis C.; Goyal, Surabhi; Hussain, Abid; Klassert, Tilman E.; Driesch, Dominik; Grozdanovic, Zarko; Sumanlatha, Gadamm; Ahmed, Niyaz; Valluri, Vijayalakshmi; Conrad, Melanie L.; Dittrich, Nickel; Schumann, Ralf R.; Lala, Birgit; Slevogt, Hortense

    2016-01-01

    Pulmonary tuberculosis (PTB) results in lung functional impairment and there are no surrogate markers to monitor the extent of lung involvement. We investigated the clinical significance of S100A12 and soluble receptor for advanced glycation end-products (sRAGE) for predicting the extent of lung involvement. We performed an observational study in India with 119 newly diagnosed, treatment naïve, sputum smear positive, HIV-negative PTB patients and 163 healthy controls. All patients were followed-up for six months. Sociodemographic variables and the serum levels of S100A12, sRAGE, esRAGE, HMGB-1, TNF-α, IFN-γ and CRP were measured. Lung involvement in PTB patients was assessed by chest radiography. Compared with healthy controls, PTB patients had increased serum concentrations of S100A12 while sRAGE was decreased. S100A12 was an independent predictor of disease occurrence (OR 1.873, 95%CI 1.212–2.891, p = 0.004). Under DOTS therapy, S100A12 decreased significantly after 4 months whereas CRP significantly decreased after 2 months (p < 0.0001). Importantly, although CRP was also an independent predictor of disease occurrence, only S100A12 was a significant predictor of lung alveolar infiltration (OR 2.60, 95%CI 1.35–5.00, p = 0.004). These results suggest that S100A12 has the potential to assess the extent of alveolar infiltration in PTB. PMID:27539060

  5. The research of optimizing exposure factors in digital chest radiography%数字X线胸部摄影适宜检查参数的研究

    Institute of Scientific and Technical Information of China (English)

    孙建忠; 王志康; 章伟敏; 蔡劲松

    2010-01-01

    目的 探讨DR胸部摄影的适宜检查参数.方法 选择73、90、125 kV分别代表低、亚高、高kV,分别选择感度200、400、800以及各级感度±4微调,使用自动曝光控制(AEC)模式对内嵌有CDRAD 2.0的胸部体模曝光,记录每次曝光的剂量面积值(DAP).应用CDRAD 2.0配套分析软件Artinis CDRAD Analyzer 1.1自动分析每次曝光的图像质量(IQFinv)值.选择10名志愿者进行73 kV,S800-2;90 kV,S800+2;125 kV,S400+2,3种组合曝光,由2名医师进行评分,记录其DAP值,所得数据应用SPSS12.0软件进行单因素方差分析.结果 (1)3种组合志愿者曝光图像质量评分73、90、125 kV分别为(2.7±0.5)、(2.9±0.3)、(2.8±0.4)分,差异无统计学意义(F=0.587,P>0.05).73、90、125 kV的DAP分别为(29.1±7.9)、(30.5±4.5)、(40.4±7.6)mGy·cm2,差异有统计学意义(F=9.803,P<0.01).(2)3种kV体模曝光DAP值随着感度的增高而下降.每级感度间,DAP值相差11%;相同感度等级,DAP值73 kV>90 kV>125 kV.(3)3种kV体模曝光IQFinv 值均随着感度的增高而下降,相同曝光剂量下,IQFinv值73 kV>90 kV>125 kV.结论 90 kV与感度S800+2~S800+4组合是DR胸部X线摄影较为适宜的检查参数.%Objective To explore the optimum exposure factors in digital chest radiography.Methods Chest phantom was exposed under auto exposure control model with 73, 90, 125kV and S200,400,800 plus or minor 4 micro-adjust for each sensitivity grade. Meanwhile dose area product (DAP) was recorded and the value of IQFinv was analyzed automatically by Artinis CDRAD Analyzer 1.1. Ten volunteers were exposed with 73 kV, S800 - 2; 90 kV, S800 + 2 and 125 kV, S400 + 2. Two radiologists evaluated and scored image quality. Statistical analysis was performed using one way ANOVA test by SPSS 12. 0. Results ( 1 ) The quality scores of volunteers' images obtained with three combinations of exposure factors were 2. 7 ± 0. 5 for 73 kV group, 2. 9 ± 0. 3 for 90 kV group and 2. 8 ± 0. 4 for

  6. X射线胸部摄影曝光剂量与图像质量相关性研究%Study on correlation between exposure dose and image quality of X-ray chest radiography

    Institute of Scientific and Technical Information of China (English)

    曹允希; 蔡小涛; 谢晋东; 曹鑫

    2014-01-01

    Objective To investigate optimal radiation dose for digital radiography by researching the correlation between radiation dose and image quality of high kV chest radiography.Methods The kV of chest radiography was setted on 120 kV while mAs was changed.The chest radiography phantom and the contrast detail phantom CDRAD2.0 were exposed by DR with different mAs from 1 to 25 mAs.The entrance doses were measured for all exposures and the images were read independently by 5 observers on a higher resolution monitor of diagnosis work station.The image quality figure (IQF) was measured for each image.Comparison of the mean IQFs with different exposure doses were conducted in order to determined which was the optimal exposure condition for high kV radiography.The image quality of normal adult using different mAs,4 and 10 mAs for high KV chest radiography was compared.Results When the mAs was increased from 1 to 25 mAs,the entrance doses varied from 0.067 to 1.468 mGy.With the entrance doses increasing,the value of IQF was decreased (F =31.00,P < 0.05).The values of IQF were statistically different between 1 and 4 mAs(F =15.3,P <0.05),and between 10 and 25 mAs(F =9.74,P <0.05).At 4 and 10 mAs with the entrance dose 0.250 and 0.606 mGy,the synthesis score of chest high kV radiography from two kinds of exposure dose was (24.8 ± 1.64),(25.8 ± 2.05),with no statistically significant difference.Conclusions For digital radiography,increasing radiation dose can improve image information.The optimal entrance dose of high kV chest radiography for standard body was about 0.250 mGy.%目的 研究数字化X射线胸部高千伏摄影曝光剂量与图像质量的关系,确定数字化X射线摄影最佳曝光剂量.方法 选择胸部高千伏摄影管电压120 kV,摄影mAs从1 mAs逐档增加至25 mAs,对模拟人体胸部厚度摄影体模与CDRAD 2.0对比度细节体模进行摄影,测量体模表面X射线入射剂量,由5位观察者独立阅读体模影像,比较任意两

  7. Bedside ultrasound reliability in locating catheter and detecting complications

    Directory of Open Access Journals (Sweden)

    Payman Moharamzadeh

    2016-10-01

    Full Text Available Introduction: Central venous catheterization is one of the most common medical procedures and is associated with such complications as misplacement and pneumothorax. Chest X-ray is among good ways for evaluation of these complications. However, due to patient’s excessive exposure to radiation, time consumption and low diagnostic value in detecting pneumothorax in the supine patient, the present study intends to examine bedside ultrasound diagnostic value in locating tip of the catheter and pneumothorax. Materials and methods: In the present cross-sectional study, all referred patients requiring central venous catheterization were examined. Central venous catheterization was performed by a trained emergency medicine specialist, and the location of catheter and the presence of pneumothorax were examined and compared using two modalities of ultrasound and x-ray (as the reference standard. Sensitivity, specificity, and positive and negative predicting values were reported. Results: A total of 200 non-trauma patients were included in the study (58% men. Cohen’s Kappa consistency coefficients for catheterization and diagnosis of pneumothorax were found as 0.49 (95% CI: 0.43-0.55, 0.89 (P<0.001, (95% CI: 97.8-100, respectively. Also, ultrasound sensitivity and specificity in diagnosing pneumothorax were 75% (95% CI: 35.6-95.5, and 100% (95% CI: 97.6-100, respectively. Conclusion: The present study results showed low diagnostic value of ultrasound in determining catheter location and in detecting pneumothorax. With knowledge of previous studies, the search still on this field.   Keywords: Central venous catheterization; complications; bedside ultrasound; radiography;

  8. Neural network-based detection of pulmonary nodules on chest radiography; Identificazione mediante reti neurali dei noduli polmonari nel radiogramma del torace

    Energy Technology Data Exchange (ETDEWEB)

    Coppini, G. [Consiglio Nazionale delle Ricerche, Pisa (Italy). Ist. di Fisiologia Patologica; Valli, G. [Florence Univ., Florence (Italy). Dipt. di Ingegneria Elettronica; Falchini, M.; Stecco, A.; Bindi, A.; Carmignani, L. [Florence Univ., Florence (Italy). Dipt. di Fisiopatologia Clinica, Sezione di Radiodiagnostica

    1999-10-01

    In this report are investigated the capabilities of an artificial neural network-based Computer-Aided Diagnosis (CAD) system in improving early detection of pulmonary nodules on chest radiographs. [Italian] Valutazione di un sistema di riconoscimento automatico basato sulla tecnologia delle reti neruali artificiali per migliorare le possibilita' di rivelazione precoce dei noduli polmonari sul radiogramma toracico.

  9. Fully automatic lung segmentation and rib suppression methods to improve nodule detection in chest radiographs.

    Science.gov (United States)

    Soleymanpour, Elaheh; Pourreza, Hamid Reza; Ansaripour, Emad; Yazdi, Mehri Sadooghi

    2011-07-01

    Computer-aided Diagnosis (CAD) systems can assist radiologists in several diagnostic tasks. Lung segmentation is one of the mandatory steps for initial detection of lung cancer in Posterior-Anterior chest radiographs. On the other hand, many CAD schemes in projection chest radiography may benefit from the suppression of the bony structures that overlay the lung fields, e.g. ribs. The original images are enhanced by an adaptive contrast equalization and non-linear filtering. Then an initial estimation of lung area is obtained based on morphological operations and then it is improved by growing this region to find the accurate final contour, then for rib suppression, we use oriented spatial Gabor filter. The proposed method was tested on a publicly available database of 247 chest radiographs. Results show that this method outperformed greatly with accuracy of 96.25% for lung segmentation, also we will show improving the conspicuity of lung nodules by rib suppression with local nodule contrast measures. Because there is no additional radiation exposure or specialized equipment required, it could also be applied to bedside portable chest x-rays. In addition to simplicity of these fully automatic methods, lung segmentation and rib suppression algorithms are performed accurately with low computation time and robustness to noise because of the suitable enhancement procedure.

  10. Image quality of a Konica Regius 336 digital system in chest radiography; Qualita' dell'immagine di un sistema digitale Konica Regius 336 per radiologia toracica

    Energy Technology Data Exchange (ETDEWEB)

    Ostinelli, A.; Frigerio, M.; Monti, A.F.; Gelosa, S.; Tognoli, P.; Perniola, N. [Azienda Ospedaliera S. Anna, Como (Italy). Servizio di Fisica Sanitaria; Gozzi, G. [Azienda Ospedaliera S. Anna, Como (Italy). Servizio di Radiologia

    2000-06-01

    Digital radiographic systems permit to optimize execution, depiction and storage of radiological images. Since a Regius 336 digital system (Konica Corp. Tokyo, Japan) devoted to chest radiography Department of S. Anna Hospital in Como, Italy, it was investigated its performance relative to image quality. Konica Regius 336 is a computed radiography system made of a phosphorescence detector plate which is scanned with an infrared semiconductor laser beam. The radiographic image obtained from the detector is subjected to image processing, which allows a stable output and the nonlinear curve typical of conventional radiographic systems. Image quality was assessed based on the following parameters: dose, contrast, noise and spatial resolution. As reference, it was assessed the same parameters on a Cronex 88 analogic chest-changer (DuPont Pharma, North Billerica, Mass, USA). The Regius 336 air kerma values were always higher than the analogic ones (about 10%), both with and without a chest phantom; noise was also greater than in analogic images, sometimes even doubled. The optical densities of a step wedge and the spatial resolution of the digital chest-changer are independent of the X-ray tube voltage consequent to broader optical latitude. Inversely, the analogic images of the wedges show great optical density variability as a function of the X-ray tube voltage (in a range of 2). The modulation transfer functions of the two systems have the same trend. The performance of the Konica Regius 336 is nearly equivalent to that of an analogic system. The main advantages of the digital system are a standard output, lower consumption of radiographic films, higher productiveness and better image quality standard level. [Italian] I sistemi radiografici digitali offrono la possibilita' di ottimizzare l'esecuzione, la visualizzazione e l'archiviazione dell'immagine radiologica. Poiche' presso il Servizio di Radiologia dell'Azienda Ospedaliera S. Anna

  11. Chest MRI

    Science.gov (United States)

    Nuclear magnetic resonance - chest; Magnetic resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI ... healthy enough to filter the contrast. During the MRI, the person who operates the machine will watch ...

  12. Value of ICU Bedside B-ultrasound and Chest X-ray in the Diagnosis of Traumatic Pneumothorax%重症监护病房床旁B超与胸部X线片检查对创伤性气胸的诊断价值研究

    Institute of Scientific and Technical Information of China (English)

    许庆林; 陈淑娟

    2013-01-01

    目的 比较重症监护病房(ICU)床边B超与胸部X线片检查对创伤性气胸的诊断价值.方法 选取我院ICU收治的84例钝性胸部创伤患者,均行CT检查,随机分为 B超组和X线组,各42例.B超组行床边B超检查,X线组行床边胸部X线片检查,将两组检查结果与CT结果对比.结果 B超组CT检查结果示气胸34例37侧,其中3例为双侧气胸,B超检查结果示气胸26例28侧,其中2例为双侧气胸;X线组CT检查结果示气胸33例35侧,其中2例为双侧气胸,胸部X线片检查结果示气胸25例26侧,其中1例为双侧气胸.B超组和X线组敏感度、特异度、阳性预测值、阴性预测值、准确度比较,差异均无统计学意义(P>0.05).结论 ICU床边B超与胸部X线片诊断气胸敏感性、特异性无显著差异,B超检查方便、无创、可动态观察,方便实用.%Objective To investigate the value of bedside ultrasonography and chest X - ray in the diagnosis of pneumothorax. Methods 84 patients with blunt chest trauma admitted to the ICU of our hospital were given CT examination and were randomly divided into B - ultrasonography group and X - ray group with each group 42 cases. B - ultrasonography group was given bedside B - ultrasonography examination while X - ray group was given bedside chest X - ray examination. The results of the two groups were compared with the CT results. Results In B - ultrasonography group, CT examination results showed 37 sides of pneumothorax in 34 cases and 3 cases were bilateral pneumothorax. While B - ultrasonography examination results showed 28 sides of pneumothorax in 26 cases and 2 cases were bilateral pneumothorax. In X - ray group, CT examination results showed 35 sides of pneumothorax in 33 cases and 2 cases were bilateral pneumothorax. While X - ray examination results showed 26 sides of pneumothorax in 25 cases and one case were bilateral pneumothorax. The sensitivity, specificity, positive predictive value, negative predictive

  13. Chest wall, lung, and pleural space trauma.

    Science.gov (United States)

    Miller, Lisa A

    2006-03-01

    Chest radiographs frequently underestimate the severity and extent of chest trauma and, in some cases, fail to detect the presence of injury. CT is more sensitive than chest radiography in the detection of pulmonary, pleural, and osseous abnormalities in the patient who has chest trauma. With the advent of multidetector CT (MDCT), high-quality multiplanar reformations are obtained easily and add to the diagnostic capabilities of MDCT. This article reviews the radiographic and CT findings of chest wall, pleural, and pulmonary injuries that are seen in the patient who has experienced blunt thoracic trauma.

  14. Neutron Radiography

    Science.gov (United States)

    Heller, A. K.; Brenizer, J. S.

    Neutron radiography and its related two-dimensional (2D) neutron imaging techniques have been established as invaluable nondestructive inspection methods and quantitative measurement tools. They have been used in a wide variety of applications ranging from inspection of aircraft engine turbine blades to study of two-phase fluid flow in operating proton exchange membrane fuel cells. Neutron radiography is similar to X-ray radiography in that the method produces a 2D attenuation map of neutron radiation that has penetrated the object being examined. However, the images produced differ and are often complementary due to the differences between X-ray and neutron interaction mechanisms. The uses and types of 2D neutron imaging have expanded over the past 15 years as a result of advances in imaging technology and improvements in neutron generators/sources and computers. Still, high-intensity sources such as those from reactors and spallation neutron sources, together with conventional film radiography, remain the mainstay of high-resolution, large field-of-view neutron imaging. This chapter presents a summary of the history, methods, and related variations of neutron radiography techniques.

  15. Automatic hanging protocol for chest radiographs

    Science.gov (United States)

    Luo, Hui; Hao, Wei; Cornelius, Craig

    2005-04-01

    Chest radiography is one of the most widely used techniques in diagnostic imaging. It makes up at least one third of all conventional diagnostic radiographic procedures in hospitals. However, in both film-screen and computed radiography, images are often digitized with the view and orientation unknown or mislabeled, which causes inefficiency in displaying them in the picture archive and communication system (PACS). Hence, the goal of this work is to provide a robust, efficient, and automatic hanging protocol for chest radiographs. To achieve it, the method star ts with recognition by extracting a set of distinctive features from chest radiographs. Next, a well-defined probabilistic classifier is used to train and classify the radiographs. Identifying the orientation of the radiographs is performed by an efficient algorithm which locates the neck, heart, and abdomen positions in radiographs. The initial experiment was performed on radiographs collected from daily routine chest exams in hospitals, and it has shown promising results.

  16. Tuberculous spondylitis presenting as severe chest pain

    Directory of Open Access Journals (Sweden)

    Martha A. Kaeser

    2012-04-01

    Full Text Available This case report describes a 32-year-old male who presented to an emergency department with severe chest pain and a history of cough, fever, night sweats, loss of appetite and weight. Chest radiography revealed a left upper lobe consolidation and multiple compression deformities in the thoracic spine. Magnetic resonance imaging demonstrated significant kyphosis and vertebral plana at two thoracic levels. Anterior compression of the spinal cord and adjacent soft tissue masses were also noted.

  17. Bedside Blood Glucose Monitoring in Hospitals

    National Research Council Canada - National Science Library

    American Diabetes Association

    2004-01-01

    Bedside Blood Glucose Monitoring in Hospitals American Diabetes Association The modern management of hospitalized patients with diabetes includes capillary blood glucose determinations at the bedside...

  18. Bedside ocular ultrasound.

    Science.gov (United States)

    Roque, Pedro J; Hatch, Nicholas; Barr, Laurel; Wu, Teresa S

    2014-04-01

    Many ocular emergencies are difficult to diagnose in the emergency setting with conventional physical examination tools. Additionally, persistent efforts to re-examine the eye may be deleterious to a patient's overall condition. Ultrasound is an important tool because it affords physicians a rapid, portable, accurate, and dynamic tool for evaluation of a variety of ocular and orbital diseases. The importance of understanding orbital anatomy, with attention to the firm attachment points of the various layers of the eye, cannot be understated. This article describes the relevant eye anatomy, delves into the ultrasound technique, and illustrates a variety of orbital pathologies detectable by bedside ultrasound.

  19. Application of mobile digital radiography in chest health examination outside the hospital%车载DR系统在院外大规模胸部健康体检中的应用价值

    Institute of Scientific and Technical Information of China (English)

    俞新华; 黎惠如; 宋敏; 曾庆之

    2014-01-01

    目的:评价车载直接数字摄影技术(DR)在院外大规模胸部健康体检中的应用价值。方法随机抽取我院2012年6~12月车载DR图像和车载传统X线摄影胶片各1000例及同时段车载X线透视1000例受检者的检查结果进行对比、分析图象质量、病变检出率及受检者的受照剂量。结果车载DR图像质量好,清晰度高,DR组甲级片率(64.2%)明显高于传统X线摄影组(43.1%),差异有统计学意义(P<0.05),且废片率为0,优于车载传统X摄影;病变检出率车载DR为7.9%,均比传统X摄影的4.6%及X线透视的3.1%高,差异有统计学意义(P<0.05),且图像可长期保存,便于对照;受检者个人受照剂量车载DR为(0.50±0.04) mGy,明显低于传统X线摄影的(2.35±0.70) mGy和X透视的(8.40±1.08) mGy,差异有统计学意义(P<0.05)。结论车载DR使用灵活、方便、高效,病变检出率高,而且明显降低受检者的照射剂量,安全性高,可作为院外健康体检首选的X影像设备之一。%Objective To analyze the application value of mobile digital radiography (DR) in chest health ex-amination outside the hospital. Methods A comparative study of mobile DR (1 000 cases), mobile traditional X-ray photography (1 000 cases) and fluoroscopy (1 000 cases) from June 2012 to December 2012 were performed to ana-lyze their image quality, detection rate of lesions and exposure dose. Results Mobile DR images were of good quali-ty, with high-definition. Class A piece rate of DR group (64.2%) was significantly higher than that of traditional X-ray photography group (43.1%), P<0.05. The scrap rate of DR group was 0, superior to the traditional X-ray photography group. The lesion detection rate on-board of DR group was 7.9%, significantly higher than traditional X-ray photogra-phy group (4.6%) and X-ray fluoroscopy group (3.1%), P<0.05. And the images of mobile DR can be preserved for a long term and were easy to control. Client

  20. [Chest pain].

    Science.gov (United States)

    Horn, Benedikt

    2015-01-01

    Chest pain in ambulatory setting is predominantly not heart-associated. Most patients suffer from muskuloskeletal or functional (psychogenic) chest pain. Differential diagnosis covers aortic dissection, rib-fracture, shingles, GERD, Tietze-Syndrome, pulmonary embolism, pleuritis, pneumothorax, pleurodynia and metastatic disease. In most cases history, symptoms and signs allow a clinical diagnosis of high pretest-probability.

  1. FLAIL CHEST

    Directory of Open Access Journals (Sweden)

    Anton Crnjac

    2003-12-01

    Full Text Available Background. Major thoracic trauma is consistent with high mortality rate because of associated injuries of vital thoracic organs and dangerous complications. The flail chest occurs after disruption of the skeletal continuity of chest wall and demands because of its pathophysiological complexity rapid and accurate diagnosis and treatment.Conclusions. Basic pathophysiological mechanism of the flail chest is respiratory distress, which is provoked by pulmonary contusions and paradoxical chest wall motion. The treatment should be pointed to improvement and support of respiratory functions and include aggressive pain control, pulmonary physiotherapy and selective mechanical ventilation. Views about operative fixation of the flail chest are still controversial. Neither mortality rate neither long-term disability are improved after operative fixation.

  2. Bedside thoracic ultrasonography of the fourth intercostal space reliably determines safe removal of tube thoracostomy after traumatic injury.

    Science.gov (United States)

    Kwan, Rita O; Miraflor, Emily; Yeung, Louise; Strumwasser, Aaron; Victorino, Gregory P

    2012-12-01

    Thoracic ultrasonography is more sensitive than chest radiography (CXR) in detecting pneumothorax; however, the role of ultrasonography to determine resolution of pneumothorax after thoracostomy tube placement for traumatic injury remains unclear. We hypothesized that ultrasonography can be used to determine pneumothorax resolution and facilitate efficient thoracostomy tube removal. We sought to compare the ability of thoracic ultrasonography at the second through fifth intercostal space (ICS) to detect pneumothorax with that of CXR and determine which ICS maximizes the positive and negative predictive value of thoracic ultrasonography for detecting clinically relevant pneumothorax resolution. A prospective, blinded clinical study of trauma patients requiring tube thoracostomy placement was performed at a university-based urban trauma center. A surgeon performed daily thoracic ultrasonographies consisting of midclavicular lung evaluation for pleural sliding in ICS 2 through 5. Ultrasonography findings were compared with findings on concurrently obtained portable CXR. Of the patients, 33 underwent 119 ultrasonographies, 109 of which had concomitant portable CXR results for comparison. Ultrasonography of ICS 4 or 5 was better than ICS 2 and 3 at detecting a pneumothorax, with a positive predictive value of 100% and a negative predictive value of 92%. The positive and negative predictive values for ICS 2 were 46% and 93% and for ICS 3 were 63% and 92%, respectively. Bedside, surgeon-performed, thoracic ultrasonography of ICS 4 for pneumothorax can safely and efficiently determine clinical resolution of traumatic pneumothorax and aid in the timely removal of thoracostomy tubes. Diagnostic study, level II.

  3. The Bedside Sherlock Holmes

    Science.gov (United States)

    Fitzgerald, Faith T.; Tierney, Lawrence M.

    1982-01-01

    There are a multitude of diagnostic clues contained in clothing, jewelry, possessions and other extracorporeal attachments that each patient brings with him or her to a physician. Because of the emphasis of classic physical diagnosis on the body of a patient solely, and because of modern practices that may have patients stripped of these articles before the first encounter with their physician, these interesting and enlightening findings are often ignored or unavailable. Incorporation of these observations into the panoply of data obtained from the history and physical examination will enhance both the accuracy and adventure of differential diagnosis. Such exercises in observation, moreover, may increase general physical diagnostic skills as well as enliven bedside rounds. PMID:7135953

  4. The bedside Sherlock Holmes.

    Science.gov (United States)

    Fitzgerald, F T; Tierney, L M

    1982-08-01

    There are a multitude of diagnostic clues contained in clothing, jewelry, possessions and other extracorporeal attachments that each patient brings with him or her to a physician. Because of the emphasis of classic physical diagnosis on the body of a patient solely, and because of modern practices that may have patients stripped of these articles before the first encounter with their physician, these interesting and enlightening findings are often ignored or unavailable. Incorporation of these observations into the panoply of data obtained from the history and physical examination will enhance both the accuracy and adventure of differential diagnosis. Such exercises in observation, moreover, may increase general physical diagnostic skills as well as enliven bedside rounds.

  5. Industrial radiographies

    CERN Multimedia

    2005-01-01

    The Radiation Protection group wishes to remind CERN staff responsible for contractors performing X-ray inspections on the CERN sites that the firms must apply the legislation in force in their country of origin, in particular with regard to the prevention of risks relating to ionizing radiation. Industrial radiography firms called on to work on the CERN sites must also comply with the rules laid down in CERN's Radiation Safety Manual and be registered in the relevant CERN database. Since CERN is responsible for safety on its own site, a number of additional rules have been laid down for this kind of work, as set out in Radiation Protection Procedure PRP30 https://edms.cern.ch/file/346848/LAST_RELEASED/PRP30.pdf The CERN Staff Member responsible for the contract shall register the company and issue notification that an X-ray inspection is to be performed via the web interface at the following address: http://cern.ch/rp-radio

  6. [Chest trauma].

    Science.gov (United States)

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe.

  7. Young Woman with a Fever and Chest Pain

    Directory of Open Access Journals (Sweden)

    Kristin H. Dwyer, MD, MPH

    2016-03-01

    Full Text Available A 26-year-old female presented to the emergency department with three days of subjective fevers, dry cough and pleuritic chest discomfort. On exam, her vital signs were significant for a heart rate of 106/minute and oxygen saturation of 95% on room air. Her lung exam revealed decreased breath sounds at the right base. A bedside lung ultrasound and a chest radiograph were performed (Figure 1a, Figure 2, and Video.

  8. Comparison of ultrasonography and radiography in diagnosis of rib fractures.

    Science.gov (United States)

    Pishbin, Elham; Ahmadi, Koorosh; Foogardi, Molood; Salehi, Maryam; Seilanian Toosi, Farrokh; Rahimi-Movaghar, Vafa

    2017-08-01

    Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior (PA) chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared. Sixty-one suspected patients were assessed. The male to female ratio was 2.4:1 (43 men and 18 women) with a mean ± SD age of (44.3 ± 19.7) years. There were totally 59 rib fractures in 38 (62.3%) patients based on radiography and USG, while 23 (37.7%) patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 (54.1%) of 61 suspected patients and radiographs revealed 32 rib fractures in 20 (32.8%) of 61 patients. A total of 58 (98.3%) rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 (45.8%) and 24 (40.7%) rib fractures, respectively. The average duration of USG was (12 ± 3) min (range 7-17 min), whereas the duration of radiography was (27 ± 6) min (range 15-37 min). The kappa coefficient showed a low level of agreement between both USG and PA chest radiography (kappa coefficient = 0.28), and between USG and oblique rib view (kappa coefficient = 0.32). USG discloses more fractures than radiography in

  9. A pilot study evaluating erect chest imaging in children, using the Lodox Statscan digital X-ray machine

    OpenAIRE

    2009-01-01

    ABSTRACT Background: Chest radiography accounts for a significant proportion of ionising radiation in children. The radiation dose of radiographs performed on the Lodox Statscan system has been shown to be lower than that of a computed radiography (CR) system. The role of the Lodox Statscan (hereafter referred to as the Statscan) in routine erect chest radiography in children has not been evaluated. Objective: To evaluate the image quality and diagnostic accuracy of erect paedi...

  10. International Neutron Radiography Newsletter

    DEFF Research Database (Denmark)

    Domanus, Joseph Czeslaw

    1986-01-01

    At the First World Conference on Neutron Radiography i t was decided to continue the "Neutron Radiography Newsletter", published previously by J.P. Barton, as the "International Neutron Radiography Newsletter" (INRNL), with J.C. Doraanus as editor. The British Journal of Non-Destructive Testing...

  11. Increasing mobile radiography productivity.

    Science.gov (United States)

    Wong, Edward; Lung, Ngan Tsz; Ng, Kris; Jeor, Patrick

    2013-01-01

    Mobile radiography using computed radiography (CR) cassettes is a common equipment combination with a workflow bottleneck limited by location of CR readers. Advent of direct digital radiography (DDR) mobile x-ray machines removes this limitation by immediate image review and quality control. Through the use of key performance indicators (KPIs), the increase in efficiency can be quantified.

  12. The Enhanced Workflow and Efficiency of the Wireless Local Area Network (WLAN)-Based Direct Digital Radiography (DDR) Portable Radiography.

    Science.gov (United States)

    Ngan, Tsz-Lung; Wong, Edward Ting-Hei; Ng, Kris Lap-Shun; Jeor, Patrick Kwok-Shing; Lo, Gladys Goh

    2015-06-01

    With the implementation of the PACS in the hospital, there is an increasing demand from the clinicians for immediate access and display of radiological images. Recently, our hospital has installed the first wireless local area network (WLAN)-based direct digital radiography (DDR) portable radiography system. The DDR portable radiography system allows wireless retrieval of modality worklist and wireless transmission of portable X-ray image on the console to the Picture Archiving and Communication System (PACS), via WLAN connection of wireless fidelity (Wi-Fi). The aim of this study was to analyze the workflow and performance between the WLAN-based DDR portable radiography system and the old practice using conventional portable X-ray machine with computed radiography (CR) system. A total of 190 portable chest X-ray examinations were evaluated and timed, using the conventional portable X-ray machine with CR from March to April of 2012 and using the new DDR portable radiography system on December of 2012 (n = 97 for old system and n = 93 for DDR portable system). The time interval of image becoming available to the PACS using the WLAN-based DDR portable radiography system was significantly shorter than that of the old practice using the conventional portable X-ray machine with CR (6.8 ± 2.6 min for DDR portable system; 23 ± 10.2 min for old system; p DDR portable radiography system can enhance the workflow of portable radiography by reduction of procedural steps.

  13. Diagnostic Utility of Chest X-rays in Neonatal Respiratory Distress: Determining the Sensitivity and Specificity

    Directory of Open Access Journals (Sweden)

    Hassan Mottaghi Moghadam shahri

    2014-11-01

    Full Text Available Background: Chest radiography is one of the most usual diagnostic tools for respiratory distress. Objective: The purpose of this study is to assess the specificity, sensitivity and clinical value of chest radiography of neonates with respiratory distress.Patients and Methods: A descriptive- analytical study was conducted on 102 neonates that were in neonatal intensive care unit of Imam Reza and 22 Bahman Hospitals because of respiratory distress. After confirming the neonate's respiratory distress and taking chest radiography, the radiography was described by a radiologist and final diagnosis was confirmed. Results: Most of the neonates (64.7% were born with caesarian section and were premature (78.4%. Respiratory distress syndrome (RDS was the most common reason for respiratory distress (38.2%. Chest radiography had the most sensitivity and specificity in pneumothorax and hernia (100%. For pneumosepsis, radiography had 73% sensitivity and 87% specificity, for RDS the sensitivity and specificity were 35% and 82% respectively, for congenital heart disease sensitivity of zero and specificity of 98% and for Transient tachypnea of neonates (TTN sensitivity of zero and specificity of 100%. The conformity of clinical and radiography was also calculated as 79.4% in respiratory distress Discussion and Conclusion: Although chest radiography is used as one of the most usual and accessible diagnostic tools in respiratory distress syndrome, but inaccurate specificity and sensitivity in some disease must be considered, especially in neonates.

  14. From the Heart: Interatrial Septal Aneurysm Identified on Bedside Ultrasound

    Directory of Open Access Journals (Sweden)

    Michael Butterfield

    2014-09-01

    Full Text Available A 61 year-old man presented to the Emergency Department for one day of nonspecific chest pain. Bedside echocardiogram performed by the emergency physician revealed normal systolic cardiac function but also showed a large ( > 10mm bicornuate interatrial septal aneurysm (IASA projecting into the right atrium (Figure 1, Video 1. There was no evidence of intraatrial thrombus. A formal echocardiogram performed later that day confirmed the diagnosis and also detected a patent foramen ovale (PFO with a left-to-right shunt that reversed with Valsalva maneuver. [West J Emerg Med. 2014;15(6:719–720

  15. Acute, non traumatic patterns in chest radiography of children. Recognition and understanding of radiographic appearances; Akute, nicht traumabedingte Veraenderungen des unteren Respirationstraktes des Kindes im Thoraxroentgen. Erkennen und Verstehen radiologischer Veraenderungen

    Energy Technology Data Exchange (ETDEWEB)

    Puig, S.; Hoermann, M.; Schibany, N.; Ponhold, W. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Sandstroem, S. [Bild o Funktionsdiagnostisk Centrum, Universitetssjukhus, Lund (Sweden)

    2002-03-01

    The diagnosis of acute, non-traumatic diseases of the lower respiratory tract requires exact knowledge of the specific anatomy, physiology and pathology of the pediatric chest. The absolutely and relatively smaller airways, as compared with those of adults, and the undeveloped collateral ventilation result in radiological appearances that are unique in children. Viral pneumonia is predominant only in small children up to an age of 2 years. With increasing age, there is a higher incidence of bacterial pneumonia. The differentiation of viral and bacterial etiology of a pneumonia is not possible on the basis of chest radiographs. In acute pediatric imaging, possible aspiration of foreign bodies has to be considered. Since most foreign bodies cannot be detected radiographically, indirect features such as hyperinflation or mediastinal shifts have to be evaluated. Primary lung tumors are rare in children. More common are metastases with known primary tumors. Neuroblastoma or lymphomas may mimic intrapulmonary pathologies. (orig.) [German] Die Diagnostik akuter, nicht traumabedingter Erkrankungen des unteren Respirationstraktes erfordert genaue Kenntnisse der speziellen Anatomie, Physiologie und Pathologie der kindlichen Lunge. Die absolut und auch relativ kleineren Luftwege im Vergleich zum Erwachsenen, aber auch der noch nicht ausgebildete Kollateralkreislauf fuehren zu pulmonalen Veraenderungen, wie sie nur beim Kind vorkommen. Bei den Pneumonien sind Viren nur bei Kleinkindern bis zum 2. Lebensjahr praedominant. Mit zunehmendem Alter treten Bakterien immer mehr in den Vordergrund. Eine Unterscheidung zwischen viralem und bakteriellem Erreger ist im Thoraxroentgen nicht moeglich. Haeufig ist auch eine fragliche Fremdkoerperaspiration abzuklaeren. Da die meisten Fremdkoerper nicht roentgendicht sind, muss auf indirekte Zeichen wie Ueberblaehung und Mediastinalshift geachtet werden. Primaere pulmonale Tumoren zaehlen zu den Raritaeten. Haeufiger sind Sekundaerblastome

  16. Chest trauma in children: current imaging guidelines and techniques.

    LENUS (Irish Health Repository)

    Moore, Michael A

    2011-09-01

    Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child\\'s clinical condition, and the initial radiographic findings, taking the age-related pretest probabilities of serious injury into account. The principles of as low as reasonably achievable and Image Gently should be followed. The epidemiology and pathophysiology, imaging techniques, characteristic findings, and evidence-based algorithms for pediatric chest trauma are discussed.

  17. National data analysis of general radiography projection method in medical imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Su; Seo, Deok Nam; Choi, In Seok [Dept. of Bio-Convergence Engineering, Korea University Graduate School, Seoul (Korea, Republic of); and others

    2014-09-15

    According to database of medical institutions of health insurance review and assessment service in 2013, 1,118 hospitals and clinics have department of radiology in Korea. And there are CT, fluoroscopic and general radiographic equipment in those hospitals. Above all, general radiographic equipment is the most commonly used in the radiology department. And most of the general radiographic equipment are changing the digital radiography system from the film-screen types of the radiography system nowadays. However, most of the digital radiography department are used the film-screen types of the radiography system. Therefore, in this study, we confirmed present conditions of technical items for general radiography used in hospital and research on general radiographic techniques in domestic medical institutions. We analyzed 26 radiography projection method including chest, skull, spine and pelvis which are generally used in the radiography department.

  18. New computed radiography processing condition for whole-spine radiography.

    Science.gov (United States)

    Sasagawa, Takeshi; Kunogi, Junichi; Masuyama, Shigeru; Ogihara, Satoshi; Takeuchi, Yosuke; Takeshita, Yujiro; Kamiya, Naokazu; Murakami, Hideki; Tsuchiya, Hiroyuki

    2011-12-06

    Computed radiography (CR) has many advantages compared with conventional radiographs, especially in image processing. Although CR is being used in chest radiography and mammography, it has not been applied to spine imaging. The purposes of this study were to formulate a set of new CR processing parameters and to test whether the resultant whole-spine radiographs visualized the spine more clearly than conventional images. This study included 29 patients who underwent whole-spine radiographs. We used 3 image processing methods to improve the clarity of whole-spine radiographs: gradation processing, dynamic range control processing, and multi-objective frequency processing. Radiograph definition was evaluated using vertebrae sampled from each region of the whole spine, specifically C4, C7, T8, T12, and L3; evaluation of the lateral view also included the sacral spine and femoral head. Image definition was assessed using a 3-point grading system. The conventional and processed CR images (both frontal and lateral views) were evaluated by 5 spine surgeons. In all spinal regions on both frontal and lateral views, the processed images showed statistically significantly better clarity than the corresponding conventional images, especially at T12, L3, the sacral spine, and the femoral head on the lateral view. Our set of new CR processing parameters can improve the clarity of whole-spine radiographs compared with conventional images. The greatest advantage of image processing was that it enabled clear depiction of the thoracolumbar junction, lumbar vertebrae, sacrum, and femoral head in the lateral view.

  19. Chest Pain

    Directory of Open Access Journals (Sweden)

    Samad Shams-Vahdati

    2014-03-01

    Full Text Available Introduction: Acute chest pain is an important and frequently occurring symptom in patients. Chest pain is often a sign of ischemic heart disease. Associated findings of electrocardiograph (ECG are rather heterogeneous, and traditional cardiac biomarkers such as Creatine Kinase-MB (CK-MB suffer from low cardiac specificity and sensitivity. In this study cost effectiveness of cardiac biomarkers single quantitative measurement was examined.Methods: The present descriptive-analytic study conducted on patients who were asked for troponin I and CK-MB. All patients who referred to Emergency unit of Tabriz Imam Reza educational-medical center during January 2012 to July the 2013 were included in study. All patients included in the study were documented in terms of age, sex, working shift of referring, main complaint of patient, symptoms in referring, ECG findings, and results of troponin I and CK-MB tests.Results: In this study, 2900 patients were studied including 1440 (49.7% males and 1460 (50.3% females. Mean age of patients was 62.91 (SD=14.36. Of all patients 1880 (64.8% of patients referred during 8 a.m. to 8 p.m. and 1020 (35.2% patients were referred during 8 p.m. to 8 a.m. The sensitivity of cardiac biomarkers’ test in diagnosing Acute Coronary Syndrome (ACS disease was calculated as 44.8% and its specificity was 86.6%. For diagnosing Acute Myocardial Infarction (AMI, sensitivity of cardiac biomarkers’ test was 72.2% and its specificity was 86%. None of patients who were finally underwent unstable angina diagnosis showed increase in cardiac enzymes.Conclusion: In conclusion, cardiac biomarkers can be used for screening acute chest pains, also cost effectiveness of cardiac biomarkers, appropriate specificity and sensitivity can guarantee their usefulness in emergency room.

  20. Dose in conventional radiography; Dosis en radiografia convencional

    Energy Technology Data Exchange (ETDEWEB)

    Acuna D, E.; Padilla R, Z. P.; Escareno J, E.; Vega C, H. R. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Calle Cipres No. 10, Fracc. La Penuela, 98000 Zacatecas (Mexico)

    2011-10-15

    It has been pointed out that medical exposures are the most significant sources of exposure to ionizing radiation for the general population. Inside the medical exposures the most important is the X-ray use for diagnosis, which is by far the largest contribution to the average dose received by the population. From all studies performed in radiology the chest radiography is the most abundant. In an X-ray machine, voltage and current are combined to obtain a good image and a reduce dose, however due to the workload in a radiology service individual dose is not monitored. In order to evaluate the dose due to chest radiography in this work a plate phantom was built according to the ISO recommendations using methylmethacrylate walls and water. The phantom was used in the Imaging department of the Zacatecas General Hospital as a radiology patient asking for a chest study; using thermoluminescent dosimeters, TLD 100 the kerma at the surface entrance was determined. (Author)

  1. Routine radiography does not have a role in the diagnostic evaluation of ambulatory adult febrile neutropenic cancer patients

    NARCIS (Netherlands)

    Nijhuis, CSMO; Gietema, JA; Vellenga, E; Daenen, SMGJ; De Bont, ESJM; Kamps, WA; Groen, HJM; van der Jagt, EJ; van der Graaf, WTA

    2003-01-01

    Cancer patients treated with chemotherapy are susceptible to bacterial infections. When an adult patient presents with febrile neutropenia. standard diagnostic care includes physical examination, laboratory diagnostics, chest X-ray (CXR) and sinus radiography. However, the yield of routine radiograp

  2. Assessment of clinical image quality in feline chest radiography with a needle-image plate (NIP) storage phosphor system. An approach to the evaluation of image quality in neonatal radiography; Untersuchungen zur Qualitaet von Thoraxaufnahmen bei Katzen mit einem auf einer Nadelstruktur basierenden Speicherfoliensystem. Modelluntersuchungen zur Bewertung der Bildqualitaet bei Neugeborenen

    Energy Technology Data Exchange (ETDEWEB)

    Ludewig, E.; Bosch, B.; Gaebler, K.; Succow, D.; Werrmann, A. [Klinik fuer Kleintiere, Univ. Leipzig (Germany); Hirsch, W.; Sorge, I. [Abt. Paediatrische Radiologie, Univ. Leipzig (Germany); Gosch, D. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Univ. Leipzig (Germany)

    2010-02-15

    Purpose: Is the image quality of thoracic radiographs of cats obtained with a needle-based storage phosphor (NIP) system superior to conventional (PIP) storage phosphor radiography? Is it possible to decrease the mAs by 50% with the NIP system without significant loss of information? Materials and Methods: From each of the 20 animals, three lateral radiographs were acquired. The assessment of the exposure level was based on the generated IgM-values. Images were acquired 1. with the NIP system and exposure settings equivalent to an IgM of 1.9, 2. with the PIP system and identical settings, and 3. with the NIP system and 50% of the mAs. Six blinded readers used a 5-step scale to assess the reproducibility of five anatomical structures and image noise sensation. Data were analysed using Visual Grading Characteristics Analysis (VGC). Results: While applying identical exposure values the NIP system for all features revealed superior ratings to those of the PIP system (AUC{sub VGC} values ranged from 0.81 for ''cardiac silhouette'' to 0.92 for ''trachea''). Even when reducing mAs by 50% in the NIP images all features were rated better compared with the PIP images and original settings (AUC{sub VGC} values ranged from 0.60 for ''cardiac silhouette'' to 0.74 for ''trachea'' and ''caudal thoracic field''). Conclusion: The NIP system demonstrates clearly better image quality compared to the reference PIP system. A dose reduction of 50% seems to be possible without relevant detraction from image quality. The results obtained in the animal model are valid for simulating conditions in neonatal radiological practise. (orig.)

  3. Computer-aided detection of small pulmonary nodules in chest radiographs: an observer study.

    NARCIS (Netherlands)

    Boo, D.W. De; Uffmann, M.; Weber, M.; Bipat, S.; Boorsma, E.F.; Scheerder, M.J.; Freling, N.J.; Schaefer-Prokop, C.M.

