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Sample records for spirometry chest radiographs

  1. Radiological diagnosis of chest wall tuberculosis: CT versus chest radiograph

    International Nuclear Information System (INIS)

    Liu Fugeng; Pan Jishu; Chen Qihang; Zhou Cheng; Yu Jingying; Tang Dairong

    2006-01-01

    Objective: To evaluate the role of CT or Chest radiograph in diagnosis of chest wall tuberculosis. Methods: The study population included 21 patients with chest wall tuberculosis confirmed by operation or biopsy. Chest radiograph and plain CT were performed in all eases, while enhanced CT in 9 cases, and all images were reviewed by 2 radiologists. Results: Single soft tissue mass of the chest wall was detected in all cases on CT, but not on chest radiograph(χ 2 =42.000, P 2 =4.421, P<0.05). Conclusion: CT, especially enhanced CT scan is the first choice in the diagnosis of chest wall tuberculosis. (authors)

  2. Gastric tumors on chest radiographs

    International Nuclear Information System (INIS)

    Tamura, Shozo; Kawanami, Takashi; Russell, W.J.

    1978-04-01

    Gastric neoplasms of three patients protruded into their gas-containing fornices and were first visualized on plain chest radiographs. Endoscopy and/or surgery confirmed these to be a polyp, a leiomyoma, and an adenocarcinoma. The polyp, 1.3 cm in diameter, was the smallest of these three, but smaller lesions may be detectable under suitable conditions. Adequate technique and positioning, sufficiently large lesions in the upper portion of the stomach, a central beam tangential to the tumor, sufficient gas in the stomach, and careful scrutiny by the observer are required. Lesions may be more readily visualized during chest radiography when oral sodium bicarbonate is used to distend the stomach. In chest radiography, exposure limited to the lung fields has been advocated for economy and dose reduction. However, too small an exposure field may result in loss of information potentially beneficial to the patient. Using the smaller of two popular film sizes (35 x 43 cm and 35 x 35 cm), the saving in surface and bone marrow doses is negligible, and the saving in gonad dose may be nil over that when shielding is used. The interest of the observer may be absorbed by a concomitant cardiac or pulmonary lesion. Careful scrutiny of the entire radiograph is therefore essential. (author)

  3. Chest Radiographic Findings in Newly Diagnosed Pulmonary ...

    African Journals Online (AJOL)

    Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%) ...

  4. Spirometry

    Science.gov (United States)

    Spirometry Overview Spirometry (spy-ROM-uh-tree) is a common office test used to assess how well your lungs work by ... much you exhale and how quickly you exhale. Spirometry is used to diagnose asthma, chronic obstructive pulmonary ...

  5. Chest radiographic findings in Human Immunodeficiency Virus ...

    African Journals Online (AJOL)

    This study was carried out to determine findings on chest radiographs in HIV positive/AIDS patients at the University of Benin Teaching Hospital (UBTH) Benin City. All consecutive HIV positive/AIDS patients, managed at the UBTH between 1991 and 2001 were included in the study. Patients had postero-anterior (PA) chest ...

  6. Chest radiographic findings in acute paraquat poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Na, Gyeong Gyun; Lee, Mi Sook; Kim, Hee Jun; Sun, In O [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    2016-01-15

    To describe the chest radiographic findings of acute paraquat poisoning. 691 patients visited the emergency department of our hospital between January 2006 and October 2012 for paraquat poisoning. Of these 691, we identified 56 patients whose initial chest radiographs were normal but who developed radiographic abnormalities within one week. We evaluated their radiographic findings and the differences in imaging features based on mortality. The most common finding was diffuse consolidation (29/56, 52%), followed by consolidation with linear and nodular opacities (18/56, 32%), and combined consolidation and pneumomediastinum (7/56, 13%). Pleural effusion was noted in 17 patients (30%). The two survivors (4%) showed peripheral consolidations, while the 54 patients (96%) who died demonstrated bilateral (42/54, 78%) or unilateral (12/54, 22%) diffuse consolidations. Rapidly progressing diffuse pulmonary consolidation was observed within one week on follow-up radiographs after paraquat ingestion in the deceased, but the survivors demonstrated peripheral consolidation.

  7. Understanding chest radiographic anatomy with MDCT reformations

    Energy Technology Data Exchange (ETDEWEB)

    Sussmann, A.R. [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States); Ko, J.P., E-mail: jane.ko@nyumc.or [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States)

    2010-02-15

    Chest radiograph interpretation requires an understanding of the mediastinal reflections and anatomical structures. Computed tomography (CT) improves the learning of three-dimensional (3D) anatomy, and more recently multidetector CT (MDCT) technology has enabled the creation of high-quality reformations in varying projections. Multiplanar reformations (MPRs) of varying thickness in the coronal and sagittal projections can be created for direct correlation with findings on frontal and lateral chest radiographs, respectively. MPRs enable simultaneous visualization of the craniocaudal extent of thoracic structures while providing the anatomic detail that has been previously illustrated using cadaveric specimens. Emphasis will be placed on improving knowledge of mediastinal anatomy and reflections including edges, lines, and stripes that are visible on chest radiographs.

  8. Inferior hilar window on lateral chest radiographs

    International Nuclear Information System (INIS)

    Park, C.K.; Webb, W.R.; Klein, J.S.

    1990-01-01

    This paper determines the accuracy of lateral chest radiography in the detection of masses in the inferior hilar window, a normally avascular hilar region anterior to the lower lobe bronchi. Fifty patients with normal thoracic CT scans and 25 with hilar masses/adenopathy were selected retrospectively. The 75 corresponding lateral chest radiographs were blindly evaluated for visibility of the anterior walls of the lower lobe bronchi and the presence and laterality of abnormal soft tissue (>1 cm) in the inferior hilar window. Only a 7 x 7-cm square of the lateral radiograph was viewed

  9. Cardiac and pericardial calcifications on chest radiographs

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    Ferguson, E.C., E-mail: ecferguson@hotmail.co [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States); Berkowitz, E.A. [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States)

    2010-09-15

    Many types of cardiac and pericardial calcifications identified on chest radiographs can be recognized and distinguished based on characteristic locations and appearances. The purpose of this review is to emphasize the importance of detecting cardiac and pericardial calcifications on chest radiographs, and to illustrate and describe the various types of calcifications that may be encountered and how they may be differentiated from one another. Each type of cardiac and pericardial calcification is discussed, its location and appearance described, and its significance explained. Recognizing and understanding these calcifications is important as they are often encountered in daily practice and play an important role in patient care.

  10. Chest radiograph interpretation by medical students

    International Nuclear Information System (INIS)

    Jeffrey, D.R.; Goddard, P.R.; Callaway, M.P.; Greenwood, R.

    2003-01-01

    AIM: To assess the ability of final year medical students to interpret conventional chest radiographs. MATERIALS AND METHODS: Ten conventional chest radiographs were selected from a teaching hospital radiology department library that were good radiological examples of common conditions. All were conditions that a medical student should be expected to recognize by the end of their training. One normal radiograph was included. The radiographs were shown to 52 final year medical students who were asked to describe their findings. RESULTS: The median score achieved was 12.5 out of 20 (range 6-18). There was no difference between the median scores of male and female students (12.5 and 12.3, respectively, p=0.82) but male students were more likely to be certain of their answers than female students (median certainty scores 23.0 and 14.0, respectively). The overall degree of certainty was low. On no radiograph were more than 25% of students definite about their answer. Students had received little formal radiology teaching (2-42 h, median 21) and few expressed an interest in radiology as a career. Only two (3.8%) students thought they were good at interpreting chest radiographs, 17 (32.7%) thought they were bad or awful. CONCLUSION: Medical students reaching the end of their training do not perform well at interpreting simple chest radiographs. They lack confidence and have received little formal radiological tuition. Perhaps as a result, few are interested in radiology as a career, which is a matter for concern in view of the current shortage of radiologists in the UK

  11. Chest radiographic manifestations of scrub typhus.

    Science.gov (United States)

    Abhilash, Kpp; Mannam, P R; Rajendran, K; John, R A; Ramasami, P

    2016-01-01

    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. 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. 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; Pscrub 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.

  12. 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.

  13. Use of spirometry among chest physicians and primary care physicians in India.

    Science.gov (United States)

    Vanjare, Nitin; Chhowala, Sushmeeta; Madas, Sapna; Kodgule, Rahul; Gogtay, Jaideep; Salvi, Sundeep

    2016-07-07

    Although spirometry is the gold-standard diagnostic test for obstructive airways diseases, it remains poorly utilised in clinical practice. We aimed to investigate the use of spirometry across India, the change in its usage over a period of time and to understand the reasons for its under-utilisation. Two nationwide surveys were conducted in the years 2005 and 2013, among four groups of doctors: chest physicians (CPs), general physicians (GenPs), general practitioners (GPs) and paediatricians (Ps). A total of 1,000 physicians from each of the four groups were randomly selected from our database in the years 2005 and 2013. These surveys were conducted in 52 cities and towns across 15 states in India. A questionnaire was administered to the physicians, which captured information about their demographic details, type of practice and use of spirometry. The overall response rates of the physicians in 2005 and 2013 were 42.8% and 54.9%, respectively. Spirometry was reported to be used by 55% CPs, 20% GenPs, 10% GPs and 5% Ps in 2005, and this increased by 30.9% among CPs (P value spirometry varied between 2005 and 2013. In all, 32.2% of physicians were unaware of which predicted equation they were using. The use of spirometry in India is low, although it seems to have improved over the years. The reasons identified in this study for under-utilisation should be used to address initiatives to improve the use of spirometry in clinical practice.

  14. Segmentation of ribs in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

    Ribs and clavicles in posterior-anterior (PA) digital chest radiographs often overlap with lung abnormalities such as nodules, and cause missing of these abnormalities, it is therefore necessary to remove or reduce the ribs in chest radiographs. The purpose of this study was to develop a fully automated algorithm to segment ribs within lung area in digital radiography (DR) for removal of the ribs. The rib segmentation algorithm consists of three steps. Firstly, a radiograph was pre-processed for contrast adjustment and noise removal; second, generalized Hough transform was employed to localize the lower boundary of the ribs. In the third step, a novel bilateral dynamic programming algorithm was used to accurately segment the upper and lower boundaries of ribs simultaneously. The width of the ribs and the smoothness of the rib boundaries were incorporated in the cost function of the bilateral dynamic programming for obtaining consistent results for the upper and lower boundaries. Our database consisted of 93 DR images, including, respectively, 23 and 70 images acquired with a DR system from Shanghai United-Imaging Healthcare Co. and from GE Healthcare Co. The rib localization algorithm achieved a sensitivity of 98.2% with 0.1 false positives per image. The accuracy of the detected ribs was further evaluated subjectively in 3 levels: "1", good; "2", acceptable; "3", poor. The percentages of good, acceptable, and poor segmentation results were 91.1%, 7.2%, and 1.7%, respectively. Our algorithm can obtain good segmentation results for ribs in chest radiography and would be useful for rib reduction in our future study.