    2011-01-01

    RATIONALE AND OBJECTIVES: To evaluate the impact of computer-aided detection (CAD, IQQA-Chest; EDDA Technology, Princeton Junction, NJ) used as second reader on the detection of small pulmonary nodules in chest radiography (CXR). MATERIALS AND METHODS: A total of 113 patients (mean age 62 years) wit

  4. Chest radiation - discharge

    Science.gov (United States)

    Radiation - chest - discharge; Cancer - chest radiation; Lymphoma - chest radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after your first treatment: It may be hard ...

  5. MRI of the Chest

    Medline Plus

    Full Text Available ... chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and chest wall soft tissue (muscles ... from the contrast material, including nausea, headache and pain at the site of injection. Similarly, patients are ...

  6. MRI of the Chest

    Medline Plus

    Full Text Available ... chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around the heart) disease. characterize mediastinal or pleural lesions seen by ...

  7. MRI of the Chest

    Medline Plus

    Full Text Available ... MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the chest is performed ...

  8. Chest X Ray?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Chest X Ray A chest x ray is a fast and painless imaging test ... tissue scarring, called fibrosis. Doctors may use chest x rays to see how well certain treatments are ...

  9. MRI of the Chest

    Medline Plus

    Full Text Available ... MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the chest is performed ...

  10. [Seeing the sounds--chest and lung ultrasonography].

    Science.gov (United States)

    Jakobson, Daniel J; Shemesh, Iftach

    2014-10-01

    Chest ultrasonography was considered hampered and deficient but it is now taking a prominent role as a bedside tool for the diagnosis of lung ailments. Technological development has made it accurate, fast and reliable to the extent that it is gradually replacing the traditional chest X-ray and sometimes also the computed tomography scan. In this article we review and display in a few images the diagnostic possibilities of the thoracic ultrasound examination in a diverse range of maladies such as pneumonia, pulmonary congestion, pleural effusion and other conditions.

  11. MRI of the Chest

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging (MRI) of the chest ... limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is ...

  12. Mantra meditation as a bedside spiritual intervention.

    Science.gov (United States)

    Chan, Roxane Raffin

    2014-01-01

    The increased acceptance of integrative care allows nurses to investigate their role as active providers of spiritual care at the bedside. Lack of clear role expectations and interventions support the need for a simple, flexible spiritual bedside intervention. The use of a meditation mantra is discussed.

  13. Tamponade Relief by Active Clearance of Chest Tubes.

    Science.gov (United States)

    Vistarini, Nicola; Gabrysz-Forget, Fanny; Beaulieu, Yanick; Perrault, Louis P

    2016-03-01

    Chest tubes are used in every case of cardiac surgery to evacuate shed blood from around the heart and lungs. Chest tubes can become partially or totally occluded, leading to tamponade. The purpose of this article is to discuss a novel method of maintaining chest tube patency in the early recovery after cardiothoracic surgery. The PleuraFlow Active Clearance Technology is a system to prevent chest tube clogging that can be used to help routinely maintain chest tube patency at the bedside in the intensive care unit. A patient exhibited physiologic tamponade that was confirmed by transthoracic echocardiography. The chest tube was successfully reopened by actively clearing the chest tube using Active Clearance Technology, resulting in resolution of the tamponade. The present study reports the case of a patient with massive postoperative pericardial effusion with tamponade, successfully managed by active clearance chest tube. Further studies will help define the role for this technology in routine cardiac surgery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Radiography at CERN

    CERN Document Server

    HSE Unit

    2014-01-01

    What is industrial radiography? It is a non-destructive method with a wide variety of applications, such as inspecting the quality of a weld. It uses high-energy radioactive sources or an X-ray generator.   Is this inspection technique used at CERN? Yes, it is widely used at CERN by the EN-MME Group, which outsources the work to one or more companies, depending on the workload. Is it possible to carry out radiography anywhere at CERN? Yes, it is possible to carry out radiography in any building/accelerator/experiment area at CERN (including in areas which are not normally subject to radiological hazards). When is radiography carried out? It normally takes place outside of working hours (7 p.m. to 6 a.m.). How will I know if radiography is taking place in my building? If this activity is planned in a CERN building, notices will be affixed to all of its main entrance doors at least 24 hours in advance. What are the risks? There is a risk of exposure to very high levels of radiation, dep...

  15. Advances in digital chest radiography: impact on reader performance

    NARCIS (Netherlands)

    De Boo, D.W.

    2012-01-01

    Digitalisering binnen de radiologie heeft de nodige verbeteringen opgeleverd, onder andere voor de longfoto. Vroege stadia van longkanker en kleine uitzaaiingen naar de longen worden geregeld gemist op scans, maar computerprogramma’s kunnen deze gemiste afwijkingen soms wel detecteren. De programma’

  16. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... the limitations of Bone X-ray (Radiography)? What is Bone X-ray (Radiography)? An x-ray (radiograph) ... diagnosis and disease management. top of page How is the procedure performed? The technologist, an individual specially ...

  17. Diagnosis and Treatment of Chest Injury and Emergency Diseases of Chest Organs

    Directory of Open Access Journals (Sweden)

    A. M. Khadjibaev

    2016-01-01

    Full Text Available Goal of research: to evaluate efficiency of videothoracoscopy in diagnosis and treatment of patients with injuries and emergency diseases ща chest organs.Material and methods: Study wasbased on treatment results analysis of 2111 patients with injuries and chest organs emergency diseases, who were treated at Republican Research Centre of Emergency Medicine in 2001-2014. Chest trauma made up 1396 (66,1% victims. There were 477 (22,6% patients with spontaneous pneumothorax. At the stages of initial diagnosis, the radiologic evaluations, CT investigations and videothoracoscopies were performed. In chest trauma patients the videothoracoscopy underwent in 844 cases, in spontaneous pneu#mothorax this method was employed in 290 patients. Complicated forms of lung echinococcosis were observed in 238 (11,3% patients and complicated forms of lung echinococcosis were evident in 72 patients.Results. Videothoracoscopy and video-assisted interventions allowed to eliminate lungs and pleura pathology in 1206 (57,1% patients, whereas the traditional methods were effective only in 905 cases (42,9%.Conclusions. Investigation methods such as multiplanar radioscopy, radiography, chest CT and videothora-coscopy must be included into algorithm of diagnosis and surgical treatment of chest injuries and emergency diseases of chest organs. At chest trauma the videothoracoscopy allows to avoid broad thoracotomy from 9,4% to 4,7% of cases, to reduce the frequency of repeated interventions from 17,4% to 0,5% and diminish a number of early postsurgery complications from 25,4% to 10,9%. Videothoracoscopy of chest traumas allows to reduce frequency of repeated interventions from 19,8 to 1,7%.

  18. Real-time radiography

    Energy Technology Data Exchange (ETDEWEB)

    Bossi, R.H.; Oien, C.T.

    1981-02-26

    Real-time radiography is used for imaging both dynamic events and static objects. Fluorescent screens play an important role in converting radiation to light, which is then observed directly or intensified and detected. The radiographic parameters for real-time radiography are similar to conventional film radiography with special emphasis on statistics and magnification. Direct-viewing fluoroscopy uses the human eye as a detector of fluorescent screen light or the light from an intensifier. Remote-viewing systems replace the human observer with a television camera. The remote-viewing systems have many advantages over the direct-viewing conditions such as safety, image enhancement, and the capability to produce permanent records. This report reviews real-time imaging system parameters and components.

  19. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z X-ray (Radiography) - Bone Bone x-ray uses a very small ... X-ray (Radiography)? What is Bone X-ray (Radiography)? An x-ray (radiograph) is a noninvasive medical ...

  20. Dose audit for patients undergoing two common radiography examinations with digital radiology systems.

    Science.gov (United States)

    İnal, Tolga; Ataç, Gökçe

    2014-01-01

    We aimed to determine the radiation doses delivered to patients undergoing general examinations using computed or digital radiography systems in Turkey. Radiographs of 20 patients undergoing posteroanterior chest X-ray and of 20 patients undergoing anteroposterior kidney-ureter-bladder radiography were evaluated in five X-ray rooms at four local hospitals in the Ankara region. Currently, almost all radiology departments in Turkey have switched from conventional radiography systems to computed radiography or digital radiography systems. Patient dose was measured for both systems. The results were compared with published diagnostic reference levels (DRLs) from the European Union and International Atomic Energy Agency. The average entrance surface doses (ESDs) for chest examinations exceeded established international DRLs at two of the X-ray rooms in a hospital with computed radiography. All of the other ESD measurements were approximately equal to or below the DRLs for both examinations in all of the remaining hospitals. Improper adjustment of the exposure parameters, uncalibrated automatic exposure control systems, and failure of the technologists to choose exposure parameters properly were problems we noticed during the study. This study is an initial attempt at establishing local DRL values for digital radiography systems, and will provide a benchmark so that the authorities can establish reference dose levels for diagnostic radiology in Turkey.

  1. Comparing portable computers with bedside computers when administering medications using bedside medication verification.

    Science.gov (United States)

    Ludwig-Beymer, Patti; Williams, Phillip; Stimac, Ellen

    2012-01-01

    This research examined bedside medication verification administration in 2 adult critical care units, using portable computers and permanent bedside computers. There were no differences in the number of near-miss errors, the time to administer the medications, or nurse perception of ease of medication administration, care of patients, or reliability of technology. The percentage of medications scanned was significantly higher with the use of permanent bedside computers, and nurses using permanent bedside computers were more likely to agree that the computer was always available.

  2. Chest x-ray

    Science.gov (United States)

    ... of the following symptoms: A persistent cough Chest pain from a chest injury (with a possible rib fracture or lung complication) or from heart problems Coughing up blood Difficulty breathing Fever It ...

  3. MRI of the Chest

    Medline Plus

    Full Text Available ... chest. It is primarily used to assess abnormal masses such as cancer and determine the size, extent ... of the chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, ...

  4. MRI of the Chest

    Medline Plus

    Full Text Available ... the limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) ... ray, CT and ultrasound. top of page How is the procedure performed? MRI examinations may be performed ...

  5. Chest X-Ray

    Medline Plus

    Full Text Available ... chest x-ray is used to evaluate the lungs, heart and chest wall and may be used ... diagnose and monitor treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A ...

  6. Chest X-Ray

    Medline Plus

    Full Text Available ... breath, persistent cough, fever, chest pain or injury. It may also be useful to help diagnose and ... have some concerns about chest x-rays. However, it’s important to consider the likelihood of benefit to ...

  7. MRI of the Chest

    Medline Plus

    Full Text Available ... to assess the anatomy and function of the heart and its blood flow. Tell your doctor about ... chest cavity, including the mediastinum , chest wall, pleura, heart and vessels, from almost any angle. MRI also ...

  8. Chest X-Ray

    Medline Plus

    Full Text Available ... breath, persistent cough, fever, chest pain or injury. It may also be useful to help diagnose and ... have some concerns about chest x-rays. However, it’s important to consider the likelihood of benefit to ...

  9. Management of flail chest.

    OpenAIRE

    Miller, H A; Taylor, G.A.; Harrison, A. W.; Maggisano, R.; Hanna, S.; de Lacy, J. L.; Shulman, H.

    1983-01-01

    This paper compares the management of two groups of patients with flail chest. The 25 patients in group 1 had a flail chest without other significant injuries or shock, whereas the 57 in group 2 had a flail chest with multiple injuries, shock or both. The group 1 patients were treated with repeated multiple intercostal nerve blocks or high segmental epidural analgesia, oxygen, intensive chest physiotherapy, fluid restriction, furosemide diuretics, methylprednisolone sodium succinate and collo...

  10. Bedside Teaching and Respecting the Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Touyz, Sarah Judith Jean

    2015-06-01

    Full Text Available Bedside teaching involving patients, physicians, and students is a ubiquitous technique used for medical training. Respect, valid informed consent, and transparency are key to ethical and effective teaching. Patient refusal in participating in bedside teaching must be respected. These ought to apply to patients of all ages, including children, who may not fully understand or be capable of consenting to participating in teaching.

  11. Artifacts in digital radiography

    Energy Technology Data Exchange (ETDEWEB)

    Min, Jung Whan [Dept. of Radiological Technology, Shin Gu University, Sungnam (Korea, Republic of); Kim, Jung Min [Dept. of Radiological Technology, Korea University, Seoul (Korea, Republic of); Jeong, Hoi Woun [Dept. of Radiological Technology, Beakseok Culture University, Cheonan (Korea, Republic of)

    2015-12-15

    Digital Radiography is a big part of diagnostic radiology. Because uncorrected digital radiography image supported false effect of Patient’s health care. We must be manage the correct digital radiography image. Thus, the artifact images can have effect to make a wrong diagnosis. We report types of occurrence by analyzing the artifacts that occurs in digital radiography system. We had collected the artifacts occurred in digital radiography system of general hospital from 2007 to 2014. The collected data had analyzed and then had categorize as the occurred causes. The artifacts could be categorized by hardware artifacts, software artifacts, operating errors, system artifacts, and others. Hardware artifact from a Ghost artifact that is caused by lag effect occurred most frequently. The others cases are the artifacts caused by RF noise and foreign body in equipments. Software artifacts are many different types of reasons. The uncorrected processing artifacts and the image processing error artifacts occurred most frequently. Exposure data recognize (EDR) error artifacts, the processing error of commissural line, and etc., the software artifacts were caused by various reasons. Operating artifacts were caused when the user did not have the full understanding of the digital medical image system. System artifacts had appeared the error due to DICOM header information and the compression algorithm. The obvious artifacts should be re-examined, and it could result in increasing the exposure dose of the patient. The unclear artifact leads to a wrong diagnosis and added examination. The ability to correctly determine artifact are required. We have to reduce the artifact occurrences by understanding its characteristic and providing sustainable education as well as the maintenance of the equipments.

  12. The bedside evaluation: ritual and reason.

    Science.gov (United States)

    Verghese, Abraham; Brady, Erika; Kapur, Cari Costanzo; Horwitz, Ralph I

    2011-10-18

    The bedside evaluation, consisting of the history and physical examination, was once the primary means of diagnosis and clinical monitoring. The recent explosion of imaging and laboratory testing has inverted the diagnostic paradigm. Physicians often bypass the bedside evaluation for immediate testing and therefore encounter an image of the patient before seeing the patient in the flesh. In addition to risking delayed or missed diagnosis of readily recognizable disease, physicians who forgo or circumvent the bedside evaluation risk the loss of an important ritual that can enhance the physician-patient relationship. Patients expect that some form of bedside evaluation will take place when they visit a physician. When physicians complete this evaluation in an expert manner, it can have a salutary effect. If done poorly or not at all, in contrast, it can undermine the physician-patient relationship. Studies suggest that the context, locale, and quality of the bedside evaluation are associated with neurobiological changes in the patient. Recognizing the importance of the bedside evaluation as a healing ritual and a powerful diagnostic tool when paired with judicious use of technology could be a stimulus for the recovery of an ebbing skill set among physicians.

  13. American College of Chest Physicians

    Science.gov (United States)

    ... Master Fellows Staff & Contact Us CHEST Newsroom Staff Job Opportunities at CHEST Contact Us Industry Support Industry Support ... of Global Governors Master Fellows CHEST Newsroom Staff Job Opportunities at CHEST Contact Us Industry Support Industry Advisory ...

  14. Pediatric chest CT after trauma: impact on surgical and clinical management

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Rina P. [Vanderbilt University School of Medicine, Nashville, TN (United States); Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H. [Vanderbilt University, Department of Radiology and Radiological Sciences, Vanderbilt Children' s Hospital, Nashville, TN (United States); Yu, Chang [Vanderbilt University, Department of Biostatistics, Nashville, TN (United States); Ray, Jackie [Vanderbilt University, Department of Pediatric Surgery, Vanderbilt Children' s Hospital, Nashville, TN (United States)

    2010-07-15

    Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. To assess the impact of chest CT compared with chest radiography on pediatric trauma management. Two hundred thirty-five consecutive pediatric trauma patients who had both chest CT and radiography were identified. Images were reviewed and findings were categorized and correlated with subsequent chest interventions, blinded to final outcome and management. Of the 235 children, 38.3% (90/235) had an abnormal chest radiograph and 63.8% (150/235) had an abnormal chest CT (P < 0.0001). Chest interventions followed in 4.7% (11/235); of these, the findings could be made 1 cm above the dome of the liver in 91% (10/11). Findings requiring chest intervention included pneumothorax (PTX) and vertebral fractures. PTX was found on 2.1% (5/235) of chest radiographs and 20.0% (47/235) of chest CTs (P < 0.0001); 1.7% (4/235) of the children received a chest tube for PTX, 0.85% (2/235) seen on chest CT only. Vertebral fractures were present in 3.8% of the children (9/235) and 66.7% (6/9) of those cases were treated with spinal fusion or brace. There were no instances of mediastinal vascular injury. Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients. (orig.)

  15. Use of Chest Computed Tomography in Stable Patients with Blunt Thoracic Trauma: Clinical and Forensic Perspective

    Directory of Open Access Journals (Sweden)

    Makbule Ergin

    2011-01-01

    fractures were the most common injury. Thorax computed tomography was significantly superior to chest radiography in detecting pneumothorax , hemothorax and lung contusion. Eightyone life threatening lesions were detected and 50 (61%; pneumothorax 13, hemothorax 24, lung contusion 9,and pneumomediastinum 4 of these lesions could not be detected with plain chest radiography. The clinical management [in 15 patients (30%], and the forensic assesment was changed [in 14 (28%] patients were changed.  Conclusion:We concluded that using Computed Tomography of the thorax in thoracic travmas prive meticulous assesment in management of patients and forens icissues.

  16. Quantitative film radiography

    Energy Technology Data Exchange (ETDEWEB)

    Devine, G.; Dobie, D.; Fugina, J.; Hernandez, J.; Logan, C.; Mohr, P.; Moss, R.; Schumacher, B.; Updike, E.; Weirup, D.

    1991-02-26

    We have developed a system of quantitative radiography in order to produce quantitative images displaying homogeneity of parts. The materials that we characterize are synthetic composites and may contain important subtle density variations not discernible by examining a raw film x-radiograph. In order to quantitatively interpret film radiographs, it is necessary to digitize, interpret, and display the images. Our integrated system of quantitative radiography displays accurate, high-resolution pseudo-color images in units of density. We characterize approximately 10,000 parts per year in hundreds of different configurations and compositions with this system. This report discusses: the method; film processor monitoring and control; verifying film and processor performance; and correction of scatter effects.

  17. Medical students' perceptions of bedside teaching.

    Science.gov (United States)

    Gray, David; Cozar, Octavian; Lefroy, Janet

    2017-06-01

    Bedside teaching is recognised as a valuable tool in medical education by both students and faculty members. Bedside teaching is frequently delivered by consultants; however, junior doctors are increasingly engaging in this form of clinical teaching, and their value in this respect is becoming more widely recognised. The aim of this study was to supplement work completed by previous authors who have begun to explore students' satisfaction with bedside teaching, and their perceptions of the relationship with the clinical teachers. Specifically, we aimed to identify how students perceive bedside teaching delivered by junior doctors compared with consultants. We aimed to identify how students perceived bedside teaching delivered by junior doctors compared with consultants METHODS: A questionnaire was distributed to all third-year medical students at Keele University via e-mail. Responses were submitted anonymously. Forty-six students responded (37.4%), 73.3 per cent of whom said that they felt more comfortable having bedside teaching delivered by junior doctors than by consultants. Consultants were perceived as more challenging by 60 per cent of respondents. Students appeared to value feedback on their performance, trust the validity of taught information, and to value the overall educational experience equally, regardless of the clinical grade of the teacher. Student preference does not equate to the value that they place on their bedside teaching. Junior doctors are perceived as being more in touch with students and the curriculum, whereas consultants are perceived as having higher expectations and as being both stricter and more knowledgeable. The clinical teacher's approachable manner and enthusiasm for teaching are more important than clinical grade, as is the ability to deliver well-structured constructive feedback. © 2016 John Wiley & Sons Ltd.

  18. CCD digital radiography system

    Science.gov (United States)

    Wang, Yi; Kang, Xi; Li, Yuanjing; Cheng, Jianping; Hou, Yafei; Han, Haiwei

    2009-07-01

    Amorphous silicon flat-panel detector is the mainstream used in digital radiography (DR) system. In latest years, scintillation screen coupled with CCD DR is becoming more popular in hospital. Compared with traditional amorphous silicon DR, CCD-DR has better spatial resolution and has little radiation damage. It is inexpensive and can be operated easily. In this paper, A kind of CCD based DR system is developed. We describe the construction of the system, the system performances and experiment results.

  19. Pigtail Catheters Versus Traditional Chest Tubes for Pneumothoraces in Premature Infants Treated in a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Yi-Hsuan Wei

    2014-10-01

    Conclusion: Pigtail catheters are a safe and effective alternative to traditional chest tubes for premature infants receiving treatment for pneumothoraces in a neonatal intensive care unit. Placement of pigtail catheters is an easy and quick bedside procedure and is particularly useful for premature infants who require immediate air drainage.

  20. Effect of comfort pads and incubator design on neonatal radiography

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Xia; Baad, Michael; Reiser, Ingrid; Feinstein, Kate A.; Lu, Zhengfeng [University of Chicago Medicine, Department of Radiology, Chicago, IL (United States)

    2016-01-15

    There has been increasing interest in patient dose reduction in neonatal intensive care units. Removing comfort pads for radiography has been identified as a potential means to decrease patient dose. To assess the effect of comfort pads and support trays on detector entrance exposure (DEE) and image quality for neonatal radiography, and its implication for patient dose. Comfort pads and support trays from three incubator and warmer systems were examined. The attenuation of the primary beam by these structures was measured using a narrow beam geometry. Their effect on DEE and image quality was then assessed using typical neonatal chest radiography techniques with three configurations: (1) both the comfort pad and support included in the beam, (2) only the support tray included and (3) both the comfort pad and support tray removed. Comfort pads and support trays were found to attenuate the primary beam by 6-15%. Eliminating these structures from the X-ray beam's path was found to increase the detector entrance exposure by 28-36% and increase contrast-to-noise ratio by more than 21%, suggesting room for patient dose reduction when the same image quality is maintained. Comfort pads and tray support devices can have a considerable effect on DEE and image quality, with large variations among different incubator designs. Positioning the image detector directly underneath neonatal patients for radiography is a potential means for patient dose reduction. However, such benefit should be weighed against the risks of moving the patient. (orig.)

  1. Radiography with polarised neutrons

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, Michael L.

    2010-08-20

    In this thesis I present a new technique for the spatially resolved investigation of the magnetic properties of bulk samples. Standard one dimensional neutron depolarisation analysis is combined with neutron radiography to a method we call Neutron Depolarisation Imaging (NDI). The experimental setup which was installed at the neutron radiography beam line ANTARES at FRM II consists of a double crystal monochromator, neutron polariser, spin flipper, polarisation analyser and a position sensitive CCD detector. A comprehensive discussion of the requirements for these components is given and the limitations of the method are shown. The maximum spatial resolution which can be achieved with a neutron radiography setup is determined by the collimation of the neutron beam and the distance between sample and detector. Different types of polarisers have been tested and their advantages and disadvantages are discussed. A double crystal monochromator and a new type of polariser employing polarising neutron supermirrors based on the principle of an optical periscope were developed and tested during this work. Furthermore, NDI measurements on various samples of the weakly ferromagnetic materials Pd{sub 1-x}Ni{sub x} and Ni{sub 3}Al are presented. Neutron depolarisation radiography and tomography measurements were conducted with a spatial resolution as high as 0.3 mm on Pd{sub 1-x}Ni{sub x} and Ni{sub 3}Al samples. The feasibility of NDI experiments under hydrostatic pressures up to 10 kbar was shown on a sample of Ni{sub 3}Al using a modified Cu:Be clamp cell. A decrease of the ordering temperature by 2 K under hydrostatic pressure was determined from the NDI measurements and shows the potential of the method for further high pressure experiments. Additionally a method was developed which in principle allows to obtain the intrinsic dependence of the ordering temperature T{sub C} on the ordered moment Ms from NDI measurements on inhomogeneous samples containing regions with

  2. Chest pain associated with moderator band pacing.

    Science.gov (United States)

    Goli, Anil K; Kaszala, Karoly; Osman, Mohammed N; Lucke, John; Carrillo, Roger

    2014-10-01

    A 65-year-old man was evaluated for chronic chest pain that had been present for 8 years after placement of a dual-chamber implantable cardioverter-defibrillator to treat inducible ventricular tachycardia. Previous coronary angiography had revealed nonobstructive coronary artery disease and a left ventricular ejection fraction of 0.45 to 0.50, consistent with mild idiopathic nonischemic cardiomyopathy. Evaluation with chest radiography and transthoracic echocardiography showed the implantable cardioverter-defibrillator lead to be embedded within the right ventricle at the moderator band, which had mild calcification. Treatment included extraction of the dual-coil lead and placement of a new single-coil right ventricular lead at the mid septum. The patient had complete relief of symptoms after the procedure. This case shows that chest pain can be associated with the placement of a right ventricular implantable cardioverter-defibrillator lead in the moderator band and that symptomatic relief can occur after percutaneous lead extraction and the implantation of a new right ventricular lead to the mid septal region.

  3. Central venous cannulation: are routine chest radiographs necessary after B-mode and colour Doppler sonography check?

    Energy Technology Data Exchange (ETDEWEB)

    Lanza, Cecilia; Fabrizzi, Giancarlo [Pediatric Radiology Department-Presidio Salesi, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona (Italy); Russo, Marco [Ospedale Civile Engles Profili, Servizio di Radiologia, Ancona (Italy)

    2006-12-15

    After the insertion of a central venous catheter, a chest radiograph is usually obtained to ensure correct positioning of the catheter tip. To determine in a paediatric population whether B-mode and colour Doppler sonography after central venous access is useful to evaluate catheter position, thus obviating the need for a postprocedural radiograph. A prospective study of 107 consecutive central venous access procedures placed in a paediatric intensive care unit was performed. At the end of the procedure, B-mode and colour Doppler sonography were used to assess catheter position and check for complications. A postprocedural chest radiograph was obtained in all patients. In 96 patients postprocedural B-mode and colour Doppler sonography showed colour Doppler signals within the vena cava. Among the 11 patients predicted to have a potential complication, there was one pneumothorax and ten malpositions. Chest radiography showed a total of 13 complications - 1 pneumothorax and 12 malpositions. The concordance between colour Doppler sonography and chest radiography was 98.1% in the detection of catheter position; sonography had a sensitivity of 84.6% and a specificity of 100%. The close concordance between B-mode and colour Doppler sonography and chest radiography justifies the more frequent use of sonography to evaluate catheter position because ionizing radiation is eliminated. Chest radiography may then be performed only when there is suspected inappropriate catheter tip position after sonography. (orig.)

  4. Scatter in cargo radiography.

    Science.gov (United States)

    Miller, Erin A; Caggiano, Joseph A; Runkle, Robert C; White, Timothy A; Bevill, Aaron M

    2011-03-01

    As a complement to passive detection systems, radiographic inspection of cargo is an increasingly important tool for homeland security because it has the potential to detect highly attenuating objects associated with special nuclear material or surrounding shielding, in addition to screening for items such as drugs or contraband. Radiographic detection of such threat objects relies on high image contrast between regions of different density and atomic number (Z). Threat detection is affected by scatter of the interrogating beam in the cargo, the radiographic system itself, and the surrounding environment, which degrades image contrast. Here, we estimate the extent to which scatter plays a role in radiographic imaging of cargo containers. Stochastic transport simulations were performed to determine the details of the radiography equipment and surrounding environment, which are important in reproducing measured data and to investigate scatter magnitudes for typical cargo. We find that scatter plays a stronger role in cargo radiography than in typical medical imaging scenarios, even for low-density cargo, with scatter-to-primary ratios ranging from 0.14 for very low density cargo, to between 0.20 and 0.40 for typical cargo, and higher yet for dense cargo.

  5. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning

    NARCIS (Netherlands)

    Ginneken, B. van

    2017-01-01

    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant techn

  6. Chest X-ray patterns of pulmonary multidrug-resistant tuberculosis in ...

    African Journals Online (AJOL)

    2016-03-18

    Mar 18, 2016 ... 1Department of Radiology,. University of ... rifampicin, is a particular area of public health concern in South Africa, where the estimated. MDR-TB .... Frontal chest X-rays were acquired using digital radiography. (with Kodak ...

  7. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning

    NARCIS (Netherlands)

    Ginneken, B. van

    2017-01-01

    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant

  8. Implementing bedside handover: strategies for change management.

    Science.gov (United States)

    McMurray, Anne; Chaboyer, Wendy; Wallis, Marianne; Fetherston, Cathy

    2010-09-01

    To identify factors influencing change in two hospitals that moved from taped and verbal nursing handover to bedside handover. Bedside handover is based on patient-centred care, where patients participate in communicating relevant and timely information for care planning. Patient input reduces care fragmentation, miscommunication-related adverse events, readmissions, duplication of services and enhances satisfaction and continuity of care. Analysing change management was a component of a study aimed at developing a standard operating protocol for bedside handover communication. The research was undertaken in two regional acute care hospitals in two different states of Australia. Data collection included 532 semi-structured observations in six wards in the two hospitals and 34 in-depth interviews conducted with a purposive sample of nursing staff involved in the handovers. Observation and interview data were analysed separately then combined to generate thematic analysis of factors influencing the change process in the transition to bedside handover. Themes included embedding the change as part of the big picture, the need to link the project to standardisation initiatives, providing reassurance on safety and quality, smoothing out logistical difficulties and learning to listen. We conclude that change is more likely to be successful when it is part of a broader initiative such as a quality improvement strategy. Nurses are generally supportive of quality improvement initiatives, particularly those aimed at standardising care. For successful implementation, change managers should be mindful of clinicians' attitudes, motivation and concerns and their need for reassurance when changing their practice. This is particularly important when change is dramatic, as in moving from verbal handover, conducted in the safety of the nursing office, to bedside handover where there is greater transparency and accountability for the accuracy and appropriateness of communication

  9. Multidetector computed tomography-spectrum of blunt chest wall and lung injuries in polytraumatized patients

    Energy Technology Data Exchange (ETDEWEB)

    Peters, S., E-mail: soeren.peters@rub.d [Department of Radiology and Nuclear Medicine, BG Universitaetsklinikum Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789 Bochum (Germany); Nicolas, V.; Heyer, C.M. [Department of Radiology and Nuclear Medicine, BG Universitaetsklinikum Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789 Bochum (Germany)

    2010-04-15

    Accidental injuries are the leading cause of death in the 15 to 44-year-old age group. Blunt chest trauma is often encountered in these patients and is associated with a mortality of up to 25%. Although conventional radiography still plays an important role in the initial emergency room setting, for follow-up in the intensive care unit, multidetector computed tomography has established itself as the standard imaging method for the evaluation of chest trauma patients. The following review presents salient radiological findings of the chest wall and shoulder girdle, thoracic spine, pleural space, and lung in polytraumatized patients.

  10. Chest computed tomography

    DEFF Research Database (Denmark)

    Loeve, Martine; Krestin, Gabriel P.; Rosenfeld, Margaret

    2013-01-01

    Clinical trials for the treatment of cystic fibrosis (CF) lung disease are important to test and optimize new therapeutic interventions. To evaluate the effect of these interventions, sensitive and accurate outcome measures are needed. The most commonly used endpoints are spirometric variables...... are not suitable to study CF lung disease in young children. Chest computed tomography (CT) holds great promise for use as a sensitive surrogate endpoint in CF. A large body of evidence has been produced to validate the use of chest CT as primary endpoint to study CF lung disease. However, before chest CT can...

  11. Posterior diaphragmatic defect detected on chest CT: the incidence according to age and the lateral chest radiographic appearances

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Son Youl; Choi, Yo Won; Jeon, Seok Chol; Heo, Jeong Nam; Park, Choong Ki [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2007-03-15

    We wanted to investigate the incidence of posterior diaphragmatic defect on chest CT in various age groups and its lateral chest radiographic appearances. The chest CT scans of 78 patients of various ages with posterior diaphragmatic defect were selected among 1,991 patients, and they were analyzed for the incidence of defect in various age groups, the defect location and the herniated contents. Their lateral chest radiographs were analyzed for the shape of the posterior diaphragm and the posterior costophrenic sulcus. The patients' ages ranged from 34 to 87 with the tendency of a higher incidence in the older patients. The defect most frequently involved the medial two thirds (n = 49, 50.4%) and middle one third (n = 36, 37%) of the posterior diaphragm. The retroperitoneal fat was herniated into the thorax through the defect in all patients, and sometimes with the kidney (n = 8). Lateral chest radiography showed a normal diaphragmatic contour (n = 51, 49.5%), blunting of the posterior costophrenic sulcus (n = 41, 39.8%), focal humping of the posterior diaphragm (n = 7, 6.8%), or upward convexity (n = 4, 3.9%) of the posterior costophrenic sulcus on the affected side. The posterior diaphragmatic defect discovered in asymptomatic patients who are without a history of peridiaphragmatic disease is most likely acquired, and this malady increases in incidence according to age. An abnormal contour of the posterior diaphragm or the costophrenic sulcus on a lateral chest radiograph may be a finding of posterior diaphragmatic defect.

  12. Radiography students' clinical learning styles.

    Science.gov (United States)

    Ward, Patti; Makela, Carole

    2010-01-01

    To examine the common learning styles of radiography students during clinical practice. Descriptive research methodology, using a single self-report questionnaire, helped to identify common learning styles of radiography students during clinical practice. The results indicated that 3 learning styles predominate among radiography students during clinical practice: task oriented, purposeful and tentative. Insight into clinical practice learning styles can help students understand how they learn and allow them to recognize ways to maximize learning. It also heightens awareness among clinical instructors and technologists of the different learning styles and their relevance to clinical practice education.

  13. Simple X-ray versus ultrasonography examination in blunt chest trauma: effective tools of accurate diagnosis and considerations for rib fractures.

    Science.gov (United States)

    Hwang, Eun Gu; Lee, Yunjung

    2016-12-01

    Simple radiography is the best diagnostic tool for rib fractures caused by chest trauma, but it has some limitations. Thus, other tools are also being used. The aims of this study were to investigate the effectiveness of ultrasonography (US) for identifying rib fractures and to identify influencing factors of its effectiveness. Between October 2003 and August 2007, 201 patients with blunt chest trauma were available to undergo chest radiographic and US examinations for diagnosis of rib fractures. The two modalities were compared in terms of effectiveness based on simple radiographic readings and US examination results. We also investigated the factors that influenced the effectiveness of US examination. Rib fractures were detected on radiography in 69 patients (34.3%) but not in 132 patients. Rib fractures were diagnosed by using US examination in 160 patients (84.6%). Of the 132 patients who showed no rib fractures on radiography, 92 showed rib fractures on US. Among the 69 patients of rib fracture detected on radiography, 33 had additional rib fractures detected on US. Of the patients, 76 (37.8%) had identical radiographic and US results, and 125 (62.2%) had fractures detected on US that were previously undetected on radiography or additional fractures detected on US. Age, duration until US examination, and fracture location were not significant influencing factors. However, in the group without detected fractures on radiography, US showed a more significant effectiveness than in the group with detected fractures on radiography (P=0.003). US examination could detect unnoticed rib fractures on simple radiography. US examination is especially more effective in the group without detected fractures on radiography. More attention should be paid to patients with chest trauma who have no detected fractures on radiography.

  14. MRI of the Chest

    Medline Plus

    Full Text Available ... to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures ... artery ( dissection ). See the MRA page for more information. top of page How should I prepare? You ...

  15. MRI of the Chest

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    Full Text Available ... primarily used to assess abnormal masses such as cancer and determine the size, extent and degree of ... chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, which either ...

  16. MRI of the Chest

    Medline Plus

    Full Text Available ... primarily used to assess abnormal masses such as cancer and determine the size, extent and degree of ... chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, which either ...

  17. Chest X-Ray

    Medline Plus

    Full Text Available ... Index A-Z Spotlight October is National Breast Cancer Awareness Month Recently posted: Medical Imaging Costs Magnetoencephalography ( ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  18. MRI of the Chest

    Medline Plus

    Full Text Available ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ... the limitations of MRI of the Chest? High-quality images are assured only if you are able ...

  19. MRI of the Chest

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    Full Text Available ... a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures of ... suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank you! Do you ...

  20. MRI of the Chest

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    Full Text Available ... for lung abnormalities where Chest CT is a preferred imaging test. MR imaging can assess blood flow ... If you are anxious, confused or in severe pain, you may find it difficult to lie still ...

  1. MRI of the Chest

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    Full Text Available ... the chest uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of ... the body being imaged, send and receive radio waves, producing signals that are detected by the coils. ...

  2. MRI of the Chest

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    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging ( ... the child can watch a movie while the scan is being performed. Thus, the child remains motionless ...

  3. MRI of the Chest

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    Full Text Available ... to: assess abnormal masses, including cancer of the lungs or other tissues, which either cannot be assessed ... for differentiating and characterizing soft tissues, except for lung abnormalities where Chest CT is a preferred imaging ...

  4. Chest tube insertion - slideshow

    Science.gov (United States)

    ... presentations/100008.htm Chest tube insertion - series—Normal anatomy To use the sharing features ... pleural space is the space between the inner and outer lining of the lung. It is normally very thin, and lined only ...

  5. MRI of the Chest

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    Full Text Available ... detailed pictures of the structures within the chest. It is primarily used to assess abnormal masses such ... and determine the size, extent and degree of its spread to adjacent structures. It’s also used to ...

  6. Chest tube insertion

    Science.gov (United States)

    ... tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Kirsch TD, Sax J. Tube thoracostomy. In: Roberts JR, ed. Roberts and ... . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 10.

  7. MRI of the Chest

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging (MRI) of ... Although there is no reason to believe that magnetic resonance imaging harms the fetus, pregnant women usually are ...

  8. MRI of the Chest

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    Full Text Available ... copied to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed ... the technologist if you have medical or electronic devices in your body. These objects may interfere with ...

  9. MRI of the Chest

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    Full Text Available ... heart) and myocardial infarct (scar in the heart muscle due to prior obstruction of blood flow). determine ... ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around ...

  10. MRI of the Chest

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    Full Text Available ... ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around the heart) disease. characterize mediastinal or pleural lesions seen by other ...

  11. MRI of the Chest

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    Full Text Available ... heart) and myocardial infarct (scar in the heart muscle due to prior obstruction of blood flow). determine ... ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around ...

  12. MRI of the Chest

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    Full Text Available ... determine the presence of certain diseases. The images can then be examined on a computer monitor, transmitted ... of the chest cavity (arteries and veins). MRA can also demonstrate an abnormal ballooning out of the ...

  13. MRI of the Chest

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    Full Text Available ... is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no ... Chest? Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. ...

  14. MRI of the Chest

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    Full Text Available ... of the chest uses a powerful magnetic field, radio waves and a computer to produce detailed pictures ... medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed ...

  15. MRI of the Chest

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    Full Text Available ... detailed pictures of the structures within the chest. It is primarily used to assess abnormal masses such ... and determine the size, extent and degree of its spread to adjacent structures. It’s also used to ...

  16. Neonatal Chest Wall Rhabdomyosarcoma.

    Science.gov (United States)

    Feldman, Michael; Steiner, Zvi; Groisman, Gabriel; Nadir, Erez

    2015-06-01

    An infant was born at term with a huge chest mass diagnosed as rhabdomyosarcoma. Treatment consisted of surgical resection and chemotherapy. We describe this very rare congenital mass and the problematic therapeutic management of such a tumor in a newborn.

  17. Neonatal Chest Wall Rhabdomyosarcoma

    OpenAIRE

    Feldman, Michael; Steiner, Zvi; Groisman, Gabriel; Nadir, Erez

    2015-01-01

    An infant was born at term with a huge chest mass diagnosed as rhabdomyosarcoma. Treatment consisted of surgical resection and chemotherapy. We describe this very rare congenital mass and the problematic therapeutic management of such a tumor in a newborn.

  18. Chest X-Ray

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    Full Text Available ... CT Angiography Video: Myelography Video: CT of the Heart Video: Radioiodine I-131 Therapy Radiology and You ... x-ray is used to evaluate the lungs, heart and chest wall and may be used to ...

  19. MRI of the Chest

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    Full Text Available ... You may resume your usual activities and normal diet immediately after the exam. On very rare occasions, ... Magnetic Resonance Imaging (MRI) Safety MRI Safety During Pregnancy Images related to Magnetic Resonance Imaging (MRI) - Chest ...

  20. Lung ultrasound and chest x-ray for detecting pneumonia in an acute geriatric ward

    OpenAIRE

    2016-01-01

    Abstract Background: Our aim was to compare the accuracy of lung ultrasound (LUS) and standard chest x-ray (CXR) for diagnosing pneumonia in older patients with acute respiratory symptoms (dyspnea, cough, hemoptysis, and atypical chest pain) admitted to an acute-care geriatric ward. Methods: We enrolled 169 (80 M, 89 F) multimorbid patients aged 83.0 ± 9.2 years from January 1 to October 31, 2015. Each participant underwent CXR and bedside LUS within 6 hours from ward admission. LUS was perfo...

  1. Emergency department evaluation and management of blunt chest and lung trauma (Trauma CME).

    Science.gov (United States)

    Morley, Eric J; Johnson, Scott; Leibner, Evan; Shahid, Jawad

    2016-06-01

    The majority of blunt chest injuries are minor contusions or abrasions; however, life-threatening injuries, including tension pneumothorax, hemothorax, and aortic rupture can occur and must be recognized early. This review focuses on the diagnosis, management, and disposition of patients with blunt injuries to the ribs and lung. Utilization of decision rules for chest x-ray and computed tomography are discussed, along with the emerging role of bedside lung ultrasonography. Management controversies presented include the limitations of needle thoracostomy us¬ing standard needle, chest tube placement, and chest tube size. Finally, a discussion is provided related to airway and ventilation management to assist in the timing and type of interventions needed to maintain oxygenation.

  2. Euratom Neutron Radiography Working Group

    DEFF Research Database (Denmark)

    Domanus, Joseph Czeslaw

    1986-01-01

    In 1979 a Neutron Radiography Working Group (NRWG) was constituted within Buratom with the participation of all centers within the European Community at which neutron facilities were available. The main purpose of NRWG was to standardize methods and procedures used in neutron radiography of nuclear...... reactor fuel as well as establish standards for radiographic image quality of neutron radiographs. The NRWG meets once a year in each of the neutron radiography centers to review the progress made and draw plans for the future. Besides, ad-hoc sub-groups or. different topics within the field of neutron...... radiography are constituted. This paper reviews the activities and achievements of the NRWG and its sub-groups....

  3. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... Us News Physician Resources Professions Site Index A-Z X-ray (Radiography) - Bone Bone x-ray uses ... assess trauma patients in emergency departments. A CT scan can image complicated fractures, subtle fractures or dislocations. ...

  4. Abdomen X-Ray (Radiography)

    Science.gov (United States)

    ... Professions Site Index A-Z X-ray (Radiography) - Abdomen Abdominal x-ray uses a very small dose ... to produce pictures of the inside of the abdominal cavity. It is used to evaluate the stomach, liver, ...

  5. Proton Radiography (pRad)

    Data.gov (United States)

    Federal Laboratory Consortium — The proton radiography project has used 800 MeV protons provided by the LANSCE accelerator facility at LANL, to diagnose more than 300 dynamic experiments in support...

  6. Examination of musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Brunse, Mads Hostrup; Stochkendahl, Mette Jensen; Vach, Werner

    2010-01-01

    Chest pain may be caused by joint and muscle dysfunction of the neck and thorax (termed musculoskeletal chest pain). The objectives of this study were (1) to determine inter-observer reliability of the diagnosis 'musculoskeletal chest pain' in patients with acute chest pain of non-cardiac origin...

  7. Low-pressure cardiac tamponade masquerading as severe sepsis diagnosed with a bedside ultrasound and as the initial presentation of malignancy.

    Science.gov (United States)

    Conti, Ricardo Augusto Slaibi; Oppenheim, Ian Mandeville

    2014-01-01

    We report a patient with low-pressure cardiac tamponade masquerading as sepsis and as the initial presentation of malignancy. A quick diagnosis was done by the intensivist performing a bedside ultrasound. The diagnosis of low-pressure cardiac tamponade is a challenge because the classic physical signs of cardiac tamponade can be absent. It is made even more challenging when the vital sign changes and physical examination findings mimic severe sepsis. One of the benefits of a bedside ultrasound in the assessment of a patient with an initial diagnosis of severe sepsis or septic shock is the rapid diagnosis of cardiac tamponade if it is present. A 55-year-old male presented to the emergency department with weakness, cough, and syncope. His examination was notable only for dusky mottling of his cheeks, chest, and neck. Specifically, there was no jugular venous distension or pulsus paradoxus. A chest radiograph showed a right upper lobe infiltrate, whereas his electrocardiogram showed only sinus tachycardia. His white blood cell count and lactic acid were elevated. The sepsis protocol was started and a bedside ultrasound revealed signs of cardiac tamponade. The patient immediately improved after a pericardiocentesis. Analysis of the pericardial biopsy revealed adenocarcinoma, later determined to be from a pulmonary primary source. Because low-pressure cardiac tamponade is life-threatening and difficult to diagnose, evaluation of the pericardium with a bedside ultrasound should be considered in patients with syncope, severe sepsis, or shock.