  15. Lung involvement quantification in chest radiographs

    International Nuclear Information System (INIS)

    Giacomini, Guilherme; Alvarez, Matheus; Oliveira, Marcela de; Miranda, Jose Ricardo A.; Pina, Diana R.; Pereira, Paulo C.M.; Ribeiro, Sergio M.

    2014-01-01

    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)

  16. Chest radiographic findings of tuberculous pneumonia

    International Nuclear Information System (INIS)

    Jung, Seung Hye; Sung, Dong Wook; Yoon, Yup; Lim, Jae Hoon

    1991-01-01

    When tuberculous pneumonia appears as a segmental or loabr consolidation, its is difficult to differentiate tuberculous pneumonia from nontuberculous bacterial pneumonia radiologically. The object of this study was to define the typical radiographic findings of tuberculous pneumonia through comparative analysis of tuberculous and nontuberculous pneumonia. A review of chest radiolograph in 29 patients with tuberculous pneumonia and in 23 patients with nontuberculous bacterial pneumonia was made with regard to homogeneity, volume loss, air-fluid level within the cavities, air-bronchogram, pleural disease, and predilection sites. The characteristic findings of tuberculous pneumonia are a heterogeneous density of infiltration (66%), evidence of volume loss of infiltrative lesion (52%), and cavity formation (48%) without air - fluid level. An associated parameter of analysis is the relative absence of leukocytosis (76%)

  17. Black Lung Benefits Act: standards for chest radiographs. Final rule.

    Science.gov (United States)

    2014-04-17

    Physicians and adjudicators use chest radiographs (X-rays) as a tool in evaluating whether a coal miner suffers from pneumoconiosis (black lung disease). Accordingly, the Department's regulations implementing the Black Lung Benefits Act allow the submission of radiographs in connection with benefit claims and set out quality standards for administering and interpreting film-based chest radiographs. This final rule updates the Department's existing film-radiograph standards and provides parallel standards for digital radiographs. This rule also updates outdated terminology and removes certain obsolete provisions.

  18. Acute effects of volume-oriented incentive spirometry on chest wall volumes in patients after a stroke.

    Science.gov (United States)

    Lima, Illia Ndf; Fregonezi, Guilherme Af; Melo, Rodrigo; Cabral, Elis Ea; Aliverti, Andrea; Campos, Tânia F; Ferreira, Gardênia Mh

    2014-07-01

    The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. Twenty poststroke patients and 20 age-matched healthy subjects were studied by optoelectronic plethysmography during spontaneous quiet breathing (QB), during incentive spirometry, and during the recovery period after incentive spirometry. Incentive spirometry was associated with an increased chest wall volume measured at the pulmonary rib cage, abdominal rib cage and abdominal compartment (P = .001) and under 3 conditions (P spirometry, and postincentive spirometry, respectively. Under all 3 conditions, the contribution of the abdominal compartment to VT was greater in the stroke subjects (54.1, 43.2, and 48.9%) than in the control subjects (43.7, 40.8, and 46.1%, P = .039). In the vast majority of subjects (13/20 and 18/20 during QB and incentive spirometry, respectively), abdominal expansion precedes rib cage expansion during inspiration. Greater asymmetry between the right and left hemithoracic expansions occurred in stroke subjects compared with control subjects, but it decreased during QB (62.5%, P = .002), during incentive spirometry (19.7%), and postincentive spirometry (67.6%, P = .14). Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation. Copyright © 2014 by Daedalus Enterprises.

  19. An audit of 3859 preadmission chest radiographs of apparently ...

    African Journals Online (AJOL)

    Background: Chest radiographs are routinely requested as part of the medical screening process prior to admission to institutions. Literature on the yield of such an exercise is sparse especially in the Nigerian setting. This study was therefore carried out to assess the usefulness of routine chest radiography for students at ...

  20. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

    OpenAIRE

    Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

    2011-01-01

    Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a tru...

  1. Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

    Science.gov (United States)

    Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

    2015-01-01

    Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in 20.6% (142 of 691 [95% CI: 17.6%, 23.8%]) of cases, and no corresponding abnormalities in 38

  2. Skeletal changes mimicking intrathoracic disease on chest radiographs

    International Nuclear Information System (INIS)

    Gelderen, WFC van

    2009-01-01

    Full text: Various chest radiographs are illustrated to demonstrate features where bony changes may mimic intrathoracic disease. To confirm the skeletal origin and nature, further conventional radiographs often suffice, and the need for CT or scintigraphy may therefore be obviated. At the time of presentation for radiography of the chest, further pertinent clinical details can be obtained from the patient by the department staff, as required. All previous radiographs and radiological reports should be readily available. In order to add to the educational value of the 13 cases illustrated, all are presented in quiz format, with the answers and further images included in the text.

  3. Chest radiographic findings in neurotuberculosis without pulmonary signs and symptoms

    International Nuclear Information System (INIS)

    Aurangzeb, S.; Badshah, M.; Khan, B.R.S.