  8. Chest radiographic manifestations of scrub typhus

    Directory of Open Access Journals (Sweden)

    KPP Abhilash

    2016-01-01

    Full Text Available Background and Rationale: Respiratory system involvement in scrub typhus is seen in 20–72% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications. Materials and Methods: Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed. Results: The study cohort contained 398 patients. Common presenting complaints included fever (100%, generalized myalgia (83%, headache (65%, dyspnea (54%, cough (24.3%, and altered sensorium (14%. Almost half of the patients (49.4% had normal chest radiographs. Common radiological pulmonary abnormalities included pleural effusion (14.6%, acute respiratory distress syndrome (14%, airspace opacity (10.5%, reticulonodular opacities (10.3%, peribronchial thickening (5.8%, and pulmonary edema (2%. Cardiomegaly was noted in 3.5% of patients. Breathlessness, presence of an eschar, platelet counts of 2 mg/dL had the highest odds of having an abnormal chest radiograph. Patients with an abnormal chest X-ray had a higher requirement of noninvasive ventilation (odds ratio [OR]: 13.98; 95% confidence interval CI: 5.89–33.16, invasive ventilation (OR: 18.07; 95% CI: 6.42–50.88, inotropes (OR: 8.76; 95% CI: 4.35–17.62, higher involvement of other organ systems, longer duration of hospital stay (3.18 ± 3 vs. 7.27 ± 5.58 days; P< 0.001, and higher mortality (OR: 4.63; 95% CI: 1.54–13.85. Conclusion: Almost half of the patients with scrub typhus have abnormal chest radiographs. Chest radiography should be included as part of basic evaluation at presentation in patients with scrub typhus, especially in those with breathlessness, eschar, jaundice, and severe thrombocytopenia.

  9. Practical measurement of radiation dose in pediatric radiology: use of the dose-area product on digital fluoroscopy and neonatal chest radiographs; Mesure pratique de l'irradiation en radiopediatrie: utilisation du produit dose surface en fluorographie numerique et pour les radiographies pulmonaires neonatales

    Energy Technology Data Exchange (ETDEWEB)

    Chateil, J.F.; Rouby, C.; Brun, M.; Labessan, C.; Diard, F. [Hopital Pellegrin, Unite de Radiopediatrie A., 33 - Bordeaux (France)

    2004-05-01

    Purpose. Control of radiation dose in pediatric radiology requires knowledge of the reference levels for all examinations. These data are useful for daily quality assessment, but are not perfectly known for some radiographic examinations. The purpose of our study was to evaluate the dose related to voiding cysto-urethrograms (VCUG), upper GI (UGI) and intravenous urography (IVU). Neonatal chest radiographs in the intensive care unit were also evaluated. Material and methods. For examinations with contrast material (478VCUG, 220UGI, 80IVU), the children were divided in groups based on their weight, from 5 to 30 Kg. Measurements were performed using an ionization chamber and expressed with the-dose-area product (DAP). For chest radiographs, a direct measurement of the entrance-skin dose was performed, with secondary calculation of the DAP. Results. For-VCUGs, the DAP ranged between 42.89 cGy.cm{sup 2} and 125.41 cGy.cm{sup 2}. The range was between 76.43, and 150.62 cGy.cm{sup 2} for UGIs and between 49.06 and 83.33 cGy.cm{sup 2} for IVUs. For neonate chest radiographs, DAP calculations were between 0.29 and 0.99 cGy.cm{sup 2}. Conclusion. These values represent our reference doses. They allow continuous monitoring of our radiographic technical parameters and radiographic equipment and help to correct and improve them if necessary. (author)

  10. WE-G-204-07: Automated Characterization of Perceptual Quality of Clinical Chest Radiographs: Improvements in Lung, Spine, and Hardware Detection

    Energy Technology Data Exchange (ETDEWEB)

    Wells, J; Zhang, L; Samei, E [Duke University, Durham, NC (United States)

    2015-06-15

    Purpose: To develop and validate more robust methods for automated lung, spine, and hardware detection in AP/PA chest images. This work is part of a continuing effort to automatically characterize the perceptual image quality of clinical radiographs. [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] Methods: Our previous implementation of lung/spine identification was applicable to only one vendor. A more generalized routine was devised based on three primary components: lung boundary detection, fuzzy c-means (FCM) clustering, and a clinically-derived lung pixel probability map. Boundary detection was used to constrain the lung segmentations. FCM clustering produced grayscale- and neighborhood-based pixel classification probabilities which are weighted by the clinically-derived probability maps to generate a final lung segmentation. Lung centerlines were set along the left-right lung midpoints. Spine centerlines were estimated as a weighted average of body contour, lateral lung contour, and intensity-based centerline estimates. Centerline estimation was tested on 900 clinical AP/PA chest radiographs which included inpatient/outpatient, upright/bedside, men/women, and adult/pediatric images from multiple imaging systems. Our previous implementation further did not account for the presence of medical hardware (pacemakers, wires, implants, staples, stents, etc.) potentially biasing image quality analysis. A hardware detection algorithm was developed using a gradient-based thresholding method. The training and testing paradigm used a set of 48 images from which 1920 51×51 pixel{sup 2} ROIs with and 1920 ROIs without hardware were manually selected. Results: Acceptable lung centerlines were generated in 98.7% of radiographs while spine centerlines were acceptable in 99.1% of radiographs. Following threshold optimization, the hardware detection software yielded average true positive and true negative rates of 92.7% and 96.9%, respectively. Conclusion: Updated

  11. CHEST PHYSIOTHERAPY FOR INFANTS

    Directory of Open Access Journals (Sweden)

    Preeti S. Christian (M.P.T Cardiopulmonary Conditions

    2014-10-01

    Full Text Available In the normal lung, secretions are removed by Mucociliary activity, normal breathing cycles, and cough. In disease, increased secretion viscosity and volume, dyskinesia of the cilia, and ineffective cough combine to reduce the ability to clear secretions, and may increase exacerbations and infections. Many chest physiotherapy techniques like postural drainage, percussion and vibration are used since many years. These techniques are derived from adult studies but these techniques are quite stressful for the infants as the infant respiratory system is different from the adult respiratory system. Advance chest physiotherapy techniques were developed specifically for infants; in accordance with their physiological characteristics. So this review is to introduce some new chest physiotherapy helpful for newborn infants.

  12. Upper Gastrointestinal (GI) Tract X-Ray (Radiography)

    Science.gov (United States)

    ... Site Index A-Z X-ray (Radiography) - Upper GI Tract Upper gastrointestinal tract radiography or upper GI ... GI) Tract X-ray? What is Upper Gastrointestinal (GI) Tract Radiography? Upper gastrointestinal tract radiography, also called ...

  13. Lower Gastrointestinal (GI) Tract X-Ray (Radiography)

    Science.gov (United States)

    ... Site Index A-Z X-ray (Radiography) - Lower GI Tract Lower gastrointestinal tract radiography or lower GI ... of Lower GI Tract Radiography? What is Lower GI Tract X-ray Radiography (Barium Enema)? Lower gastrointestinal ( ...

  14. Extravascular lung water index measurement in critically ill children does not correlate with a chest x-ray score of pulmonary edema.

    NARCIS (Netherlands)

    Lemson, J.; Die, L. van; Hemelaar, A.E.A.; Hoeven, J.G. van der

    2010-01-01

    INTRODUCTION: Extravascular lung water index (EVLWI) can be measured at the bedside using the transpulmonary thermodilution technique (TPTD). The goal of this study was to compare EVLWI values with a chest x-ray score of pulmonary edema and markers of oxygenation in critically ill children. METHODS:

  15. COMPARISON OF WIRELESS DETECTORS FOR DIGITAL RADIOGRAPHY SYSTEMS: IMAGE QUALITY AND DOSE.

    Science.gov (United States)

    Mourik, J E M; van der Tol, P; Veldkamp, W J H; Geleijns, J

    2016-06-01

    The purpose of this study was to compare dose and image quality of wireless detectors for digital chest radiography. Entrance dose at both the detector (EDD) and phantom (EPD) and image quality were measured for wireless detectors of seven different vendors. Both the local clinical protocols and a reference protocol were evaluated. In addition, effective dose was calculated. Main differences in clinical protocols involved tube voltage, tube current, the use of a small or large focus and the use of additional filtration. For the clinical protocols, large differences in EDD (1.4-11.8 µGy), EPD (13.9-80.2 µGy) and image quality (IQFinv: 1.4-4.1) were observed. Effective dose was systems. Although effective dose is low, further improvement of imaging technology and acquisition protocols is warranted for optimisation of digital chest radiography.

  16. Bedside ultrasonography for verification of shoulder reduction: A long way to go

    Institute of Scientific and Technical Information of China (English)

    Koorosh Ahmadi; Amir Masoud Hashemian; Kaveh Sineh-Sepehr; Monavvar Afzal-Aghaee; Saba Jafarpour; Vafa Rahimi-Movaghar

    2016-01-01

    Purpose:Shoulder dislocation is a common joint dislocation managed by the emergency physicians in the emergency departments.Pre-and post-reduction radiographic examinations have long been the standard practice to confirm the presence of dislocation and the successful reduction.However,shoulder ultrasonography has recently been proposed as an alternative to the radiographic examination.This study aimed to assess the accuracy of ultrasonography in evaluating proper reduction of the dislocated joint.Methods:This was a prospective observational study.All patients with confirmed anterior shoulder dislocation were examined by both ultrasonography and radiography after the attempt for reduction of the dislocated joint.The examiners were blinded to the result of the other imaging modality.Results of the two methods were then compared.Results:Overall,108 patients with confirmed anterior shoulder dislocation were enrolled in the study.Ninety-one (84.3%) of the patients were males.Mean age of the participants was (30.11 ± 11.41) years.The majority of the patients had a recurrent dislocation.Bedside ultrasonography showed a sensitivity of 53.8% (95% CI:29.1%-76.8%) and a specificity of 100% (95% CI:96.1%-100%) in detecting inadequate reductions.The results of ultrasonography had a statistically significant agreement with the results of radiography (Kappa-0.672,p < 0.001).Conclusion:The results suggest that the sensitivity of post-reduction ultrasound is not sufficient for it to serve as a substitute for radiography.

  17. Bedside prediction of right subclavian venous catheter insertion length

    Directory of Open Access Journals (Sweden)

    Yoon Ji Choi

    2014-12-01

    Full Text Available Background and objective: The present study aimed to evaluate whether right subclavian vein (SCV catheter insertion depth can be predicted reliably by the distances from the SCV insertion site to the ipsilateral clavicular notch directly (denoted as I-IC, via the top of the SCV arch, or via the clavicle (denoted as I-T-IC and I-C-IC, respectively. Method: In total, 70 SCV catheterizations were studied. The I-IC, I-T-IC, and I-C-IC distances in each case were measured after ultrasound-guided SCV catheter insertion. The actual length of the catheter between the insertion site and the ipsilateral clavicular notch, denoted as L, was calculated by using chest X-ray. Results: L differed from the I-T-IC, I-C-IC, and I-IC distances by 0.14±0.53, 2.19±1.17, and -0.45 ±0.68 cm, respectively. The mean I-T-IC distance was the most similar to the mean L (intraclass correlation coefficient = 0.89. The mean I-IC was significantly shorter than L, while the mean I-C-IC was significantly longer. Linear regression analysis provided the following formula: Predicted SCV catheter insertion length (cm = -0.037 + 0.036 × Height (cm + 0.903 × I-T-IC (cm (adjusted r2 =0.64. Conclusion: The I-T-IC distance may be a reliable bedside predictor of the optimal insertion length for a right SCV cannulation.

  18. Repeated bedside echocardiography in children with respiratory failure

    Directory of Open Access Journals (Sweden)

    Jehlicka Petr

    2011-04-01

    Full Text Available Abstract Background The aim of this study was to verify the benefits and limitations of repeated bedside echocardiographic examinations in children during mechanical ventilation. For the purposes of this study, we selected the data of over a time period from 2006 to 2010. Methods A total of 235 children, average age 3.21 (SD 1.32 years were included into the study and divided into etiopathogenic groups. High-risk groups comprised: Acute lung injury and acute respiratory distress syndrome (ALI/ARDS, return of spontaneous circulation after cardiopulmonary resuscitation (ROSC, bronchopulmonary dysplasia (BPD, cardiomyopathy (CMP and cardiopulmonary disease (CPD. Transthoracic echocardiography was carried out during mechanical ventilation. The following data were collated for statistical evaluation: right and left ventricle myocardial performance indices (RV MPI; LV MPI, left ventricle shortening fraction (SF, cardiac output (CO, and the mitral valve ratio of peak velocity of early wave (E to the peak velocity of active wave (A as E/A ratio. The data was processed after a period of recovery, i.e. one hour after the introduction of invasive lines (time-1 and after 72 hours of comprehensive treatment (time-2. The overall development of parameters over time was compared within groups and between groups using the distribution-free Wilcoxons and two-way ANOVA tests. Results A total of 870 echocardiographic examinations were performed. At time-1 higher average values of RV MPI (0.34, SD 0.01 vs. 0.21, SD 0.01; p Conclusion Echocardiography complements standard monitoring of valuable information regarding cardiac load in real time. Chest excursion during mechanical ventilation does not reduce the quality of the acquired data.

  19. Use of fluorescent screens for isotope radiography

    Energy Technology Data Exchange (ETDEWEB)

    Hubbard, S. K.

    1979-01-01

    Radiographic examination can be performed on items beyond the limitation of conventional isotope radiography without a great loss of resolution. With proper film and screen selection and scatter radiation control, fluorescent screens can be a valuable additional tool for radiography.

  20. Chest X-Ray

    Medline Plus

    Full Text Available ... Therapy November 8 is the International Day of Radiology (IDoR) Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey ...

  1. MRI of the Chest

    Medline Plus

    Full Text Available ... of which shows a thin slice of the body. The images can then be studied from different angles by ... bear denotes child-specific content. Related Articles and Media MR ... Images related to Magnetic Resonance Imaging (MRI) - Chest Sponsored ...

  2. MRI of the Chest

    Medline Plus

    Full Text Available ... vessels and heart chambers. display lymph nodes and blood vessels, including vascular and lymphatic malformations of the chest. assess disorders ... aneurysms some types of metal coils placed within blood vessels nearly all cardiac defibrillators and pacemakers You should ...

  3. CT angiography - chest

    Science.gov (United States)

    ... look for a possible site to insert a catheter for hemodialysis For swelling of the face or upper arms that cannot be explained To look for a suspected birth defect of the aorta or other blood vessels in the chest To look for a balloon dilation of an artery (aneurysm) To look for ...

  4. MRI of the Chest

    Medline Plus

    Full Text Available ... vertebrae, ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around the heart) disease. characterize mediastinal or pleural lesions seen by other ... chemical changes in the tissues. As the hydrogen atoms return to their usual ...

  5. Bone tissue engineering: from bench to bedside

    Directory of Open Access Journals (Sweden)

    Maria A. Woodruff

    2012-10-01

    Full Text Available The drive to develop bone grafts for the filling of major gaps in the skeletal structure has led to a major research thrust towards developing biomaterials for bone engineering. Unfortunately, from a clinical perspective, the promise of bone tissue engineering which was so vibrant a decade ago has so far failed to deliver the anticipated results of becoming a routine therapeutic application in reconstructive surgery. Here we describe our bench to bedside concept, the first clinical results and a detailed analysis of long-term bone regeneration studies in preclinical animal models, exploiting methods of micro- and nano analysis of biodegradable composite scaffolds.

  6. An improved automatic computer aided tube detection and labeling system on chest radiographs

    Science.gov (United States)

    Ramakrishna, Bharath; Brown, Matthew; Goldin, Jonathan; Cagnon, Christopher; Enzmann, Dieter

    2012-03-01

    Tubes like Endotracheal (ET) tube used to maintain patient's airway and the Nasogastric (NG) tube used to feed the patient and drain contents of the stomach are very commonly used in Intensive Care Units (ICU). The placement of these tubes is critical for their proper functioning and improper tube placement can even be fatal. Bedside chest radiographs are considered the quickest and safest method to check the placement of these tubes. Tertiary ICU's typically generate over 250 chest radiographs per day to confirm tube placement. This paper develops a new fully automatic prototype computer-aided detection (CAD) system for tube detection on bedside chest radiographs. The core of the CAD system is the randomized algorithm which selects tubes based on their average repeatability from seed points. The CAD algorithm is designed as a 5 stage process: Preprocessing (removing borders, histogram equalization, anisotropic filtering), Anatomy Segmentation (to identify neck, esophagus, abdomen ROI's), Seed Generation, Region Growing and Tube Selection. The preliminary evaluation was carried out on 64 cases. The prototype CAD system was able to detect ET tubes with a True Positive Rate of 0.93 and False Positive Rate of 0.02/image and NG tubes with a True Positive Rate of 0.84 and False Positive Rate of 0.02/image respectively. The results from the prototype system show that it is feasible to automatically detect both tubes on chest radiographs, with the potential to significantly speed the delivery of imaging services while maintaining high accuracy.

  7. Teaching Evidence-Based Physical Diagnosis: Six Bedside Lessons.

    Science.gov (United States)

    McGee, Steven

    2016-12-01

    Evidence-based physical diagnosis is an essential part of the bedside curriculum. By using the likelihood ratio, a simple measure of diagnostic accuracy, teachers can quickly adapt this approach to their bedside teaching. Six recurring themes in evidence-based physical diagnosis are fully reviewed, with examples, in this article.

  8. Bedside teaching in medical education: a literature review.

    Science.gov (United States)

    Peters, Max; Ten Cate, Olle

    2014-04-01

    Bedside teaching is seen as one of the most important modalities in teaching a variety of skills important for the medical profession, but its use is declining. A literature review was conducted to reveal its strengths, the causes of its decline and future perspectives, the evidence with regard to learning clinical skills and patient/student/teacher satisfaction. PubMed, Embase and the Cochrane library were systematically searched with regard to terms related to bedside teaching. Articles regarding the above-mentioned subjects were included. Bedside teaching has shown to improve certain clinical diagnostic skills in medical students and residents. Patients, students/residents and teachers all seem to favour bedside teaching, for varying reasons. Despite this, the practice of bedside teaching is declining. Reasons to explain this decline include the increased patient turnover in hospitals, the assumed violation of patients' privacy and an increased reliance on technology in the diagnostic process. Solutions vary from increasingly using residents and interns as bedside teachers to actively educating staff members regarding the importance of bedside teaching and providing them with practical essentials. Impediments to bedside teaching need to be overcome if this teaching modality is to remain a valuable educational method for durable clinical skills.

  9. Bedside echo for chest pain: an algorithm for education and assessment

    OpenAIRE

    Amini R; Stolz LA; Kartchner JZ; Thompson M; Stea N; Hawbaker N; Joshi R; Adhikari S

    2016-01-01

    Richard Amini, Lori A Stolz, Jeffrey Z Kartchner, Matthew Thompson, Nicholas Stea, Nicolaus Hawbaker, Raj Joshi, Srikar Adhikari Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA Background: Goal-directed ultrasound protocols have been developed to facilitate efficiency, throughput, and patient care. Hands-on instruction and training workshops have been shown to positively impact ultrasound tr...

  10. Improving early diagnosis of pulmonary infections in patients with febrile neutropenia using low-dose chest computed tomography

    NARCIS (Netherlands)

    Gerritsen, M G; Willemink, M J; Pompe, E; van der Bruggen, T; van Rhenen, A; Lammers, J W J|info:eu-repo/dai/nl/071697624; Wessels, F; Sprengers, R W; de Jong, Pim|info:eu-repo/dai/nl/287955672; Minnema, M C|info:eu-repo/dai/nl/171618149

    2017-01-01

    We performed a prospective study in patients with chemotherapy induced febrile neutropenia to investigate the diagnostic value of low-dose computed tomography compared to standard chest radiography. The aim was to compare both modalities for detection of pulmonary infections and to explore

  11. 'Aorta-in-aorta' sign on chest radiograph representing enlarged left superior intercostal and hemiazygos veins

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Yon Mi; Lee, Kyung Soo; Kim, Tae Sung [School of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2002-06-01

    We recently encountered a patient with membranous obstruction of the inferior vena cava in whom the left superior intercostal and hemiazygos veins were dilated. At chest radiography, the dilation simulated the presence of a second aortic knob and descending thoracic aorta lateral to the originals, and an 'aorta-in-aorta' appearance was thus created.

  12. A pilot study evaluating erect chest imaging in children, using the Lodox Statscan digital X-ray machine

    Directory of Open Access Journals (Sweden)

    Rupesh Baloo Daya

    2009-11-01

    Full Text Available ABSTRACT Background: Chest radiography accounts for a significant proportion of ionising radiation in children. The radiation dose of radiographs performed on the Lodox Statscan system has been shown to be lower than that of a computed radiography (CR system. The role of the Lodox Statscan (hereafter referred to as the Statscan in routine erect chest radiography in children has not been evaluated. Objective: To evaluate the image quality and diagnostic accuracy of erect paediatric chest radiographs obtained with the Statscan and compare this with conventional erect chest images obtained with a CR system. Materials and Methods: Thirty three children with suspected chest pathology were enrolled randomly over a period of three months. Erect chest radiographs were obtained with the Statscan, and a Shimadzu R-20J X-ray machine coupled with a Fuji FCR 5000 CR system. Image quality and diagnostic accuracy and diagnostic capability were evaluated between the two modalities. Results: The erect Statscan allowed superior visualisation of the three major airways. Statscan images however, demonstrated exposure and movement artifacts with hemidiaphragms and ribs most prone to movement. Bronchovascular clarity was also considered unsatisfactory on the Statscan images. Conclusion: The Statscan has limitations in erect chest radiography in terms of movement artefacts, exposure fluctuations, and poor definition of lung markings. Despite this, the Statscan allows better visualisation of the major airways, equivalent to a ‘high KV’ film at a fraction of the radiation dose. This supports the finding of an earlier study evaluating Statscan images in trauma cases, where the images were taken supine. Statscan has great potential in assisting in the diagnosis of childhood tuberculosis where airway narrowing occurs as a result of nodal compression.

  13. Practical application of suspension criteria scenarios in general radiography, computed radiography,digital radiography and fluoroscopy.

    Science.gov (United States)

    O'Connor, U; Gallagher, A; O'Reilly, G; Dowling, A; Malone, J F

    2013-02-01

    Radiological equipment must be assessed against criteria for acceptability to ensure that it meets the minimum standards for patient safety. This assessment is typically led by a medical physicist with input from radiology staff and the equipment supplier. Equipment that does not meet the criteria requires action and may be suspended from clinical use. European Commission report RP 91 will be revised and replaced as RP 162. It has been drawn up to aid medical physicists with the assessment process and provide guidance on suspension levels. This paper details several cases where the criteria in the proposed RP 162 were applied in general radiography, computed radiography, digital radiography and fluoroscopy. The factors considered by the medical physicist and the outcome of each case are presented. The proposed RP 162 report improves on its predecessor and provides a robust set of criteria for ensuring that patient safety within the EU medical exposures framework is optimised.

  14. Utility and potential of bedside ultrasound in palliative care

    Directory of Open Access Journals (Sweden)

    Ekta Dhamija

    2015-01-01

    Full Text Available Bedside ultrasound is an important tool in modern palliative care practice. It can be utilized for rapid diagnostic evaluation or as an image guidance to perform invasive therapeutic procedures. With advent of portable ultrasound machines, it can also be used in community or home care settings, apart from palliative care wards. Major applications of bedside ultrasound include drainage of malignant pleural effusions and ascites, nerve blocks, venous access, evaluation of urinary obstruction, deep vein thrombosis and abscesses. Bedside ultrasound leads to better clinical decision-making as well as more accurate and faster invasive therapeutic procedures. It also enhances patient comfort and reduces cost burden. However, use of bedside ultrasound is still not widespread among palliative care givers, owing to initial cost, lack of basic training in ultrasound and apprehensions about its use. A team approach involving radiologists is important to develop integration of bedside ultrasound in palliative care.

  15. Bedside ultrasound procedures: musculoskeletal and non-musculoskeletal.

    Science.gov (United States)

    Sahlani, Lydia; Thompson, Laura; Vira, Amar; Panchal, Ashish R

    2016-04-01

    The widespread availability of ultrasound (US) technology has increased its use for point of care applications in many health care settings. Focused (point of care) US is defined as the act of bringing US evaluation to the bedside for real-time performance. These images are collected immediately by the practitioner, allowing for direct integration into the physician's medical decision-making process. The real-time bedside diagnostic ability of US becomes a key tool for the management of patients. The purpose of this review is to (1) provide a general description of the use of focused US for bedside procedures; (2) specify the indications and common techniques used in bedside US procedures; and (3) describe the techniques used for each bedside intervention.

  16. Sandstorm in the chest?

    Directory of Open Access Journals (Sweden)

    Talluri MR

    2011-07-01

    Full Text Available A 32 year old female presented with dry cough and progressive breathlessness of one year duration. There was no history suggestive of collagen vascular disease, lung parenchymal infection or allergic airway disease. Clinical evaluation showed basal fine inspiratory crepitations. Radiographic examination of the chest revealed a black pleura line and lung parenchymal calcification. CT scan of the chest demonstrated nodular calcification of lung parenchyma with a “crazy pavement” pattern, which is suggestive of alveolar calcification. Pulmonary function test showed a severe restrictive defect. On transbronchial lung biopsy calcific spherules suggestive of the alveolar microlithiasis were seen. Diagnosis of pulmonary alveolar microlithiasis was made and symptomatic treatment was given, as there is no specific therapy available. The case illustrates an unusual cause of shortness of breath in a young female with striking radiographic features.

  17. CHEST PHYSIOTHERAPY FOR INFANTS

    OpenAIRE

    2014-01-01

    In the normal lung, secretions are removed by Mucociliary activity, normal breathing cycles, and cough. In disease, increased secretion viscosity and volume, dyskinesia of the cilia, and ineffective cough combine to reduce the ability to clear secretions, and may increase exacerbations and infections. Many chest physiotherapy techniques like postural drainage, percussion and vibration are used since many years. These techniques are derived from adult studies but these techniques are quite str...

  18. Posteroanterior chest X-ray for the diagnosis of pneumothorax: methods, usage, and resolution

    Directory of Open Access Journals (Sweden)

    Denise Rossato Silva

    2010-08-01

    Full Text Available Denise Rossato Silva, Sandra Jungblut Schuh, Paulo de Tarso Roth DalcinUniversidade Federal do Rio Grande do Sul, Porto Alegre-RS, BrazilAbstract: Most pneumothoraces are demonstrated on fully inspired erect posteroanterior (PA chest X-ray (CXR. Expiratory films may have a role in the clinical management of patients with a small respiratory reserve in whom pneumothorax is suspected and not demonstrated on the inspiratory film. PA CXR can be used for the diagnosis of spontaneous and ­nonspontaneous pneumothoraces. When digital radiography is used, for most authors, a 2.5-lp/mm spatial ­resolution is satisfactory to detect a pneumothorax.Keywords: radiography, computed tomography, pneumothorax, posteroanterior chest X-ray

  19. Bedside ultrasound in pediatric emergency medicine.

    Science.gov (United States)

    Levy, Jason A; Noble, Vicki E

    2008-05-01

    Bedside emergency ultrasound has been used by emergency physicians for >20 years for a variety of conditions. In adult centers, emergency ultrasound is routinely used in the management of victims of blunt abdominal trauma, in patients with abdominal aortic aneurysm and biliary disease, and in women with first-trimester pregnancy complications. Although its use has grown dramatically in the last decade in adult emergency departments, only recently has this tool been embraced by pediatric emergency physicians. As the modality advances and becomes more available, it will be important for primary care pediatricians to understand its uses and limitations and to ensure that pediatric emergency physicians have access to the proper training, equipment, and experience. This article is meant to review the current literature relating to emergency ultrasound in pediatric emergency medicine, as well as to describe potential pediatric applications.

  20. Construction of pediatric homogeneous phantoms for optimization of chest and skull radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Allan Felipe Fattori, E-mail: allan@ibb.unesp.br [Instituto de Biociências de Botucatu, P.O. BOX 510, Departamento de Física e Biofísica, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil); Miranda, José Ricardo de Arruda, E-mail: jmiranda@ibb.unesp.br [Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil); Bacchim Neto, Fernando Antonio, E-mail: fernando.bacchim@gmail.com [Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil); Duarte, Sérgio Barbosa, E-mail: sbd@cbpf.br [Centro Brasileiro de Pesquisas Físicas, Laboratório de Altas Energias, Dr. Xavier Sigaud, 150, Rio de Janeiro, 22290-180 Rio de Janeiro (Brazil); Pina, Diana Rodrigues de, E-mail: drpina@fmb.unesp.br [Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil)

    2015-08-15

    Highlights: • We developed two pediatric patient-equivalent phantoms. • Our phantoms were used in the optimization process of computed radiography systems. • We evaluated physical quantities such as effective detective quantum efficiency and contrast-to-noise ratio. • We determined optimized techniques for pediatric protocols. - Abstract: Objectives: To develop two pediatric patient-equivalent phantoms, the Pediatric Chest Equivalent Patient (PCEP) and the Pediatric Skull Equivalent Patient (PSEP) for children aged 1 to 5 years. We also used both phantoms for image quality evaluations in computed radiography systems to determine Gold Standard (GS) techniques for pediatric patients. Methods: To determine the simulator materials thickness (Lucite and aluminum), we quantified biological tissues (lung, soft, and bone) using an automatic computational algorithm. To objectively establish image quality levels, two physical quantities were used: effective detective quantum efficiency and contrast-to-noise ratio. These quantities were associated to values obtained for standard patients from previous studies. Results: For chest radiographies, the GS technique applied was 81 kVp, associated to 2.0 mAs and 83.6 μGy of entrance skin dose (ESD), while for skull radiographies, the GS technique was 70 kVp, associated to 5 mAs and 339 μGy of ESD. Conclusion: This procedure allowed us to choose optimized techniques for pediatric protocols, thus improving quality of diagnosis for pediatric population and reducing diagnostic costs to our institution. These results could also be easily applied to other services with different equipment technologies.

  1. The neonatal chest

    Energy Technology Data Exchange (ETDEWEB)

    Lobo, Luisa [Servico de Imagiologia Geral do Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisbon (Portugal)]. E-mail: mluisalobo@gmail.com

    2006-11-15

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented.

  2. The evaluation of bedside teaching – an instrument for staff ...

    African Journals Online (AJOL)

    to role-model professional behaviour. These qualities .... The bedside teaching evaluation questionnaire (Fig.1) was adapted ... on a scale of 1 - 5, with 1 meaning 'not done' and 5 .... study relates to issues such as students' motivation to learn,.

  3. Improving nurse–physician teamwork through interprofessional bedside rounding

    Science.gov (United States)

    Henkin, Stanislav; Chon, Tony Y; Christopherson, Marie L; Halvorsen, Andrew J; Worden, Lindsey M; Ratelle, John T

    2016-01-01

    Background Teamwork between physicians and nurses has a positive association with patient satisfaction and outcomes, but perceptions of physician–nurse teamwork are often suboptimal. Objective To improve nurse–physician teamwork in a general medicine inpatient teaching unit by increasing face-to-face communication through interprofessional bedside rounds. Intervention From July 2013 through October 2013, physicians (attendings and residents) and nurses from four general medicine teams in a single nursing unit participated in bedside rounding, which involved the inclusion of nurses in morning rounds with the medicine teams at the patients’ bedside. Based on stakeholder analysis and feedback, a checklist for key patient care issues was created and utilized during bedside rounds. Assessment To assess the effect of bedside rounding on nurse–physician teamwork, a survey of selected items from the Safety Attitudes Questionnaire (SAQ) was administered to participants before and after the implementation of bedside rounds. The number of pages to the general medicine teams was also measured as a marker of physician–nurse communication. Results Participation rate in bedside rounds across the four medicine teams was 58%. SAQ response rates for attendings, residents, and nurses were 36/36 (100%), 73/73 (100%), and 32/73 (44%) prior to implementation of bedside rounding and 36 attendings (100%), 72 residents (100%), and 14 (19%) nurses after the implementation of bedside rounding, respectively. Prior to bedside rounding, nurses provided lower teamwork ratings (percent agree) than residents and attendings on all SAQ items; but after the intervention, the difference remained significant only on SAQ item 2 (“In this clinical area, it is not difficult to speak up if I perceive a problem with patient care”, 64% for nurses vs 79% for residents vs 94% for attendings, P=0.02). Also, resident responses improved on SAQ item 1 (“Nurse input is well received in this area

  4. Blind bedside insertion of small bowel feeding tubes.

    LENUS (Irish Health Repository)

    Duggan, SN

    2009-12-01

    The use of Naso-Jejunal (NJ) feeding is limited by difficulty in feeding tube placement. Patients have traditionally required transfer to Endoscopy or Radiology for insertion of small bowel feeding tubes, with clear resource implications. We hypothesised that the adoption of a simple bedside procedure would be effective and reduce cost. Clinical nutrition and nurse specialist personnel were trained in the 10\\/10\\/10 method of blind bedside NJ insertion.

  5. Mucopolysaccharidosis: abnormal findings on abdomen and chest excluding musculoskeletal system

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jeung Hee; Yoon, Dae Young; Seo, Young Lan; Han, Dae Hee; Choi, Chul Soon; Bae, Sang Hoon; Yoon, Young Cheol; Park, Sang Joon [Samsung Medical Center, Seoul (Korea, Republic of); Kim Han, Bok Yung; Yoon, Hye Kyung; Cho, Jae Min [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    Mucopolysaccharidosis (MPS) is a lysosomal storage disease that causes tissue distortion and dysfunction due to the infiltration of mucopolysaccharide in connective tissue. The purpose of this study was to evaluate the characteristic findings of abdominal CT and plain chest radiography in patients with MPS. Sixty-two children with MPS diagnosed by urine analysis were involved in this study; 24 of these underwent abdominal CT and the findings were reviewed by two radiologists, who reached a consensus. Organomegaly was classified as severe, moderate or mild. On chest PA radiographs of 42 of the children, the transverse diameter of the trachea was measured and compared with that of 42 normal controls. Student's t test was used for statistical analysis. At abdominal CT, hepatomegaly was observed in 22 patients (92%; 2 severe, 15 moderate and 5 mild); and splenomegaly was present in 18 (75%; 2 severe, 4 moderate and 12 mild). Among eight patients(33%) with pancreatic enlargement, one had a severly enlarged pancreas, while in the remaining seven, enlargement was mild. Also present were inguinal hernia (n=15), umbilical hernia (n=12), undulation with thickening of the diaphragmatic crura (n=10), abnormalities related to the male genitalia (n=5) and vascular anomaly (n=3). In MPS patients, the mid-point diameter of the trachea (range, 5.6-9 mm; mean, 6.9 mm) was significantly less than in normal controls (range, 8-14 mm; mean, 10.8 mm) (p<0.001). An awareness of the characteristic abnormalities observed at abdominal CT and chest PA radiography can lead to a better understanding of MPS in children.

  6. Mucopolysaccharidosis: abnormal findings on abdomen and chest excluding musculoskeletal system

    Energy Technology Data Exchange (ETDEWEB)

    KimHan, Bo Kyung; Yoon, Hye Kyung; Cho, Jae Min [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Moon, Jeung Hee; Yoon, Dae Young; Seo, Young Lan; Han, Dae Hee; Choi, Chul Soon; Bae, Sang Hoon; Yoon, Young Cheol; Park, Sang Joon [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    Mucopolysaccharidosis (MPS) is a lysosomal storage disease that causes tissue distortion and dysfunction due to the infiltration of mucopolysaccharide in connective tissue. The purpose of this study was to evaluate the characteristic findings of abdominal CT and plain chest radiography in patients with MPS. Sixty-two children with MPS diagnosed by urine analysis were involved in this study; 24 of these underwent abdominal CT and the findings were reviewed by two radiologists, who reached a consensus. Organomegaly was classified as severe, moderate or mild. On chest PA radiographs of 42 of the children, the transverse diameter of the trachea was measured and compared with that of 42 normal controls. Student's t test was used for statistical analysis. At abdominal CT, hepatomegaly was observed in 22 patients (92%; 2 severe, 15 moderate and 5 mild); and splenomegaly was present in 18 (75%; 2 severe, 4 moderate and 12 mild). Among eight patients (33%) with pancreatic enlargement, one had a severly enlarged pancreas, while in the remaining seven, enlargement was mild. Also present were inguinal hernia (n=15), umbilical hernia (n=12), undulation with thickening of the diaphragmatic crura (n=10). abnormalities related to the male genitalia (n=5) and vascular anomaly (n=3). In MPS patients, the mid-point diameter of the trachea (range, 5.6-9 mm; mean, 6.9 mm) was significantly less than in normal controls (range, 8-14 mm; mean, 10.8 mm)(p<0.001). An awareness of the characteristic abnormalities observed at abdominal CT and chest PA radiography can lead to a better understanding of MPS in children.

  7. Tomografia computadorizada de alta resolução na silicose: correlação com radiografia e testes de função pulmonar High-resolution computed tomography in silicosis: correlation with chest radiography and pulmonary function tests

    Directory of Open Access Journals (Sweden)

    Agnaldo José Lopes

    2008-05-01

    Full Text Available OBJETIVO: Correlacionar os parâmetros tomográficos com os de função pulmonar em portadores de silicose, bem como comparar os resultados da tomografia computadorizada de alta resolução (TCAR com os da radiografia de tórax. MÉTODOS: Foi realizado um estudo de corte transversal, em que foram avaliados 44 pacientes não-tabagistas e sem história pregressa de tuberculose. As radiografias foram classificadas de acordo com a proposta da Organização Internacional do Trabalho. Utilizando um sistema de escore semiquantitativo, os seguintes achados na TCAR foram quantificados: extensão total do envolvimento pulmonar, opacidades parenquimatosas e enfisema. Foram realizados espirometria, oscilações forçadas, avaliação dos volumes pulmonares pela técnica de diluição com hélio e medida da diffusing capacity of the lung for carbon monoxide (DLCO, capacidade de difusão do monóxido de carbono. RESULTADOS: Dos 44 pacientes estudados, 41 eram homens, com média de idade de 48,4 anos. Na análise comparativa, 4 pacientes classificados na categoria 0 pela radiografia foram reclassificados na categoria 1 pela TCAR e, enquanto a radiografia diagnosticou 23 casos de fibrose maciça progressiva, a TCAR estabeleceu esse diagnóstico em 33 doentes. Para o escore de opacidades, as maiores correlações foram observadas com as medidas de fluxo, DLCO e complacência. Já o enfisema correlacionou-se negativamente com as medidas de volume, DLCO e fluxo. Nesta amostra com predomínio de grandes opacidades (75% dos indivíduos, a deterioração da função pulmonar associou-se com a extensão das alterações estruturais. CONCLUSÕES: Na silicose, a TCAR é superior à radiografia tanto na detecção precoce da doença quanto na identificação de fibrose maciça progressiva.OBJECTIVE: To correlate tomographic findings with pulmonary function findings, as well as to compare chest X-ray findings with high resolution computed tomography (HRCT findings, in

  8. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.

    NARCIS (Netherlands)

    A. Gates; L. Warnock; Dr. C.P. van der Schans

    2013-01-01

    BACKGROUND: Chest physiotherapy is widely used in people with cystic fibrosis in order to clear mucus from the airways. OBJECTIVES: To determine the effectiveness and acceptability of chest physiotherapy compared to no treatment or spontaneous cough alone to improve mucus clearance in cystic

  9. Fully automated calculation of cardiothoracic ratio in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Jiang, Luan; Chen, Gang; Li, Qiang

    2017-03-01

    The calculation of Cardiothoracic Ratio (CTR) in digital chest radiographs would be useful for cardiac anomaly assessment and heart enlargement related disease indication. The purpose of this study was to develop and evaluate a fully automated scheme for calculation of CTR in digital chest radiographs. Our automated method consisted of three steps, i.e., lung region localization, lung segmentation, and CTR calculation. We manually annotated the lung boundary with 84 points in 100 digital chest radiographs, and calculated an average lung model for the subsequent work. Firstly, in order to localize the lung region, generalized Hough transform was employed to identify the upper, lower, and outer boundaries of lung by use of Sobel gradient information. The average lung model was aligned to the localized lung region to obtain the initial lung outline. Secondly, we separately applied dynamic programming method to detect the upper, lower, outer and inner boundaries of lungs, and then linked the four boundaries to segment the lungs. Based on the identified outer boundaries of left lung and right lung, we corrected the center and the declination of the original radiography. Finally, CTR was calculated as a ratio of the transverse diameter of the heart to the internal diameter of the chest, based on the segmented lungs. The preliminary results on 106 digital chest radiographs showed that the proposed method could obtain accurate segmentation of lung based on subjective observation, and achieved sensitivity of 88.9% (40 of 45 abnormalities), and specificity of 100% (i.e. 61 of 61 normal) for the identification of heart enlargements.

  10. Are chest radiographs routinely necessary following thoracostomy tube removal?

    Energy Technology Data Exchange (ETDEWEB)

    Pacharn, Preeyacha; Heller, Daniel N.D.; Kammen, Bamidele F.; Bryce, Thomas J.; Bailey, Richard A.; Brasch, Robert C. [Department of Radiology, University of California San Francisco, CA (United States); Reddy, Mohan V. [Department of Surgery, University of California San Francisco (United States)

    2002-02-01

    Objective: Chest radiographs (CXRs) are routinely obtained at many institutions in all pediatric patients following thoracostomy tube removal to search for pneumothorax (PTX). To aid in evaluating the necessity of this practice, this study investigates whether clinical signs and symptoms may be a sensitive predictor of PTX in such patients. Materials and methods: Reports from CXRs obtained following chest tube removal in all pediatric patients (374 patients) who underwent cardiac surgery with chest tube placement over 1 year were reviewed. For cases with reported PTX, the PTX was quantified and chart review was performed to assess whether signs and symptoms of PTX preceded the CXR result. Results: Fifty-one of 374 children (13.6%) had a radiographically defined PTX within 6 h after thoracostomy tube removal. The PTX was large (>40%) in 2 children, moderate (20-40%) in 5 children, and small (<20%) in 44 children. Symptoms (dyspnea, tachypnea, respiratory distress) or signs (increased oxygen requirement, worsening arterial blood gas and/or hypotension) of respiratory distress were present at the time of the initial CXR in six of seven patients, who later underwent a major clinical intervention, and in one patient who did not. Major clinical interventions were performed in all patients with a large PTX, four of five patients with a moderate PTX, and one patient with a small PTX that later enlarged. Conclusions: Clinical signs and symptoms identified nearly all patients with significant pneumothoraces. Future prospective investigations may examine reserving chest radiography following chest tube removal for select groups, such as symptomatic patients or those with tenuous cardiovascular status. (orig.)

  11. Incidental findings in chest X-rays; Zufallsbefunde im Roentgenthorax

    Energy Technology Data Exchange (ETDEWEB)

    Wielpuetz, M.O.; Kauczor, H.U. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany); Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik, Heidelberg (Germany); Weckbach, S. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany)

    2017-04-15

    Conventional projection radiography (chest x-ray) is one of the most frequently requested procedures in radiology. Even though chest x-ray imaging is frequently performed in asymptomatic patients for preoperative assessment, clinically relevant incidental findings are relatively scarce. This is due to the relatively low sensitivity of chest x-rays where few clinically relevant incidental findings are to be expected, as any detectable pathologies will as a rule already be clinically symptomatic. Recommendations from relevant societies for the management of incidental findings, apart from the clarification of incidental nodules, do not exist. This review article therefore describes the most frequent and typical incidental findings of lung parenchyma (apart from pulmonary nodules), mediastinal structures including the hilum of the lungs, pleura, chest wall and major vessels. Also described are those findings which can be diagnosed with sufficient certainty from chest x-rays so that further clarification is not necessary and those which must be further clarified by multislice imaging procedures or other techniques. (orig.) [German] Eine der haeufigsten Untersuchungen in der Radiologie ist die konventionelle Projektionsradiographie des Thorax (Roentgenthorax). Auch wenn projektionsradiographische Aufnahmen im Rahmen einer praeoperativen Abklaerung haeufig als orientierende Untersuchung angefertigt werden, sind - bedingt durch die relativ geringe Sensitivitaet des Roentgenthorax - wenig klinisch relevante Zufallsbefunde zu erwarten, da nachweisbare Pathologien in der Regel bereits auch klinisch apparent sind. Empfehlungen entsprechender Fachgesellschaften zu Zufallsbefunden im Roentgenthorax jenseits der Abklaerung von Rundherden liegen nicht vor. Die vorliegende Arbeit beleuchtet daher haeufige und typische Zufallsbefunde des Lungenparenchyms (ausser den Lungenrundherden), der mediastinalen Strukturen einschliesslich der Hili, der Pleura, der Thoraxwand sowie der

  12. Fracture healing: direct magnification versus conventional radiography

    Energy Technology Data Exchange (ETDEWEB)

    Link, T.M. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany); Kessler, T. [Dept. of Traumatic and Hand Surgery, Westfaelische Wilhelms-Univ., Muenster (Germany); Lange, T. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany); Overbeck, J. [Dept. of Traumatic and Hand Surgery, Westfaelische Wilhelms-Univ., Muenster (Germany); Fiebich, M. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany); Peters, P.E. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany)

    1994-08-01

    The aim of the study was to evaluate the potential of magnification radiography in diagnosing fracture healing and assessing its complications. Seventy-three patients with fractures or who had undergone osteotomy were radiographed with both conventional (non-magnified) and magnification (5-fold) techniques. Since 10 patients were radiographed twice and 1 three times, 83 radiographs using each technique were obtained. All radiographs were analysed and the findings correlated with the patients` follow-up studies. The microfocal X-ray unit used for magnification radiography had a focal spot size of 20-130 {mu}m. As an imaging system, digital luminescence radiography was employed with magnification, while normal film-screen systems were used with conventional radiography. Magnification radiography proved superior to conventional radiography in 47% of cases: endosteal and periosteal callus formations were seen earlier and better in 26 cases, and osseous union could be evaluated with greater certainty in 33 cases. In 49% of cases magnification radiography was equal and in 4% inferior to conventional radiography. Additionally an ``inter-observer analysis`` was carried out. Anatomical and pathological structures were classified into one of four grades. Results were significantly (P < 0.01) better using magnification radiography. We conclude that the magnification technique is a good method for monitoring fracture healing in its early stages. (orig.)

  13. Computed radiography (FCR) with a dual side reading system. Comparison with conventional radiography for visualization of nodular lung cancers

    Energy Technology Data Exchange (ETDEWEB)

    Ha-kawa, Shangkil; Yoshida, Tsunetaka; Sougawa, Mitsuharu; Harima, Yohko; Sawada, Satoshi [Kansai Medical Univ., Moriguchi, Osaka (Japan)

    2003-02-01

    To assess the diagnostic capability Fuji computed radiography (FCR) using a dual side reading system was compared to the conventional radiography using a film-screen system. Twenty-eight patients with lung cancer were examined with a new FCR system (FCR 5501D) and a conventional screen-film system concurrently. FCR utilizes a reading system that detects emissions from dual sides of imaging plate. Chest X-rays were obtained with same exposure factors in both systems. Image qualities of both systems were compared by two radiologists using a five-level score. There were no lesion that FCR images were inferior to film-screen images. The frequency of score +1 or +2 that FCR images were superior to film-screen images was 31% in large nodular shadows, 40% in accompanying shadows with a nodule, 67% of small nodular shadows, and 43% of the lymph node swelling in the hilum of the lung or mediastinum. In large nodular shadows which were the most frequent abnormality score +1 or +2 were observed in 43% of adenocarcinoma and 26% of squamous cell lung cancer. FCR with the dual side reading system is superior to the conventional screen-film system for visualization of nodular lung cancers. (author)

  14. Initial clinical evaluation of stationary digital chest tomosynthesis

    Science.gov (United States)

    Hartman, Allison E.; Shan, Jing; Wu, Gongting; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping; Heath, Michael; Wang, Xiaohui; Foos, David

    2016-03-01

    Computed Tomography (CT) is the gold standard for image evaluation of lung disease, including lung cancer and cystic fibrosis. It provides detailed information of the lung anatomy and lesions, but at a relatively high cost and high dose of radiation. Chest radiography is a low dose imaging modality but it has low sensitivity. Digital chest tomosynthesis (DCT) is an imaging modality that produces 3D images by collecting x-ray projection images over a limited angle. DCT is less expensive than CT and requires about 1/10th the dose of radiation. Commercial DCT systems acquire the projection images by mechanically scanning an x-ray tube. The movement of the tube head limits acquisition speed. We recently demonstrated the feasibility of stationary digital chest tomosynthesis (s-DCT) using a carbon nanotube (CNT) x-ray source array in benchtop phantom studies. The stationary x-ray source allows for fast image acquisition. The objective of this study is to demonstrate the feasibility of s-DCT for patient imaging. We have successfully imaged 31 patients. Preliminary evaluation by board certified radiologists suggests good depiction of thoracic anatomy and pathology.

  15. [Musculoskeletal-related chest pain].

    Science.gov (United States)

    Sturm, C; Witte, T

    2017-01-01

    Approximately 10-50% of chest pains are caused by musculoskeletal disorders. The association is twice as frequent in primary care as in emergency admissions. This article provides an overview of the most important musculoskeletal causes of chest pain and on the diagnostics and therapy. A selective search and analysis of the literature related to the topic of musculoskeletal causes of chest pain were carried out. Non-inflammatory diseases, such as costochondritis and fibromyalgia are frequent causes of chest pain. Inflammatory diseases, such as rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus are much less common but are more severe conditions and therefore have to be diagnosed and treated. The diagnostics and treatment often necessitate interdisciplinary approaches. Chest pain caused by musculoskeletal diseases always represents a diagnosis by exclusion of other severe diseases of the heart, lungs and stomach. Physiotherapeutic and physical treatment measures are particularly important, including manual therapy, transcutaneous electrical stimulation and stabilization exercises, especially for functional myofascial disorders.

  16. Blood gas analysis for bedside diagnosis.

    Science.gov (United States)

    Singh, Virendra; Khatana, Shruti; Gupta, Pranav

    2013-07-01

    Arterial blood gas is an important routine investigation to monitor the acid-base balance of patients, effectiveness of gas exchange, and the state of their voluntary respiratory control. Majority of the oral and maxillofacial surgeons find it difficult to interpret and clinically correlate the arterial blood gas report in their everyday practice. This has led to underutilization of this simple tool. The present article aims to simplify arterial blood gas analysis for a rapid and easy bedside interpretation. In context of oral and maxillofacial surgery, arterial blood gas analysis plays a vital role in the monitoring of postoperative patients, patients receiving oxygen therapy, those on intensive support, or with maxillofacial trauma with significant blood loss, sepsis, and comorbid conditions like diabetes, kidney disorders, Cardiovascular system (CVS) conditions, and so on. The value of this analysis is limited by the understanding of the basic physiology and ability of the surgeon to interpret the report. Using a systematic and logical approach by using these steps would make the interpretation simple and easy to use for oral and maxillofacial surgeons.

  17. Computerized method to compensate for breathing body motion in dynamic chest radiographs

    Science.gov (United States)

    Matsuda, H.; Tanaka, R.; Sanada, S.

    2017-03-01

    Dynamic chest radiography combined with computer analysis allows quantitative analyses on pulmonary function and rib motion. The accuracy of kinematic analysis is directly linked to diagnostic accuracy, and thus body motion compensation is a major concern. Our purpose in this study was to develop a computerized method to reduce a breathing body motion in dynamic chest radiographs. Dynamic chest radiographs of 56 patients were obtained using a dynamic flat-panel detector. The images were divided into a 1 cm-square and the squares on body counter were used to detect the body motion. Velocity vector was measured using cross-correlation method on the body counter and the body motion was then determined on the basis of the summation of motion vector. The body motion was then compensated by shifting the images based on the measured vector. By using our method, the body motion was accurately detected by the order of a few pixels in clinical cases, mean 82.5% in right and left directions. In addition, our method detected slight body motion which was not able to be identified by human observations. We confirmed our method effectively worked in kinetic analysis of rib motion. The present method would be useful for the reduction of a breathing body motion in dynamic chest radiography.

  18. Diagnostic Accuracy of Ultrasonography and Radiography in Detection of Pulmonary Contusion; a Systematic Review and Meta-Analysis

    OpenAIRE

    HOSSEINI, Mostafa; Ghelichkhani, Parisa; Baikpour, Masoud; Tafakhori, Abbas; Asady, Hadi; Haji Ghanbari, Mohammad Javad; Yousefifard, Mahmoud; Safari, Saeed

    2015-01-01

    Introduction: Ultrasonography is currently being used as one of the diagnostic modalities in various medical emergencies for screening of trauma patients. The diagnostic value of this modality in detection of traumatic chest injuries has been evaluated by several studies but its diagnostic accuracy in diagnosis of pulmonary contusion is a matter of discussion. Therefore, the present study aimed to determine the diagnostic accuracy of ultrasonography and radiography in detection of pulmonary c...

  19. Multiple imaging radiography at LNLS

    Energy Technology Data Exchange (ETDEWEB)

    Hoennicke, M.G. [LORXI, Departamento de Fisica, Universidade Federal do Parana, Caixa Postal 19091, 81531-990 Curitiba (Brazil)], E-mail: marcelohonnicke@yahoo.com.br; Cusatis, C. [LORXI, Departamento de Fisica, Universidade Federal do Parana, Caixa Postal 19091, 81531-990 Curitiba(Brazil); Antunes, A. [Departamento de Fisica Aplicada, Instituto de Fisica, Universidade de Sao Paulo, Caixa Postal 66318, 05315-970 Sao Paulo (Brazil); Safatle, A.M.V.; Barros, P.S.M. [Laboratorio de Oftalmologia Experimental e Comparativa, Departamento de Cirurgia, Faculdade de Medicina Veterinaria, Universidade de Sao Paulo, 05508-900 Sao Paulo (Brazil); Morelhao, S.L. [Departamento de Fisica Aplicada, Instituto de Fisica, Universidade de Sao Paulo, Caixa Postal 66318, 05315-970 Sao Paulo (Brazil)

    2008-01-11

    An analyzer-based X-ray phase-contrast imaging (ABI) setup has been mounted at the Brazilian Synchrotron Light Laboratory (LNLS) for multiple imaging radiography (MIR) purposes. The algorithm employed for treating the MIR data collected at LNLS is described, and its reliability in extracting the distinct types of contrast that can be obtained with MIR is demonstrated by analyzing a test sample (thin polyamide wire). As a practical application, the possibility of studying ophthalmic tissues, corneal sequestra in this case, via MIR is investigated.

  20. Computational radiology in skeletal radiography

    Energy Technology Data Exchange (ETDEWEB)

    Peloschek, Ph.; Nemec, S. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Widhalm, P. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Pattern Recognition and Image Processing Group, Department of Computer Aided Automation, Vienna University of Technology, Wiedner Hauptstrasse 8-10/020, A-1040 Vienna (Austria); Donner, R. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Pattern Recognition and Image Processing Group, Department of Computer Aided Automation, Vienna University of Technology, Wiedner Hauptstrasse 8-10/020, A-1040 Vienna (Austria); Institute for Computer Graphics and Vision, Graz University of Technology, Inffeldgasse 16, A-8010 Graz (Austria); Birngruber, E. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Thodberg, H.H. [Visiana Aps, Sollerodvej 57C, DK-2840 Holte (Denmark); Kainberger, F. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Langs, G. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)], E-mail: georg.langs@meduniwien.ac.at

    2009-11-15

    Recent years have brought rapid developments in computational image analysis in musculo-skeletal radiology. Meanwhile the algorithms have reached a maturity that makes initial clinical use feasible. Applications range from joint space measurement to erosion quantification, and from fracture detection to the assessment of alignment angles. Current results of computational image analysis in radiography are very promising, but some fundamental issues remain to be clarified, among which the definition of the optimal trade off between automatization and operator-dependency, the integration of these tools into clinical work flow and last not least the proof of incremental clinical benefit of these methods.

  1. Paediatric dose measurement in a full-body digital radiography unit

    Energy Technology Data Exchange (ETDEWEB)

    Maree, Gert J.; Hering, Egbert R. [Groote Schuur Hospital and University of Cape Town, Division of Medical Physics, Cape Town (South Africa); Irving, Benjamin J. [University of Cape Town, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Cape Town, Western Cape (South Africa)

    2007-10-15

    Ionizing radiation has a detrimental effect on the human body, particularly in children. Thus it is important to minimize the dose. Linear slit-scanning X-ray units offer the possibility of dose reductions. In order to further develop linear slit-scanning radiography, the dose needs to be accurately calculated for various examinations. To measure the entrance dose (free-in-air) and calculate the effective doses for various radiological examinations in children on Lodox Statscan and Shimadzu radiography units. Entrance doses (free-in-air) were measured using a dose meter and ionization chamber on the Statscan and Shimadzu units at two South African hospitals. The entrance doses were measured for a number of common examinations and were used to compute the effective dose using a Monte Carlo program. The standard deviation of the entrance doses was in the range 0-0.6%. The effective dose from the Statscan unit was well below that from the Shimadzu unit as well as that found in other radiological studies from around the world in children. The one exception was chest examination where the dose was similar to that in other studies worldwide due to the use of Chest AP projection compared to Chest PA used in the comparitive studies. Linear slit-scanning systems help reduce the dose in radiological examinations in children. (orig.)

  2. NEUTRON RADIOGRAPHY: A SECOND PROGRESS REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Berger, H

    1962-08-31

    The progress made on investigations of neutron radiography since October 1960 is discussed. The problems of the production of the neutron image will be discussed. The emphasis will be on the characteristics of many of the photographic imaging methods which can be used for neutron radiography. (auth)

  3. Process waste assessment for the Radiography Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, N.M.

    1994-07-01

    This Process Waste Assessment was conducted to evaluate the Radiography Laboratory, located in Building 923. It documents the processes, identifies the hazardous chemical waste streams generated by these processes, recommends possible ways to minimize waste, and serves as a reference for future assessments of this facility. The Radiography Laboratory provides film radiography or radioscopy (electronic imaging) of weapon and nonweapon components. The Radiography Laboratory has six x-ray machines and one gamma ray source. It also has several other sealed beta- and gamma-ray isotope sources of low microcurie ({mu}Ci) activity. The photochemical processes generate most of the Radiography Laboratory`s routinely generated hazardous waste, and most of that is generated by the DuPont film processor. Because the DuPont film processor generates the most photochemical waste, it was selected for an estimated material balance.

  4. Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song [Dankook University College of Medicine, Dankook University Hospital, Cheonan (Korea, Republic of)

    2010-12-15

    The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

  5. Value of noninvasive assessment of patients with atypical chest pain and suspected coronary spasm using ergonovine infusion and thallium-201 scintigraphy.

    Science.gov (United States)

    DiCarlo, L A; Botvinick, E H; Canhasi, B S; Schwartz, A S; Chatterjee, K

    1984-10-01

    Twenty-six patients with known benign coronary anatomic characteristics and atypical chest pain syndromes were evaluated for the possibility of coronary spasm. Incremental intravenous ergonovine maleate infusions were administered, and thallium-201 scintigraphy was performed at the peak dosage and during recovery in the coronary care unit. With ergonovine therapy, 4 patients (16%) had chest pain associated with electrocardiographic (ECG) or scintigraphic changes. Nine patients (35%) had chest pain without associated ECG or scintigraphic changes, and 13 patients did not have chest pain in response to ergonovine administration, although 2 (8%) had ergonovine-induced scintigraphic defects. All 4 patients with ergonovine-induced chest pain and associated ECG or scintigraphic abnormalities had resolution or reduction of chest pain after medical treatment. However, 7 of the 9 patients with ergonovine-induced chest pain in the absence of ECG or scintigraphic abnormalities continued to have symptoms despite medical treatment a mean of 18 months later. In this limited study of a select group, bedside ergonovine provocation appeared safe. Many patients had chest pain, but few showed ECG or scintigraphic evidence of ischemia. Perfusion scintigraphy appears to have potential complementary value for the identification of an ischemic cardiac cause of atypical chest pain and provides a rationale for appropriate therapy.

  6. Value of noninvasive assessment of patients with atypical chest pain and suspected coronary spasm using ergonovine infusion and thallium-201 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    DiCarlo, L.A. Jr.; Botvinick, E.H.; Canhasi, B.S.; Schwartz, A.S.; Chatterjee, K.

    1984-10-01

    Twenty-six patients with known benign coronary anatomic characteristics and atypical chest pain syndromes were evaluated for the possibility of coronary spasm. Incremental intravenous ergonovine maleate infusions were administered, and thallium-201 scintigraphy was performed at the peak dosage and during recovery in the coronary care unit. With ergonovine therapy, 4 patients (16%) had chest pain associated with electrocardiographic (ECG) or scintigraphic changes. Nine patients (35%) had chest pain without associated ECG or scintigraphic changes, and 13 patients did not have chest pain in response to ergonovine administration, although 2 (8%) had ergonovine-induced scintigraphic defects. All 4 patients with ergonovine-induced chest pain and associated ECG or scintigraphic abnormalities had resolution or reduction of chest pain after medical treatment. However, 7 of the 9 patients with ergonovine-induced chest pain in the absence of ECG or scintigraphic abnormalities continued to have symptoms despite medical treatment a mean of 18 months later. In this limited study of a select group, bedside ergonovine provocation appeared safe. Many patients had chest pain, but few showed ECG or scintigraphic evidence of ischemia. Perfusion scintigraphy appears to have potential complementary value for the identification of an ischemic cardiac cause of atypical chest pain and provides a rationale for appropriate therapy.

  7. Radiology illustrated. Chest radiology

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of). Dept. of Radiology; Han, Joungho [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of). Dept. of Pathology; Chung, Man Pyo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of). Dept. of Medicine; Jeong, Yeon Joo [Pusan National Univ. Hospital, Busan (Korea, Republic of). Dept. of Radiology

    2014-04-01

    Pattern approach to the diagnosis of lung diseases based on CT scan appearances. Guide to quick and reliable differential diagnosis. CT-pathology correlation. Emphasis on state-of-the-art MDCT. The purpose of this atlas is to illustrate how to achieve reliable diagnoses when confronted by the different abnormalities, or ''disease patterns'', that may be visualized on CT scans of the chest. The task of pattern recognition has been greatly facilitated by the advent of multidetector CT (MDCT), and the focus of the book is very much on the role of state-of-the-art MDCT. A wide range of disease patterns and distributions are covered, with emphasis on the typical imaging characteristics of the various focal and diffuse lung diseases. In addition, clinical information relevant to differential diagnosis is provided and the underlying gross and microscopic pathology is depicted, permitting CT-pathology correlation. The entire information relevant to each disease pattern is also tabulated for ease of reference. This book will be an invaluable handy tool that will enable the reader to quickly and easily reach a diagnosis appropriate to the pattern of lung abnormality identified on CT scans.

  8. Improvement of material decomposition and image quality in dual-energy radiography by reducing image noise

    Science.gov (United States)

    Lee, D.; Kim, Y.-s.; Choi, S.; Lee, H.; Choi, S.; Jo, B. D.; Jeon, P.-H.; Kim, H.; Kim, D.; Kim, H.; Kim, H.-J.

    2016-08-01

    Although digital radiography has been widely used for screening human anatomical structures in clinical situations, it has several limitations due to anatomical overlapping. To resolve this problem, dual-energy imaging techniques, which provide a method for decomposing overlying anatomical structures, have been suggested as alternative imaging techniques. Previous studies have reported several dual-energy techniques, each resulting in different image qualities. In this study, we compared three dual-energy techniques: simple log subtraction (SLS), simple smoothing of a high-energy image (SSH), and anti-correlated noise reduction (ACNR) with respect to material thickness quantification and image quality. To evaluate dual-energy radiography, we conducted Monte Carlo simulation and experimental phantom studies. The Geant 4 Application for Tomographic Emission (GATE) v 6.0 and tungsten anode spectral model using interpolation polynomials (TASMIP) codes were used for simulation studies and digital radiography, and human chest phantoms were used for experimental studies. The results of the simulation study showed improved image contrast-to-noise ratio (CNR) and coefficient of variation (COV) values and bone thickness estimation accuracy by applying the ACNR and SSH methods. Furthermore, the chest phantom images showed better image quality with the SSH and ACNR methods compared to the SLS method. In particular, the bone texture characteristics were well-described by applying the SSH and ACNR methods. In conclusion, the SSH and ACNR methods improved the accuracy of material quantification and image quality in dual-energy radiography compared to SLS. Our results can contribute to better diagnostic capabilities of dual-energy images and accurate material quantification in various clinical situations.

  9. Chest radiographic findings of leptospirosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mee Hyun; Jung, Hee Tae; Lee, Young Joong; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1986-04-15

    1. A study on chest radiographic findings of 54 cases with pneumonia like symptoms was performed. Of 54 cases, 8 cases were confirmed to be leptospirosis and 7 cases were leptospirosis combined with Korean hemorrhagic fever. 2. Of 8 cases of leptospirosis, 4 cases showed abnormal chest radiographic findings: acinar nodular type 2, massive confluent consolidation type 2. Of 7 cases of leptospirosis combined with Korean hemorrhagic fever: acinar nodular type 3, massive confluent consolidation type 1, and increased interstitial markings type 1 respectively. 3. It was considered to be difficult to diagnose the leptospirosis on chest radiographic findings alone, especially the case combined with Korean hemorrhagic fever.

  10. Migraine patients consistently show abnormal vestibular bedside tests

    Directory of Open Access Journals (Sweden)

    Eliana Teixeira Maranhão

    2015-01-01

    Full Text Available Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs.Objective To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls.Method Cross-sectional study including sixty individuals – thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls.Results Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity.Conclusion Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  11. CHEST WALL HAMARTOMA : Case Report

    OpenAIRE

    Gülden DİNİZ; Ortaç, Ragıp; Aktaş, Safiye; TEMİR, Günyüz; HOŞGÖR, Münevver; Karaca, İrfan

    2005-01-01

    A case of four-month – old girl diagnosed as chest wall hamartoma is presented. This entity is an extremely rare but characteristic lesion of the ribs usually presenting in the neonate or infant with a mass or respiratory symptoms. Complete sponraneous regression of the lesion has been reported. Recently conservative management of asymptomatic childiren was recommended. Although rare, this condition ought to be kept in mind while dealing with infantile chest wall masses to avoid an errone...

  12. CHEST WALL HAMARTOMA : Case Report

    OpenAIRE

    Gülden DİNİZ; Ortaç, Ragıp; Aktaş, Safiye; HOŞGÖR, Günyüz TEMİR2Münevver; Karaca, İrfan

    2005-01-01

    A case of four-month – old girl diagnosed as chest wall hamartoma is presented. This entity is an extremely rare but characteristic lesion of the ribs usually presenting in the neonate or infant with a mass or respiratory symptoms. Complete sponraneous regression of the lesion has been reported. Recently conservative management of asymptomatic childiren was recommended. Although rare, this condition ought to be kept in mind while dealing with infantile chest wall masses to avoid...

  13. Percutaneous catheter drainage of thoracic fluid: the usefulness and safety of bedside trocar placement under ultrasound guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon [Seoul Medical Center, Seoul (Korea, Republic of)

    2006-07-15

    The author wanted to evaluate the usefulness and safety of the trocar technique for US-guided bedside catheter placement into thoracic fluid collections, and this technique has generally been reserved for the larger or superficial fluid collections. 42 drainage procedures were performed in 38 patients at the bedside. The patients were positioned supine or semi-upright. A drainage catheter system with a stylet and cannula assembly was used and all of the catheters were inserted using the trocar technique. The procedures consisted of drainage of empyema (n=14), malignant effusion (n=13), lung abscess (n=3), massive transudate (n=8), hemothorax (n=2) and chest wall hematoma (n=2). The clinical results were classified as successful (complete and partially successful), failure or undetermined. The medical records and images were retrospectively reviewed to evaluate the success rate, the complications and the procedure time. Technical success was achieved in all of the 42 procedures. With using the trocar technique, all the catheters were placed into even the small collections without significant complications. Drainage was successful in 36 (85.7%) of the 42 procedures. The average volume of thoracic fluid that was aspirated manually at the time of catheter placement was 420 mL (range: 35 to 1470 mL). The procedure time was less than 10 minutes from US-localization to complete catheter placement in all of the procedures. The trocar technique under US guidance can be an efficient and safe alternative to the Seldinger or guide-wire exchange technique for bedside catheter placement in the critically ill or hemodynamically unstable patients.

  14. Bedside ultrasound education in Canadian medical schools: A national survey

    Directory of Open Access Journals (Sweden)

    Peter Steinmetz

    2016-04-01

    Results:  Approximately half of the 13 responding medical schools had integrated bedside ultrasound teaching into their undergraduate curriculum. The most common trends in undergraduate ultrasound teaching related to duration (1-5 hours/year in 50% of schools, format (practical and theoretical in 67% of schools, and logistics (1:4 instructor to student ratio in 67% of schools. The majority of responding vice-deans indicated that bedside ultrasound education should be integrated into the medical school curriculum (77%, and cited a lack of ultrasound machines and infrastructure as barriers to integration. Conclusions: This study documents the current characteristics of undergraduate ultrasound education in Canada.

  15. Standard guide for computed radiography

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This guide provides general tutorial information regarding the fundamental and physical principles of computed radiography (CR), definitions and terminology required to understand the basic CR process. An introduction to some of the limitations that are typically encountered during the establishment of techniques and basic image processing methods are also provided. This guide does not provide specific techniques or acceptance criteria for specific end-user inspection applications. Information presented within this guide may be useful in conjunction with those standards of 1.2. 1.2 CR techniques for general inspection applications may be found in Practice E2033. Technical qualification attributes for CR systems may be found in Practice E2445. Criteria for classification of CR system technical performance levels may be found in Practice E2446. Reference Images Standards E2422, E2660, and E2669 contain digital reference acceptance illustrations. 1.3 The values stated in SI units are to be regarded as the st...

  16. Proton Radiography at Los Alamos

    Energy Technology Data Exchange (ETDEWEB)

    Saunders, Alexander [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-28

    The proton radiography (pRad) facility at Los Alamos National Lab uses high energy protons to acquire multiple frame flash radiographic sequences at megahertz speeds: that is, it can make movies of the inside of explosions as they happen. The facility is primarily used to study the damage to and failure of metals subjected to the shock forces of high explosives as well as to study the detonation of the explosives themselves. Applications include improving our understanding of the underlying physical processes that drive the performance of the nuclear weapons in the United States stockpile and developing novel armor technologies in collaboration with the Army Research Lab. The principle and techniques of pRad will be described, and examples of some recent results will be shown.

  17. SU-D-209-06: Study On the Dose Conversion Coefficients in Pediatric Radiography with the Development of Children Voxel Phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Q [Institute of Radiation Medicine Fudan University, Shanghai (China); Shanghai General Hospital, Shanghai, Shanghai (China); Zhuo, W; Liu, H [Institute of Radiation Medicine Fudan University, Shanghai (China); Liu, Y; Chen, T [Shanghai General Hospital, Shanghai, Shanghai (China)

    2016-06-15

    Purpose: Conversion coefficients of organ dose normalized to entrance skin dose (ESD) are widely used to evaluate the organ doses directly using ESD without time-consuming dose measurement, this work aims to investigate the dose conversion coefficients in pediatric chest and abdomen radiography with the development of 5 years and 10 years old children voxel phantoms. Methods: After segmentation of organs and tissues from CT slice images of ATOM tissue-equivalent phantoms, a 5-year-old and a 10-year-old children computational voxel phantoms were developed for Monte Carlo simulation. The organ doses and the entrance skin dose for pediatric chest postero-anterior projection and abdominal antero-posterior projection were simulated at the same time, and then the organ dose conversion coefficients were calculated.To verify the simulated results, dose measurement was carried out with ATOM tissue-equivalent phantoms for 5 year chest radiography. Results: Simulated results and experimental results matched very well with each other, the result differences of all the organs covered in radiation field were below 16% for 5-year-old child in chest projection. I showed that the conversion coefficients of organs covered in the radiation field were much larger than organs out of the field for all the study cases, for example, the conversion coefficients of stomach, liver intestines, and pancreas are larger for abdomen radiography while conversion coefficients of lungs are larger for chest radiography. Conclusion: The voxel children phantoms were helpful to evaluate the radiation doses more accurately and efficiently. Radiation field was the essential factor that affects the organ dose, use reasonably small field should be encouraged for radiation protection. This work was supported by the National Natural Science Foundation of China(11475047)

  18. Estimation of patient exposure in dental radiography

    Energy Technology Data Exchange (ETDEWEB)

    Yasaki, Shiro; Yukishita, Kentaro; Daibo, Motoji; Suzuki, Yousuke [Ohu Univ., Koriyama, Fukushima (Japan). School of Dentistry

    1998-12-01

    Purpose of this study is to examine comparison of absorbed dose in each mode of newest Multimode Panoramic Radiography and Dental Radiography. The absorbed dose of Dental Radiography uses modified IWAI`s data. The effective doses were calculated using modified tissue weighting factors recommended by International Commission on Radiological Protection (ICRP) in 1990. The result of estimate in effective dose, panoramic auto function mode (4.92 {mu}Sv) was lower than dental full mouth (43.12 {mu}Sv). And clinical effective dose was higher than the other`s modes, in linear tomogram modes. The absorbed dose of patient in Dental Radiography is decreasing in recent years. But in daily clinical work we should pay atteation to justification and optimization. (author)

  19. Single-exposure dual-energy computed radiography.

    Science.gov (United States)

    Stewart, B K; Huang, H K

    1990-01-01

    This paper focuses on analysis and development of a single-exposure dual-energy digital radiographic method using computed radiography (Fuji FCR-101 storage phosphor system). A detector sandwich consisting of storage phosphor imaging plates and an interdetector filter is used. The goal of this process is to provide a simple dual-energy method using typical plane-projection radiographic equipment and techniques. This approach exploits the transparency of the storage phosphor plates, using radiographic information that would be otherwise lost, to provide energy selective information essentially as a by-product of the radiographic examination. In order to effectively make use of the large dynamic range of the storage phosphor imaging plates (10,000:1), a computed radiography image reading mode of fixed analog-to-digital converter gain and variable photomultiplier sensitivity provides image data which can be related to relative incident exposure for export to the decomposition algorithm. Scatter rejection requirements necessitated crossed 12:1 grids for a field size of 36 x 36 cm. Optimal technique parameters obtained from computer simulation through minimization of the aluminum and Plexiglas equivalent image uncertainty under conditions of constant absorbed does resulted as: 100 kVp using a 0.15-mm-thick tin (Sn) interdetector filter for the lung field. This yields a surface exposure of 23 mR and a surface absorbed dose of 0.26 mGy for a 23-cm-thick chest. Clinical application in evaluation of the solitary pulmonary nodule is discussed, along with an image set demonstrating this application.

  20. Imaging beamline for high energy proton radiography

    Institute of Scientific and Technical Information of China (English)

    WEI Tao; YANG Guo-Jun; LONG Ji-Dong; WANG Shao-Heng; HE Xiao-Zhong

    2012-01-01

    Proton radiography is a new tool for advanced hydrotesting.This article will discuss the basic concept of proton radiography first,especially the magnetic lens system.Then a scenario of 50 GeV imaging beamline will be described in every particular,including the matching section,Zumbro lens system and imaging system.The simulation result shows that the scenario of imaging beamline performs well,and the influence of secondary particles can be neglected.

  1. Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Gregory Mansella

    2014-01-01

    Full Text Available Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the “Mackling effect.” Sonographic findings consistent with pneumomediastinum, like the “air gap” sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate.

  2. H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, S.-Y. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, J.H., E-mail: jhkate@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Eo, H.; Jeon, T.Y.; Shin, K.E.; Shin, W.S.; Jung, H.N. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Y.-J. [Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-04-15

    Aim: To describe the frequency, pattern, and outcome of chest radiographic abnormalities in children with H1N1 influenza infection. Materials and methods: Three hundred and fourteen paediatric patients with confirmed H1N1 influenza infection who underwent chest radiography at presentation at a single institution during the outbreak in 2009 were retrospectively reviewed. Abnormal chest radiographic findings related to acute infection were analysed in terms of frequency, pattern, and distribution. Medical records and follow-up radiographs were also reviewed to assess clinical features and outcomes. Results: Chest lesions suggesting acute infection were identified in 49 (16%) patients (mean age 8.2 years, range approximately 1.8-18.5 years). The most common finding was prominent peribronchial marking (71%), followed by air-space opacity (51%) with or without volume decrease, generalized hyperinflation (24%), and pleural effusion (20%). Other minor findings included pneumomediastinum (n = 2) and a nodule (n = 1). Distributions were bilateral (55%) or unilateral (45%) with frequent involvement of lower (78%), and middle (59%) lung zones. Thirty-nine patients (80%) were hospitalized and six (12%) required mechanical ventilation, followed by recovery. Thirty-one out of the 33 patients that underwent follow-up radiography showed marked resolution of all radiographic abnormalities. Conclusion: The frequency of a chest radiographic abnormality was found to be low in children with H1N1 influenza infection. Although typical radiographic findings of a viral lower respiratory infection were more common, unilateral involvement and air-space opacity were common, often with pleural effusion. Furthermore, pulmonary lesions showed near complete resolution on follow-up radiographs in the majority of patients.

  3. The bedside assistant in robotic surgery--keys to success.

    Science.gov (United States)

    Yuh, Bertram

    2013-01-01

    Taking on the position of bedside assistant for a surgical robotic team can be a daunting task. Keys to success include preparation, proper operation set up, effective use of instruments to augment the actions of the console surgeon, and readiness for surgical emergencies. Effective communication, repetitive execution, and readiness facilitate the efforts of the surgical team.

  4. Accidental Carotid Artery Cannulation Detected by Bedside Ultrasound

    Directory of Open Access Journals (Sweden)

    Chiles, Kris

    2011-02-01

    Full Text Available This report highlights the importance of using bedside ultrasound in the emergency department to confirm guide-wire placement when performing central venous catheter placement prior to dilating and cannulating the vessel. [West J Emerg Med. 2011;12(1:100-101.

  5. Bedside Ultrasound in a Case of Blunt Scrotal Trauma

    Directory of Open Access Journals (Sweden)

    Mark Cannis

    2013-03-01

    Full Text Available This case study describes a patient who suffered blunt force trauma to the scrotum. Use of bedsideemergency ultrasound facilitated early diagnosis of a ruptured testicle and allowed for prompturological consultation and timely surgical repair. The utility of bedside emergency ultrasound inthe evaluation of testicular trauma, as well as the outcome of our case, is discussed here.

  6. Beyond bench and bedside: disentangling the concept of translational research

    NARCIS (Netherlands)

    Laan, van der Anna Laura; Boenink, Marianne

    2015-01-01

    The label ‘Translational Research’ (TR) has become ever more popular in the biomedical domain in recent years. It is usually presented as an attempt to bridge a supposed gap between knowledge produced at the lab bench and its use at the clinical bedside. This is claimed to help society harvest the b

  7. Simulation of proton radiography terminal at IMP

    CERN Document Server

    Yan, Yan; Huang, Zhi-Wu; Wang, Jie; Yao, Ze-En; Wang, Jun-Run; Wei, Zheng; Yang, Jian-Cheng; Yuan, You-Jin

    2015-01-01

    Proton radiography is used for advanced hydrotesting as a new type radiography technology due to its powerful penetration capability and high detection efficiency. A new proton radiography terminal will be developed to radiograph static samples at Institute of Modern Physics of Chinese Academy of Science (IMP-CAS). The proton beam with the maximum energy of 2.6 GeV will be produced by Heavy Ion Research Facility in Lanzhou-Cooling Storage Ring (HIRFL-CSR). The proton radiography terminal consists of the matching magnetic lens and the Zumbro lens system. In this paper, the design scheme and all optic parameters of this beam terminal for 2.6GeV proton energy are presented by simulating the beam optics using WINAGILE code. My-BOC code is used to test the particle tracking of proton radiography beam line. Geant4 code and G4beamline code are used for simulating the proton radiography system. The results show that the transmission efficiency of proton without target is 100%, and the effect of secondary particles ca...

  8. Organ Doses and Effective Doses in Pediatric Radiography: Patient-Dose Survey in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Kiljunen, T.; Tietaevaeinen, A.; Parviainen, T.; Viitala, A.; Kortesniemi, M. (Radiation Practices Regulation, Radiation and Nuclear Safety Authority, Helsinki (Finland))

    2009-01-15

    Background: Use of the effective dose in diagnostic radiology permits the radiation exposure of diverse diagnostic procedures to be quantified. Fundamental knowledge of patient doses enhances the implementation of the 'as low as reasonably achievable' (ALARA) principle. Purpose: To provide comparative information on pediatric examination protocols and patient doses in skull, sinus, chest, abdominal, and pelvic radiography examinations. Material and Methods: 24 Finnish hospitals were asked to register pediatric examination data, including patient information and examination parameters and specifications. The total number of examinations in the study was 1916 (1426 chest, 228 sinus, 96 abdominal, 94 skull, and 72 pelvic examinations). Entrance surface dose (ESD) and dose-area products (DAP) were calculated retrospectively or DAP meters were used. Organ doses and effective doses were determined using a Monte Carlo program (PCXMC). Results: There was considerable variation in examination protocols between different hospitals, indicating large variations in patient doses. Mean effective doses of different age groups ranged from 5 muSv to 14 muSv in skull and sinus examinations, from 25 muSv to 483 muSv in abdominal examinations, and from 6 muSv to 48 muSv in chest examinations. Conclusion: In chest and sinus examinations, the amount of data was extensive, allowing national pediatric diagnostic reference levels to be defined. Parameter selection in pediatric examination protocols should be harmonized in order to reduce patient doses and improve optimization

  9. Clinical Factors Associated With Chest Imaging Findings in Hospitalized Infants With Bronchiolitis.

    Science.gov (United States)

    Nazif, Joanne M; Taragin, Benjamin H; Azzarone, Gabriella; Rinke, Michael L; Liewehr, Sheila; Choi, Jaeun; Esteban-Cruciani, Nora

    2017-10-01

    Despite recommendations against routine imaging, chest radiography (CXR) is frequently performed on infants hospitalized for bronchiolitis. We conducted a review of 811 infants hospitalized for bronchiolitis to identify clinical factors associated with imaging findings. CXR was performed on 553 (68%) infants either on presentation or during hospitalization; 466 readings (84%) were normal or consistent with viral illness. Clinical factors significantly associated with normal/viral imaging were normal temperature (odds ratio = 1.66; 95% CI = 1.03-2.67) and normal oxygen saturation (odds ratio = 1.77; 95% CI = 1.1-2.83) on presentation. Afebrile patients with normal oxygen saturations were nearly 3 times as likely to have a normal/viral CXR as patients with both fever and hypoxia. Our findings support the limited role of radiography in the evaluation of hospitalized infants with bronchiolitis, especially patients without fever or hypoxia.

  10. [Chest ultrasonography in pleurapulmonary disease].

    Science.gov (United States)

    Gallego Gómez, M P; García Benedito, P; Pereira Boo, D; Sánchez Pérez, M

    2014-01-01

    Although the initial diagnosis and follow-up of pleuropulmonary disease are normally done with plain chest films and the gold standard for chest disease is computed tomography, diverse studies have established the usefulness of chest ultrasonography in the diagnosis of different pleuropulmonary diseases like pleural effusion and lung consolidation, among others. In this article, we show the different ultrasonographic patterns for pleuropulmonary disease. The availability of ultrasonography in different areas (ICU, recovery areas) makes this technique especially important for critical patients because it obviates the need to transfer the patient. Moreover, ultrasonography is noninvasive and easy to repeat. On the other hand, it enables the direct visualization of pleuropulmonary disease that is necessary for interventional procedures. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  11. Screening for chest disease in college students: policies of student health services regarding the use of routine screening chest radiographs and tuberculin skin tests

    Energy Technology Data Exchange (ETDEWEB)

    Fager, S.S.; Slap, G.B.; Kitz, D.S.; Eisenberg, J.M.

    1984-02-01

    A survey of college health services was conducted to determine their policies regarding the use of screening chest radiographs and tuberculin skin tests. Pre-enrollment chest radiographs are prescribed for all incoming students by 24% of the 531 respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 20%, 19%, and 6%, respectively. Periodic chest radiography is conducted for all students by 7% of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 22%, 16%, and 8%, respectively. Pre-enrollment tuberculin skin tests are prescribed for all incoming students by 52% of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48%, 29%, and 9%, respectively. Periodic tuberculin skin testing is conducted for all students by 27% of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48%, 23%, and 16%, respectively. It is estimated from these data that 723,000 incoming students in the United States received screening chest radiographs in 1979 with estimated charges totaling between $7 million and $27 million. There may be 0.05 to 0.33 induced cases of lung cancer, leukemia, thyroid cancer, and female breast cancer over a 20-year period among this group of students exposed to ionizing radiation.

  12. Contemporary management of flail chest.

    Science.gov (United States)

    Vana, P Geoff; Neubauer, Daniel C; Luchette, Fred A

    2014-06-01

    Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management.

  13. Proton radiography for clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Talamonti, C., E-mail: cinzia.talamonti@unifi.i [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Reggioli, V. [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); Bruzzi, M. [INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Dipartimento di Energetica, Universita degli Studi di Firenze, via S. Marta 3, I-50139 Firenze (Italy); Bucciolini, M. [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Civinini, C. [INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Marrazzo, L. [Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Menichelli, D. [INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Finland) (Italy); Dipartimento di Energetica, Universita degli Studi di Firenze, via S. Marta 3, I-50139 Firenze (Italy); Pallotta, S. [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Randazzo, N. [INFN, sezione di Catania, via S. Sofia 64, I-95123 Catania (Italy); Sipala, V. [INFN, sezione di Catania, via S. Sofia 64, I-95123 Catania (Italy); Dipartimento di Fisica, Universita degli Studi di Catania, via S. Sofia 64, I-95123 Catania (Italy)

    2010-01-11

    Proton imaging is not yet applied as a clinical routine, although its advantages have been demonstrated. In the context of quality assurance in proton therapy, proton images can be used to verify the correct positioning of the patient and to control the range of protons. Proton computed tomography (pCT) is a 3D imaging method appropriate for planning and verification of proton radiation treatments, because it allows evaluating the distributions of proton stopping power within the tissues and can be directly utilized when the patient is in the actual treatment position. The aim of the PRoton IMAging experiment, supported by INFN, and the PRIN 2006 project, supported by MIUR, is to realize a proton computed radiography (pCR) prototype for reconstruction of proton images from a single projection in order to validate the technique with pre-clinical studies and, eventually, to conceive the configuration of a complete pCT system. A preliminary experiment performed at the 250 MeV proton synchrotron of Loma Linda University Medical Center (LLUMC) allowed acquisition of experimental data before the completion of PRIMA project's prototype. In this paper, the results of the LLUMC experiment are reported and the reconstruction of proton images of two phantoms is discussed.

  14. Thorium-uranium fission radiography

    Science.gov (United States)

    Haines, E. L.; Weiss, J. R.; Burnett, D. S.; Woolum, D. S.

    1976-01-01

    Results are described for studies designed to develop routine methods for in-situ measurement of the abundance of Th and U on a microscale in heterogeneous samples, especially rocks, using the secondary high-energy neutron flux developed when the 650 MeV proton beam of an accelerator is stopped in a 42 x 42 cm diam Cu cylinder. Irradiations were performed at three different locations in a rabbit tube in the beam stop area, and thick metal foils of Bi, Th, and natural U as well as polished silicate glasses of known U and Th contents were used as targets and were placed in contact with mica which served as a fission track detector. In many cases both bare and Cd-covered detectors were exposed. The exposed mica samples were etched in 48% HF and the fission tracks counted by conventional transmitted light microscopy. Relative fission cross sections are examined, along with absolute Th track production rates, interaction tracks, and a comparison of measured and calculated fission rates. The practicality of fast neutron radiography revealed by experiments to data is discussed primarily for Th/U measurements, and mixtures of other fissionable nuclei are briefly considered.

  15. Mobile real time radiography system

    Energy Technology Data Exchange (ETDEWEB)

    Vigil, J.; Taggart, D.; Betts, S. [Los Alamos National Lab., NM (United States)] [and others

    1997-11-01

    A 450-keV Mobile Real Time Radiography (RTR) System was delivered to Los Alamos National Laboratory (LANL) in January 1996. It was purchased to inspect containers of radioactive waste produced at (LANL). Since its delivery it has been used to radiograph more than 600 drums of radioactive waste at various LANL sites. It has the capability of inspecting waste containers of various sizes from <1-gal. buckets up to standard waste boxes (SWB, dimensions 54.5 in. x 71 in. x 37 in.). It has three independent x-ray acquisition formats. The primary system used is a 12- in. image intensifier, the second is a 36-in. linear diode array (LDA) and the last is an open system. It is fully self contained with on board generator, HVAC, and a fire suppression system. It is on a 53-ft long x 8-ft. wide x 14-ft. high trailer that can be moved over any highway requiring only an easily obtainable overweight permit because it weights {approximately}38 tons. It was built to conform to industry standards for a cabinet system which does not require an exclusion zone. The fact that this unit is mobile has allowed us to operate where the waste is stored, rather than having to move the waste to a fixed facility.