    2008-01-01

    To determine the chest radiographic findings in patients of adult neurotuberculosis, with no pulmonary signs and symptoms. A total of 100 patients fulfilling pre-defined criteria of neurotuberculosis were included. Chest radiographic (CXR) evidence of pulmonary TB was looked for in those patients and its frequency, pattern and association with the clinical grades at presentation was determined by using Chi-square test. Out of the 100 patients of neurotuberculosis, with no clinical evidence of pulmonary TB, radiographic evidence of pulmonary TB was seen in only 30% patients. The predominant patterns on CXR were apical infiltration (26.6%), military mottling (20%) and hilar enlargement (16.6%). Positive CXR was found in 16.7% patients in clinical grade I and 40% and 43.3% in patients in grade II and III respectively. There was a strong association of grade II and grade III with positive chest radiographic findings (p= 0.03). Patients of neurotuberculosis may have chest radiographic evidence of pulmonary TB even in the absence of pulmonary signs and symptoms at presentation. There is a strong association of clinical grade II and grade III with positive chest radiographic findings. (author)

  4. Chest radiographic features of human metapneumovirus infection in pediatric patients

    International Nuclear Information System (INIS)

    Hilmes, Melissa A.; Daniel Dunnavant, F.; Singh, Sudha P.; Ellis, Wendy D.; Payne, Daniel C.; Zhu, Yuwei; Griffin, Marie R.; Edwards, Kathryn M.; Williams, John V.

    2017-01-01

    Human metapneumovirus (HMPV) was identified in 2001 and is a common cause of acute respiratory illness in young children. The radiologic characteristics of laboratory-confirmed HMPV acute respiratory illness in young children have not been systematically assessed. We systematically evaluated the radiographic characteristics of acute respiratory illness associated with HMPV in a prospective cohort of pediatric patients. We included chest radiographs from children <5 years old with acute respiratory illness who were enrolled in the prospective New Vaccine Surveillance Network (NVSN) study from 2003 to 2009 and were diagnosed with HMPV by reverse transcription-polymerase chain reaction (RT-PCR). Of 215 HMPV-positive subjects enrolled at our tertiary care children's hospital, 68 had chest radiographs obtained by the treating clinician that were available for review. Two fellowship-trained pediatric radiologists, independently and then in consensus, retrospectively evaluated these chest radiographs for their radiographic features. Parahilar opacities were the most commonly observed abnormality, occurring in 87% of children with HMPV. Hyperinflation also occurred frequently (69%). Atelectasis (40%) and consolidation (18%) appeared less frequently. Pleural effusion and pneumothorax were not seen on any radiographs. The clinical presentations of HMPV include bronchiolitis, croup and pneumonia. Dominant chest radiographic abnormalities include parahilar opacities and hyperinflation, with occasional consolidation. Recognition of the imaging patterns seen with common viral illnesses like respiratory syncytial virus (RSV) and HMPV might facilitate diagnosis and limit unnecessary antibiotic treatment. (orig.)

  5. Chest radiographic features of human metapneumovirus infection in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Hilmes, Melissa A.; Daniel Dunnavant, F.; Singh, Sudha P.; Ellis, Wendy D. [Vanderbilt University School of Medicine, Department of Radiology, Nashville, TN (United States); Payne, Daniel C. [Centers for Disease Control and Prevention, Atlanta, GA (United States); Zhu, Yuwei [Vanderbilt University School of Medicine, Department of Biostatistics, Nashville, TN (United States); Griffin, Marie R. [Vanderbilt University School of Medicine, Department of Health Policy, Nashville, TN (United States); Edwards, Kathryn M. [Vanderbilt University School of Medicine, Department of Pediatrics, Nashville, TN (United States); Williams, John V. [University of Pittsburgh School of Medicine, Department of Pediatrics, Pittsburgh, PA (United States); University of Pittsburgh of UPMC, Children' s Hospital of Pittsburgh, Pittsburgh, PA (United States)

    2017-12-15

    Human metapneumovirus (HMPV) was identified in 2001 and is a common cause of acute respiratory illness in young children. The radiologic characteristics of laboratory-confirmed HMPV acute respiratory illness in young children have not been systematically assessed. We systematically evaluated the radiographic characteristics of acute respiratory illness associated with HMPV in a prospective cohort of pediatric patients. We included chest radiographs from children <5 years old with acute respiratory illness who were enrolled in the prospective New Vaccine Surveillance Network (NVSN) study from 2003 to 2009 and were diagnosed with HMPV by reverse transcription-polymerase chain reaction (RT-PCR). Of 215 HMPV-positive subjects enrolled at our tertiary care children's hospital, 68 had chest radiographs obtained by the treating clinician that were available for review. Two fellowship-trained pediatric radiologists, independently and then in consensus, retrospectively evaluated these chest radiographs for their radiographic features. Parahilar opacities were the most commonly observed abnormality, occurring in 87% of children with HMPV. Hyperinflation also occurred frequently (69%). Atelectasis (40%) and consolidation (18%) appeared less frequently. Pleural effusion and pneumothorax were not seen on any radiographs. The clinical presentations of HMPV include bronchiolitis, croup and pneumonia. Dominant chest radiographic abnormalities include parahilar opacities and hyperinflation, with occasional consolidation. Recognition of the imaging patterns seen with common viral illnesses like respiratory syncytial virus (RSV) and HMPV might facilitate diagnosis and limit unnecessary antibiotic treatment. (orig.)

  6. Should the lateral chest radiograph be routinely performed?

    International Nuclear Information System (INIS)

    Osman, Fatuma; Williams, Imelda

    2014-01-01

    Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

  7. Spirometry-Assisted High Resolution Chest Computed Tomography in Children: Is it Worth the Effort?

    Science.gov (United States)

    Otjen, Jeffrey Parke; Swanson, Jonathan Ogden; Oron, Assaf; DiBlasi, Robert M; Swortzel, Tim; van Well, Jade Adriana Marie; Gommers, Eva Anna Elisabeth; Rosenfeld, Margaret

    Image quality of high resolution chest computed tomographies (HRCTs) depends on adequate breath holds at end inspiration and end expiration. We hypothesized that implementation of spirometry-assisted breath holds in children undergoing HRCTs would improve image quality over that obtained with voluntary breath holds by decreasing motion artifact and atelectasis. This is a retrospective case-control study of HRCTs obtained at a tertiary care children's hospital before and after implementation of a spirometry-assisted CT protocol, in which children ≥8 years of age are first trained in supine slow vital capacity maneuvers and then repeat the maneuvers in the CT scanner, coached by a respiratory therapist. Spirometry-assisted CT scans (cases) were matched by age, gender and diagnosis (cystic fibrosis vs other) to CT scans obtained with voluntary breath holds in the 6 years before implementation of the spirometry assistance protocol (controls), and evaluated by 2 blinded pediatric radiologists. Among both cases and controls (N = 50 each), 10 carried the diagnosis of cystic fibrosis and 40 had other diagnoses. Mean age was 12.9 years (range: 7.5-20.1) among cases and 13.0 (7.1-19.7) among controls. Mean (SD) inspiratory image density among cases was -852 (37) Hounsfield units (HU) and -828 (43) among controls (p = 0.006). Mean (SD) expiratory image density was -629 (95) HU among cases and -688 (83) HU among controls (p = 0.002). Mean (SD) change in image density between inspiratory and expiratory images was +222 (85) HU among cases and +140 (76) HU among controls (p 0.80). Atelectasis was present on inspiratory images in 8 cases and 9 controls and on expiratory images in 9 cases and 10 controls (p > 0.80). Spirometry-assisted CTs had a significantly greater difference in lung density between inspiratory and expiratory scans than those performed with voluntary breath holds, likely improving the ability to detect air trapping. No appreciable difference in image quality

  8. Effect of display type and room illuminance in chest radiographs

    International Nuclear Information System (INIS)

    Liukkonen, Esa; Jartti, Airi; Haapea, Marianne; Oikarinen, Heljae; Ahvenjaervi, Lauri; Mattila, Seija; Nevala, Terhi; Palosaari, Kari; Perhomaa, Marja; Nieminen, Miika T.

    2016-01-01

    To compare diagnostic accuracy in the detection of subtle chest lesions on digital chest radiographs using medical-grade displays, consumer-grade displays, and tablet devices under bright and dim ambient light. Five experienced radiologists independently assessed 50 chest radiographs (32 with subtle pulmonary findings and 18 without apparent findings) under bright (510 lx) and dim (16 lx) ambient lighting. Computed tomography was used as the reference standard for interstitial and nodular lesions and follow-up chest radiograph for pneumothorax. Diagnostic accuracy and sensitivity were calculated for assessments carried out in all displays and compared using the McNemar test. The level of significance was set to p < 0.05. Significant differences in sensitivity between the assessments under bright and dim lighting were found among consumer-grade displays in interstitial opacities with, and in pneumothorax without, Digital Imaging and Communication in Medicine-Grayscale Standard Display Function (DICOM-GSDF) calibration. Compared to 6 megapixel (MP) display under bright lighting, sensitivity in pneumothorax was lower in the tablet device and the consumer-grade display. Sensitivity in interstitial opacities was lower in the DICOM-GSDF calibrated consumer-grade display. A consumer-grade display with or without DICOM-GSDF calibration or a tablet device is not suitable for reading digital chest radiographs in bright lighting. No significant differences were observed between five displays in dim light. (orig.)

  9. Chest radiographs of near-drowned children

    International Nuclear Information System (INIS)

    Wunderlich, P.; Rupprecht, E.; Burkhardt, J.; Trefftz, F.; Thomsen, H.

    1985-01-01

    From 1972 through 1983 there were 10 near-drowned children (7 boys and 3 girls) aged 1 to 4 years, treated as inpatients at the Children's Hospital of the Medical Academy Dresden. Three of them showed a severe aspiration pneumonia which in one case was complicated by bilateral pneumothoraces. In a further five children there were radiological signs of pulmonary oedema. Only in two children were the X-ray pictures of the chest normal. (orig.)

  10. Chest radiographic data acquisition and quality assurance in multicenter studies

    International Nuclear Information System (INIS)

    Cleveland, R.H.; Schluchter, M.; Easley, K.A.; Wood, B.P.; Berdon, W.E.; Boechat, M.I.; Meziane, M.; Mellins, R.B.; Norton, K.I.; Singleton, E.; Trautwein, L.

    1997-01-01

    Background. Multicenter studies rely on data derived from different institutions. Forms can be designed to standardize the reporting process allowing reliable comparison of data. Objective. The purpose of the report is to provide a standardized method, developed as a part of a multicenter study of vertically transmitted HIV, for assessing chest radiographic results. Materials and methods. Eight hundred and five infants and children were studied at five centers; 3057 chest radiographs were scored. Data were entered using a forced-choice, graded response for 12 findings. Quality assurance measures and inter-rater agreement statistics are reported. Results. The form used for reporting chest radiographic results is presented. Inter-rater agreement was moderate to high for most findings, with the best correlation reported for the presence of bronchovascular markings and/or reticular densities addressed as a composite question (kappa = 0.71). The presence of nodular densities (kappa 0.56) and parenchymal consolidation (kappa = 0.57) had moderate agreement. Agreement for lung volume was low. Conclusion. The current tool, developed for use in the pediatric population, is applicable to any study involving the assessment of pediatric chest radiographs for a large population, whether at one or many centers. (orig.)