  16. Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report

    Directory of Open Access Journals (Sweden)

    Mostafa Mehrara

    2017-01-01

    Full Text Available Introduction: Although many protocols are available in the field of the prehospital medical care (PMC, there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC.Method: In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards.Results: 101 cases with the mean age of 56.7 ± 12.3 years (30-78 were audited (55.4% male. 61 (60.3% patients had chest pain and 40 (39.7% cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%, O2 therapy (32.8%, nitroglycerin administration (60.7%, and aspirin administration (52.5% in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%, O2 therapy (75%, cardiac monitoring (25%, pupils examination (25%, bedside glucometery (50%, and assessing for naloxone administration (55% in prehospital care of patients with LOC were fair to poor.Conclusion: There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting.

  17. What is the clinical significance of chest CT when the chest x-ray result is normal in patients with blunt trauma?

    Science.gov (United States)

    Kea, Bory; Gamarallage, Ruwan; Vairamuthu, Hemamalini; Fortman, Jonathan; Lunney, Kevin; Hendey, Gregory W; Rodriguez, Robert M

    2013-08-01

    Computed tomography (CT) has been shown to detect more injuries than plain radiography in patients with blunt trauma, but it is unclear whether these injuries are clinically significant. This study aimed to determine the proportion of patients with normal chest x-ray (CXR) result and injury seen on CT and abnormal initial CXR result and no injury on CT and to characterize the clinical significance of injuries seen on CT as determined by a trauma expert panel. Patients with blunt trauma older than 14 years who received emergency department chest imaging as part of their evaluation at 2 urban level I trauma centers were enrolled. An expert trauma panel a priori classified thoracic injuries and subsequent interventions as major, minor, or no clinical significance. Of 3639 participants, 2848 (78.3%) had CXR alone and 791 (21.7%) had CXR and chest CT. Of 589 patients who had chest CT after a normal CXR result, 483 (82.0% [95% confidence interval [CI], 78.7-84.9%]) had normal CT results, and 106 (18.0% [95% CI, 15.1%-21.3%]) had CTs diagnosing injuries-primarily rib fractures, pulmonary contusion, and incidental pneumothorax. Twelve patients had injuries classified as clinically major (2.0% [95% CI, 1.2%-3.5%]), 78 were clinically minor (13.2% [95% CI, 10.7%-16.2%]), and 16 were clinically insignificant (2.7% (95% CI, 1.7%-4.4%]). Of 202 patients with CXRs suggesting injury, 177 (87.6% [95% CI, 82.4%-91.5%]) had chest CTs confirming injury and 25 (12.4% [95% CI, 8.5%-17.6%]) had no injury on CT. Chest CT after a normal CXR result in patients with blunt trauma detects injuries, but most do not lead to changes in patient management. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Anatomical decomposition in dual energy chest digital tomosynthesis

    Science.gov (United States)

    Lee, Donghoon; Kim, Ye-seul; Choi, Sunghoon; Lee, Haenghwa; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Lung cancer is the leading cause of cancer death worldwide and the early diagnosis of lung cancer has recently become more important. For early screening lung cancer, computed tomography (CT) has been used as a gold standard for early diagnosis of lung cancer [1]. The major advantage of CT is that it is not susceptible to the problem of misdiagnosis caused by anatomical overlapping while CT has extremely high radiation dose and cost compared to chest radiography. Chest digital tomosynthesis (CDT) is a recently introduced new modality for lung cancer screening with relatively low radiation dose compared to CT [2] and also showing high sensitivity and specificity to prevent anatomical overlapping occurred in chest radiography. Dual energy material decomposition method has been proposed for better detection of pulmonary nodules as means of reducing the anatomical noise [3]. In this study, possibility of material decomposition in CDT was tested by simulation study and actual experiment using prototype CDT. Furthermore organ absorbed dose and effective dose were compared with single energy CDT. The Gate v6 (Geant4 application for tomographic emission), and TASMIP (Tungsten anode spectral model using the interpolating polynomial) code were used for simulation study and simulated cylinder shape phantom consisted of 4 inner beads which were filled with spine, rib, muscle and lung equivalent materials. The patient dose was estimated by PCXMC 1.5 Monte Carlo simulation tool [4]. The tomosynthesis scan was performed with a linear movement and 21 projection images were obtained over 30 degree of angular range with 1.5° degree of angular interval. The proto type CDT system has same geometry with simulation study and composed of E7869X (Toshiba, Japan) x-ray tube and FDX3543RPW (Toshiba, Japan) detector. The result images showed that reconstructed with dual energy clearly visualize lung filed by removing unnecessary bony structure. Furthermore, dual energy CDT could enhance

  19. A robust neuro-fuzzy classifier for the detection of cardiomegaly in digital chest radiographies

    Directory of Open Access Journals (Sweden)

    Fabián Torres-Robles

    2014-01-01

    Full Text Available Presentamos un nuevo procedimiento que determina de forma automática y fiable la presencia de cardiomegalia en radiografías torácicas. El CTR muestra la relación entre el tamaño del corazón y el tamaño del tórax. El esquema propuesto utiliza un clasificador robusto difuso para encontrar los valores correctos del tamaño del tórax y los límites del corazón derecho e izquierdo para medir el agrandamiento del corazón para detectar cardiomegalia. El método propuesto utiliza operaciones clásicas de morfología para segmentar los pulmones proporcionando baja complejidad computacional y el método difuso propuesto es robusto para encontrar las medidas correctas del CTR proporcionando un cálculo rápido porque las reglas difusas usan operaciones aritméticas elementales para desempeñar una buena detección de cardiomegalia. Finalmente, se mejoran los resultados de clasificación del método difuso propuesto utilizando una red neuronal función de base radial (RBF en términos de precisión, sensibilidad y especificidad.

  20. Application of the Stephan et al. Chest Radiograph Comparison Method to Decomposed Human Remains.

    Science.gov (United States)

    Isa, Mariyam I; Hefner, Joseph T; Markey, Michael A

    2017-09-01

    This manuscript describes the use of comparative radiography of the chest to facilitate positive identification of human remains in advanced stages of decomposition. The method reported by Stephan et al. for positive identification of dry, disarticulated skeletal elements was used on semifleshed, decomposing remains. Positive identification was established through multiple points of concordance observed in radiographs of the left and right clavicles and the C5-T1 vertebrae. This case study demonstrates the applicability of the Stephan et al.'s method in cases involving decomposing remains. © 2017 American Academy of Forensic Sciences.

  1. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Mahmoud Yousefifard

    2016-01-01

    Full Text Available Introduction: The role of ultrasonography in detection of pleural effusion has long been a subject of interest but controversial results have been reported. Accordingly, this study aims to conduct a systematic review of the available literature on diagnostic value of ultrasonography and radiography in detection of pleural effusion through a meta-analytic approach. Methods: An extended search was done in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. Two reviewers independently extracted the data and assessed the quality of the articles. Meta-analysis was performed using a mixed-effects binary regression model. Finally, subgroup analysis was carried out in order to find the sources of heterogeneity between the included studies. Results: 12 studies were included in this meta-analysis (1554 subjects, 58.6% male. Pooled sensitivity of ultrasonography in detection of pleural effusion was 0.94 (95% CI: 0.88-0.97; I2= 84.23, p<0.001 and its pooled specificity was calculated to be 0.98 (95% CI: 0.92-1.0; I2= 88.65, p<0.001, while sensitivity and specificity of chest radiography were 0.51 (95% CI: 0.33-0.68; I2= 91.76, p<0.001 and 0.91 (95% CI: 0.68-0.98; I2= 92.86, p<0.001, respectively. Sensitivity of ultrasonography was found to be higher when the procedure was carried out by an intensivist or a radiologist using 5-10 MHz transducers. Conclusion: Chest ultrasonography, as a screening tool, has a higher diagnostic accuracy in identification of plural effusion compared to radiography. The sensitivity of this imaging modality was found to be higher when performed by a radiologist or an intensivist and using 5-10MHz probes.

  2. Muon radiography for exploration of Mars geology

    Directory of Open Access Journals (Sweden)

    S. Kedar

    2013-06-01

    Full Text Available Muon radiography is a technique that uses naturally occurring showers of muons (penetrating particles generated by cosmic rays to image the interior of large-scale geological structures in much the same way as standard X-ray radiography is used to image the interior of smaller objects. Recent developments and application of the technique to terrestrial volcanoes have demonstrated that a low-power, passive muon detector can peer deep into geological structures up to several kilometers in size, and provide crisp density profile images of their interior at ten meter scale resolution. Preliminary estimates of muon production on Mars indicate that the near horizontal Martian muon flux, which could be used for muon radiography, is as strong or stronger than that on Earth, making the technique suitable for exploration of numerous high priority geological targets on Mars. The high spatial resolution of muon radiography also makes the technique particularly suited for the discovery and delineation of Martian caverns, the most likely planetary environment for biological activity. As a passive imaging technique, muon radiography uses the perpetually present background cosmic ray radiation as the energy source for probing the interior of structures from the surface of the planet. The passive nature of the measurements provides an opportunity for a low power and low data rate instrument for planetary exploration that could operate as a scientifically valuable primary or secondary instrument in a variety of settings, with minimal impact on the mission's other instruments and operation.

  3. Muon radiography for exploration of Mars geology

    Directory of Open Access Journals (Sweden)

    S. Kedar

    2012-10-01

    Full Text Available Muon radiography is a technique that uses naturally occurring showers of muons (penetrating particles generated by cosmic rays to image the interior of large scale geological structures in much the same way as standard X-ray radiography is used to image the interior of smaller objects. Recent developments and application of the technique to terrestrial volcanoes have demonstrated that a low-power, passive muon detector can peer deep into geological structures up to several kilometers in size, and provide crisp density profile images of their interior at ten meter scale resolution. Preliminary estimates of muon production on Mars indicate that the near horizontal Martian muon flux, which could be used for muon radiography, is as strong or stronger than that on Earth, making the technique suitable for exploration of numerous high priority geological targets on Mars. The high spatial resolution of muon radiography also makes the technique particularly suited for the discovery and delineation of Martian caverns, the most likely planetary environment for biological activity. As a passive imaging technique, muon radiography uses the perpetually present background cosmic ray radiation as the energy source for probing the interior of structures from the surface of the planet. The passive nature of the measurements provides an opportunity for a low power and low data rate instrument for planetary exploration that could operate as a scientifically valuable primary or secondary instrument in a variety of settings, with minimal impact on the mission's other instruments and operation.

  4. Human dimensions in bedside teaching: focus group discussions of teachers and learners.

    Science.gov (United States)

    Ramani, Subha; Orlander, Jay D

    2013-01-01

    Clinical teaching has moved from the bedside to conference rooms; many reasons are described for this shift. Yet, essential clinical skills, professionalism, and humanistic patient interactions are best taught at the bedside. Clinical teaching has moved from the bedside to conference rooms; many reasons are described for this decline. This study explored perceptions of teachers and learners on the value of bedside teaching and the humanistic dimensions of bedside interactions that make it imperative to shift clinical teaching back to the bedside. Focus group methodology was used to explore teacher and learner opinions. Four teacher groups consisted of (a) Chief Residents, (b) Residency Program Directors, (c) skilled bedside teachers, and (d) a convenience group of other Department of Medicine faculty at Boston University School of Medicine. Six learner groups consisted 2 each of 3rd-year students, PGY1 medicine residents, and PGY2 medicine residents. Each discussion lasted 60 to 90 minutes. Sessions were audiotaped, transcribed, and analyzed using qualitative methods. Teachers and learners shared several opinions on bedside teaching, particularly around humanistic aspects of bedside interactions. The key themes that emerged included (a) patient involvement in discussions, (b) teachers as role models of humanism, (c) preserving learner autonomy, (d) direct observation and feedback of learners at the bedside, (e) interactions with challenging patients, and (e) admitting limitations. Within these themes, participants noted some behaviors best avoided at the bedside. Teachers and learners regard the bedside as a valuable venue in which to learn core values of medicine. They proposed many strategies to preserve these humanistic values and improve bedside teaching. These strategies are essential for true patient-centered care.

  5. [What are the tools for post-occupational follow-up, how should they be performed and what are their performance, limits and benefit/risk ratio? Chest X-Ray and CT scan].

    Science.gov (United States)

    Ferretti, G

    2011-06-01

    Chest radiography and computed tomography (CT) are the two radiological techniques used for the follow-up of people exposed to asbestos. Since the last conference of consensus (1999), the scientific literature has primarily covered high-resolution CT and high-resolution volume CT (HR-VCT). We consider in turn the contribution of digital thoracic radiography, recommendations for the performance of HR-VCT to ensure the quality of examination while controlling the delivered radiation dose, and the need to refer to the "CT atlas of benign diseases related to asbestos exposure", published by a group of French experts in 2007, for interpretation. The results of the published studies concerning radiography or CT are then reviewed. We note the great interobserver variability in the recognition of pleural plaques and asbestosis, indicating the need for adequate training of radiologists, and the importance of defining standardized, quantified criteria for CT abnormalities. The very low agreement between thoracic and general radiologists must be taken into account. The reading of CT scans in cases of occupational exposure to asbestos should be entrusted to thoracic radiologists or to general radiologists having validated specific training. A double interpretation of CT could be considered in medicosocial requests. CT is more sensitive than chest radiography in the detection of bronchial carcinoma but generates a great number of false positive results (96 to 99%). No scientific data are available to assess the role of imaging by either CT or chest radiography in the early detection of mesothelioma.

  6. Diagnosis of vertebral fractures on lateral chest X-ray: Intraobserver agreement of semi-quantitative vertebral fracture assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jagt-Willems, H.C. van der, E-mail: Hvanderjagt@spaarneziekenhuis.nl [Department of Geriatrics, Slotervaart Hospital, Amsterdam (Netherlands); Department of Internal Medicine, Spaarne Hospital, Hoofddorp (Netherlands); Munster, B.C. van [Department of Internal Medicine, Academic Medical Center, Amsterdam (Netherlands); Department of Geriatrics, Gelre Hospitals, Apeldoorn (Netherlands); Leeflang, M. [Department of Geriatrics, Gelre Hospitals, Apeldoorn (Netherlands); Beuerle, E. [Department of Radiology, Slotervaart Hospital, Amsterdam (Netherlands); Tulner, C.R. [Department of Geriatrics, Slotervaart Hospital, Amsterdam (Netherlands); Lems, W.F. [Department of Rheumatology, VU Medical Center, Amsterdam (Netherlands)

    2014-12-15

    Highlights: • (Lateral) chest X-ray's are often performed in older individuals for various reasons. • Vertebral fractures are visualized on lateral chest X-ray, but the diagnosis of vertebral fractures is until now only validated on (lateral) spine X-ray's. • This study shows that a (lateral) chest X-ray is sufficient for the diagnosis of vertebral fractures. • Older individuals with a vertebral fracture on a (lateral) chest X-ray do not need further radiography with thoracic spine X-ray or vertebral fracture assessment with DXA. - Abstract: Background: In clinical practice lateral images of the chest are performed for various reasons. As these lateral chest X rays show the vertebrae of the thoracic and thoraco-lumbar region, we wondered if these X-rays can be used for evaluation of vertebral fractures instead of separate thoracic spine X-rays. Methods: To evaluate the agreement and intraobserver reliability of the semi-quantitative method for vertebral fractures on the lateral chest X-ray (X-chest) in comparison to the lateral thoracic spine X-ray (X-Tspine), two observers scored vertebral fractures on X-Tspine and twice on X-chest, separately, blinded and in different time periods. Agreement and Cohens’ kappa were calculated for a diagnosis of any fracture on patient level and on vertebral body level. The study was done in patients visiting an outpatient geriatric day clinic, with a high prevalence of vertebral fractures. Results: 109 patients were included. The intraobserver agreement for X-chest versus X-Tspine was 95–98% for the two levels of fracturing, with a Cohen's kappa of 0.88–0.91. The intraobserver agreement and reliability of the re-test on the X-chest showed an agreement between 91 and 98% with a Cohen's kappa of 0.81–0.93. More vertebrae were visible on the X-chest, mean 10.2, SD 0.66 versus mean 9.8, SD 0.73 on the X-Tspine (p < 0.001). Conclusion: The results show good agreement and intraobserver reliability on

  7. Recurrent Primary Spontaneous Pneumothorax is Common Following Chest Tube and Conservative Treatment

    DEFF Research Database (Denmark)

    Olesen, Winnie Hedevang; Lindahl-Jacobsen, Rune; Katballe, Niels;

    2016-01-01

    INTRODUCTION: Previous studies on primary spontaneous pneumothorax reported variable recurrence rates, but they were based on heterogeneous patient populations including secondary pneumothorax. We investigated young patients with primary spontaneous pneumothorax exclusively and used a national...... registry to track readmissions and calculate independent predictors of recurrence. METHODS: A prospective cohort study of consecutive young patients who were admitted over a 5-year period with their first episode of primary spontaneous pneumothorax and treated conservatively with a chest tube. Baseline...... characteristics were obtained from questionnaires presented on admittance. All patients were discharged with fully expanded lungs on chest radiography. Patient charts were identified in the national electronic patient registry for detailed information on readmissions due to recurrent spontaneous pneumothorax...

  8. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning.

    Science.gov (United States)

    van Ginneken, Bram

    2017-03-01

    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant technology for tackling CAD in the lungs, generally producing better results than do classical rule-based approaches, and how the field is now rapidly changing: in the last few years, we have seen how even better results can be obtained with deep learning. The key differences among rule-based processing, machine learning, and deep learning are summarized and illustrated for various applications of CAD in the chest.

  9. Effects of angular range on image quality of chest digital tomosynthesis

    Science.gov (United States)

    Lee, Haenghwa; Kim, Ye-seul; Choi, Sunghoon; Lee, Dong-Hoon; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Chest digital tomosynthesis (CDT) is a new 3D imaging technique that can be expected to improve clinical diagnosis over conventional chest radiography. We investigated the effect of the angular range of data acquisition on the image quality using newly developed CDT system. The four different acquisition sets were studied using +/-15°, +/-20°, +/-30°, and +/-35° angular ranges with 21 projection views (PVs). The point spread function (PSF), modulation transfer function (MTF), artifact spread function (ASF), and normalized contrast-to-noise ratio (CNR) were used to evaluate the image quality. We found that increasing angular ranges improved vertical resolution. The results indicated that there was the opposite relationship of the CNR with angular range for the two tissue types. While CNR for heart tissue increased with increasing angular range, CNR for spine bone decreased. The results showed that the angular range is an important parameter for the CDT exam.

  10. Elevated Intracranial Pressure Diagnosis with Emergency Department Bedside Ocular Ultrasound

    Directory of Open Access Journals (Sweden)

    D. Amin

    2015-01-01

    Full Text Available Bedside sonographic measurement of optic nerve sheath diameter can aid in the diagnosis of elevated intracranial pressure in the emergency department. This case report describes a 21-year-old female presenting with 4 months of mild headache and 2 weeks of recurrent, transient binocular vision loss. Though limited by patient discomfort, fundoscopic examination suggested the presence of blurred optic disc margins. Bedside ocular ultrasound (BOUS revealed wide optic nerve sheath diameters and bulging optic discs bilaterally. Lumbar puncture demonstrated a cerebrospinal fluid (CSF opening pressure of 54 cm H2O supporting the suspected diagnosis of idiopathic intracranial hypertension. Accurate fundoscopy can be vital to the appropriate diagnosis and treatment of patients with suspected elevated intracranial pressure, but it is often technically difficult or poorly tolerated by the photophobic patient. BOUS is a quick and easily learned tool to supplement the emergency physician’s fundoscopic examination and help identify patients with elevated intracranial pressure.

  11. Bedside diagnosis of mitochondrial dysfunction in aneurysmal subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Jacobsen, A.; Nielsen, T. H.; Nilsson, O.

    2014-01-01

    to diagnose and separate cerebral ischemia and mitochondrial dysfunction bedside. The study explores whether cerebral biochemical variables in SAH patients most frequently exhibit a pattern indicating ischemia or mitochondrial dysfunction. Methods - In 55 patients with severe SAH, intracerebral microdialysis...... was performed during neurocritical care with bedside analysis and display of glucose, pyruvate, lactate, glutamate, and glycerol. The biochemical patterns observed were compared to those previously described in animal studies of induced mitochondrial dysfunction as well as the pattern obtained in patients...... with recirculated cerebral infarcts. Results - In 29 patients, the biochemical pattern indicated mitochondrial dysfunction while 10 patients showed a pattern of cerebral ischemia, six of which also exhibited periods of mitochondrial dysfunction. Mitochondrial dysfunction was observed during 5162 h. An ischemic...

  12. Bench-to-bedside review: An approach to hemodynamic monitoring--Guyton at the bedside.

    Science.gov (United States)

    Magder, Sheldon

    2012-10-29

    Hemodynamic monitoring is used to identify deviations from hemodynamic goals and to assess responses to therapy. To accomplish these goals one must understand how the circulation is regulated. In this review I begin with an historical review of the work of Arthur Guyton and his conceptual understanding of the circulation and then present an approach by which Guyton's concepts can be applied at the bedside. Guyton argued that cardiac output and central venous pressure are determined by the interaction of two functions: cardiac function, which is determined by cardiac performance; and a return function, which is determined by the return of blood to the heart. This means that changes in cardiac output are dependent upon changes of one of these two functions or of both. I start with an approach based on the approximation that blood pressure is determined by the product of cardiac output and systemic vascular resistance and that cardiac output is determined by cardiac function and venous return. A fall in blood pressure with no change in or a rise in cardiac output indicates that a decrease in vascular resistance is the dominant factor. If the fall in blood pressure is due to a fall in cardiac output then the role of a change in the return function and cardiac function can be separated by the patterns of changes in central venous pressure and cardiac output. Measurement of cardiac output is a central component to this approach but until recently it was not easy to obtain and was estimated from surrogates. However, there are now a number of non-invasive devices that can give measures of cardiac output and permit the use of physiological principles to more rapidly appreciate the primary pathophysiology behind hemodynamic abnormalities and to provide directed therapy.

  13. Radiography With the Patient in the centre

    DEFF Research Database (Denmark)

    Møller, Louise

    2016-01-01

    . Several of these elements have a technical focus. There are relations in an MR scan affecting which actions are included in the scan pathway. However, it is the radiographers who decide which actions to include. Patients and radiographers in this study agreed that center in radiography is about directing......The health care system is becoming more technological, and at the same time, it is verbalized that the patient should be in the center. The purpose of this study was to illucidate how radiography with the patient in the center is performed and what patients and radiographers understand about center...... in radiography. Qualitative methods was used; observations of three MR scans and interviews with three patients and three radiographers are discussed. In the description of an MR scan, it appeared that more elements are involved and that each element has a center of equal importance to complete the MR scan...

  14. Thyroid dose distribution in dental radiography

    Energy Technology Data Exchange (ETDEWEB)

    Bristow, R.G.; Wood, R.E.; Clark, G.M. (Ontario Cancer Institute, Toronto (Canada))

    1989-10-01

    The anatomic position and proven radiosensitivity of the thyroid gland make it an organ of concern in dental radiography. A calibrated thermoluminescent dosimetry system was used to investigate the absorbed dose (microGy) to the thyroid gland resultant from a minimum irradiated volume, intraoral full-mouth radiography technique with the use of rectangular collimation with a lead-backed image receptor, and conventional panoramic radiography performed with front and rear lead aprons. Use of the minimum irradiated volume technique resulted in a significantly decreased absorbed dose over the entire thyroid region ranging from 100% to 350% (p less than 0.05). Because this intraoral technique results in radiographs with greater image quality and also exposes the thyroid gland to less radiation than the panoramic, this technique may be an alternative to the panoramic procedure.

  15. The transverse diameter of the chest on routine radiographs reliably estimates gestational age and weight in premature infants

    Energy Technology Data Exchange (ETDEWEB)

    Dietz, Kelly R. [University of Minnesota, Department of Radiology, Minneapolis, MN (United States); Zhang, Lei [University of Minnesota, Biostatistical Design and Analysis Center, Minneapolis, MN (United States); Seidel, Frank G. [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States)

    2015-08-15

    Prior to digital radiography it was possible for a radiologist to easily estimate the size of a patient on an analog film. Because variable magnification may be applied at the time of processing an image, it is now more difficult to visually estimate an infant's size on the monitor. Since gestational age and weight significantly impact the differential diagnosis of neonatal diseases and determine the expected size of kidneys or appearance of the brain by MRI or US, this information is useful to a pediatric radiologist. Although this information may be present in the electronic medical record, it is frequently not readily available to the pediatric radiologist at the time of image interpretation. To determine if there was a correlation between gestational age and weight of a premature infant with their transverse chest diameter (rib to rib) on admission chest radiographs. This retrospective study was approved by the institutional review board, which waived informed consent. The maximum transverse chest diameter outer rib to outer rib was measured on admission portable chest radiographs of 464 patients admitted to the neonatal intensive care unit (NICU) during the 2010 calendar year. Regression analysis was used to investigate the association between chest diameter and gestational age/birth weight. Quadratic term of chest diameter was used in the regression model. Chest diameter was statistically significantly associated with both gestational age (P < 0.0001) and birth weight (P < 0.0001). An infant's gestational age and birth weight can be reliably estimated by comparing a simple measurement of the transverse chest diameter on digital chest radiograph with the tables and graphs in our study. (orig.)

  16. Diagnosis of Necrotizing Fasciitis with Bedside Ultrasound: the STAFF Exam

    OpenAIRE

    Erik Castleberg; Natasa Jenson; Vi Am Dinh

    2014-01-01

    The early diagnosis of necrotizing fasciitis is often ambiguous. Computed tomography and magnetic resonance imaging, while sensitive and specific modalities, are often time consuming or unavailable. We present a case of necrotizing fasciitis that was rapidly diagnosed using bedside ultrasound evaluating for subcutaneous thickening, air, and fascial fluid (STAFF). We propose the STAFF ultrasound exam may be beneficial in the rapid evaluation of unstable patients with consideration of necrotizi...

  17. THE PREDICTION OF DIFFICULT INTUBATION WITH BEDSIDE SCORING SYSTEMS

    OpenAIRE

    Gerçek, Arzu; Lim, Sema; İşler, Banu; Eti, Zeynep; Göğüs, Yılmaz

    2016-01-01

    Objective: The aim of this study was to evaluate the correlation of sex, age, bedside scoring systems and body mass index with laryngoscopic view in patients with clinically difficult intubation.Methods: Five hundred patients, aged 20-70 years, were included in the study. The age, sex, weight and height of the patients were recorded preoperatively and body mass index was calculated. The patients were examined for Mallampati classification, thyromental distance, mouth opening, neck mobility an...

  18. Digital radiography: a survey of pediatric dentists.

    Science.gov (United States)

    Russo, Julie M; Russo, James A; Guelmann, Marcio

    2006-01-01

    The purpose of this study was to: (1) determine the popularity of digital radiography among members of the American Academy of Pediatric Dentistry (AAPD); and (2) report the most common systems in use. An AAPD-approved, voluntary, and anonymous electronic survey was developed and sent to 923 board certified pediatric dentists. Years in practice and in-office x-ray technology (digital or conventional) were inquired about initially. If negative for the use of digital radiography, future consideration for converting to digital radiography was ascertained. For positive responses, more in-depth information was requested. Information on type of system (sensor or phosphor plate), user friendliness, diagnostic ability, patient's comfort, general costs, durability, and parental and overall satisfaction was collected. For most of the questions, a 5-point assessment scale was used. Opportunity for additional comments was provided upon survey completion. Data was analyzed using descriptive statistics. A 32% (296/923) response rate was obtained. Twenty-six percent of practitioners (78/296) implemented digital radiography in their practices, whereas 71% considered future acquisition. Similar distribution for sensor and phosphor plate users was found. Sensor technology was reported to produce faster images, but was less tolerable by young children due to size and thickness. Phosphor plates were considered more children friendly, less expensive, and less durable. Parental satisfaction was very high with great marketing value. Picture quality was comparable to conventional film. Overall, digital radiography users would recommend it to other pediatric dentists. Digital radiography is not yet popular among pediatric dentists. Cost reduction and technology advancement may enhance utilization.

  19. Do lean practices lead to more time at the bedside?

    Science.gov (United States)

    Brackett, Tiffany; Comer, Linda; Whichello, Ramona

    2013-01-01

    The aim of this review is to evaluate the application of value-added processes in healthcare, with an emphasis on their effects on bedside nursing. Literature relevant to Lean methodology and inpatient care was reviewed, excluding all research related to other service lines (i.e., surgical services, emergency services, laboratory, radiology, etc.). Increased value is also an important tenet of transforming care at the bedside (TCAB), an initiative launched by the Institute for Healthcare Improvement (IHI) and the Robert Wood Johnson Foundation (RWJF). Therefore, articles concerning TCAB were also included in this review. A systematic study of the literature revealed varied applications of Lean principles in practice, ranging from the implementation of a single tool, to full organizational restructuring. All articles reviewed reported positive results, although the majority lacked strong supporting evidence for claims of improvement. Even though there is some indication that the application of Lean principles to nursing processes is successful in improving specific outcomes, the authors cannot conclude that the implementation of Lean methodology or TCAB greatly influences direct patient care, or increases time spent at the bedside. © 2011 National Association for Healthcare Quality.

  20. Bedside ultrasonography-Applications in critical care: Part II

    Directory of Open Access Journals (Sweden)

    Jose Chacko

    2014-01-01

    Full Text Available Point of care ultrasonography, performed by acute care physicians, has developed into an invaluable bedside tool providing important clinical information with a major impact on patient care. In Part II of this narrative review, we describe ultrasound guided central venous cannulation, which has become standard of care with internal jugular vein cannulation. Besides improving success rates, real-time guidance also significantly reduces the incidence of complications. We also discuss compression ultrasonography - a quick and effective bedside screening tool for deep vein thrombosis of the lower extremity. Abdominal ultrasound offers vital clues in the emergency setting; in the unstable trauma victim, a focused examination may provide immediate answers and has largely superseded diagnostic peritoneal lavage in diagnosing intraperitoneal bleed. From estimation of intracranial pressure to transcranial Doppler studies, ultrasound is becoming increasingly relevant to neurocritical care. Ultrasound may also help with airway management in several situations, including percutaneous tracheostomy. Clearly, bedside ultrasonography has become an indispensable part of intensive care practice - in the rapid assessment of critically ill-patients as well as in enhancing the safety of invasive procedures.

  1. Proton Radiography: Its uses and Resolution Scaling

    Energy Technology Data Exchange (ETDEWEB)

    Mariam, Fesseha G. [Los Alamos National Laboratory

    2012-08-09

    Los Alamos National Laboratory has used high energy protons as a probe in flash radiography for over a decade. In this time the proton radiography project has used 800 MeV protons, provided by the LANSCE accelerator facility at LANL, to diagnose over five-hundred dynamic experiments in support of stockpile stewardship programs as well as basic materials science. Through this effort significant experience has been gained in using charged particles as direct radiographic probes to diagnose transient systems. The results of this experience will be discussed through the presentation of data from experiments recently performed at the LANL pRad.

  2. Statistical Uncertainty in Quantitative Neutron Radiography

    CERN Document Server

    Piegsa, Florian M

    2016-01-01

    We demonstrate a novel procedure to calibrate neutron detection systems commonly used in standard neutron radiography. This calibration allows determining the uncertainties due to Poisson-like neutron counting statistics for each individual pixel of a radiographic image. The obtained statistical errors are necessary in order to perform correct quantitative analysis. This fast and convenient method is applied to real data measured at the cold neutron radiography facility ICON at the Paul Scherrer Institute. Moreover, from the results the effective neutron flux at the beam line is determined.

  3. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.

    Science.gov (United States)

    Warnock, Louise; Gates, Alison

    2015-12-21

    Chest physiotherapy is widely used in people with cystic fibrosis in order to clear mucus from the airways. This is an updated version of previously published reviews. To determine the effectiveness and acceptability of chest physiotherapy compared to no treatment or spontaneous cough alone to improve mucus clearance in cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of the most recent search of the Group's Cystic Fibrosis Trials Register: 02 June 2015. Randomised or quasi-randomised clinical studies in which a form of chest physiotherapy (airway clearance technique) were taken for consideration in people with cystic fibrosis compared with either no physiotherapy treatment or spontaneous cough alone. Both authors independently assessed study eligibility, extracted data and assessed the risk of bias in the included studies. There was heterogeneity in the published outcomes, with variable reporting which meant pooling of the data for meta-analysis was not possible. The searches identified 157 studies, of which eight cross-over studies (data from 96 participants) met the inclusion criteria. There were differences between studies in the way that interventions were delivered, with several of the intervention groups combining more than one treatment modality. One included study looked at autogenic drainage, six considered conventional chest physiotherapy, three considered oscillating positive expiratory pressure, seven considered positive expiratory pressure and one considered high pressure positive expiratory pressure. Of the eight studies, six were single-treatment studies and in two, the treatment intervention was performed over two consecutive days (once daily in one, twice daily in the other). This enormous heterogeneity in the treatment

  4. Actinomycosis - Left Post Chest Wall

    Directory of Open Access Journals (Sweden)

    Kafil Akhtar, M. Naim, S. Shamshad Ahmad, Nazoora Khan, Uroos Abedi, A.H. Khan*

    2008-01-01

    Full Text Available A forty year old female of weak body built presented with recurring small hard lumps in let posteriorchest wall for 3 years and discharging ulcers for 3 months duration. Clinically, the provisional diagnosiswas malignancy with secondary infection. FNAC showed features suggestive of dysplasia buthistopathology confirmed the diagnosis as actinomycosis. The present case is reported due to rare incidenceof actinomycosis at post chest wall with muscle involvement.

  5. Simple pulmonary eosinophilia (loeffler's syndrome): chest radiographic and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Kyung Jae; Lee, Kyung Soo; Kim, Tae Sung; Chung, Man Pyo; Choi, Dong Chull; Kwon, O Jung [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2000-01-01

    The purpose of our study is to describe the chest radiographic and CT findings of simple pulmonary eosinophilia. Twenty-six patients with simple pulmonary eosinophilia underwent chest radiography and CT scanning; the results were analyzed retrospectively by two chest radiologists, focusing on the patterns and distribution of the parenchymal abnormalities. The chest radiographs were normal in eight patients (31%), while among the remaining 18 patients, they showed subtle opacity (n=3D9), nodules (n=3D8), consolidation (n=3D2), and mass (n=3D1). Follow-up chest radiographs (m=3D18) demonstrated complete (n=3D16) or partial (n=3D1) resolution of parenchymal lesions or migratory lesions (n=3D1). On CT, nodule(s) (n=3D19) were most commonly seen, followed by ground-glass opacity (n=3D16), consolidation (n=3D3), and mass (n=3D1). A peripheral halo surrounding a nodule or an area of consolidation was seen in 18 patients. The nodules(s) (n=3D19) were subpleural (n=3D13) or random (=3D6). Areas of ground-glass opacity (n=3D16) were subpleural (n=3D13), random (n=3D2), or central (n=3D1). All lesions were patchy rather than diffuse. Follow-up CT in nine patients showed complete (n=3D7) or partial (n=3D2) resolution of parenchymal lesions. Chest radiographs of patients with simple pulmonary eosinophilia often reveal no abnormality. The most common finding is subtle opacity or nodule(s), while CT reveals transient nodule(s) with a surrounding halo or transient areas of ground glass opacity. (author)

  6. Feline dental radiography and radiology: A primer.

    Science.gov (United States)

    Niemiec, Brook A

    2014-11-01

    Information crucial to the diagnosis and treatment of feline oral diseases can be ascertained using dental radiography and the inclusion of this technology has been shown to be the best way to improve a dental practice. Becoming familar with the techniques required for dental radiology and radiography can, therefore, be greatly beneficial. Novices to dental radiography may need some time to adjust and become comfortable with the techniques. If using dental radiographic film, the generally recommended 'E' or 'F' speeds may be frustrating at first, due to their more specific exposure and image development requirements. Although interpreting dental radiographs is similar to interpreting a standard bony radiograph, there are pathologic states that are unique to the oral cavity and several normal anatomic structures that may mimic pathologic changes. Determining which teeth have been imaged also requires a firm knowledge of oral anatomy as well as the architecture of dental films/digital systems. This article draws on a range of dental radiography and radiology resources, and the benefit of the author's own experience, to review the basics of taking and interpreting intraoral dental radiographs. A simplified method for positioning the tubehead is explained and classic examples of some common oral pathologies are provided. © ISFM and AAFP 2014.

  7. Establishing rigour in qualitative radiography research

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, F.J. [School of Healthcare Professions, University of Salford, Salford M6 6PU (United Kingdom)], E-mail: f.j.murphy@salford.ac.uk; Yielder, J. [Medical Imaging, School of Health Sciences, Unitec, Auckland (New Zealand)

    2010-02-15

    The vast majority of radiography research is subject to critique and evaluation from peers in order to justify the method and the outcome of the study. Within the quantitative domain, which the majority of medical imaging publications tend to fall into, there are prescribed methods for establishing scientific rigour and quality in order to critique a study. However, researchers within the qualitative paradigm, which is a developing area of radiography research, are often unclear about the most appropriate methods to measure the rigour (standards and quality) of a research study. This article considers the issues related to rigour, reliability and validity within qualitative research. The concepts of reliability and validity are briefly discussed within traditional positivism and then the attempts to use these terms as a measure of quality within qualitative research are explored. Alternative methods for research rigour in interpretive research (meanings and emotions) are suggested in order to compliment the existing radiography framework that exists for qualitative studies. The authors propose the use of an established model that is adapted to reflect the iterative process of qualitative research. Although a mechanistic approach to establishing rigour is rejected by many qualitative researchers, it is argued that a guide for novice researchers within a developing research base such as radiography is appropriate in order to establish the credibility and trustworthiness of a qualitative study.

  8. Safety Testing of Industrial Radiography Devices

    Energy Technology Data Exchange (ETDEWEB)

    Trapp, D.J.

    1999-09-29

    The Nuclear Regulatory Commission contracted the Savannah River Technology Center to verify the relevancy of the 10 CFR Part 34 requirements for the normal use of portable gamma radiography systems and to propose recommendations for changes or modifications to the requirements.

  9. Radiography Student Participation in Professional Organizations.

    Science.gov (United States)

    Michael, Kimberly; Tran, Xuan; Keller, Shelby; Sayles, Harlan; Custer, Tanya

    2017-09-01

    To gather data on educational program requirements for student membership in a state or national professional society, organization, or association. A 10-question online survey about student involvement in professional societies was emailed to 616 directors of Joint Review Committee on Education in Radiologic Technology (JRCERT)-accredited radiography programs. A total of 219 responses were received, for a 36% response rate. Of these, 89 respondents (41%) answered that their programs require students to join a professional organization. The society respondents most often required (70%) was a state radiography society. Sixty respondents (68%) answered that students join a society at the beginning of the radiography program (from matriculation to 3 months in). Of programs requiring student membership in professional societies, 42 (49%) reported that their students attend the state or national society annual conference; however, participation in activities at the conferences and in the society throughout the year is lower than conference attendance. Some directors stated that although their programs' policies do not allow membership mandates, they encourage students to become members, primarily so that they can access webinars and other educational materials or information related to the profession. Survey data showed that most JRCERT-accredited radiography programs support but do not require student membership in professional organizations. The data reveal that more programs have added those requirements in recent years. Increased student participation could be realized if programs mandated membership and supported it financially. ©2017 American Society of Radiologic Technologists.

  10. INDUSTRIAL RADIOGRAPHY COURSE, INSTRUCTORS' GUIDE. VOLUME 2.

    Science.gov (United States)

    Texas A and M Univ., College Station. Engineering Extension Service.

    INFORMATION RELATIVE TO THE LESSON PLANS IN "INDUSTRIAL RADIOGRAPHY COURSE, INSTRUCTOR'S GUIDE, VOLUME I" (VT 003 565) IS PRESENTED ON 52 INFORMATION SHEETS INCLUDING THE SUBJECTS SHIELDING EQUATIONS AND LOGARITHMS, METAL PROPERTIES, FIELD TRIP INSTRUCTIONS FOR STUDENTS, WELDING SYMBOLS AND SIZES, SAMPLE REPORT FORMS, AND TYPICAL SHIPPING…

  11. Conditions for radiation protection in industrial radiography

    CERN Document Server

    1999-01-01

    The leaflet specifies radiation protection requirements for industrial radiography in Norway. The regulations are directed towards companies using or distributing sealed radioactive sources, x-ray equipment or accelerators in non-destructive material testing (NDT). Technical requirements to the equipment, as well as administrative requirements for use, licensing, qualifications, handling of accidents etc. are given. (Author)

  12. Comprehensive Optimization Process of Paranasal Sinus Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Saarakkala, S. (Dept. of Clinical Radiology, Kuopio Univ. Hospital, Kuopio (Finland)); Nironen, K.; Hermunen, H.; Aarnio, J.; Heikkinen, J.O. (Dept. of Radiology, Etel-Savo Hospital District, Mikkeli Central Hospital, Mikkeli (Finland))

    2009-04-15

    Background: The optimization of radiological examinations is important in order to reduce unnecessary patient radiation exposure. Purpose: To perform a comprehensive optimization process for paranasal sinus radiography at Mikkeli Central Hospital (Finland). Material and Methods: Patients with suspicion of acute sinusitis were imaged with a Kodak computed radiography (CR) system (n=20) and with a Philips digital radiography (DR) system (n=30) using focus-detector distances (FDDs) of 110 cm, 150 cm, or 200 cm. Patients' radiation exposure was determined in terms of entrance surface dose and dose-area product. Furthermore, an anatomical phantom was used for the estimation of point doses inside the head. Clinical image quality was evaluated by an experienced radiologist, and physical image quality was evaluated from the digital radiography phantom. Results: Patient doses were significantly lower and image quality better with the DR system compared to the CR system. The differences in patient dose and physical image quality were small with varying FDD. Clinical image quality of the DR system was lowest with FDD of 200 cm. Further, imaging with FDD of 150 cm was technically easier for the technologist to perform than with FDD of 110 cm. Conclusion: After optimization, it was recommended that the DR system with FDD of 150 cm should always be used at Mikkeli Central Hospital. We recommend this kind of comprehensive approach in all optimization processes of radiological examinations.

  13. Development of patient collation system by kinetic analysis for chest dynamic radiogram with flat panel detector

    Science.gov (United States)

    Tsuchiya, Yuichiro; Kodera, Yoshie

    2006-03-01

    In the picture archiving and communication system (PACS) environment, it is important that all images be stored in the correct location. However, if information such as the patient's name or identification number has been entered incorrectly, it is difficult to notice the error. The present study was performed to develop a system of patient collation automatically for dynamic radiogram examination by a kinetic analysis, and to evaluate the performance of the system. Dynamic chest radiographs during respiration were obtained by using a modified flat panel detector system. Our computer algorithm developed in this study was consisted of two main procedures, kinetic map imaging processing, and collation processing. Kinetic map processing is a new algorithm to visualize a movement for dynamic radiography; direction classification of optical flows and intensity-density transformation technique was performed. Collation processing consisted of analysis with an artificial neural network (ANN) and discrimination for Mahalanobis' generalized distance, those procedures were performed to evaluate a similarity of combination for the same person. Finally, we investigated the performance of our system using eight healthy volunteers' radiographs. The performance was shown as a sensitivity and specificity. The sensitivity and specificity for our system were shown 100% and 100%, respectively. This result indicated that our system has excellent performance for recognition of a patient. Our system will be useful in PACS management for dynamic chest radiography.

  14. The role of whole body spiral CT in the primary work-up of polytrauma patients - comparison with conventional radiography and abdominal sonography; Die Rolle der Ganzkoerper-Spiral-CT bei der Primaerdiagnostik polytraumatisierter Patienten - Vergleich mit konventioneller Radiographie und Abdomensonographie

    Energy Technology Data Exchange (ETDEWEB)

    Albrecht, T.; Schlippenbach, J. von; Wolf, K.J. [Klinik und Poliklinik fuer Radiologie und Nuklearmedizin, Charite - Campus Benjamin Franklin (Germany); Stahel, P.F.; Ertel, W. [Klinik fuer Unfall- und Wiederherstellungschirurgie, Charite - Campus Benjamin Franklin (Germany)

    2004-08-01

    Purpose: To evaluate the role of routine 'whole body spiral CT' in the primary work-up of polytrauma patients for injuries of the thorax, abdomen and spine, and to compare the results with those of conventional radiography of the chest and spine and abdominal ultrasound. Materials and Methods: Fifty consecutive polytrauma patients underwent contrast-enhanced single slice spiral CT (5 mm collimation) from the vertex to the floor of the pelvis as part of the primary work-up after emergency room admission. Overlapping high resolution sections and sagittal reformations of the spine were obtained. Reports of additional chest radiographs (n=43), abdominal ultrasound examinations (n=47) and spine radiographs (n=36) performed in the emergency room were available for retrospective comparison. The 'final diagnoses', which served as the standard of reference, were taken from the patients' records using all information that became available until discharge or death, such as findings from further imaging, surgery and autopsy. Results: CT showed 109 (97%) of 112 thoracic and abdominal soft-tissue injuries. Relevant injuries missed were an early splenic laceration and an early pelvic hematoma, both of which became clinically apparent several hours later. There were 4 false positive CT findings. Conventional chest radiography demonstrated only 20% of thoracic and sonography 22% of abdominal injuries. Chest radiography and sonography produced 2 false-positive findings each. CT showed 66 (87%) of 76 vertebral fractures including all 19 unstable ones. CT missed 5 anterior vertebral body and 5 spinous/transverse process fractures. Conventional radiography found 71% of vertebral fractures including only 50% of the unstable one. (orig.)