  11. Chest radiographic findings in bronchogenic carcinoma in pakistani population

    International Nuclear Information System (INIS)

    Suliman, M.I.; Ali, B.; Majeed, H.; Qureshi, F.

    2008-01-01

    To observe the common radiographic findings in histologically confirmed cases of bronchogenic carcinoma. This descriptive study comprised of 35 consecutive histopathologically / cytological confirmed cases of bronchogenic carcinoma that were admitted from January 2000 to April 2003 in Bahawal Victoria Hospital Bahawalpur. Plain chest radiographs were obtained in all cases Two radiologists blinded to the cell types were asked to interpret the radiographs. Hilar mass was the major manifestation in 62.8% cases. Chest radiographs showed 7 different types of lesions in four cell varieties in 35 cases, these included hilar mass in 62% cases of squamous cell carcinoma. Cavitation and rib erosion were found exclusively in squamous cell type carcinoma. In small cell carcinomas, hilar Involvement was present in 83.3% cases. Half of large cell carcinomas and one case of adenocarcinoma presented with a peripheral mass. Hilar mass was seen in 50% cases with adenocarcinoma Wide mediastinum was seen only in cases with small cell carcinoma. The chest radiograph findings in bronchogenic carcinoma has more or less a standard patterns which Can help the physician in better suspicion and diagnosis. (author)

  12. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

    Directory of Open Access Journals (Sweden)

    Omar Hesham R

    2011-09-01

    Full Text Available Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

  13. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients.

    Science.gov (United States)

    Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

    2011-09-27

    Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

  14. Computerized detection of lung nodules in digital chest radiographs

    International Nuclear Information System (INIS)

    Giger, M.L.; Doi, K.; MacMahon, H.

    1987-01-01

    Detection of cancerous lung nodules in chest radiographs is one of the more important tasks performed by a radiologist. In addition, the ''miss rate'' associated with the radiographic detection of lung nodules is approximately 30%. A computerized scheme that alerts the radiologist to possible locations of lung nodules should allow this number of false-negative diagnoses to be reduced. The authors are developing a computer-aided nodule detection scheme based on a difference image approach. They attempt to eliminate the camouflaging background structure of the normal lung anatomy by creating, from a single-projection chest image, two images: one in which the signal-to-noise ratio (SNR) of the nodule is maximized and another in which that SNR is suppressed while the processed background remains essentially the same. Thus, the difference between these two processed images should consist of the nodule superimposed on a relatively uniform background in which the detection task may be simplified. This difference image approach is fundamentally different from conventional subtraction techniques (e.g., temporal or dual-energy subtraction) in that the two images which are subtracted arise from the same single-projection chest radiograph. Once the difference image is obtained, thresholding is performed along with tests for circularity, size and growth in order to extract the nodules. It should be noted that once an original chest image is input to the computer the nodule detection process is totally automated

  15. Radiographic findings in the chest of patients following cardiac transplantation

    International Nuclear Information System (INIS)

    Shirazi, K.K.; Amendola, M.A.; Tisnado, J.; Cho, S.R.; Beachley, M.C.; Lower, R.R.

    1983-01-01

    The postoperative chest radiographic findings in 38 patients undergoing orthotopic (37 patients) and heterotopic (1 patient) cardiac transplantation were evaluated. Findings were correlated with those of echocardiograms, sputum and blood cultures, and lung and heart biopsies. The radiographic manifestations in the chest of these patients are classified in the following three main categories: 1) newly formed cardiac silhouette findings due to the transplanted heart itself, i.e., changes in size and shape of the new heart and pericardial effusion resulting from the placement of a smaller heart in a larger pericardial sac. 2) infectious complications due to bacteria, fungal, and other opportunistic agents secondary to immunosuppressive therapy, and 3) usual postoperatice complications following thoracomoty and open-heart surgery. (orig.)

  16. Estimation of lung volumes from chest radiographs using shape information

    International Nuclear Information System (INIS)

    Pierce, R.J.; Brown, D.J.; Holmes, M.; Cumming, G.; Denison, D.M.

    1979-01-01

    The cross-sectional shapes of the chest and its contained structures were assessed in post-mortem anatomical sections and from computerised tomographic scans in living subjects. These shapes are described by simple equations that can be used to increase the accuracy of measuring lung volumes from chest radiographs. Radiographic estimates of total lung capacity, using the equations, were compared with plethysmographic and single-breath helium dilution measurements in 35 normal subjects. After correction for posture effects the radiographic estimates of TLC, which measure the displacement volume of the lung, exceeded the plethysmographic estimates of contained gas volume by a mean of 720 ml, which was taken as the volume of tissue, blood, and water in the lungs. The single-breath dilution estimates of TLC fell short of the plethysmographic values by a mean of 480 ml, taken as the volume of contained gas that was inaccessible to helium in 10 seconds. The tomographic studies suggested that the radiographic technique of measuring lung displacement volumes has an accuracy of +- 210 ml. The method is rapid and simple to use and the intra- and inter-observer variabilities of <1% and <5% respectively. (author)

  17. Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern

    International Nuclear Information System (INIS)

    Umans, U.; Golding, R.P.; Duraku, S.; Manoliu, R.A.

    2001-01-01

    The aim of this study was to describe the findings on plain chest radiographs in patients with herpes simplex virus pneumonia (HSVP). The study was based on 17 patients who at a retrospective search have been found to have a monoinfection with herpes simplex virus. The diagnosis was established by isolation of the virus from material obtained during fiberoptic bronchoscopy (FOB) which also included broncho-alveolar lavage and tissue sampling. Fourteen patients had a chest radiograph performed within 24 h of the date of the FOB. Two radiographs showed no abnormalities of the lung parenchyma. The radiographs of the other 12 patients showed lung opacification, predominantly lobar or more extensive and always bilateral. Most patients presented with a mixed airspace and interstitial pattern of opacities, but 11 of 14 showed at least an airspace consolidation. Lobar, segmental, or subsegmental atelectasis was present in 7 patients, and unilateral or bilateral pleural effusion in 8 patients, but only in 1 patient was it a large amount. In contradiction to the literature which reports a high correlation between HSVP and acute respiratory distress syndrome (ARDS), 11 of 14 patients did not meet the pathophysiological criteria for ARDS. The radiologist may suggest the diagnosis of HSVP when bilateral airspace consolidation or mixed opacities appear in a susceptible group of patients who are not thought to have ARDS or pulmonary edema. The definite diagnosis of HSV pneumonia can be established only on the basis of culture of material obtained by broncho-alveolar lavage. (orig.)

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

    International Nuclear Information System (INIS)

    Pacharn, Preeyacha; Heller, Daniel N.D.; Kammen, Bamidele F.; Bryce, Thomas J.; Bailey, Richard A.; Brasch, Robert C.; Reddy, Mohan V.

    2002-01-01

    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.)

  19. Reassessing the standard chest radiograph for intraparenchymal activity

    International Nuclear Information System (INIS)

    Putman, C.E.; Hoeck, B.

    1986-01-01

    Despite the recent enthusiasm for better means of determining the extent of the active inflammatory response in the lung parenchyma of sarcoidosis patients, standard chest radiography remains a reliable method of determining staging, and parenchymal activity as well. The chest radiograph is characteristically used to determine the severity and course of sarcoidosis, but most studies imply there are poor correlations between the radiographic opacities and other indicators such as physiological parameters, gallium scans, and computed tomography and bronchoalveolar lavage results. In this preliminary communication, the authors report a new method of determining sarcoidosis activity, as compared to gallium scan, based solely on the standard chest radiograph. This method is based on the presence or absence of air bronchogram abnormalities, peribronchial cuffing, and subpleural thickening. Adenopathy and linear, reticulonodular, and nodular opacities are not included in this system. In 85 recent studies, which were performed in 51 patients with biopsy-proven sarcoidosis, this staging method agreed with gallium scanning in 68.2% of the patients. This system failed in specific and identifiable subgroups of patients that we will delineate. The authors will not report the comparative indices with a pulmonary function analysis or bronchoalveolar lavage results. Their database has not been tabulated to conclusively present these results, but it is their belief that this methodology will probably have a better correlation with lavage results and small airway function than would results of gallium scans. Of singular importance is the fact that this method can, with a more than acceptable degree of accuracy, distinguish between ''low-intensity'' alveolitis and ''high-intensity'' alveolitis

  20. Temporal subtraction of dual-energy chest radiographs

    International Nuclear Information System (INIS)

    Armato, Samuel G. III; Doshi, Devang J.; Engelmann, Roger; Caligiuri, Philip; MacMahon, Heber

    2006-01-01

    Temporal subtraction and dual-energy imaging are two enhanced radiography techniques that are receiving increased attention in chest radiography. Temporal subtraction is an image processing technique that facilitates the visualization of pathologic change across serial chest radiographic images acquired from the same patient; dual-energy imaging exploits the differential relative attenuation of x-ray photons exhibited by soft-tissue and bony structures at different x-ray energies to generate a pair of images that accentuate those structures. Although temporal subtraction images provide a powerful mechanism for enhancing visualization of subtle change, misregistration artifacts in these images can mimic or obscure abnormalities. The purpose of this study was to evaluate whether dual-energy imaging could improve the quality of temporal subtraction images. Temporal subtraction images were generated from 100 pairs of temporally sequential standard radiographic chest images and from the corresponding 100 pairs of dual-energy, soft-tissue radiographic images. The registration accuracy demonstrated in the resulting temporal subtraction images was evaluated subjectively by two radiologists. The registration accuracy of the soft-tissue-based temporal subtraction images was rated superior to that of the conventional temporal subtraction images. Registration accuracy also was evaluated objectively through an automated method, which achieved an area-under-the-ROC-curve value of 0.92 in the distinction between temporal subtraction images that demonstrated clinically acceptable and clinically unacceptable registration accuracy. By combining dual-energy soft-tissue images with temporal subtraction, misregistration artifacts can be reduced and superior image quality can be obtained

  1. Computerized detection of pneumothorax on digital chest radiographs

    International Nuclear Information System (INIS)

    Sanada, S.; Doi, K.; MacMahon, H.; Montner, S.M.

    1990-01-01

    This paper reports on neumothoraces that are clinically important abnormalities that usually appear as a subtle, fine line pattern on chest radiographs. We are developing a computer vision system for automated detection of pneumothorax to aid radiologists diagnosis. Chest images were digitized with a 0.175-mm pixel size, yielding a 2,000 x 2,430 matrix size, and 10 bits of gray scale. After indentification of the lung regions, an edge detection filter was employed in the apical areas to enhance a pneumothorax pattern. Ribs were detected with a technique based on statistical analysis of edge gradients and their orientations. Points located on a curved line suggestive of a pneumothorax in this enhanced image were detected with a Hough transform

  2. Horizontal fissure on neonatal plain chest radiographs: clinical implications

    International Nuclear Information System (INIS)

    Konarzewska, J.; Zawadzka-Kepczynska, A.; Bianek-Bodzak, A.; Kawinska-Kilianczyk, A.; Domzalska-Popadiuk, I.