  15. MRI versus radiography of acromioclavicular joint dislocation.

    Science.gov (United States)

    Nemec, Ursula; Oberleitner, Gerhard; Nemec, Stefan F; Gruber, Michael; Weber, Michael; Czerny, Christian; Krestan, Christian R

    2011-10-01

    Acromioclavicular joint injuries are usually diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. In view of the implementation of MRI for visualization of the acromioclavicular joint, the purpose of this study was to describe the MRI findings of acromioclavicular joint dislocation in comparison with the radiographic findings. Forty-four patients with suspected unilateral acromioclavicular joint dislocation after acute trauma were enrolled in this prospective study. All patients underwent digital radiography and 1-T MRI with a surface phased-array coil. MRI included coronal proton density-weighted turbo spin-echo and coronal 3D T1-weighted fast field-echo water-selective sequences. The Rockwood classification was used to assess acromioclavicular joint injuries at radiography and MRI. An adapted Rockwood classification was used for MRI evaluation of the acromioclavicular joint ligaments. The classifications of acromioclavicular joint dislocations diagnosed with radiography and MRI were compared. Among 44 patients with Rockwood type I-IV injuries on radiographs, classification on radiographs and MR images was concordant in 23 (52.2%) patients. At MRI, the injury was reclassified to a less severe type in 16 (36.4%) patients and to a more severe type in five (11.4%) patients. Compared with the findings according to the original Rockwood system, with the adapted system that included MRI findings, additional ligamentous lesions were found in 11 (25%) patients. In a considerable number of patients, the MRI findings change the Rockwood type determined with radiography. In addition to clinical assessment and radiography, MRI may yield important findings on ligaments that may influence management.

  16. CARDIOVASCULAR DISORDERS IN ADOLESCENTS WITH CHEST PAIN

    Directory of Open Access Journals (Sweden)

    Sri Endah Rahayuningsih

    2014-06-01

    Full Text Available Objective: To detect cardiovascular abnormalities in adolescents with chest pain. Methods: In this cross sectional study, the subjects were 25 adolescents with chest pain who came to the Cardiac Center of Dr. Hasan Sadikin General Hospital, Bandung during the period of January 2008 to January 2011. The presence of established cardiovascular disorders were based on history, physical examination, electrocardiography and echocardiography Results: It was found that 13/25 adolescents with chest pain had cardiovascular abnormalities. Of the 25 teens that came with chest pain, most of which showed normal electrocardiographic results, only 9/25 of those with dysrhythmias experienced sinus tachycardia and 8 had a first degree AV block. Echocardiography examination showed only four patients with abnormal cardiac anatomy. No correlation between nutritional status and chest pain, and cardiovascular abnormalities and chest pain (p=0.206 and p=0.632, respectively. There was a positive correlation between sex and cardiovascular abnormalities in adolescents with chest pain (p=0.007. Chest pain is a prevalent problem that is usually benign and that it frequently signals underlying cardiac disease. Conclusions: Cardiovascular abnormalities in adolescents with symptoms of chest pain are found in some cases. There is no correlation between female and male adolescents with chest pain and cardiovascular abnormalities.

  17. Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip

    Directory of Open Access Journals (Sweden)

    Fereshteh Salimi

    2015-01-01

    Full Text Available Background: Proper placement of central venous catheter (CVC tip could reduce early and late catheter-related complications. Although the live fluoroscopy is standard of care for placement of the catheter, it is not available in many centers. Therefore, the present study evaluated the sensitivity and specificity of bedside chest X-ray (CXR for proper positioning of the catheter tip. Materials and Methods: A total of 82 adult patients undergoing elective placement of tunneled CVC were enrolled in this study during 2010-2012. The catheter tip position was evaluated by postoperative bedside chest radiographs as well as trans-thoracic echocardiogram as definite diagnostic tool. The catheter position was considered correct if the tip was positioned in the right atrium both in CXR or echocardiography. Finally, CXRs interpreted by expert radiologist. Thus findings were compared by echocardiography. Sensitivity, specificity, accuracy, positive, and negative predictive values were calculated. Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL, and P < 0.05 considered as significant. Results: The patients were 57.37 ± 18.91 years of age, weighed 65.79 ± 15.58 kg and were 166.36 ± 9.91 cm tall. Sensitivity and specificity of CXR for proper catheter tip position were 74.3% and 58.3%, respectively. Positive and negative predictive values were 91.2% and 28%. In addition accuracy, positive likelihood ratio, and negative likelihood ratio were 71.9%, 1.78, and 2.27 respectively. Conclusion: Bedside CXR alone does not reliably predict malpositioning after CVC placement.

  18. Flail chest and pulmonary contusion.

    Science.gov (United States)

    Bastos, Renata; Calhoon, John H; Baisden, Clinton E

    2008-01-01

    Flail chest is most often accompanied by a significant underlying pulmonary parenchymal injury and can be a life-threatening thoracic injury. Its management is often complicated by the other injuries it is frequently associated with. Similarly, mortality and morbidity are dictated most often by the associated injuries and findings. Its treatment is complex and should first be one of pain management, judicious fluid resuscitation, and excellent pulmonary toilet. In those patients requiring mechanical ventilatory support, or who require ipsilateral thoracocotomy, rib stabilization may be considered depending on a host of potentially conflicting indications and contraindications. At the end of this section are listed the current major recommendations and their levels of evidence.

  19. Chest neoplasms with infectious etiologies.

    Science.gov (United States)

    Restrepo, Carlos S; Chen, Melissa M; Martinez-Jimenez, Santiago; Carrillo, Jorge; Restrepo, Catalina

    2011-12-28

    A wide spectrum of thoracic tumors have known or suspected viral etiologies. Oncogenic viruses can be classified by the type of genomic material they contain. Neoplastic conditions found to have viral etiologies include post-transplant lymphoproliferative disease, lymphoid granulomatosis, Kaposi's sarcoma, Castleman's disease, recurrent respiratory papillomatosis, lung cancer, malignant mesothelioma, leukemia and lymphomas. Viruses involved in these conditions include Epstein-Barr virus, human herpes virus 8, human papillomavirus, Simian virus 40, human immunodeficiency virus, and Human T-lymphotropic virus. Imaging findings, epidemiology and mechanism of transmission for these diseases are reviewed in detail to gain a more thorough appreciation of disease pathophysiology for the chest radiologist.

  20. Diagnosis of necrotizing faciitis with bedside ultrasound: the STAFF Exam.

    Science.gov (United States)

    Castleberg, Erik; Jenson, Natasa; Dinh, Vi Am

    2014-02-01

    The early diagnosis of necrotizing fasciitis is often ambiguous. Computed tomography and magnetic resonance imaging, while sensitive and specific modalities, are often time consuming or unavailable. We present a case of necrotizing fasciitis that was rapidly diagnosed using bedside ultrasound evaluating for subcutaneous thickening, air, and fascial fluid (STAFF). We propose the STAFF ultrasound exam may be beneficial in the rapid evaluation of unstable patients with consideration of necrotizing fasciitis, in a similar fashion to the current use of a focused assessment with sonography for trauma exam in the setting of trauma.

  1. Image quality and exposure dose in digital projection radiography; Bildqualitaet und Dosis in der Digitalen Projektionsradiographie

    Energy Technology Data Exchange (ETDEWEB)

    Busch, H.P.; Busch, S.; Decker, C.; Schilz, C. [Krankenhaus der Barmherzigen Brueder Trier, Abt. fuer Radiologie, Trier (Germany)

    2003-01-01

    Purpose: Comparison of the imaging capabilities of storage phosphor (computed) radiography and flat plate radiography with conventional film-screen radiography to find new strategies for quality and dose management, i.e., optimizing imaging quality and dose depending on the imaging method and clinical situation. Materials and Methods: Images of a CDRAD-phantom, hand-phantom, abdomen-phantom and chest-phantom obtained with different exposure voltages (50 kV, 73 kV, 109 kV) and different speeds (200, 400, 800, 1600) were processed with various digital systems (flat plate detector: Digital Diagnost [Philips]; storage phosphors: ADC-70 [Agfa], ADC-Solo [Agfa], FCR XG 1 [Fuji]) and a conventional film-screen system (HT100G/Ortho Regular [Agfa]). Results: The evaluation of CDRAD images found the flat plate detector system to have the highest contrast detectability for all dose levels, followed by the FCR XG 1, ADC-Solo and ADC-70 systems. Comparison of the organ-phantom images found the flat plate detector system to be equal to film-screen radiography and especially to storage phosphor systems even for low exposure doses. Conclusions: Flat plate radiography systems demonstrate the highest potential for high image quality when reducing the exposure dose. Depending on the system generation, the storage phosphor systems also show an improved image quality, but the possibility of a dose reduction is limited in comparison with the flat plate detector system. (orig.) [German] Ziel: Die vergleichende Darstellung der Abbildungseigenschaften verschiedener Speicherfoliengeraete und einer Flachdetektoranlage mit Film/Folienaufnahmen kann zu neuen Strategien des Qualitaets- und Dosismanagements fuehren, d.h. zu einer Optimierung von Bildqualitaet und Dosis in Abhaengigkeit von der Untersuchungsmethode und der klinischen Fragestellung. Methode: Aufnahmen von einem CDRAD-Phantom, Handphantom, Abdomenphantom und Thoraxphantom wurden mit verschiedenen digitalen Systemen (Flachdetektor

  2. Technique for chest compressions in adult CPR

    Directory of Open Access Journals (Sweden)

    Rajab Taufiek K

    2011-12-01

    Full Text Available Abstract Chest compressions have saved the lives of countless patients in cardiac arrest as they generate a small but critical amount of blood flow to the heart and brain. This is achieved by direct cardiac massage as well as a thoracic pump mechanism. In order to optimize blood flow excellent chest compression technique is critical. Thus, the quality of the delivered chest compressions is a pivotal determinant of successful resuscitation. If a patient is found unresponsive without a definite pulse or normal breathing then the responder should assume that this patient is in cardiac arrest, activate the emergency response system and immediately start chest compressions. Contra-indications to starting chest compressions include a valid Do Not Attempt Resuscitation Order. Optimal technique for adult chest compressions includes positioning the patient supine, and pushing hard and fast over the center of the chest with the outstretched arms perpendicular to the patient's chest. The rate should be at least 100 compressions per minute and any interruptions should be minimized to achieve a minimum of 60 actually delivered compressions per minute. Aggressive rotation of compressors prevents decline of chest compression quality due to fatigue. Chest compressions are terminated following return of spontaneous circulation. Unconscious patients with normal breathing are placed in the recovery position. If there is no return of spontaneous circulation, then the decision to terminate chest compressions is based on the clinical judgment that the patient's cardiac arrest is unresponsive to treatment. Finally, it is important that family and patients' loved ones who witness chest compressions be treated with consideration and sensitivity.

  3. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  4. Relevant surgical anatomy of the chest wall.

    Science.gov (United States)

    Naidu, Babu V; Rajesh, Pala B

    2010-11-01

    The chest wall, like other regional anatomy, is a remarkable fusion of form and function. Principal functions are the protection of internal viscera and an expandable cylinder facilitating variable gas flow into the lungs. Knowledge of the anatomy of the whole cylinder (ribs, sternum, vertebra, diaphragm, intercostal spaces, and extrathoracic muscles) is therefore not only important in the local environment of a specific chest wall resection but also in its relation to overall function. An understanding of chest wall kinematics might help define the loss of function after resection and the effects of various chest wall substitutes. Therefore, this article is not an exhaustive anatomic description but a focused summary and discussion.

  5. Potential of ultrasound in the pediatric chest

    Energy Technology Data Exchange (ETDEWEB)

    Trinavarat, Panruethai, E-mail: pantrinavarat@hotmail.com [Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330 (Thailand); Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at [Department of Radiology, Division of Pediatric Radiology, University Hospital Graz (Austria)

    2014-09-15

    Ultrasound (US) of chest, even with inherent limitations of the US beam and air, has been useful in many pediatric chest conditions. It has extended its role and is now widely used by many subspecialists in medicine. This review article will cover techniques, indications, and applications of chest US in neonates, infants and children, including also different common as well as some rare and modern aspects and applications, such as pleural effusion, pneumothorax, pulmonary lesions, mediastinum, diaphragm, and chest wall. Other related imaging modalities are also briefly discussed.

  6. Potential of ultrasound in the pediatric chest.

    Science.gov (United States)

    Trinavarat, Panruethai; Riccabona, Michael

    2014-09-01

    Ultrasound (US) of chest, even with inherent limitations of the US beam and air, has been useful in many pediatric chest conditions. It has extended its role and is now widely used by many subspecialists in medicine. This review article will cover techniques, indications, and applications of chest US in neonates, infants and children, including also different common as well as some rare and modern aspects and applications, such as pleural effusion, pneumothorax, pulmonary lesions, mediastinum, diaphragm, and chest wall. Other related imaging modalities are also briefly discussed.

  7. Does it require to exclude cardiobiliary reflex in every acute coronary syndrome follow up patient with bedside ultrasound on emergency department

    Directory of Open Access Journals (Sweden)

    Mustafa Bolatkale

    2017-06-01

    Full Text Available In emergency department, physicians can diagnose pulseless electrical activity, asystole, pericardial effusions, ischemic heart disease, wall motion abnormalities, valvular cardiac disease volume status or global cardiac function evaluating with electrocardiographic findings or using bedside cardiac ultrasonography. But these two methods are not always sufficient to explain the underlying another pathologies such as pancreatitis and acute cholecystitis which can mimick acute cardiac events. Patients who are followed up with a preliminary diagnosis of acute coronary syndrome in the emergency department, might have underlying biliary or pancreatic pathologies, or even more, these might be the sole reason of the clinical picture. So bedside abdomen ultrasonography and liver enzymes may be requested in all patients with suspected cardiac pathology with a normal cardiac ultrasonography when a patient presented with acute chest or abdominal pain. Physicians must be aware for coexisting pathophysiologies and take into account the differential diagnosis of all life-threatening causes such as cardiac ischemia or acute abdominal situations. So the diagnostic tests for gallbladder pathology could be added to cardiac ultrasonography

  8. Update on bedside ultrasound (US) diagnosis of acute cholecystitis (AC).

    Science.gov (United States)

    Zenobii, Maria Francesca; Accogli, Esterita; Domanico, Andrea; Arienti, Vincenzo

    2016-03-01

    Acute cholecystitis (AC) represents a principal cause of morbidity worldwide and is one of the most frequent reasons for hospitalization due to gastroenteric tract diseases. AC should be suspected in presence of clinical signs and of gallstones on an imaging study. Upper abdominal US represents the first diagnostic imaging step in the case of suspected AC. Computed tomography (CT) with intravenous contrast (IV) or magnetic resonance imaging (MRI) with gadolinium contrast and technetium hepatobiliary iminodiacetic acid (Tc-HIDA) can be employed to exclude complications. US examination should be performed with right subcostal oblique, with longitudinal and intercostal scans. Normal gallbladder US findings and AC major and minor US signs are described. Polyps, sludge and gallbladder wall thickening represent the more frequent pitfalls and they must be differentiated from stones, duodenal artifacts and many other non-inflammatory conditions that cause wall thickening, respectively. By means of bedside ultrasound, the finding of gallstones in combination with acute pain, when the clinician presses the gallbladder with the US probe (the sonographic Murphy's sign), has a 92.2 % positive predictive value for AC. In our preliminary experience, bedside US-performed by echoscopy (ES) and/or point-of-care US (POCUS) demonstrated good reliability in detecting signs of AC, and was always integrated with physical examination and performed by a skilled operator.

  9. Bedside coaching to improve nurses' recognition of delirium.

    Science.gov (United States)

    Gordon, Susan Jean; Melillo, Karen Devereaux; Nannini, Angela; Lakatos, Barbara E

    2013-10-01

    Delirium is a widespread complication of hospitalization and is frequently unrecognized by nurses and other healthcare professionals. Patients with neuroscience diagnoses are at increased risk for delirium as compared with other patients. The aims of this quality improvement project were to (1) increase neuroscience nurses' knowledge of delirium, (2) integrate coaching into evidence-based practice, and (3) evaluate the effectiveness of this combined approach to improve nurses' recognition of delirium on a neuroscience unit. Institutional review board approval was obtained. A retrospective chart review of randomly selected patients admitted before the intervention was completed. The (modified) Nurse's Knowledge of Delirium Tool was electronically administered to nursing staff (n = 47), followed within 2 weeks by a didactic presentation on delirium. Bedside coaching was performed over a period of 4 weeks. The (modified) Nurses Knowledge of Delirium Tool was electronically readministered to nurses 4 weeks later to determine the change in aggregate knowledge. A postintervention chart review was conducted. SPSS software was used to analyze descriptive statistics with regard to chart reviews, documentation, and change in questionnaire scores. Findings reveal that neuroscience nurses recognize the absence of delirium 94.4% of the time and the presence of delirium 100% of the time after a didactic session and coaching. The postintervention chart review showed a statistically significant increase (p = .000) in the documentation of delirium screening results. Expert coaching at the bedside may be a reliable method for teaching nurses to use evidence-based screening tools to detect delirium in patients with neuroscience diagnoses.

  10. Real-Time Neutron Radiography at CARR

    Institute of Scientific and Technical Information of China (English)

    HE; Lin-feng; HAN; Song-bai; WANG; Hong-li; WU; Mei-mei; WEI; Guo-hai; WANG; Yu

    2012-01-01

    <正>A real-time detector system for neutron radiography based on CMOS camera has been designed for the thermal neutron imaging facility under construction at China Advanced Research Reactor (CARR). This system is equipped with a new scientific CMOS camera with 5.5 million pixels and speed up to 100 fps at full frame. The readout noise is less than 2.4 electron per pixel. It is capable of providing

  11. Assessment of cold neutron radiography capability

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, T.E. Jr.; Roberts, J.A.

    1998-12-31

    This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at Los Alamos National Laboratory (LANL). The authors goals were to demonstrate and assess cold neutron radiography techniques at the Los Alamos Neutron Science Center (LANSCE), Manual Lujan Neutron Scattering Center (Lujan Center), and to investigate potential applications of the capability. The authors have obtained images using film and an amorphous silicon detector. In addition, a new technique they have developed allows neutron radiographs to be made using only a narrow range of neutron energies. Employing this approach and the Bragg cut-off phenomena in certain materials, they have demonstrated material discrimination in radiography. They also demonstrated the imaging of cracks in a sample of a fire-set case that was supplied by Sandia National Laboratory, and they investigated whether the capability could be used to determine the extent of coking in jet engine nozzles. The LANSCE neutron radiography capability appears to have applications in the DOE stockpile maintenance and science-based stockpile stewardship (SBSS) programs, and in industry.

  12. Digital radiography: image quality and radiation dose.

    Science.gov (United States)

    Seibert, J Anthony

    2008-11-01

    Digital radiography devices, rapidly replacing analog screen-film detectors, are now common in diagnostic radiological imaging, where implementation has been accelerated by the commodity status of electronic imaging and display systems. The shift from narrow latitude, fixed-speed screen-film detectors to wide latitude, variable-speed digital detectors has created a flexible imaging system that can easily result in overexposures to the patient without the knowledge of the operator, thus potentially increasing the radiation burden of the patient population from radiographic examinations. In addition, image processing can be inappropriately applied causing inconsistent or artifactual appearance of anatomy, which can lead to misdiagnosis. On the other hand, many advantages can be obtained from the variable-speed digital detector, such as an ability to lower dose in many examinations, image post-processing for disease-specific conditions, display flexibility to change the appearance of the image and aid the physician in making a differential diagnosis, and easy access to digital images. An understanding of digital radiography is necessary to minimize the possibility of overexposures and inconsistent results, and to achieve the principle of as low as reasonably achievable (ALARA) for the safe and effective care of all patients. Thus many issues must be considered for optimal implementation of digital radiography, as reviewed in this article.

  13. SU-F-P-06: Moving From Computed Radiography to Digital Radiography: A Collaborative Approach to Improve Image Quality

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, D; Mlady, G; Selwyn, R [University of New Mexico School of Medicine, Albuquerque, NM (United States); Valenti, D; Bateman, T; Norris, V [University of New Mexico Hospital, Albuquerque, New Mexico (United States)

    2016-06-15

    Purpose: To bring together radiologists, technologists, and physicists to utilize post-processing techniques in digital radiography (DR) in order to optimize image acquisition and improve image quality. Methods: Sub-optimal images acquired on a new General Electric (GE) DR system were flagged for follow-up by radiologists and reviewed by technologists and medical physicists. Various exam types from adult musculoskeletal (n=35), adult chest (n=4), and pediatric (n=7) were chosen for review. 673 total images were reviewed. These images were processed using five customized algorithms provided by GE. An image score sheet was created allowing the radiologist to assign a numeric score to each of the processed images, this allowed for objective comparison to the original images. Each image was scored based on seven properties: 1) overall image look, 2) soft tissue contrast, 3) high contrast, 4) latitude, 5) tissue equalization, 6) edge enhancement, 7) visualization of structures. Additional space allowed for additional comments not captured in scoring categories. Radiologists scored the images from 1 – 10 with 1 being non-diagnostic quality and 10 being superior diagnostic quality. Scores for each custom algorithm for each image set were summed. The algorithm with the highest score for each image set was then set as the default processing. Results: Images placed into the PACS “QC folder” for image processing reasons decreased. Feedback from radiologists was, overall, that image quality for these studies had improved. All default processing for these image types was changed to the new algorithm. Conclusion: This work is an example of the collaboration between radiologists, technologists, and physicists at the University of New Mexico to add value to the radiology department. The significant amount of work required to prepare the processing algorithms, reprocessing and scoring of the images was eagerly taken on by all team members in order to produce better quality

  14. Role of digital tomosynthesis and dual energy subtraction digital radiography in detecting pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Sarvana G. [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Garg, Mandeep Kumar, E-mail: gargmandeep01@gmail.com [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Khandelwal, Niranjan; Gupta, Pankaj [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Gupta, Dheeraj; Aggarwal, Ashutosh Nath [Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India); Bansal, Subash Chand [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012 (India)

    2015-07-15

    Highlights: • Accuracy of digital tomosynthesis for nodule detection is substantially higher. • Improvement in diagnostic accuracy is most pronounced for nodules <10 mm. • There is five times increase in radiation dose compared to DR. - Abstract: Objective: Digital tomosynthesis (DT) and dual-energy subtraction digital radiography (DES-DR) are known to perform better than conventional radiography in the detection of pulmonary nodules. Yet the comparative diagnostic performances of DT, DES-DR and digital radiography (DR) is not known. The present study compares the diagnostic performances of DT, DES-DR and DR in detecting pulmonary nodules. Subjects and methods: The institutional Review Board approved the study and informed written consent was obtained. Fifty-five patients (30 with pulmonary nodules, 25 with non-nodular focal chest pathology) were included in the study. DT and DES-DR were performed within14 days of MDCT. Composite images acquired at high kVp as part of DES-DR were used as DR images. Images were analyzed for presence of nodules and calcification in nodules. Interpretations were assigned confidence levels from 1 to 5 according to Five-Point rating scale. Areas under the receiver operating characteristic curves were compared using Z test. Results: A total of 110 (88 non-calcified, 22 calcified) nodules were identified on MDCT. For detection of nodules, DR showed cumulative sensitivity and specificity of 25.45% and 67.97%, respectively. DT showed a cumulative sensitivity and specificity of 60.9% and 85.07%, respectively. The performance was significantly better than DR (p < 0.003). DES-DR showed sensitivity and specificity of 27.75% and 82.64%, not statistically different from those of DR (p—0.92). In detection of calcification, there was no statistically significant difference between DT, DES-DR and DR. Conclusions: DT performs significantly better than DES-DR and DR at the cost of moderate increase in radiation dose.

  15. Remote interpretation of chest roentgenograms.

    Science.gov (United States)

    Andrus, W S; Hunter, C H; Bird, K T

    1975-04-01

    A series of 98 chest films was interpreted by two physicians on the basis of monitor display of the transmitted television signal representing the roentgenographic image. The transmission path was 14 miles long, and included one active repeater station. Receiver operating characteristic curves were drawn to compare interpretations rendered on television view of the image with classic, direct view interpretations of the same films. Performance in these two viewing modes was found to be quite similar. When films containing only hazy densities lacking internal structure or sharp margins, were removed from the sample, interpretation of the remaining films was essentially identical via the two modes. Since hazy densities are visible on retrospective examination, interpretation of roentgenograms at a distance via television appears to be a feasible route for delivery of radiologic services.

  16. Systematic Interpretation of Adult Thorax Radiography

    Directory of Open Access Journals (Sweden)

    Torel Ogur

    2009-10-01

    Full Text Available Thorax x-ray film is a routine radiological test which is commonly ordered, relatively inexpensive and available for most of the health services. It also offers numerous useful information in medical decision making in a lot of clinical situations. So it is very important to learn to interpret effectively chest x ray film in clinical practice, for medical students and physicians. This review is intended to give a basic opinion for systematic review of chest x-ray film. [TAF Prev Med Bull 2009; 8(5.000: 427-436

  17. Chest pain and exacerbations of bronchiectasis

    Directory of Open Access Journals (Sweden)

    King PT

    2012-12-01

    Full Text Available Paul T King,1,2 Stephen R Holdsworth,2 Michael Farmer,1 Nicholas J Freezer,1 Peter W Holmes11Department of Respiratory and Sleep Medicine, 2Monash University Department of Medicine, Monash Medical Centre, Melbourne, Victoria, AustraliaBackground: Bronchiectasis is a common disease and a major cause of respiratory morbidity. Chest pain has been described as occurring in the context of bronchiectasis but has not been well characterized. This study was performed to describe the characteristics of chest pain in adult bronchiectasis and to define the relationship of this pain to exacerbations.Subjects and methods: We performed a prospective study of 178 patients who were followed-up for 8 years. Subjects were reviewed on a yearly basis and assessed for the presence of chest pain. Subjects who had chest pain at the time of clinical review by the investigators were included in this study. Forty-four patients (25% described respiratory chest pain at the time of assessment; in the majority of cases 39/44 (89%, this occurred with an exacerbation and two distinct types of chest pain could be described: pleuritic (n = 4 and non-pleuritic (n = 37, with two subjects describing both forms. The non-pleuritic chest pain occurred most commonly over both lower lobes and was mild to moderate in severity. The pain subsided as patients recovered. Conclusion: Non-pleuritic chest pain occurs in subjects with bronchiectasis generally in association with exacerbations.Keywords: sputum, collapse, bronchitis, airway obstruction

  18. Comparison of radiography and ultrasonography in the detection of lung and liver cysts in cattle and buffaloes

    Directory of Open Access Journals (Sweden)

    Ashwani Kumar

    2016-10-01

    Full Text Available Aim: Echinococcosis is the major cause of lung and liver cysts in ruminants. This study compared usefulness of radiography and ultrasonography (USG in the detection of lung and/or liver cysts in sick bovine animals. The study also worked out cooccurrence of lung and liver cysts, and whether these cysts were primary cause of sickness or not. Materials and Methods: This study was conducted on 45 sick bovine (37 buffaloes and 8 cattle suffering from lung and liver cysts. A complete history of illness and clinical examination was carried out. Lateral radiographs of chest and reticular region were taken. In radiographically positive or suspected cases of cysts, USG of the lung and liver region was done. Depending on the location of cyst and clinical manifestations of the animal, the cysts were categorized as primary or secondary causes of sickness. Results: Using either imaging technique, it was observed that 46.7% of the animals had both lung and liver cysts, whereas 33.3% had only lung and 20% had only liver cyst. Cysts were identified as primary cause of sickness in 31.1% animals only. For diagnosing lung cysts, radiography (71.1% and USG (62.2% had similar diagnostic utility. However, for detecting liver cysts, USG was the only imaging tool. Conclusion: The lung and liver cysts, depending on their number and size may be a primary cause of sickness in bovine. Radiography and USG are recommended, in combination, as screening tools to rule out echinococcosis.

  19. Spiral CT for evaluation of chest trauma; Spiral-CT beim Thoraxtrauma

    Energy Technology Data Exchange (ETDEWEB)

    Roehnert, W. [Universitaetsklinikum Dresden (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Weise, R. [Universitaetsklinikum Dresden (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik

    1997-07-01

    After implementation of spiral CT in our department, we carried out an analysis for determining anew the value of CT as a modality of chest trauma diagnosis in the emergency department. The retrospective study covers a period of 10 months and all emergency patients with chest trauma exmined by spiral CT. The major lesions of varying seriousness covered by this study are: pneumothorax, hematothorax, pulmonary contusion or laceration, mediastinal hematoma, rupture of a vessel, injury of the heart and pericardium. The various fractures are not included in this study. In many cases, spiral CT within relatively short time yields significant diagnostic findings, frequently saving additional angiography. A rigid diagnostic procedure cannot be formulated. Plain-film chest radiography still remains a diagnostic modality of high value. (Orig.) [Deutsch] Nach Einfuehrung der Spiral-CT in unserer Einrichtung versuchten wir, den Stellenwert der Computertomographie in der Notfalldiagnostik des Thoraxtraumas neu zu bestimmen. Dazu wurden retrospektiv ueber einen Zeitraum von 10 Monaten alle mittels Spiral-CT untersuchten Notfallpatienten mit Thoraxverletzungen ausgewertet. Im Vordergrund standen folgende Befunde unterschiedlichen Schweregrades: Pneumothorax, Haematothorax, Lungenkontusion/-lazeration, Mediastinalhaematom, Gefaessruptur, Herz- und Herzbeutelverletzung. Auf die unterschiedlichen Frakturen wird bewusst nicht naeher eingegangen. In vielen Faellen liefert die Spiral-CT mit relativ geringem Zeitaufwand wesentliche diagnostische Aussagen. Haeufig kann auf eine Angiographie verzichtet werden. Ein starres diagnostisches Stufenschema laesst sich nicht definieren. Die Thoraxuebersichtsaufnahme besitzt einen unveraendert hohen Stellenwert. (orig.)

  20. Evaluation of effective dose with chest digital tomosynthesis system using Monte Carlo simulation

    Science.gov (United States)

    Kim, Dohyeon; Jo, Byungdu; Lee, Youngjin; Park, Su-Jin; Lee, Dong-Hoon; Kim, Hee-Joung

    2015-03-01

    Chest digital tomosynthesis (CDT) system has recently been introduced and studied. This system offers the potential to be a substantial improvement over conventional chest radiography for the lung nodule detection and reduces the radiation dose with limited angles. PC-based Monte Carlo program (PCXMC) simulation toolkit (STUK, Helsinki, Finland) is widely used to evaluate radiation dose in CDT system. However, this toolkit has two significant limits. Although PCXMC is not possible to describe a model for every individual patient and does not describe the accurate X-ray beam spectrum, Geant4 Application for Tomographic Emission (GATE) simulation describes the various size of phantom for individual patient and proper X-ray spectrum. However, few studies have been conducted to evaluate effective dose in CDT system with the Monte Carlo simulation toolkit using GATE. The purpose of this study was to evaluate effective dose in virtual infant chest phantom of posterior-anterior (PA) view in CDT system using GATE simulation. We obtained the effective dose at different tube angles by applying dose actor function in GATE simulation which was commonly used to obtain the medical radiation dosimetry. The results indicated that GATE simulation was useful to estimate distribution of absorbed dose. Consequently, we obtained the acceptable distribution of effective dose at each projection. These results indicated that GATE simulation can be alternative method of calculating effective dose in CDT applications.

  1. Role of chest computed tomography in prevention of occupational respiratory disease: review of recent literature.

    Science.gov (United States)

    Weissman, David N

    2015-06-01

    This review provides an update on literature published over the past 5 years that is relevant to using chest computed tomography (CT) as a tool for preventing occupational respiratory disease. An important area of investigation has been in the use of low-dose CT (LDCT) to screen asbestos-exposed populations for lung cancer. Two recent systematic reviews have reached conclusions in support of screening. Based on the limited evidence that is currently available, the Finnish Institute of Occupational Health has recommended LDCT screening in asbestos-exposed individuals if their personal combination of risk factors yields a risk for lung cancer equal to that needed for entry into the National Lung Screening Trial. It has also recommended further research, such as to document the optimal frequency of screening and the effectiveness of screening. Recent literature continues to support high-resolution CT (HRCT) as being more sensitive than chest radiography in detecting pneumoconiosis. However, there are insufficient data to determine the effectiveness of HRCT screening in improving individual outcomes if used in screening for pneumoconiosis and its routine use for this purpose cannot be recommended. However, if HRCT is used to evaluate populations, recent literature shows that the International Classification of HRCT for Occupational and Environmental Respiratory Diseases provides an important tool for reproducible evaluation and recording of findings. HRCT is an important tool for individual patient management and recent literature has documented that chest HRCT findings are significantly associated with outcomes such as pulmonary function and mortality.

  2. FINDINGS OF CHEST RADIOGRAPH AND SPIRAL COMPUTED TOMOGRAPHY IN SWYER-JAMES SYNDROME

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To evaluate the value of X-ray and spiral computed tomography (SCT) in the diagnosis of SwyerJames syndrome (SJS).Methods A total of 28 patients, 12 males and 16 females, were studied retrospectively. Ages ranged from 11 to 57 years, the mean age was 32 years. All patients underwent inspiratory chest X-ray films, 5 with expiratory chest films and 1 with bronchogram. Furthermore, inspiratory and expiratory SCT scans were performed. The SCT findings were analyzed and compared with X-ray films.Results SCT demonstrated 56 lobes with hyperlucency and diminished vascularity. The size of 51 lobes were smaller and 5 were normal. X-ray films showed that hyperlucency was only in 29 lobes, in which 19 lobes were smallsized and the other 10 lobes normal. There were 56 lobes with air-trapping on expiratory SCT scans, but only 5 lobes with air-trapping on expiratory X-ray films. Bronchogram in 1 case demonstrated bronchiectasis and bronchiolitis obliterans. SCT showed 24 patients with bronchiectasis, 9 patients with tuberculosis, 10 patients with bronchiolitis, and 2 with segmental collapse. Conclusion SCT scan is superior to chest radiography in the diagnosis and differential diagnosis of SJS.

  3. Lung involvement quantification in chest radiographs; Quantificacao de comprometimento pulmonar em radiografias de torax

    Energy Technology Data Exchange (ETDEWEB)

    Giacomini, Guilherme; Alvarez, Matheus; Oliveira, Marcela de; Miranda, Jose Ricardo A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Pina, Diana R.; Pereira, Paulo C.M.; Ribeiro, Sergio M., E-mail: giacomini@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem

    2014-12-15

    Tuberculosis (TB) caused by Mycobacterium tuberculosis, is an infectious disease which remains a global health problem. The chest radiography is the commonly method employed to assess the TB's evolution. The methods for quantification of abnormalities of chest are usually performed on CT scans (CT). This quantification is important to assess the TB evolution and treatment and comparing different treatments. However, precise quantification is not feasible for the amount of CT scans required. The purpose of this work is to develop a methodology for quantification of lung damage caused by TB through chest radiographs. It was developed an algorithm for computational processing of exams in Matlab, which creates a lungs' 3D representation, with compromised dilated regions inside. The quantification of lung lesions was also made for the same patients through CT scans. The measurements from the two methods were compared and resulting in strong correlation. Applying statistical Bland and Altman, all samples were within the limits of agreement, with a confidence interval of 95%. The results showed an average variation of around 13% between the two quantification methods. The results suggest the effectiveness and applicability of the method developed, providing better risk-benefit to the patient and cost-benefit ratio for the institution. (author)

  4. How do radiologists do it? The influence of experience and training on searching for chest nodules

    Energy Technology Data Exchange (ETDEWEB)

    Manning, David [Department of Medical Imaging Sciences, St Martin' s College, Lancaster LA1 3JD (United Kingdom)]. E-mail: d.manning@ucsm.ac.uk; Ethell, Susan [Department of Medical Imaging Sciences, St Martin' s College, Lancaster LA1 3JD (United Kingdom); Donovan, Tim [Department of Medical Imaging Sciences, St Martin' s College, Lancaster LA1 3JD (United Kingdom); Crawford, Trevor [Department of Psychology, Lancaster University, Lancaster (United Kingdom)

    2006-05-15

    Four observer groups with different levels of expertise were tested to investigate the nature of expert performance. The task was the detection and localisation of significant pulmonary nodules in postero-anterior views of the chest. One hundred and twenty digitised chest images were used. The observer groups were 8 experienced radiologists, 5 experienced radiographers before and after six months training in chest image interpretation, and 8 undergraduate radiography students. Eye tracking was carried out to investigate differences in visual search strategies between observers. Detection performance was measured with an Alternate Free Response Operating Characteristic technique. Performance measures showed the experienced group of radiologists plus radiographers after training were better at the task than the remainder (t-test p = 0.046). Differences were shown in the eye-tracking parameters between the groups: saccadic amplitude (ANOVA p 0.00047), number of fixations before and after training (t-test p = 0.041), and scrutiny time per decision and per film for the experienced versus the inexperienced observers (t-test p = 0.02). Visual coverage reduced with increasing level of experience but this result did not reach significance. Generally there were distinct differences in the search strategies between the experienced and inexperienced observers and we discuss the significance of these findings. We believe the results support some recent theoretical models of expert performance and that the findings may prove to be helpful in 'fast-track' educational programmes of image interpretation for non-radiology practitioners.

  5. Solitary Plasmacytoma of the Chest Wall

    Directory of Open Access Journals (Sweden)

    Servet Kayhan

    2014-03-01

    Full Text Available A previously healthy 55-year-old man with right sided lateral chest pain admitted to clinic. It was found a solid and painful mass at the right 4th rib in physical examination. Chest X-ray and thoracic computarized tomography showed an opacity measured 60x33 mm within the right chest wall destructing the 4th rib. Needle aspiration was performed from tumor and cytologic examination showed atypic plasma cell infiltration. The patient was scheduled for a chest wall resection and reconstructive surgery. Examination of a permanent section showed that the chest wall tumor was solitary plasmacytoma. There was no evidence of multiple myeloma recurrence after two years from the operation.

  6. Bedside arterial blood gas monitoring system using fluorescent optical sensors

    Science.gov (United States)

    Bartnik, Daniel J.; Rymut, Russell A.

    1995-05-01

    We describe a bedside arterial blood gas (ABG) monitoring system which uses fluorescent optical sensors in the measurement of blood pH, PCO2 and PO2. The Point-of-Care Arterial Blood Gas Monitoring System consists of the SensiCathTM optical sensor unit manufactured by Optical Sensors Incorporated and the TramTM Critical Care Monitoring System with ABG Module manufactured by Marquette Electronics Incorporated. Current blood gas measurement techniques require a blood sample to be removed from the patient and transported to an electrochemical analyzer for analysis. The ABG system does not require removal of blood from the patient or transport of the sample. The sensor is added to the patient's existing arterial line. ABG measurements are made by drawing a small blood sample from the arterial line in sufficient quantity to ensure an undiluted sample at the sensor. Measurements of pH, PCO2 and PO2 are made within 60 seconds. The blood is then returned to the patient, the line flushed and results appear on the bedside monitor. The ABG system offers several advantages over traditional electrochemical analyzers. Since the arterial line remains closed during the blood sampling procedure the patient's risk of infection is reduced and the caregiver's exposure to blood is eliminated. The single-use, disposable sensor can be measure 100 blood samples over 72 hours after a single two-point calibration. Quality Assurance checks are also available and provide the caregiver the ability to assess system performance even after the sensor is patient attached. The ABG module integrates with an existing bedside monitoring system. This allows ABG results to appear on the same display as ECG, respiration, blood pressure, cardiac output, SpO2, and other clinical information. The small module takes up little space in the crowded intensive care unit. Performance studies compare the ABG system with an electrochemical blood gas analyzer. Study results demonstrated accurate and precise blood

  7. Development and User Research of a Smart Bedside Station System toward Patient-Centered Healthcare System.

    Science.gov (United States)

    Yoo, Sooyoung; Lee, Kee-Hyuck; Baek, Hyunyoung; Ryu, Borim; Chung, Eunja; Kim, Kidong; Yi, Jay Chaeyong; Park, Soo Beom; Hwang, Hee

    2015-09-01

    User experience design that reflects real-world application and aims to support suitable service solutions has arisen as one of the current issues in the medical informatics research domain. The Smart Bedside Station (SBS) is a screen that is installed on the bedside for the personal use and provides a variety of convenient services for the patients. Recently, bedside terminal systems have been increasingly adopted in hospitals due to the rapid growth of advanced technology in healthcare at the point of care. We designed user experience (UX) research to derive users' unmet needs and major functions that are frequently used in the field. To develop the SBS service, a service design methodology, the Double Diamond Design Process Model, was undertaken. The problems or directions of the complex clinical workflow of the hospital, the requirements of stakeholders, and environmental factors were identified through the study. The SBS system services provided to patients were linked to the hospital's main services or to related electronic medical record (EMR) data. Seven key services were derived from the results of the study. The primary services were as follows: Bedside Check In and Out, Bedside Room Service, Bedside Scheduler, Ready for Rounds, My Medical Chart, Featured Healthcare Content, and Bedside Community. This research developed a patient-centered SBS system with improved UX using service design methodology applied to complex and technical medical services, providing insights to improve the current healthcare system.

  8. Venous chest anatomy: clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Chasen, M.H.; Charnsangavej, C. [Department of Diagnostic Imaging, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030 (United States)

    1998-03-01

    This article provides a practical approach to the clinical implications and importance of understanding the collateral venous anatomy of the thorax. Routine radiography, conventional venography, computed tomography (CT), and magnetic resonance (MR) imaging studies provide correlative anatomic models for the demonstration of how interconnecting collateral vascular networks within the thorax maintain venous stability at all times. Five major systems comprise the collateral venous network of the thorax ( Fig. 1 ). These include the paravertebral, azygos-hemiazygos, internal mammary, lateral thoracic, and anterior jugular venous systems (AJVS). The five systems are presented in the following sequence: (a) a brief introduction to the importance of catheter position and malposition in understanding access to the thoracic venous system, (b) the anatomy of the azygos-hemiazygos systems and their relationship with the paravertebral plexus, (c) the importance of the AJVS, (d) 'loop' concepts interconnecting the internal mammary and azygos-hemiazygos systems by means of the lateral thoracic and intercostal veins, and (e) the interconnecting venous networks on the thoracic side of the thoracoabdominal junction. Certain aspects of the venous anatomy of the thorax will not be discussed in this chapter and include (a) the intra-abdominal anastomoses between the superior and inferior vena cavae (IVC) via the internal mammary, lateral thoracic, and azygos-hemiazygos systems (beyond the scope of this article), (b) potential collateral vessels involving vertebral, parascapular, thyroidal, thymic, and other smaller veins that might anastomose with the major systems, and (c) anatomic variants and pitfalls that may mimic pathologic conditions (space limitations). (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  9. Equine cellular therapy--from stall to bench to bedside?

    Science.gov (United States)

    Burk, Janina; Badylak, Stephen F; Kelly, Jeremy; Brehm, Walter

    2013-01-01

    Pioneering clinical stem cell research is being performed in the horse, a recipient of cutting edge veterinary medicine as well as a unique animal model, paving the way for human medical applications. Although demonstrable progress has been made on the clinical front, in vitro characterization of equine stem cells is still in comparatively early stages. To translate the promising results of clinical stem cell therapy in the horse, advances must be made in the characterization of equine stem cells. Aiming to improve communication between veterinarians and other natural scientists, this review gives an overview of veterinary "bedside" achievements, focusing on stem cell therapies in equine orthopedics as well as the current state of in vitro characterization of equine multipotent mesenchymal stromal cells (MSCs) and equine embryonic stem cells (ESCs).

  10. [Vertigo in the Emergency Department: new bedside tests].

    Science.gov (United States)

    Tamás, T László; Garai, Tibor; Tompos, Tamás; Szirmai, Ágnes

    2016-03-13

    According to international statistics, the first examination of 25% of patients with vertigo is carried out in Emergency Departments. The most important task of the examining physician is to diagnose life threatening pathologic processes. One of the most difficult otoneurological diagnostic challange in Emergency Departments is to differentiate between dangerous posterior scale stroke presenting with isolated vertigo and the benign vestibular neuritis.These two disorders can be safely differentiated using fast, non-invasive, evidence based bedside tests which have been introduced in the past few years. 35% of stroke cases mimicking vestibular neuritis (pseudoneuritis) are misdiagnosed at the Emergency Department, and 40% of these cases develop complications. During the first 48 hours, sensitivity for stroke of the new test that is based on the malfunction of the oculomotor system is better than the diffusion-weighted cranial magnetic resonance imaging. Using special test glasses each component of the new test can be made objective and repeatable.

  11. Implementing interprofessional bedside rounding at the prequalification stage

    Directory of Open Access Journals (Sweden)

    Tuite DR

    2016-10-01

    Full Text Available Daniel R Tuite,1 David Healy,1 Thomas S MacKinnon2 1Faculty of Medicine, Brighton and Sussex Medical School, Brighton, 2School of Medicine, Imperial College London, London, UKWe read with great interest the paper by Henkin et al,1 demonstrating that the use of interprofessional bedside rounding (IBR significantly improved nurse–physician teamwork, particularly from the nurses’ point of view. This finding is relevant when one takes into account the importance of interdisciplinary teamwork; a review conducted by Epstein concluded that effective interprofessional teamwork both maximizes patient safety and increases job satisfaction and efficiency.2 We, as medical students, believe that inadequate emphasis is placed on interprofessional collaboration at the prequalification phase, and therefore, we suggest that implementing IBR at the university level could represent a method to improve teamwork between the nurses and doctors of the future.  View the original paper by Henkin et al.  

  12. Elderly Woman with Abdominal Pain: Bedside Ultrasound Diagnosis of Diverticulitis

    Directory of Open Access Journals (Sweden)

    Jason D. Heiner

    2015-10-01

    Full Text Available A 72-year-old otherwise healthy female presented to the emergency department with two weeks of worsening abdominal pain. She was afebrile with normal vital signs. Her physical examination was notable for moderate abdominal tenderness without rebound to the left and suprapubic regions of the abdomen. Laboratory studies were remarkable for a white blood cell count of 13,000/mm3. A focused bedside ultrasound over the patient’s region of maximal discomfort revealed a thickened bowel wall and several small contiguous hypoechoic projections surrounding a hyperechoic center, suggestive of diverticulitis (Figure. She was given metronidazole and ciprofloxacin and her diagnosis of uncomplicated colonic diverticulitis was confirmed by computed tomography (CT.

  13. Prevalence of diabetic autonomic neuropathy measured by simple bedside tests

    DEFF Research Database (Denmark)

    Dyrberg, Torben Bech; Benn, Jette; Christiansen, J S

    1981-01-01

    To investigate the prevalence of diabetic autonomic neuropathy, five simple bedside tests, beat-to-beat variation during quiet respiration, beat-to-beat variation during forced respiration, heart rate and blood pressure response to standing, heart rate response to exercise, and heart rate response....... The prevalence of diabetic autonomic neuropathy in the whole diabetic population indicated by abnormal response in beat-to-beat variation during forced respiration was 27%. Diabetic autonimic neuropathy increased in frequency with duration of disease. Patients with nephropathy or proliferative retinopathy had...... a significantly higher prevalence of diabetic autonomic neuropathy as indicated by abnormal beat-to-beat variation during forced respirations (p less than 0.01) than patients without these complications....

  14. Computed radiography in an emergency department setting

    Science.gov (United States)

    Andriole, Katherine P.; Gould, Robert G.; Arenson, Ronald L.

    1997-05-01

    Evaluation of radiologist and non-radiologist physician acceptance of computed radiography (CR) as an alternative to film-based radiography in an emergency department (ED) is performed. All emergency department radiographs are performed using photostimulable phosphor plates and rad by a computed radiography laser reader placed in the former emergency department darkroom. Soft copy images are simultaneously transmitted to high- and medium-resolution dual-monitor display stations located in radiology and ED reading rooms respectively. The on-call radiologist is automatically paged by the Radiology Information System (RIS) upon exam completion, to read the new ED imaging study. Patient demographic information including relevant clinical history is conveyed to the radiologist via the RIS. A 'wet read' preliminary radiology report is immediately transmitted back to the ED. Radiology and ED physicians are surveyed to ascertain preferences for CR or traditional screen-film, based on system implementation, image viewing and clinical impact issues. Preliminary results indicate a preference for filmless CR among the ED physicians if digital reliability and speed issues are met. This preference appears to be independent of physician level of experience. Inexperienced radiologists-in-training appear to have less comfort with softcopy reading for primary diagnosis. However, additional training in softcopy reading techniques can improve confidences. Image quality issues are most important tot he radiologist, while speed and reliability are the major issues for ED physicians. Reasons for CR preference include immediate access to images on display stations, near-zero exam retake rates, and improved response time and communication between radiology and the emergency department clinician.

  15. [Chest pains in the dental environment].

    Science.gov (United States)

    Garfunkel, A; Galili, D; Findler, M; Zusman, S P; Malamed, S F; Elad, S; Kaufman, E

    2002-01-01

    Chest pain does not necessarily indicate cardiac disease. The most common causes of acute chest pain encountered in dental situations include hyperventilation, pulmonary embolism, angina pectoris and myocardial infarction. Stress and fear often cause rapid breathing or hyperventilation. This usually occurs in young adults and although the hyperventilating patient often complains of chest pain, this is rarely a manifestation of cardiac disease. Pulmonary embolism usually indicates the occlusion of a pulmonary artery causing severe chest pain. The primary clinical manifestation of angina pectoris is chest pain. Although most instances of anginal pain are easily terminated, the dentist must always consider the possibility that the supposed anginal attack is actually a sign of acute myocardial infarction (AMI). AMI is a clinical syndrome caused by a deficient coronary arterial blood supply to a region of myocardium that results in cellular death. There is a high incidence of mortality among AMI with death often occurring within 2 hours of the onset of signs and symptoms. The initial clinical manifestations of all types of chest pain can be similar. Therefore the dentist must develop proficiency in constituting a differential diagnosis and an efficient management protocol. As in most medical situations prevention is the most powerful tool. However, if chest pains do occur, measures such as airway management, oxygen supplementation, coronary artery dilation, analgesis and in extreme cases, cardiopulmonary resuscitation and evacuation to the emergency room, may be necessary.

  16. Axial Tomography from Digitized Real Time Radiography

    Science.gov (United States)

    Zolnay, A. S.; McDonald, W. M.; Doupont, P. A.; McKinney, R. L.; Lee, M. M.

    1985-01-18

    Axial tomography from digitized real time radiographs provides a useful tool for industrial radiography and tomography. The components of this system are: x-ray source, image intensifier, video camera, video line extractor and digitizer, data storage and reconstruction computers. With this system it is possible to view a two dimensional x-ray image in real time at each angle of rotation and select the tomography plane of interest by choosing which video line to digitize. The digitization of a video line requires less than a second making data acquisition relatively short. Further improvements on this system are planned and initial results are reported.

  17. Digital Radiography Qualification of Tube Welding

    Science.gov (United States)

    Carl, Chad

    2012-01-01

    The Orion Project will be directing Lockheed Martin to perform orbital arc welding on commodities metallic tubing as part of the Multi Purpose Crew Vehicle assembly and integration process in the Operations and Checkout High bay at Kennedy Space Center. The current method of nondestructive evaluation is utilizing traditional film based x-rays. Due to the high number of welds that are necessary to join the commodities tubing (approx 470), a more efficient and expeditious method of nondestructive evaluation is desired. Digital radiography will be qualified as part of a broader NNWG project scope.

  18. Digital radiography in the aerospace industry

    Science.gov (United States)

    Buchanan, R. A.; Bueno, C.; Barry, R. C.; Barker, M. D.

    An account is given of the bases of digital radiography (DR), with a view to the identification of NDE systems with the greatest usefulness to the aerospace industry and the nature of the advanced image processing and reconstruction techniques that have been devised thus far. The spatial resolution of any DR system is fundamentally limited by the number of pixels in the digital image and the system field-of-view. Attention is given to the problems of image geometric unsharpness and radiation quantum noise limits, as well as to the potential role of advanced DR in future NDT of aerospace components.

  19. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  20. Chest pain: a time for concern?

    Science.gov (United States)

    King, Joan E; Magdic, Kathy S

    2014-01-01

    When a patient complains of chest pain, the first priority is to establish whether the situation is life threatening. Life-threatening differential diagnoses that clinicians must consider include acute coronary syndrome, cardiac tamponade, pulmonary embolus, aortic dissection, and tension pneumothorax. Nonthreatening causes of chest pain that should be considered include spontaneous pneumothorax, pleural effusion, pneumonia, valvular diseases, gastric reflux, and costochondritis. The challenge for clinicians is not to be limited by "satisfaction of search" and fail to consider important differential diagnoses. The challenge, however, can be met by developing a systematic method to assess chest pain that will lead to the appropriate diagnosis and appropriate treatment plan.

  1. Chest pain of cardiac and noncardiac origin.

    Science.gov (United States)

    Lenfant, Claude

    2010-10-01

    Chest pain is one of the most common symptoms driving patients to a physician's office or the hospital's emergency department. In approximately half of the cases, chest pain is of cardiac origin, either ischemic cardiac or nonischemic cardiac disease. The other half is due to noncardiac causes, primarily esophageal disorder. Pain from either origin may occur in the same patient. In addition, psychological and psychiatric factors play a significant role in the perception and severity of the chest pain, irrespective of its cause. Chest pain of ischemic cardiac disease is called angina pectoris. Stable angina may be the prelude of ischemic cardiac disease; and for this reason, it is essential to ensure a correct diagnosis. In most cases, further testing, such as exercise testing and angiography, should be considered. The more severe form of chest pain, unstable angina, also requires a firm diagnosis because it indicates severe coronary disease and is the earliest manifestation of acute myocardial infarction. Once a diagnosis of stable or unstable angina is established, and if a decision is made not to use invasive therapy, such as coronary bypass, percutaneous transluminal coronary angioplasty, or stent insertion, effective medical treatment of associated cardiac risk factors is a must. Acute myocardial infarction occurring after a diagnosis of angina greatly increases the risk of subsequent death. Chest pain in women warrants added attention because women underestimate their likelihood to have coronary heart disease. A factor that complicates the clinical assessment of patients with chest pain (both cardiac and noncardiac in origin) is the relatively common presence of psychological and psychiatric conditions such as depression or panic disorder. These factors have been found to cause or worsen chest pain; but unfortunately, they may not be easily detected. Noncardiac chest pain represents the remaining half of all cases of chest pain. Although there are a number of

  2. Preliminary Study of Indirect Neutron Radiography Method at CARR

    Institute of Scientific and Technical Information of China (English)

    WEI; Guo-hai; HAN; Song-bai; WANG; Hong-li; HE; Lin-feng; WANG; Yu; WU; Mei-mei; LIU; Yun-tao; CHEN; Dong-feng

    2013-01-01

    The Indirect Neutron Radiography is a powerful technique for non-destructively measuring specimens with radioactivity in the nuclear industrial field.China Advanced Research Reactor(CARR)is an excellent platform for Indirect Neutron Radiography and the experimental conditions based on CARR,mainly the first and the second exposure time,have been calculated and analyzed by the Monte Carlo

  3. Local-Reference Patient Dose Evaluation in Conventional Radiography Examinations in Mazandaran, Iran

    Directory of Open Access Journals (Sweden)

    Khoshdel-Navi D.

    2016-06-01

    Full Text Available Background: The most efficient application of ionizing radiation is serving medical purposes and using this radiation has caused people to learn that artificial sources of radiation exposure among these resources can be of highest exposure rate. Obiective: The present study is aimed at initially establishing a baseline for localreference dose level in Mazandaran, Iran in 12 projections of the most conventional x-ray examination. Methods: In this study, 13 public hospitals in Mazandaran province were selected for review and required data collected for ten adult patients with mean weight of 70±10kg in each projection. Then, information of each center was separately analyzed. Next, in order to measure x-ray output tube, the dosimeter RTI model Barracuda calibrated has been applied for measuring air karma within energy rage of 40-150kvp. ESAK and ESD parameters, usually used for monitoring DRL in conventional radiography, were calculated. Results: Mean ESDs in this study has been obtained to 1.47±0.98 for skull (PA/ AP, 1.01±0.79 for skull (LAT, 0.67±0.38 for cervical spine (AP, 0.79±0.37 for cervical (LAT, 0.49±0.38 for chest (PA/AP, 1.06±0.44 for chest (LAT, 2.15±0.73 for thoracic spine (AP, 3±0.87 for thoracic spine (LAT, 2.81 ±0.82 for lumbar spine (AP, 4.28±0.78 for lumbar (LAT, 2.07±1.17 for abdomen and 1.90±0.99 for pelvis, respectively. The ESDs calculated for chest examination in both projections, PA and LAT are more than values recommended by the UK (2000, Brazil and Slovenia. Conclusion: The present study has determined wide variations in radiation dose of x-ray examinations among hospitals in Mazandaran, Iran. In order to reduce skin dose, an optimization procedure should be considered. Application of a reference dose (DRL could be a practical method for this purpose. The role of optimization of radiography parameters for reducing patient dose is a significant issue. Through optimizing parameters, it would be possible to

  4. Simulation of computed radiography with imaging plate detectors

    Energy Technology Data Exchange (ETDEWEB)

    Tisseur, D.; Costin, M. [CEA LIST, CEA Saclay 91191 Gif sur Yvette Cedex (France); Mathy, F. [CEA-LETI, Campus Minatec, F-38054, Grenoble (France); Schumm, A. [EDF R and D, 1 avenue du général de gaulle 92141 Clamart (France)

    2014-02-18

    Computed radiography (CR) using phosphor imaging plate detectors is taking an increasing place in Radiography Testing. CR uses similar equipment as conventional radiography except that the classical X-ray film is replaced by a numerical detector, called image plate (IP), which is made of a photostimulable layer and which is read by a scanning device through photostimulated luminescence. Such digital radiography has already demonstrated important benefits in terms of exposure time, decrease of source energies and thus reduction of radioprotection area besides being a solution without effluents. This paper presents a model for the simulation of radiography with image plate detectors in CIVA together with examples of validation of the model. The study consists in a cross comparison between experimental and simulation results obtained on a step wedge with a classical X-ray tube. Results are proposed in particular with wire Image quality Indicator (IQI) and duplex IQI.

  5. Digital radiography image quality: image processing and display.

    Science.gov (United States)

    Krupinski, Elizabeth A; Williams, Mark B; Andriole, Katherine; Strauss, Keith J; Applegate, Kimberly; Wyatt, Margaret; Bjork, Sandra; Seibert, J Anthony

    2007-06-01

    This article on digital radiography image processing and display is the second of two articles written as part of an intersociety effort to establish image quality standards for digital and computed radiography. The topic of the other paper is digital radiography image acquisition. The articles were developed collaboratively by the ACR, the American Association of Physicists in Medicine, and the Society for Imaging Informatics in Medicine. Increasingly, medical imaging and patient information are being managed using digital data during acquisition, transmission, storage, display, interpretation, and consultation. The management of data during each of these operations may have an impact on the quality of patient care. These articles describe what is known to improve image quality for digital and computed radiography and to make recommendations on optimal acquisition, processing, and display. The practice of digital radiography is a rapidly evolving technology that will require timely revision of any guidelines and standards.

  6. Bedside Evaluation of Cerebral Energy Metabolism in Severe Community-Acquired Bacterial Meningitis

    DEFF Research Database (Denmark)

    Rom Poulsen, Frantz; Schulz, Mette; Jacobsen, Anne

    2015-01-01

    community-acquired meningitis utilizing intracerebral microdialysis and bedside biochemical analysis. According to previous studies, cerebral ischemia was defined as lactate/pyruvate (LP) ratio >30 with intracerebral pyruvate level

  7. Bedside diagnosis of imported malaria using the Binax Now malaria antigen detection test

    DEFF Research Database (Denmark)

    Wiese, Lothar; Bruun, Brita; Baek, Leif

    2006-01-01

    a period of 14 months. The Binax Now Malaria rapid test was used at the bedside and in the clinical microbiology laboratory. The training of clinical staff was monitored and their experience with the use of the test was recorded. 542 patients were included, 80 of whom had malaria diagnosed by microscopy....... The rapid test used at the bedside had a sensitivity of 88% for the detection of P. falciparum compared to 95% when the test was performed in the microbiology laboratory. The risk of technical problems and invalid tests was highest when the test was used at the bedside. The rapid diagnostic test may...... be useful for the diagnosis of P. falciparum malaria when used by routine laboratory staff, but could lead to misdiagnoses when used at the bedside. Microscopy is still essential in order to identify the few missed diagnoses, to determine the degree of parasitaemia, and to ensure species diagnosis...

  8. H1N1 influenza in an Irish population: patterns of chest radiograph abnormality in patients testing positive.

    LENUS (Irish Health Repository)

    O'Sullivan, K

    2012-02-29

    The winter of 2010\\/2011 saw a second peak in the number of H1N1 cases detected in Ireland. The purpose of this study was to investigate the radiological characteristics of patients diagnosed during this period. A retrospective analysis of these cases was performed. Chest radiographs were classified as normal or abnormal. A total of 37 patients were included. Of these, 22 (59%) of chest radiographs were abnormal and 15 (41%) were normal. In the 7 paediatric patients, 4 (57%) had a perihilar distribution of disease, 2 (28%) had peripherally based disease with 1 (14%) having a mixed distribution. A series of radiographs was available for 9 patients, 6 of these showed a radiographic deterioration from the initial study. The majority of chest radiographs of patients with confirmed H1N1 infection will be abnormal. In children, disease is more likely to be perihilar in distribution. Chest radiography is an important initial investigation in patients with H1N1 infection and is useful to track progression of disease in the subset of patients requiring hospitalization for severe disease.

  9. Nuclear track radiography of 'hot' aerosol particles

    CERN Document Server

    Boulyga, S F; Kievets, M K; Lomonosova, E M; Zhuk, I V; Yaroshevich, O I; Perelygin, V P; Petrova, R I; Brandt, R; Vater, P

    1999-01-01

    Nuclear track radiography was applied to identify aerosol 'hot' particles which contain elements of nuclear fuel and fallout after Chernobyl NPP accident. For the determination of the content of transuranium elements in radioactive aerosols the measurement of the alpha-activity of 'hot' particles by SSNTD was used in this work, as well as radiography of fission fragments formed as a result of the reactions (n,f) and (gamma,f) in the irradiation of aerosol filters by thermal neutrons and high energy gamma quanta. The technique allowed the sizes and alpha-activity of 'hot' particles to be determined without extracting them from the filter, as well as the determination of the uranium content and its enrichment by sup 2 sup 3 sup 5 U, sup 2 sup 3 sup 9 Pu and sup 2 sup 4 sup 1 Pu isotopes. Sensitivity of determination of alpha activity by fission method is 5x10 sup - sup 6 Bq per particle. The software for the system of image analysis was created. It ensured the identification of track clusters on an optical imag...

  10. Clinical Applications of Reverse Panoramic Radiography

    Directory of Open Access Journals (Sweden)

    Sujatha S Reddy

    2011-09-01

    Full Text Available The essence of oral and maxil-lofacial radiology is not only to be an important tool in the diagnostic assessment of dental patients but also to equip the clinician with the ability to interpret images of certain maxillocraniofacial structures of importance to dental, medical and surgical practices. Although combinations of several conven-tional x-ray projections can be adequate in a number of clinical situations, radiographic assessment of certain craniofacial structures some-times needs to be facilitated by other imaging modalities. A not-so-recent development called reverse panoramic radiography may be a useful adjuvant to such a situation, at least in the near future. It is essentially a technique where the patient is placed backwards in the panoramic machine in a reverse position in such a way that x-ray beam is directed through the patient’s face and the exit beam then passes through the patient’s head on the opposite side where it is captured on the receptor. The following manuscript is an attempt to throw light on this technique and the impact it may have on dental, medical and surgical practices. The advantages and disadvantages of reverse panoramic radiography and it’s comparison to conventional panoramic radiographs and other skull views are also dis-cussed.

  11. Discovering Ways That Influence the Older Nurse to Continue Bedside Practice

    OpenAIRE

    LeeAnna Spiva; Patricia Hart; Frank McVay

    2011-01-01

    A descriptive qualitative approach was used to investigate older nurses practicing bedside nursing and to identify ways to influence older nurses to continue bedside practice. A purposive sample of 18 older nurses was recruited from a healthcare system located in the Southeastern United States. Interpretative analysis of interviews resulted in the identification of three constitutive patterns and eight themes. The first constitutive pattern identified was attributes of the older nurse. The th...

  12. Common Acupoints in Chest and Abdomen

    Institute of Scientific and Technical Information of China (English)

    Journal of Acupuncture and Tuina Science Editor; CUI Xue-jun

    2003-01-01

    @@ Tiantu (CV 21) Location: In the center of the suprasternal fossa(Fig. l ). Indications: Cough, dyspnea, chest pain, pharyngolaryngeal swelling and pains, sudden hoarseness of the voice, goiter, globus hystericus, and dysphagia.

  13. THE DEADLY DOZEN OF CHEST TRAUMA

    African Journals Online (AJOL)

    Enrique

    Severe chest injuries are responsible for 25% of all trauma deaths, and in a ... mechanical compression of the trachea, laryngeal trauma such as thyroid or cricoid ... Unit Head at Chris Hani .... mechanical ventilation to 'internally splint' the ...

  14. Tuberculosis, advanced - chest x-rays (image)

    Science.gov (United States)

    Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, ... death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying ...

  15. High Brightness Neutron Source for Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Cremer, J. T.; Piestrup, Melvin, A.; Gary, Charles, K.; Harris, Jack, L. Williams, David, J.; Jones, Glenn, E.; Vainionpaa, J. , H.; Fuller, Michael, J.; Rothbart, George, H.; Kwan, J., W.; Ludewigt, B., A.; Gough, R.., A..; Reijonen, Jani; Leung, Ka-Ngo

    2008-12-08

    This research and development program was designed to improve nondestructive evaluation of large mechanical objects by providing both fast and thermal neutron sources for radiography. Neutron radiography permits inspection inside objects that x-rays cannot penetrate and permits imaging of corrosion and cracks in low-density materials. Discovering of fatigue cracks and corrosion in piping without the necessity of insulation removal is possible. Neutron radiography sources can provide for the nondestructive testing interests of commercial and military aircraft, public utilities and petrochemical organizations. Three neutron prototype neutron generators were designed and fabricated based on original research done at the Lawrence Berkeley National Laboratory (LBNL). The research and development of these generators was successfully continued by LBNL and Adelphi Technology Inc. under this STTR. The original design goals of high neutron yield and generator robustness have been achieved, using new technology developed under this grant. In one prototype generator, the fast neutron yield and brightness was roughly 10 times larger than previously marketed neutron generators using the same deuterium-deuterium reaction. In another generator, we integrate a moderator with a fast neutron source, resulting in a high brightness thermal neutron generator. The moderator acts as both conventional moderator and mechanical and electrical support structure for the generator and effectively mimics a nuclear reactor. In addition to the new prototype generators, an entirely new plasma ion source for neutron production was developed. First developed by LBNL, this source uses a spiral antenna to more efficiently couple the RF radiation into the plasma, reducing the required gas pressure so that the generator head can be completely sealed, permitting the possible use of tritium gas. This also permits the generator to use the deuterium-tritium reaction to produce 14-MeV neutrons with increases

  16. ACR Appropriateness Criteria(®) acute nonspecific chest pain-low probability of coronary artery disease.

    Science.gov (United States)

    Hoffmann, Udo; Venkatesh, Vikram; White, Richard D; Woodard, Pamela K; Carr, J Jeffrey; Dorbala, Sharmila; Earls, James P; Jacobs, Jill E; Mammen, Leena; Martin, Edward T; Ryan, Thomas; White, Charles S

    2012-10-01

    This document outlines the usefulness of available diagnostic imaging for patients without known coronary artery disease and at low probability for having coronary artery disease who do not present with classic signs, symptoms, or electrocardiographic abnormalities indicating acute coronary syndrome but rather with nonspecific chest pain leading to a differential diagnosis, including pulmonary, gastrointestinal, or musculoskeletal pathologies. A number of imaging modalities are available to evaluate the broad spectrum of possible pathologies in these patients, such as chest radiography, multidetector CT, MRI, ventilation-perfusion scans, cardiac perfusion scintigraphy, transesophageal and transthoracic echocardiography, PET, spine and rib radiography, barium esophageal and upper gastrointestinal studies, and abdominal ultrasound. It is considered appropriate to start the assessment of these patients with a low-cost, low-risk diagnostic test such as a chest x-ray. Contrast-enhanced gated cardiac and ungated thoracic multidetector CT as well as transthoracic echocardiography are also usually considered as appropriate in the evaluation of these patients as a second step if necessary. A number of rest and stress single-photon emission CT myocardial perfusion imaging, ventilation-perfusion scanning, aortic and chest MR angiographic, and more specific x-ray and abdominal examinations may be appropriate as a third layer of testing, whereas MRI of the heart or coronary arteries and invasive testing such as transesophageal echocardiography or selective coronary angiography are not considered appropriate in these patients. Given the low risk of these patients, it is mandated to minimize radiation exposure as much as possible using advanced and appropriate testing protocols. The ACR Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review

  17. Relevant surgical anatomy of the chest wall

    OpenAIRE

    Rajesh, Pala Babu; Naidu, Babu V.

    2010-01-01

    The chest wall, like other regional anatomy, is a remarkable fusion of form and function. Principal functions are the protection of internal viscera and an expandable cylinder facilitating variable gas flow into the lungs. Knowledge of the anatomy of the whole cylinder (ribs, sternum, vertebra, diaphragm, intercostal spaces, and extrathoracic muscles) is therefore not only important in the local environment of a specific chest wall resection but also in its relation to overall function. An un...

  18. CARDIOVASCULAR DISORDERS IN ADOLESCENTS WITH CHEST PAIN

    OpenAIRE

    Sri Endah Rahayuningsih; Rahmat Budi; Herry Garna

    2014-01-01

    Objective: To detect cardiovascular abnormalities in adolescents with chest pain. Methods: In this cross sectional study, the subjects were 25 adolescents with chest pain who came to the Cardiac Center of Dr. Hasan Sadikin General Hospital, Bandung during the period of January 2008 to January 2011. The presence of established cardiovascular disorders were based on history, physical examination, electrocardiography and echocardiography Results: It was found that 13/25 adolesce...

  19. Finding on a chest radiograph: A dangerous complication of subclavian vein cannulation

    Directory of Open Access Journals (Sweden)

    Srinivasan Nataraj

    2010-01-01

    Full Text Available Cannulation of the subclavian vein has its inherent risks. Post procedure chest radiograph is one of the investigations done to rule out immediate complications. Unless the clinician is aware as to what to look for in the radiograph, some of the dangerous complications can be overlooked. Accidental subclavian artery cannulation is identified immediately by color and jet of the blood. Also the position of the catheter tip has to be confirmed by obtaining the arterial pressure tracing using a pressure transducer. Non availability of Doppler ultrasound and pressure transducer are limiting factors for immediate confirmation of proper catheter placement. Also, in patients with severe hypotension and reduced oxygen content of blood, accidental arterial puncture may not show the characteristic bright red pulsatile back flow of arterial blood. In these situations radiography can be used as a diagnostic tool to rule out subclavian artery cannulation.

  20. Characterization of interstitial lung disease in chest radiographs using SOM artificial neural network

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo-Marques, P.M. de; Ambrosio, P.E.; Pereira, R.R. Jr.; Valini, R. de A.; Salomao, S.C. [Faculty of Medicine of Ribeirao Preto, Univ. of Sao Paulo (Brazil)

    2007-06-15

    This paper presents an automated approach to apply a self-organizing map (SOM) artificial neural network (ANN) as a tool for feature extraction and dimensionality reduction to recognize and characterize radiologic patterns of interstitial lung diseases in chest radiography. After feature extraction and dimensionality reduction a multilayer perceptron (MLP) ANN is applied for radiologic patterns classification in normal, linear, nodular or mixed. A leave-one-out methodology was applied for training and test over a database containing 17 samples of linear pattern, 9 samples of nodular pattern, 9 samples of mixed pattern and 18 samples of normal pattern. The MLP network provided an average result of 88.7% of right classification, with 100% of right classification for linear pattern, 55.5% for nodular pattern, 77.7% for mixed pattern and 100% for normal pattern. (orig.)

  1. Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art

    Directory of Open Access Journals (Sweden)

    Marcos Duarte Guimaraes

    2015-02-01

    Full Text Available Magnetic resonance imaging (MRI has several advantages in the evaluation of cancer patients with thoracic lesions, including involvement of the chest wall, pleura, lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis, staging, surgical planning, treatment response evaluation and follow-up of these patients. In the present review, the authors contextualize the relevance of MRI in the evaluation of thoracic lesions in cancer patients. Considering that MRI is a widely available method with high contrast and spatial resolution and without the risks associated with the use of ionizing radiation, its use combined with new techniques such as cine-MRI and functional methods such as perfusion- and diffusion-weighted imaging may be useful as an alternative tool with performance comparable or complementary to conventional radiological methods such as radiography, computed tomography and PET/CT imaging in the evaluation of patients with thoracic neoplasias.

  2. [Yes, we should keep ABO agglutination test within bedside transfusion checks].

    Science.gov (United States)

    Daurat, G

    2008-11-01

    ABO incompatible transfusions are still a frequent cause of serious adverse transfusion reactions. Bedside check is intended to detect patient errors and prevent ABO mismatch. France is one of the few countries that includes ABO agglutination test for red blood cells in bedside checks. Evaluation of this ABO agglutination test, performed with a special card, shows that, on the field, despite frequent users' mishandling, it can detect up to 93% of ABO incompatibilities. This is not enough to rely on this sole test for bedside checks. But, linking it with an another test, currently, checks that the right blood is given to the right patient, rises the sensitivity of the whole bedside procedure up to an estimated 99.65%, for detection of ABO incompatibilities. This linkage has been introduced in the French regulation in 2003. Since then, the incidence of ABO incompatible transfusions has decreased dramatically and faster than in any other country, so France has now, probably, the lowest rate of ABO incompatible transfusions. The investigation of the few ABO accidents that still occur, shows that professionals have always bypassed this linkage. On the other hand, introducing bedside recipient and blood products barcode or radio-chip checks in all the 1500 French hospitals, though technically possible, would provide very little enhancement and lead to major difficulties and expenses. Linkage of ABO agglutination test to patient and blood checks within the bedside procedure has proved to be efficient and should be kept.

  3. From the present status of chest CT screening. The latest report from the laboratory using installation CT

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Yoshimasa [Tokyo Health Service Association (Japan)

    1999-04-01

    The screening that used helical CT was enforced from 1997. Radiographical condition is as follows; voltage 120 kV, current 50 mA, beam width 10 mm, table speed 20 mm/sec/rot. Image data was reconstructed with 10 mm interval using 180 degree opposed beam interpolation. The detecting rate of lung cancer was 5.1% before transduction of CT, but 8.9% after transduction. The rate of stage 1 was 53.5% before transduction but 82.7% after transduction. Among 29 cases of lung cancer, 3 cases were detected with exfoliative cytology of sputum, and 26 cases by CT image. All of lung cancer diagnosed only with helical CT were in stage 1, and 16 cases were adenocarcinoma, and 2 cases were squamous cell carcinoma. Radius of cancer was an average of 30.4 mm before CT transduction, but 16.04 mm after the transduction. Radius of cancer which could be found by chest direct X-ray radiography was an average of 26.25 mm, and that which could be found out only with CT was an average of 11.5 mm. Cancer found by chest direct X-ray radiography was solid tumor, and contrast of image was high. There was also non-solid cancer whose image showed low contrast, in cancer discovered only with CT. In cost-benefit analysis, CT screening is more expensive but more beneficial than photofluoroscopic examination for lung cancer. (K.H.)

  4. Longitudinal changes in extended roles in radiography: A new perspective

    Energy Technology Data Exchange (ETDEWEB)

    Price, R.C. [School of Paramedic Sciences, Physiotherapy and Radiography, Faculty of Health and Human Sciences, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB (United Kingdom)]. E-mail: r.c.price@herts.ac.uk; Le Masurier, S.B. [University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB (United Kingdom)

    2007-02-15

    Purpose: The purpose of this research was to update data on the scope of changes to radiographic practice since the principal author's last survey in 2000. The study also sought to identify any regional patterns in the adoption and diffusion of extended roles and to map the implementation of the 4-tier structure. Method: Structured questionnaires were sent to radiology managers at acute National Health Service (NHS) trusts across the United Kingdom. Information sought included region, teaching/non-teaching status, the nature of extended role tasks undertaken and the year in which these tasks were adopted, numbers of radiographers and radiologists in post. Information was also sought on the implementation of the '4-tier structure'. Results: Some 177 questionnaires were returned from a total of 258 dispatched giving a 68.6% response rate. In 166 trusts, radiographers administered intravenous injections; they performed barium enemas in 147 trusts and barium meals in 19 trusts, while a red dot system was in operation in 143 trusts. Each category showed an increase from that reported in 2000. Likewise reporting by radiographers had increased since 2000. Responses indicated that at 146 trusts, radiographers were reporting in ultrasound; reporting of the appendicular skeleton was undertaken at 81 trusts and axial skeletal reporting at 70 trusts. Barium enemas were reported by radiographers in 78 trusts. Reporting was also undertaken by radiographers on barium meals, mammography, nuclear medicine, paediatric and chest radiography; and all showed an increase in frequency since 2000. Regional differences were again apparent in reporting, with a greater prevalence in the English regions, with the exception of London. In respect of the 4-tier structure, 59% of the sample employed assistant practitioners, 47% advanced practitioners and 3% employed consultants. The numbers reported in each category (excluding practitioners) were 158 assistants, 623 advanced

  5. Parachordoma of the chest waII: case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Seung Hyun; Sung, Nak Kwan; Jung, Kyung Jae; Lee, Young Hwan; Park, Young Chan; Kim, Ho Kyun; Park, So Yoon; Park, Ki Sung [School of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Ko, Sung Min [School of Medicine, Keimyoung Univ., Daegu (Korea, Republic of)

    2004-09-01

    We report radiologic findings in a case of chest wall parachordoma in a 32-year-old maIe with right upper back pain. The plain radiograph and CT scan of the chest revealed a soft tissue mass in the right lateral chest wall with rib erosion. En-bloc surgical resection with chest wall reconstruction was performed.

  6. Psychiatric syndromes associated with atypical chest pain

    Directory of Open Access Journals (Sweden)

    Nikolić Gordana

    2010-01-01

    Full Text Available Background/Aim. Chest pain often indicates coronary disease, but in 25% of patients there is no evidence of ischemic heart disease using standard diagnostic tests. Beside that, cardiologic examinations are repeated several times for months. If other medical causes could not be found, there is a possibility that chest pain is a symptom of psychiatric disorder. The aim of this study was to determine the presence of psychiatric syndromes, increased somatization, anxiety, stress life events exposure and characteristic of chest pain expression in persons with atypical chest pain and coronary patients, as well as to define predictive parameters for atypical chest pain. Method. We compared 30 patients with atypical chest pain (E group to 30 coronary patients (K group, after cardiological and psychiatric evaluation. We have applied: Mini International Neuropsychiatric Interview (MINI, The Symptom Checklist 90-R (SCL-90 R, Beck Anxiety Inventory (BAI, Holms-Rahe Scale of stress life events (H-R, Questionnaire for pain expression Pain-O-Meter (POM. Significant differences between groups and predictive value of the parameters for atypical chest pain were determined. Results. The E group participants compared to the group K were younger (33.4 ± 5.4 : 48.3 ± 6,4 years, p < 0.001, had a moderate anxiety level (20.4 ± 11.9 : 9.6 ± 3.8, p < 0.001, panic and somatiform disorders were present in the half of the E group, as well as eleveted somatization score (SOM ≥ 63 -50% : 10%, p < 0.01 and a higher H-R score level (102.0 ± 52.2 : 46.5 ± 55.0, p < 0.001. Pain was mild, accompanied with panic. The half of the E group subjects had somatoform and panic disorders. Conclusion. Somatoform and panic disorders are associated with atypical chest pain. Pain expression is mild, accompained with panic. Predictive factors for atypical chest pain are: age under 40, anxiety level > 20, somatization ≥ 63, presence of panic and somatoform disorders, H-R score > 102

  7. A blended approach to invasive bedside procedural instruction.

    Science.gov (United States)

    Lenchus, Joshua; Issenberg, S Barry; Murphy, Daniel; Everett-Thomas, Ruth; Erben, Laura; Arheart, Kristopher; Birnbach, David J

    2011-01-01

    This study assessed the impact of a blended, standardized curriculum for invasive bedside procedural training on medical knowledge and technical skills for Internal Medicine residents. The investigators developed a curriculum in procedural instruction and performance for Internal Medicine house staff, and implemented the program at a tertiary care academic medical center with a primary affiliation with a US medical school. The investigators chose procedures recommended for technical competence by the American Board of Internal Medicine: lumbar puncture, thoracentesis, paracentesis, central venous catheter insertion, and knee arthrocentesis. The program included: (1) assessment of baseline medical knowledge and technical proficiency on mannequins, (2) video instruction of procedure, (3) faculty-led discussion of critical concepts, (4) faculty demonstration of the procedure on mannequin, (5) individual practice on simulators, (6) post-intervention knowledge evaluation, and (7) post-intervention skills evaluation. The performance achieved during the initial skills evaluation on a mannequin was compared to the performance achieved on the first patient subsequent to the instructional portion. All participants with complete data demonstrated a statistically significant pre-intervention to post-intervention improvement (p instruction can significantly improve performance in participants' medical knowledge and technical skills.

  8. Bedside Tested Ocular Motor Disorders in Multiple Sclerosis Patients

    Directory of Open Access Journals (Sweden)

    G. Servillo

    2014-01-01

    Full Text Available Background/Aims. Ocular motor disorders (OMDs are a common feature of multiple sclerosis (MS. In clinical practice, if not reported by patients, OMDs are often underdiagnosed and their prevalence is underestimated. Methods. We studied 163 patients (125 women, 76.7%, 38 men, 23.3%; median age 45.0 years; median disease duration 10 years; median EDSS 3.5 with definite MS (n=150, 92% or clinically isolated syndrome (n=13, 8% who underwent a thorough clinical examination of eye movements. Data on localization of previous relapses, MS subtype, and MRI findings were collected and analyzed. Results. Overall, 111/163 (68.1% patients showed at least one abnormality of eye movement. Most frequent OMDs were impaired smooth pursuit (42.3%, saccadic dysmetria (41.7%, unilateral internuclear ophthalmoplegia (14.7%, slowing of saccades (14.7%, skew deviation (13.5%, and gaze evoked nystagmus (13.5%. Patients with OMDs had more severe disability (P=0.0005 and showed more frequently infratentorial MRI lesions (P=0.004. Localization of previous relapses was not associated with presence of OMDs. Conclusion. OMDs are frequent in patients with stable (no relapses MS. A precise bedside examination of eye motility can disclose abnormalities that imply the presence of subclinical MS lesions and may have a substantial impact on definition of the diagnosis and on management of MS patients.

  9. Bedside tests to predict laryngoscopic difficulty in pediatric patients.

    Science.gov (United States)

    Mansano, André Marques; Módolo, Norma Sueli Pinheiro; Silva, Leopoldo Muniz da; Ganem, Eliana Maria; Braz, Leandro Gobbo; Knabe, Andrea de Carvalho; Freitas, Fernanda Moreira de

    2016-04-01

    Pediatric airway management is a priority during anesthesia, critical care and emergency medicine. The purpose of this study is to validate bedside tests that predict airway management difficulty in anesthetized children. Children under 12 years of age were recruited in a cross-sectional study to assess the value of some anthropometric measures as predictors of laryngoscopic difficulty. The patients were divided into three groups by age. Weight, height, neck circumference, BMI (body mass index), inter incisors distance thyromental distance, sternomental distance, frontal plane to chin distance (FPCD) and the Mallampati index were determined and were correlated with the CML (Cormack & Lehane classification). The incidence of difficult laryngoscopy (CML 3 or 4) was 3.58%. Factors that were significantly associated with laryngoscopic difficulty included short inter incisors distance, high FPCD, thyromental distance, sternomental distance and the Mallampati index. The FPCD/weight index exhibited a higher area under the ROC curve than any other variable considered. This study confirms that the FPCD and the FPCD/weight ratio are the most consistent predictors of laryngoscopic difficulty in pediatric patients. For patients over 6 months of age, the IID also correlated with laryngoscopic difficulty. For children who were capable of obeying simple orders, the Mallampati test correlated better with laryngoscopic difficulty than did the Mallampati test with phonation. Our results strongly suggest that skilled professionals should perform airway management in children, especially in patients with a high FPCD or a high FPCD/weight ratio. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Performance evaluation of a computed radiography system

    Energy Technology Data Exchange (ETDEWEB)

    Roussilhe, J.; Fallet, E. [Carestream Health France, 71 - Chalon/Saone (France); Mango, St.A. [Carestream Health, Inc. Rochester, New York (United States)

    2007-07-01

    Computed radiography (CR) standards have been formalized and published in Europe and in the US. The CR system classification is defined in those standards by - minimum normalized signal-to-noise ratio (SNRN), and - maximum basic spatial resolution (SRb). Both the signal-to-noise ratio (SNR) and the contrast sensitivity of a CR system depend on the dose (exposure time and conditions) at the detector. Because of their wide dynamic range, the same storage phosphor imaging plate can qualify for all six CR system classes. The exposure characteristics from 30 to 450 kV, the contrast sensitivity, and the spatial resolution of the KODAK INDUSTREX CR Digital System have been thoroughly evaluated. This paper will present some of the factors that determine the system's spatial resolution performance. (authors)

  11. Digital radiography exposure indices: A review

    Energy Technology Data Exchange (ETDEWEB)

    Mothiram, Ursula; Brennan, Patrick C; Lewis, Sarah J [Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, Sydney, New South Wales (Australia); Moran, Bernadette [Department of Clinical Medicine, Trinity College, Dublin (Ireland); Robinson, John [Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Faculty of Health Science, University of Sydney, Sydney, New South Wales (Australia)

    2014-06-15

    Digital radiography (DR) technologies have the advantage of a wide dynamic range compared to their film-screen predecessors, however, this poses a potential for increased patient exposure if left unchecked. Manufacturers have developed the exposure index (EI) to counter this, which provides radiographers with feedback on the exposure reaching the detector. As these EIs were manufacturer-specific, a wide variety of EIs existed. To offset this, the international standardised EI has been developed by the International Electrotechnical Commission (IEC) and the American Association of Physicists in Medicine (AAPM). The purpose of this article is to explore the current literature relating to EIs, beginning with the historical development of the EI, the development of the standardised EI and an exploration of common themes and studies as evidenced in the research literature. It is anticipated that this review will provide radiographers with a useful guide to understanding EIs, their application in clinical practice, limitations and suggestions for further research.

  12. Machine learning applied to proton radiography

    CERN Document Server

    Chen, Nicholas Fang Yew; Ceurvorst, Luke; Ratan, Naren; Sadler, James; Levy, Matthew; Trines, Raoul; Bingham, Robert; Norreys, Peter

    2016-01-01

    Proton radiography is a technique extensively used to resolve magnetic field structures in high energy density plasmas, revealing a whole variety of interesting phenomena such as magnetic reconnection and collisionless shocks found in astrophysical systems. Existing methods of analyzing proton radiographs give mostly qualitative results or specific quantitative parameters such as magnetic field strength, and recent work showed that the line-integrated transverse magnetic field can be reconstructed in specific regimes where many simplifying assumptions were needed. Using artificial neural networks, we suggest a novel 3-D reconstruction method that works for a more general case. A proof of concept is presented here, with mean reconstruction errors of less than 5 percent even after introducing noise. We demonstrate that over the long term, this approach is more computationally efficient compared to other techniques. We also highlight the need for proton tomography because (i) certain field structures cannot be r...

  13. Oral history in radiography: Listening to pioneers

    Energy Technology Data Exchange (ETDEWEB)

    Ferris, Christine [International Development Facilitator, Robert Winston Building, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP (United Kingdom)], E-mail: c.m.ferris@shu.ac.uk; Winslow, Michelle [University of Sheffield, Oral History Society, Academic Unit of Supportive Care, Sykes House, Little Common Lane, Sheffield S11 9NE (United Kingdom)], E-mail: m.winslow@sheffield.ac.uk

    2009-12-15

    We explore the professional value of the collection and analysis of oral histories in the history of radiography. Drawing on oral histories collected from radiographers, we analyse accounts of experiences to identify common themes, some of which are of current significance, whilst others have faded from existence. 15 oral histories were collected from radiographers whose combined practice spans the years 1930-1973. The sample consists of 6 male and 9 female radiographers. Themes identified in the oral histories include radiographers as invisible pioneers who worked in professionally unclaimed territory and their dangerous working environment. The oral histories reveal the working world of the radiographer as having encompassed a practice ethos where challenges became an accepted part of work. We gain insight into less observable aspects of the radiographer's role, the difficulties they faced, how they invented techniques and equipment, and how they managed their practice including protecting the public from ionising radiation sources.

  14. Polarized neutron radiography with a periscope

    Science.gov (United States)

    Schulz, Michael; Neubauer, Andreas; Mühlbauer, Martin; Calzada, Elbio; Schillinger, Burkhard; Pfleiderer, Christian; Böni, Peter

    2010-01-01

    The interaction of the magnetic moment of the neutron with magnetic fields provides a powerful probe for spatially resolved magnetisation measurements in magnetic materials. We have tested a periscope as a new type of polarizer providing neutron beams with a high polarization and a low divergence. The observed inhomogeneity of the beam caused by the waviness of the glass substrates was quantified by means of Monte-Carlo simulations using the software package McStas. The results show that beams of high homogeneity can be produced if the waviness is reduced to below 1.0·10-5 rad. Finally, it is shown that radiography with polarized neutrons is a powerful method for measuring the spatially resolved magnetisation in optically float-zoned samples of the weak itinerant ferromagnet Ni3Al, thereby aiding the identification of the appropriate growth parameters.

  15. Polarized neutron radiography with a periscope

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, Michael; Neubauer, Andreas; Muehlbauer, Martin; Schillinger, Burkhard; Pfleiderer, Christian; Boeni, Peter [Technische Universitaet Muenchen, Physik Department, E21, Garching (Germany); Calzada, Elbio, E-mail: michael.schulz@frm2.tum.d [Technische Universitaet Muenchen, Forschungsneutronenquelle Heinz Maier Leibnitz (FRM II), Garching (Germany)

    2010-01-01

    The interaction of the magnetic moment of the neutron with magnetic fields provides a powerful probe for spatially resolved magnetisation measurements in magnetic materials. We have tested a periscope as a new type of polarizer providing neutron beams with a high polarization and a low divergence. The observed inhomogeneity of the beam caused by the waviness of the glass substrates was quantified by means of Monte-Carlo simulations using the software package McStas. The results show that beams of high homogeneity can be produced if the waviness is reduced to below 1.0{center_dot}10{sup -5} rad. Finally, it is shown that radiography with polarized neutrons is a powerful method for measuring the spatially resolved magnetisation in optically float-zoned samples of the weak itinerant ferromagnet Ni{sub 3}Al, thereby aiding the identification of the appropriate growth parameters.

  16. Measuring microfocus focal spots using digital radiography

    Energy Technology Data Exchange (ETDEWEB)

    Fry, David A [Los Alamos National Laboratory

    2009-01-01

    Measurement of microfocus spot size can be important for several reasons: (1) Quality assurance during manufacture of microfocus tubes; (2) Tracking performance and stability of microfocus tubes; (3) Determining magnification (especially important for digital radiography where the native spatial resolution of the digital system is not adequate for the application); (4) Knowledge of unsharpness from the focal spot alone. The European Standard EN 12543-5 is based on a simple geometrical method of calculating focal spot size from unsharpness of high magnification film radiographs. When determining microfocus focal spot dimensions using unsharpness measurements both signal-to-noise (SNR) and magnification can be important. There is a maximum accuracy that is a function of SNR and therefore an optimal magnification. Greater than optimal magnification can be used but it will not increase accuracy.

  17. Vertex occlusal radiography in localizing unerupted mesiodentes

    Directory of Open Access Journals (Sweden)

    P Chalakkal

    2011-01-01

    Full Text Available The aim was to compare the vertex occlusal projection with the anterior maxillary occlusal projection in localizing the position of mesiodentes. Mesiodentes were observed in an 8-year-old boy with an anterior maxillary occlusal radiograph. A vertex occlusal radiograph was taken to compare it with the former in terms of mesiodentes localization with respect to the maxillary central incisors. The vertex occlusal radiograph provided greater details of the position and proximity of mesiodentes with respect to the long axis of maxillary central incisors in comparison to the anterior maxillary occlusal radiograph. Vertex occlusal radiography is an important diagnostic tool in diagnosing the presence, position, and proximity of mesiodentes with respect to the long axis of normally aligned maxillary central incisors. However, it is not recommended for routine use in a patient as its radiation dose is higher than conventional intraoral radiographic methods.

  18. Muscle parameters estimation based on biplanar radiography.

    Science.gov (United States)

    Dubois, G; Rouch, P; Bonneau, D; Gennisson, J L; Skalli, W

    2016-11-01

    The evaluation of muscle and joint forces in vivo is still a challenge. Musculo-Skeletal (musculo-skeletal) models are used to compute forces based on movement analysis. Most of them are built from a scaled-generic model based on cadaver measurements, which provides a low level of personalization, or from Magnetic Resonance Images, which provide a personalized model in lying position. This study proposed an original two steps method to access a subject-specific musculo-skeletal model in 30 min, which is based solely on biplanar X-Rays. First, the subject-specific 3D geometry of bones and skin envelopes were reconstructed from biplanar X-Rays radiography. Then, 2200 corresponding control points were identified between a reference model and the subject-specific X-Rays model. Finally, the shape of 21 lower limb muscles was estimated using a non-linear transformation between the control points in order to fit the muscle shape of the reference model to the X-Rays model. Twelfth musculo-skeletal models were reconstructed and compared to their reference. The muscle volume was not accurately estimated with a standard deviation (SD) ranging from 10 to 68%. However, this method provided an accurate estimation the muscle line of action with a SD of the length difference lower than 2% and a positioning error lower than 20 mm. The moment arm was also well estimated with SD lower than 15% for most muscle, which was significantly better than scaled-generic model for most muscle. This method open the way to a quick modeling method for gait analysis based on biplanar radiography.

  19. Comparison of Indirect CsI/a:Si and Direct a:Se Digital Radiography. An assessment of contrast and detail visualization

    Energy Technology Data Exchange (ETDEWEB)

    Fischbach, F.; Freund, T.; Pech, M.; Werk, M.; Bassir, C.; Stoever, B.; Felix, R.; Ricke, J. [Humboldt-Univ. Medical School, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiology

    2003-11-01

    Purpose: To assess and quantify the image quality at two dose levels for an amorphous Silicon (a:Si) Cesium Iodide (CsI) flat panel system compared with a direct amorphous Selenium (a:Se) digital radiography system. Material and Methods: A contrast detectability test was performed employing the CDRAD-phantom at mAs-values leading to approximately equal phantom entrance doses of 41.4, 57.9, 75.1 and 120.8 {mu}Gy for the a:Se and 39.9, 58.4, 75.6 and 117.9 {mu}Gy for the CsI system. Images were presented to 4 independent observers. For quantitative comparison, the image quality figure (IQF) was calculated. Statistical analysis was performed using Pearson's correlation and the Wilcoxon test. A ROC-analysis was performed employing the TRG-phantom in a high- and a low-dose setting leading to entrance doses of 126.2 and 35 {mu}Gy for the direct, and 125.9 and 34.4 {mu}Gy for the indirect system. Statistical significance was evaluated using the Wilcoxon test. Results: The flat panel a:Si digital system provided superior results compared with the a:Se drum digital system with respect to low-dose settings for CDRAD-phantom and ROC-analysis, ensuring a better image quality with respect to contrast and detail detectability. Higher-dose settings provided similar results for both systems. Conclusion: Image quality of a:Si flat panel digital radiography proved to be superior to a:Se drum digital radiography using low-dose settings. If the primary target is dose reduction indirect flat panel technology should be used. Digital radiography amorphous selenium amorphous silicon chest radiography.

  20. Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department.

    Science.gov (United States)

    Testa, Americo; Francesconi, Andrea; Giannuzzi, Rosangela; Berardi, Silvia; Sbraccia, Paolo

    2015-12-01

    The economic crisis, the growing healthcare demand, and Defensive Medicine wastefulness, strongly recommend the restructuring of the entire medical network. New health technology, such as bedside ultrasonography, might successfully integrate the clinical approach optimizing the use of limited resources, especially in a person-oriented vision of medicine. Bedside ultrasonography is a safe and reliable technique, with worldwide expanding employment in various clinical settings, being considered as "the stethoscope of the 21st century". However, at present, bedside ultrasonography lacks economic analysis. We performed a Cost-Benefit Analysis "ex ante", with a break-even point computing, of bedside ultrasonography implementation in an Internal Medicine department in the mid-term. Number and kind estimation of bedside ultrasonographic studies were obtained by a retrospective study, whose data results were applied to the next 3-year period (foresight study). All 1980 foreseen bedside examinations, with prevailing multiorgan ultrasonographic studies, were considered to calculate direct and indirect costs, while specific and generic revenues were considered only after the first semester. Physician professional training, equipment purchase and working time represented the main fixed and variable cost items. DRG increase/appropriateness, hospitalization stay shortening and reduction of traditional ultrasonography examination requests mainly impacted on calculated revenues. The break-even point, i.e. the volume of activity at which revenues exactly equal total incurred costs, was calculated to be 734 US examinations, corresponding to € 81,998 and the time considered necessary to reach it resulting 406 days. Our economic analysis clearly shows that bedside ultrasonography implementation in clinical daily management of an Internal Medicine department can produce consistent savings, or economic profit according to managerial choices (i.e., considering public or private targets

  1. Radiation induced osteosarcoma of the chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Sugimoto, Tsutomu; Yuki, Yoshihiro; Oizumi, Hiroyuki; Iijima, Yoshiyuki; Fujishima, Tsukasa; Shimazaki, Yasuhisa [Yamagata Univ. (Japan). School of Medicine

    1996-11-01

    We report a successful resection of an osteosarcoma in the chest wall developed 25 years after irradiation. A 74-year-old woman was admitted to our hospital for her swelling in the left chest wall at August 24, 1995. At 49-year-old, she had undergone an operation and postoperative irradiation for left breast cancer. A computed tomography demonstrated a mass in the left chest wall that destructed the first rib, extending into the pleural space and invaded into the left common carotid and subclavian arteries. We planned a radical resection of the mass after repeated CT scannings, since it was histopathologically diagnosed as a chondrosarcoma and showed a rapid growth. The tumor was completely removed with radical transmediastinal forequarter amputation of the partial chest wall and total left upper extremity. The left common carotid artery was partially replaced with 6 mm EPTFE vascular prosthesis. The chest wall was reconstructed with Marlex-mesh prosthesis and a myocutaneous flap. She was discharged uneventfully and has not shown any evidence of recurrence. (author)

  2. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

    Science.gov (United States)

    Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

    2016-12-01

    Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

  3. How to create a degree course in radiography: a recipe

    Energy Technology Data Exchange (ETDEWEB)

    Pratt, S. E-mail: Pratt@cf.ac.uk; Adams, C. E-mail: AdamsC1@cf.ac.uk

    2003-11-01

    This article explains how an undergraduate programme is devised and validated. Since 1993, all courses in radiography have been of graduate level with radiography education being based in higher educational institutions. Before a new degree is implemented a review of the existing programme is undertaken. The proposed degree philosophy and learning outcomes need to be determined before the content; its mode of delivery and assessment are developed. Input from stakeholders (such as clinical colleagues) is necessary as well as adherence to policies and strategies for radiography education. Throughout the development process compliance with policy, both national and local, is critical. All radiography programmes have to be validated/accredited by representatives from national organisations--such as The Society and College of Radiographers (SCoR). These representatives scrutinise the proposed degree course documentation; often they may also inspect the clinical and university facilities in which the education and training will take place.

  4. Dosimetry and optimization in digital radiography based on the detail contrast resolution

    Energy Technology Data Exchange (ETDEWEB)

    Gomes B, W. O. [Instituto Federal da Bahia, Rua Emidio dos Santos s/n, Barbalho 40301-015, Salvador de Bahia (Brazil); Gomes de C, A., E-mail: wilsonottobatista@gmail.com [Secretaria de Saude do Estado da Bahia, Salvador de Bahia (Brazil)

    2016-10-15

    In digital radiography, computed radiography systems (CR) and portable panels a-Si (DR) are adapted to equipment previously used for the system screen / film. Therefore it maintains the characteristics as grid, filtration, yield, etc. Otherwise, the systems dedicated with a-Si panels (DR), are designed to operate with these image receptors. The ability to detect in low contrast details is reduced for all systems with increasing ratio of scattered radiation / primary radiation. In this context there is a need to acquire experience and adjust exposure protocols to ensure the quality of the image with maintaining kerma values in the surface as low as possible. The contrast resolution is defined as the ability of the system to distinguish similar degrees of attenuation of the object and is a parameter used to maintain the quality index and comparison between different systems. The protocols were: chest (90 and 102 kV with the range of 2-20 m As) and abdomen (80 kV in the range of 10-80 m As). Kerma values were evaluated with a solid state sensors. Based on analysis of these curves C-D, which identified the technique would imply a lower kerma input surface while maintaining image quality from the point of view of contrast-detail resolution. The results show that the IQFinv varies little throughout the range of m As, while the value of kerma varies linearly with in m As. Also, the complete analysis of the curves indicate that there was an increase in the definition of detail with increasing m As. The conclusion is that, in the transition phase of the new receivers are needed to assess and adjust practiced protocols to ensure the quality index of the image taking into account aspects of radiation protection of the patient. And even with digital technology, good radiographic technique should be practiced. (Author)

  5. Prephonatory chest wall posturing in stutterers.

    Science.gov (United States)

    Baken, R J; McManus, D A; Cavallo, S A

    1983-09-01

    The possibility that prephonatory chest wall posturing is abnormal in stutterers was explored by observing rib cage and abdominal hemicircumference changes during the interval between the presentation of a stimulus and the production of/alpha/by a group of stutterers (N = 5). It was found that the patterns of chest wall adjustment for phonation were qualitatively identical in the stutterers and in a comparable group of normal men studied previously. There was, however, a significant difference in the way in which lung volume changed during the execution of the chest wall adjustment. This was considered to be indicative of delayed glottal closure among the stutterers rather than representative of a primary ventilatory disturbance.

  6. Imaging of Chest Wall Lesions in Children

    Directory of Open Access Journals (Sweden)

    A. Hekmatnia

    2008-01-01

    Full Text Available Chest wall lesions in childhood include a wide range of pathologies; Benign lesions include lipoma, neurofibroma, lymphangioma, hemangioma, and mesenchymal hamartoma."nMalignant lesions include Neuroblastoma, Rhabdo-myosarcoma, Ewing sarcoma, and Askin tumor."nSystemic diseases such as leukemia, lymphoma, Langerhans cell histiocytosis, and also infections such as tuberculosis, and actinomycosis may also cause chest wall lesions."nThe imaging characteristics of these lesions are re-viewed, but only a minority of the lesions shows diagnostic imaging features, and most of lesions re-quire biopsy and histopathological examination for "ndefinitive diagnosis."nThe role of different modalities is discussed with an emphasis on magnetic resonance imaging for demonstrating lesion morphology and local spread. Computed tomography and neuclear medicine being used mainly to assess remote disease."nIn this lecture, we discuss about imaging of chest wall lesions in children.

  7. Cardiogenic shock following blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Rodríguez-González Fayna

    2010-01-01

    Full Text Available Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

  8. [Chest wall mesenchymal hamartoma: a case report].

    Science.gov (United States)

    Morales, Olga Lucía; Valencia, María de la Luz; Gómez, Carolina; Pérez, María del Pilar; Sanín, Emilio; Vásquez, Luz Marina

    2010-01-01

    Chest wall mesenchymal hamartoma is an extremely rare benign tumor. Approximately 80 cases have been reported in the literature. Most tumors are manifested at birth with a painless palpable mass of the chest wall, usually unilateral. Respiratory symptoms result from extrinsic compression of the pulmonary parenchyma, and the severity of the symptoms will depend on the size and location of the lesion. Imaging features are characteristic, but definitive diagnosis is histological. Herein, a case is described of a four month old infant with diagnosis of chest wall mesenchymal hamartoma, manifested at birth. Different treatment options are described, including expectations from tumor management, the possibility of spontaneous regression, and the morbidity associated with the surgical option.

  9. Cardio-thoracic surgical patients' experience on bedside nursing handovers: Findings from a qualitative study.

    Science.gov (United States)

    Lupieri, Giulia; Creatti, Chiara; Palese, Alvisa

    2016-08-01

    The purpose of this study was to describe the experiences of postoperative cardio-thoracic surgical patients experiencing nursing bedside handover. A descriptive qualitative approach was undertaken. A purposeful sampling technique was adopted, including 14 patients who went through cardio-thoracic surgery and witnessed at least two bedside handovers. The study was performed in a Cardio-thoracic ICU localised in a Joint Commission International accredited Academic Hospital in north-eastern Italy from August to November 2014. The experience of patients participating at the bedside handover is based on four main themes: (1) 'discovering a new nursing identity', (2) 'being apparently engaged in a bedside handover', (3) 'experiencing the paradox of confidentiality' and (4) 'having the situation under control'. With the handover performed at the bedside in a postoperative setting, two interconnected potential effects may be achieved with regard to patients, nurses and the nursing profession. Nurses have a great opportunity to express their closeness to patients and to promote awareness of the important growth that nursing has achieved over the years as a profession and discipline. Therefore, patients may better perceive nursing competence and feel safer during the postoperative care pathway. They can appreciate nurses' humanity in caring and trust their competence and professionalism.

  10. Eating disorders: from bench to bedside and back.

    Science.gov (United States)

    Gaetani, Silvana; Romano, Adele; Provensi, Gustavo; Ricca, Valdo; Lutz, Thomas; Passani, Maria Beatrice

    2016-12-01

    The central nervous system and viscera constitute a functional ensemble, the gut-brain axis, that allows bidirectional information flow that contributes to the control of feeding behavior based not only on the homeostatic, but also on the hedonic aspects of food intake. The prevalence of eating disorders, such as anorexia nervosa, binge eating and obesity, poses an enormous clinical burden, and involves an ever-growing percentage of the population worldwide. Clinical and preclinical research is constantly adding new information to the field and orienting further studies with the aim of providing a foundation for developing more specific and effective treatment approaches to pathological conditions. A recent symposium at the XVI Congress of the Societá Italiana di Neuroscienze (SINS, 2015) 'Eating disorders: from bench to bedside and back' brought together basic scientists and clinicians with the objective of presenting novel perspectives in the neurobiology of eating disorders. Clinical studies presented by V. Ricca illustrated some genetic aspects of the psychopathology of anorexia nervosa. Preclinical studies addressed different issues ranging from the description of animal models that mimic human pathologies such as anorexia nervosa, diet-induced obesity, and binge eating disorders (T. Lutz), to novel interactions between peripheral signals and central circuits that govern food intake, mood and stress (A. Romano and G. Provensi). The gut-brain axis has received increasing attention in the recent years as preclinical studies are demonstrating that the brain and visceral organs such as the liver and guts, but also the microbiota are constantly engaged in processes of reciprocal communication, with unexpected physiological and pathological implications. Eating is controlled by a plethora of factors; genetic predisposition, early life adverse conditions, peripheral gastrointestinal hormones that act directly or indirectly on the central nervous system, all are

  11. Emerging Applications of Bedside 3D Printing in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Michael P Chae

    2015-06-01

    Full Text Available Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D reconstructions, are limited by their representation on 2D workstations. 3D printing has been embraced by early adopters to produce medical imaging-guided 3D printed biomodels that facilitate various aspects of clinical practice. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. With increasing accessibility, investigators are now able to convert standard imaging data into Computer Aided Design (CAD files using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography (SLA, multijet modeling (MJM, selective laser sintering (SLS, binder jet technique (BJT, and fused deposition modeling (FDM. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without out-sourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. In this review the existing uses of 3D printing in plastic surgery practice, spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative aesthetics, are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, patient and surgical trainee education, and the development of intraoperative guidance tools and patient-specific prosthetics in everyday surgical practice.

  12. Emerging Applications of Bedside 3D Printing in Plastic Surgery.

    Science.gov (United States)

    Chae, Michael P; Rozen, Warren M; McMenamin, Paul G; Findlay, Michael W; Spychal, Robert T; Hunter-Smith, David J

    2015-01-01

    Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing

  13. Cyclotron production of (44)Sc: From bench to bedside.

    Science.gov (United States)

    van der Meulen, Nicholas P; Bunka, Maruta; Domnanich, Katharina A; Müller, Cristina; Haller, Stephanie; Vermeulen, Christiaan; Türler, Andreas; Schibli, Roger

    2015-09-01

    (44)Sc, a PET radionuclide, has promising decay characteristics (T1/2 = 3.97 h, Eβ(+)av = 632 keV) for nuclear imaging and is an attractive alternative to the short-lived (68)Ga (T1/2 = 68 min, Eβ(+)av = 830 keV). The aim of this study was the optimization of the (44)Sc production process at an accelerator, allowing its use for preclinical and clinical PET imaging. (44)CaCO3 targets were prepared and irradiated with protons (~11 MeV) at a beam current of 50 μA for 90 min. (44)Sc was separated from its target material using DGA extraction resin and concentrated using SCX cation exchange resin. Radiolabeling experiments at activities up to 500 MBq and stability tests were performed with DOTANOC by investigating different scavengers, including gentisic acid. Dynamic PET of an AR42J tumor-bearing mouse was performed after injection of (44)Sc-DOTANOC. The optimized chemical separation method yielded up to 2 GBq (44)Sc of high radionuclidic purity. In the presence of gentisic acid, radiolabeling of (44)Sc with DOTANOC was achieved with a radiochemical yield of ~99% at high specific activity (10 MBq/nmol) and quantities which would allow clinical application. The dynamic PET images visualized increasing uptake of (44)Sc-DOTANOC into AR42J tumors and excretion of radioactivity through the kidneys of the investigated mouse. The concept "from-bench-to-bedside" was clearly demonstrated in this extended study using cyclotron-produced (44)Sc. Sufficiently high activities of (44)Sc of excellent radionuclidic purity are obtainable for clinical application, by irradiation of enriched calcium at a cyclotron. This work demonstrates a promising basis for introducing (44)Sc to clinical routine of nuclear imaging using PET. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  15. Evaluation and treatment of musculoskeletal chest pain.

    Science.gov (United States)

    Ayloo, Amba; Cvengros, Teresa; Marella, Srimannarayana

    2013-12-01

    This article summarizes the evaluation and treatment of musculoskeletal causes of chest pain. Conditions such as costochondritis, rib pain caused by stress fractures, slipping rib syndrome, chest wall muscle injuries, fibromyalgia, and herpes zoster are discussed, with emphasis on evaluation and treatment of these and other disorders. Many of these conditions can be diagnosed by the primary care clinician in the office by history and physical examination. Treatment is also discussed, including description of manual therapy and exercises as needed for some of the conditions. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Chest wall abscess due to Prevotella bivia

    Institute of Scientific and Technical Information of China (English)

    Gwo-jong HSU; Cheng-ren CHEN; Mei-chu LAI; Shi-ping LUH

    2009-01-01

    Prevotella bivia is associated with pelvic inflammatory disease. A 77-year-old man developed a rapidly growing chest wall abscess due to P. Bivia within days. He underwent surgical resection of the infected area; his postoperative course was un-eventful. This is the first case of chest wall abscess due to P. Bivia infection. Its correct diagnosis cannot be underestimated be-cause fulminam infections can occur in aged or immunocompromised patients if treated incorrectly. Prompt, appropriate surgical management, and antibiotic therapy affect treatment outcome.

  17. Findings chest radiograph and CT in mediastinitis: effcacy of CT in patients with delayed diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Son, Eun Ju; Hong, Yong Kook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    To analyse the causes the radiologic findings in patients with mediastinitis and to evaluate the efficacy of chest CT scanning in patients with delayed diagnosis. Seventeen patients with histopathologically(n=15) or clinically diagnosed(n=2) mediastinitis were involved in this study. Eleven of the former group underwent surgery, and in four, tube drainage was performed. All underwent chest radiography and CT scanning, and in seven patients, the causes of delayed diagnosis were analysed. The most common cause of mediastinitis was esophageal rupture(n=11). Others were extension from neck abscess to the mediastinum(n=3), complications after a Benthall procedure(n=1), tuberculous lymphadenitis(n=1) and mycotic aneurysm(n=1). Patients with esophageal rupture suffered from underlying diseases such as esophageal cancer(n=2), iatrogenic esophageal rupture(n=2), Boerhaave's syndrome(n=2), and esophagitis(n=1). In patients with neck abscess (n=3), each was secondary to infected cystic hygroma, Ludwig angina, or deep neck infection, respectively. On chest CT, patients with esophageal rupture(n=11) had an abscess in the posterior mediastinum ; nine abscesses extended to the cervical area along the retropharyngeal space, and the patient with Ludwig angina had an abscess involving all compartments of the mediastinum. Among the total of 17 patients, diagnostic delays were found in seven, while five had spontaneous esophageal ruptures and two suffered complications after a Benthall procedure and Tbc lymphadenitis, respectively. The causes of diagnostic delay varied. Among seven patients, pnevmonia was initially diagnosed in two, who were treated ; one had multiorgan failure, and one was suffering from pericardial effusion and lung abscess. In three other patients, chest radiographs initially showed non-specific findings, leading to delayed CT examination. The most common cause of mediastinitis was esophageal rupture, and in these patients, chest radiographs and clinical

  18. Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system

    Science.gov (United States)

    Moore, C. S.; Wood, T. J.; Avery, G.; Balcam, S.; Needler, L.; Joshi, H.; Saunderson, J. R.; Beavis, A. W.

    2016-11-01

    The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQm and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

  19. Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system.

    Science.gov (United States)

    Moore, C S; Wood, T J; Avery, G; Balcam, S; Needler, L; Joshi, H; Saunderson, J R; Beavis, A W

    2016-11-07

    The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQm and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

  20. Learning Clinical Skills during Bedside Teaching Encounters in General Practice: A Video-Observational Study with Insights from Activity Theory

    Science.gov (United States)

    Ajjawi, Rola; Rees, Charlotte; Monrouxe, Lynn V.

    2015-01-01

    Purpose: This paper aims to explore how opportunities for learning clinical skills are negotiated within bedside teaching encounters (BTEs). Bedside teaching, within the medical workplace, is considered essential for helping students develop their clinical skills. Design/methodology/approach: An audio and/or video observational study examining…

  1. Inter-observer variation in the interpretation of chest radiographs for pneumonia in community-acquired lower respiratory tract infections

    Energy Technology Data Exchange (ETDEWEB)

    Hopstaken, R.M. E-mail: rogier.hopstaken@hag.unimaas.nl; Witbraad, T.; Engelshoven, J.M.A. van; Dinant, G.J

    2004-08-01

    AIM: To assess inter-observer variation in the interpretation of chest radiographs of individuals with pneumonia versus those without pneumonia. MATERIALS AND METHODS: Chest radiographs of out-patients with a lower respiratory tract infection (LRTI) were assessed for the presence of infiltrates by radiologists from three local hospitals and were reassessed by one university hospital radiologist. Various measures of inter-observer agreement were calculated. RESULTS: The observed proportional agreement was 218 in 243 patients (89.7%). Kappa was 0.53 (moderate agreement) with a 95% confidence interval of 0.37 to 0.69. The observed positive agreement (59%) was much lower than for negative agreement (94%). Kappa was considerably lower, if chronic obstructive pulmonary disease was present ({kappa}=0.20) or Streptococcus pneumoniae ({kappa}=-0.29) was the infective agent. CONCLUSION: The overall inter-observer agreement adjusted for chance was moderate. Inter-observer agreement in cases with pneumonia was much worse than the agreement in negative (i.e. non-pneumonia) cases. A general practitioner's selection of patients with a higher chance of having pneumonia for chest radiography would thus not improve the observer agreement.

  2. European Guidelines for AP/PA chest X-rays: routinely satisfiable in a paediatric radiology division?

    Energy Technology Data Exchange (ETDEWEB)

    Tschauner, Sebastian; Marterer, Robert; Guebitz, Michael; Weissensteiner, Sabine; Sorantin, Erich [Medical University of Graz, Division of Paediatric Radiology, Department of Radiology, Graz (Austria); Kalmar, Peter I. [Medical University of Graz, Division of Vascular and Interventional Radiology, Department of Radiology, Graz (Austria); Talakic, Emina [Medical University of Graz, Division of General Radiological Diagnostics, Department of Radiology, Graz (Austria)

    2016-02-15

    Accurate collimation helps to reduce unnecessary irradiation and improves radiographic image quality, which is especially important in the radiosensitive paediatric population. For AP/PA chest radiographs in children, a minimal field size (MinFS) from ''just above the lung apices'' to ''T12/L1'' with age-dependent tolerance is suggested by the 1996 European Commission (EC) guidelines, which were examined qualitatively and quantitatively at a paediatric radiology division. Five hundred ninety-eight unprocessed chest X-rays (45 % boys, 55 % girls; mean age 3.9 years, range 0-18 years) were analysed with a self-developed tool. Qualitative standards were assessed based on the EC guidelines, as well as the overexposed field size and needlessly irradiated tissue compared to the MinFS. While qualitative guideline recommendations were satisfied, mean overexposure of +45.1 ± 18.9 % (range +10.2 % to +107.9 %) and tissue overexposure of +33.3 ± 13.3 % were found. Only 4 % (26/598) of the examined X-rays completely fulfilled the EC guidelines. This study presents a new chest radiography quality control tool which allows assessment of field sizes, distances, overexposures and quality parameters based on the EC guidelines. Utilising this tool, we detected inadequate field sizes, inspiration depths, and patient positioning. Furthermore, some debatable EC guideline aspects were revealed. (orig.)

  3. Chest pain in focal musculoskeletal disorders

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-01-01

    overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence...

  4. The HEART score for chest pain patients

    NARCIS (Netherlands)

    Backus, B.E.

    2012-01-01

    The HEART score was developed to improve risk stratification in chest pain patients in the emergency department (ED). This thesis describes series of validation studies of the HEART score and sub studies for individual elements of the score. The predictive value of the HEART score for the occurrence

  5. When to Remove a Chest Tube.

    Science.gov (United States)

    Novoa, Nuria M; Jiménez, Marcelo F; Varela, Gonzalo

    2017-02-01

    Despite the increasing knowledge about the pleural physiology after lung resection, most practices around chest tube removal are dictated by personal preferences and experience. This article discusses recently published data on the topic and suggests opportunities for further investigation and future improvements. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Cardiac injuries in blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Tobon-Gomez Catalina

    2009-09-01

    Full Text Available Abstract Blunt chest traumas are a clinical challenge, both for diagnosis and treatment. The use of Cardiovascular Magnetic Resonance can play a major role in this setting. We present two cases: a 12-year-old boy and 45-year-old man. Late gadolinium enhancement imaging enabled visualization of myocardial damage resulting from the trauma.

  7. Treatment of 336 cases of chest trauma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing; CHU Xiang-yang; LIU Yi; WANG Yun-xi

    2012-01-01

    Objective: To summarize the clinical features,diagnosis and treatment of chest trauma.Methods: A retrospective analysis was conducted among 336 cases of chest trauma admitted to our hospital from January 2009 to May 2011.Results:Out of all cases,325 were cured,accounting for 96.7%; 11 died,accounting for 3.3%.Among the dead cases,one died of hemorrhagic shock,three of acute respiratory distress syndrome,three of multiple organ failure,and four of severe multiple traumas.Conclusions:(1) For patients with severe chest trauma,early emergency treatment is crucial to save life.(2) Open thoracic surgery is needed for acute cardiac tamponade,intrapulmonary vascular injuries,progressive intrathoracic bleeding,lung laceration,tracheal breakage,and diaphragmatic injury.In addition,operative timing and method should be well chosen.(3) Pulmonary contusion is one of common complications in chest trauma,for which the combination of strong anti-infection therapy and mechanical ventilation is an effective treatment strategy.

  8. Risk stratification in chest pain patients

    NARCIS (Netherlands)

    Poldervaart, J.M.

    2016-01-01

    Yearly, a total of approximately 200,000 patients in The Netherlands present to the emergency department with chest pain. Only 20% of these patients will have an acute coronary syndrome (ACS), and need prompt admission and treatment. However, differentiating between ACS and other, mostly

  9. The Funen Neck and Chest Pain study

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan; Kyvik, Kirsten Ohm

    2006-01-01

    OBJECTIVE: To describe the Funen Neck and Chest Pain (FNCP) study and carry out a comprehensive non-response analysis of the quality of the survey. METHODS: The FNCP questionnaire was sent out to 7000 randomly selected individuals aged 20-71 years living in Funen County, Denmark. A full description...

  10. Treatment of 336 cases of chest trauma

    Directory of Open Access Journals (Sweden)

    ZHANG Jing

    2012-06-01

    Full Text Available 【Abstract】Objective: To summarize the clinical features, diagnosis and treatment of chest trauma. Methods: A retrospective analysis was conducted among 336 cases of chest trauma admitted to our hospital from January 2009 to May 2011. Results: Out of all cases, 325 were cured, accounting for 96.7%; 11 died, accounting for 3.3%. Among the dead cases, one died of hemorrhagic shock, three of acute respi-ratory distress syndrome, three of multiple organ failure, and four of severe multiple traumas. Conclusions: (1 For patients with severe chest trauma, early emergency treatment is crucial to save life. (2 Open thoracic surgery is needed for acute cardiac tamponade, intrapulmonary vascular injuries, progressive intrathoracic bleeding, lung laceration, tracheal breakage, and diaphrag-matic injury. In addition, operative timing and method should be well chosen. (3 Pulmonary contusion is one of common complications in chest trauma, for which the com-bination of strong anti-infection therapy and mechanical ventilation is an effective treatment strategy. Key words: Thoracic injuries; Thoracotomy; Emer-gency treatment

  11. VAC® for external fixation of flail chest

    DEFF Research Database (Denmark)

    Winge, Rikke; Berg, Jais O; Albret, Rikke

    2012-01-01

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure...

  12. Chest injury in victims of Bam earthquake

    Institute of Scientific and Technical Information of China (English)

    Seyed Mohammad Ghodsi; Moosa Zargar; Ali Khaji; Mojgan Karbakhsh

    2006-01-01

    Objective: To analyze the data of trauma patients with thoracic injury in the earthquake of Bam admitted to hospitals of Tehran University of Medical Science (TUMS)for better understanding the type and consequence of thoracic injuries in a major earthquake.Methods: After Bam earthquake registering 6.5 on the Richter scale, 526 trauma patients were admitted to hospitals of TUMS. Among them, 53 patients sustained thoracic injury.Results: This group was composed of 21 females (39.6%) and 32 males (60.4%). Fifteen patients (28.3%) had isolated chest injuries. Rib fracture (36.4%) was the most common injury in our patients and haemo/pneumothorax (25.5%) followed. Superficial injury was the most common accompanying injury. Multipletrauma patients with chest injury had higher injury severity score (ISS) versus patients with isolated chest injury (P =0.003).Conclusions: Chest wall injuries and haemo/pneumothorax comprise a considerable number of injuries in survival victims of earthquakes. Consequently, the majority of these patients can be treated with observation or tube thoracostomy. We should train and equip the health workers and members of rescue teams to treat and manage these patients in the field.

  13. Beam Characterization at the Neutron Radiography Facility

    Energy Technology Data Exchange (ETDEWEB)

    Sarah Morgan; Jeffrey King

    2013-01-01

    The quality of a neutron imaging beam directly impacts the quality of radiographic images produced using that beam. Fully characterizing a neutron beam, including determination of the beam’s effective length-to-diameter ratio, neutron flux profile, energy spectrum, image quality, and beam divergence, is vital for producing quality radiographic images. This project characterized the east neutron imaging beamline at the Idaho National Laboratory Neutron Radiography Reactor (NRAD). The experiments which measured the beam’s effective length-to-diameter ratio and image quality are based on American Society for Testing and Materials (ASTM) standards. An analysis of the image produced by a calibrated phantom measured the beam divergence. The energy spectrum measurements consist of a series of foil irradiations using a selection of activation foils, compared to the results produced by a Monte Carlo n-Particle (MCNP) model of the beamline. Improvement of the existing NRAD MCNP beamline model includes validation of the model’s energy spectrum and the development of enhanced image simulation methods. The image simulation methods predict the radiographic image of an object based on the foil reaction rate data obtained by placing a model of the object in front of the image plane in an MCNP beamline model.

  14. Alpha particle radiography of small insects

    Energy Technology Data Exchange (ETDEWEB)

    Chingshen Su [National Tsing Hua Univ., Hsinchu (Taiwan) Inst. of Nuclear Science

    1993-12-31

    Radiographies of ants, mosquitoes, cockroaches and small bugs have been done with a radioisotope {sup 244}Cm alpha source. Energy of alpha particles was varied by attenuating the 5.81 MeV alpha particles with adjustable air spacings from the source to the sample. The LR-115 was used to register radiographs. The image of the insect registered on the LR-115 was etched out in a 2.5 N NaOH solution at 52{sup o}C for certain minutes, depending on various irradiation conditions for the insects. For larger insects, a scanning device for the alpha particle irradiation has been fabricated to take the radiograph of whole body of the insect, and the scanning period can be selected to give desired irradiation dosage. A CCDTV camera system connected to a microscope interfaced to an IBM/AT computer is used to register the microscopic image of the radiograph and to print it out with a video copy processor. (Author).

  15. Comparison of state dental radiography safety regulations.

    Science.gov (United States)

    McDaniel, Thomas F; Parashar, Vijay

    2015-01-01

    The aim of this study was to compare and provide an overview of state policies on occupational exposure, dosimetry, collimation, patient protection, and the use of portable handheld X-ray machines in dentistry. State government webpages containing radiation protection rules and regulations were scanned. The contents were compared against current federal regulations established by the Nuclear Regulatory Commission (NRC) and the US Food and Drug Administration (FDA). They were further evaluated in light of current recommendations from the National Council on Radiation Protection & Measurements (NCRP) and the American Dental Association (ADA). Most states' regulations mirror the exposure limits set forth by the NRC and FDA. Nonregulatory recommendations regarding use of dental radiography are periodically put forth by the NCRP and the ADA. State and federal agencies often follow recommendations from these scientific organizations when creating regulations. Clinicians must be aware of their state's radiation protection rules, as variations among states exist. In addition, recommendations published by organizations such as the NCRP and the ADA, while not legally binding, contribute significantly to the reduction of radiation risks for operators and patients alike.

  16. A dose monitoring system for dental radiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chena; Lee, Sam Sun; Kim, Jo Eun; Huh, Kyung Hoe; Yi, Woo Jin; Heo, Min Suk; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Symkhampha, Khanthaly [Dept. of Oral and Maxillofacial Radiology, Department of Basic Science, Faculty of Dentistry, University of Health Sciences, Vientiane (Lao People' s Democratic Republic); Lee, Woo Jin [Dept. of Interdisciplinary Program in Radiation, Applied Life Sciences Major, College of Medicine, BK21, and Dental Research Institute, Seoul National University, Seoul (Korea, Republic of); Yeom, Heon Young [School of Computer Science Engineering, Seoul National University, Seoul (Korea, Republic of)

    2016-06-15

    The current study investigates the feasibility of a platform for a nationwide dose monitoring system for dental radiography. The essential elements for an unerring system are also assessed. An intraoral radiographic machine with 14 X-ray generators and five sensors, 45 panoramic radiographic machines, and 23 cone-beam computed tomography (CBCT) models used in Korean dental clinics were surveyed to investigate the type of dose report. A main server for storing the dose data from each radiographic machine was prepared. The dose report transfer pathways from the radiographic machine to the main sever were constructed. An effective dose calculation method was created based on the machine specifications and the exposure parameters of three intraoral radiographic machines, five panoramic radiographic machines, and four CBCTs. A viewing system was developed for both dentists and patients to view the calculated effective dose. Each procedure and the main server were integrated into one system. The dose data from each type of radiographic machine was successfully transferred to the main server and converted into an effective dose. The effective dose stored in the main server is automatically connected to a viewing program for dentist and patient access. A patient radiation dose monitoring system is feasible for dental clinics. Future research in cooperation with clinicians, industry, and radiologists is needed to ensure format convertibility for an efficient dose monitoring system to monitor unexpected radiation dose.

  17. Portable Digital Radiography and Computed Tomography Manual

    Energy Technology Data Exchange (ETDEWEB)

    2007-11-01

    This user manual describes the function and use of the portable digital radiography and computed tomography (DRCT) scanner. The manual gives a general overview of x-ray imaging systems along with a description of the DRCT system. An inventory of the all the system components, organized by shipping container, is also included. In addition, detailed, step-by-step procedures are provided for all of the exercises necessary for a novice user to successfully collect digital radiographs and tomographic images of an object, including instructions on system assembly and detector calibration and system alignment. There is also a short section covering the limited system care and maintenance needs. Descriptions of the included software packages, the DRCT Digital Imager used for system operation, and the DRCT Image Processing Interface used for image viewing and tomographic data reconstruction are given in the appendixes. The appendixes also include a cheat sheet for more experienced users, a listing of known system problems and how to mitigate them, and an inventory check-off sheet suitable for copying and including with the machine for shipment purposes.

  18. Portable Digital Radiography and Computed Tomography Manual

    Energy Technology Data Exchange (ETDEWEB)

    2007-11-01

    This user manual describes the function and use of the portable digital radiography and computed tomography (DRCT) scanner. The manual gives a general overview of x-ray imaging systems along with a description of the DRCT system. An inventory of the all the system components, organized by shipping container, is also included. In addition, detailed, step-by-step procedures are provided for all of the exercises necessary for a novice user to successfully collect digital radiographs and tomographic images of an object, including instructions on system assembly and detector calibration and system alignment. There is also a short section covering the limited system care and maintenance needs. Descriptions of the included software packages, the DRCT Digital Imager used for system operation, and the DRCT Image Processing Interface used for image viewing and tomographic data reconstruction are given in the appendixes. The appendixes also include a cheat sheet for more experienced users, a listing of known system problems and how to mitigate them, and an inventory check-off sheet suitable for copying and including with the machine for shipment purposes.

  19. Towards Proton Therapy and Radiography at FAIR

    Science.gov (United States)

    Prall, M.; Lang, P. M.; LaTessa, C.; Mariam, F.; Merrill, F.; Shestov, L.; Simoniello, P.; Varentsov, D.; Durante, M.

    2015-04-01

    Protons having energies in the GeV range have been proposed as an alternative to Bragg-peak hadron therapy. This strategy reduces lateral scattering and overcomes uncertainties of particle range and relative biological effectiveness. GeV protons could additionally be used for targeting in image guided stereotactic radiosurgery. We experimentally demonstrated the potential of GeV protons for imaging of biological samples using E=0.8 GeV protons and the pRad setup at Los Alamos National Laboratory (LANL). In this setup, a system of magnetic lenses creates a point-to-point mapping from object to detector. This mapping compensates image blur due to lateral scattering inside the imaged (biological) object. We produced 2-dim proton radiographs of biological samples, an anthropomorphic phantom and performed simple dosimetry. High resolution tomographic reconstructions were derived from the 2-dim proton radiographs. Our experiment was performed within the framework of the PANTERA (Proton Therapy and Radiography) project. In the future, the proton microscope PRIOR (Proton Microscope for FAIR) located in the FAIR facility (Darmstadt), will focus on optimizing the technique for imaging of lesions implanted in animals and couple the irradiation with standard radiotherapy.

  20. The status of bedside teaching in the United Kingdom: the student perspective

    Directory of Open Access Journals (Sweden)

    Jones P

    2015-06-01

    Full Text Available Patrick Jones, Bhavan Prasad Rai Department of Surgery, Ninewells Hospital, Dundee, UK Purpose: Bedside teaching holds a strong tradition as a key-learning platform for clinical examination in the basic medical clerkship. There is a growing body of literature expressing concern for its witnessed decline in medical school curricula. However, the views of students toward this patient-centered cornerstone in surgical education remain under-reported. The purpose of this study was to gain a nationwide perspective on bedside teaching according to medical students in the United Kingdom. Materials and methods: An adapted Delphi method was employed to formulate the question series as part of a multi-step process including a pilot study, which was used to construct this survey. The target population was medical undergraduates in the United Kingdom and participants were recruited via social media. Outcomes assessed included exposure to bedside teaching, perceived benefits of clinical simulation, and junior doctors as clinical teachers. Barriers to clinical examination were also evaluated. Results: Overall, 368 completed surveys were received (completion rate 98.9%. Final year students were significantly more likely to report receiving insufficient bedside teaching (P<0.01. Seventy-eight percent of the study group agreed that clinical simulation is a good learning tool for clinical examination. Seventy percent of students felt junior doctors were as able as senior doctors to teach. Lack of confidence was identified as the commonest barrier to overcome when examining patients and two-thirds of students felt they burdened patients during bedside teaching. Conclusion: This prospective study confirms the exposure deficit, which medical students experience in bedside teaching. The junior doctor represents a dynamic clinical teacher in the face of working time directives. Peer learning is a novel solution to such pressures. Work is needed to re-establish the