    2005-01-01

    Regardless of etiology, pleural fluid, even in small amounts, can be visualized on the neonatal chest x-ray picture within pulmonary fissures. It remains unclear whether a marked horizontal fissure unaccompanied by any other radiological symptoms is of diagnostic value or not. Ninety-one consecutive neonatal chest radiographs with marked horizontal fissure were retrospectively analyzed. The images were made between 1999 and 2005 on 69 newborns admitted to the Neonatology Department, Institute of Obstetrics and Gynecology, Medical University of Gdansk. Analysis of the radiographs was conducted independently by three radiologists based on the following criteria: fissure thickness (marked or thickened), bronchovascular markings (increased or normal), size and shape of the heart (normal or abnormal), presence or absence of pulmonary infiltration, atelectasis, and changes related to wet lung syndrome. Due to divergent interpretations, the ultimate interpretation was established by consensus in 25 cases. The radiological findings were compared with clinical data. The compatibility of the three independent interpreters was statistically significant (p<0.0001). Marked transverse fissure was the only radiological finding on 66 x-rays. In 63 cases (69.2%) the children were asymptomatic as well. In 3 cases (3.3%) clinical symptoms of respiratory tract infection occurred. On the other 25 images, horizontal fissure was accompanied by other radiological symptoms. Chest x-ray results corresponded with clinical symptoms in 24 cases (26.4%). One child (1.1%) with radiological evidence of wet lung syndrome did not present any typical clinical symptoms of it. Horizontal fissure noted on a neonatal chest x-ray seems to be of minor diagnostic value if not accompanied by any other radiological symptoms. (author)

  3. Direct digital acquisition of neonatal portable chest radiographs

    International Nuclear Information System (INIS)

    Cohen, M.D.; Cory, D.A.; Broderick, N.J.; Smith, J.A.

    1987-01-01

    The Philips computerized radiography system utilizes a phosphor plate instead of an x-ray film to acquire radiographic images. The latent image on the plate is converted to a digital format. The authors report their initial experience with the system in more than 300 studies on intensive care neonates. The digital images provide very uniform image density. Tubes and catheters are more easily visualized than on conventional images. Soft tissues of the chest wall and bony structures are also more clearly seen on the digital images. The authors' initial experience indicates that portable digital imaging of neonates is technically feasible and provides good-quality diagnostic images

  4. Inappropriate mode switching clarified by using a chest radiograph

    Directory of Open Access Journals (Sweden)

    Brian Marino, DO

    2015-08-01

    Full Text Available An 80-year-old woman with a history of paroxysmal atrial fibrillation and atrioventricular node disease status post-dual chamber pacemaker placement was noted to have abnormal pacing episodes during a percutaneous coronary intervention. Pacemaker interrogation revealed a high number of short duration mode switching episodes. Representative electrograms demonstrated high frequency nonphysiologic recordings predominantly in the atrial lead. Intrinsic pacemaker malfunction was excluded. A chest radiograph showed excess atrial and ventricular lead slack in the right ventricular inflow. It was suspected that lead–lead interaction resulted in artifacts and oversensing, causing frequent short episodes of inappropriate mode switching.

  5. Chest radiograph in the acute traumatic rupture of the aorta

    International Nuclear Information System (INIS)

    Pinterits, F.; Grabenwoeger, F.; Dock, W.; Bardach, G.

    1987-01-01

    We tried to find out the validity of 16 wellknown signs indicating an acute traumatic aortic rupture on plain chest radiographs of 22 patients. Angiographically 11 of all patients had a tear at the aortic isthmus. It turned out that 7 of the 16 signs (widened mediastinum, loss of the aortic knob contour, opacification in the aortopulmonary window, bulging of the vascular pedicle predominantly to the left, left apical cap, depression of the left main stem bronchus and displacement of the right paraspinous interface) are of great diagnostic value. (orig.) [de

  6. Severe acute respiratory syndrome (SARS): chest radiographic features in children

    Energy Technology Data Exchange (ETDEWEB)

    Babyn, Paul S.; Gahunia, Harpal K.; Manson, David [Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario (Canada); Chu, Winnie C.W.; Metreweli, Constantine [Prince of Wales Hospital, Shatin (China); Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong (China); Tsou, Ian Y.Y.; Wansaicheong, Gervais K.L.; Chee, Thomas S.G.; Kaw, Gregory J.L. [Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng (Singapore); Allen, Upton; Bitnun, Ari; Read, Stanley [Division of Infectious Diseases, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario (Canada); Cheng, Frankie W.T.; Fok, Tai-Fai; Hon, Ellis K.L.; Li, Albert M.; Ng, Pak-Cheung [Department of Paediatrics, Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong, SAR (China); Chiu, Man-Chun; Leung, Chi-Wai [Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Lai King Hill Road, Lai Chi Kok, Hong Kong, SAR (China); Khong, Pek L. [Department of Diagnostic Radiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, SAR (China); Stringer, David A.

    2004-01-01

    We abstracted data (n=62) on the radiologic appearance and course of SARS in pediatric patients with suspect (n=25) or probable (n=37) SARS, diagnosed in five hospital sites located in three cities: Toronto, Singapore, and Hong Kong. Available chest radiographs and thoracic CTs were reviewed for the presence of the following radiographic findings: airspace disease, air bronchograms, airways inflammation and peribronchial thickening, interstitial disease, pleural effusion, and hilar adenopathy. A total of 62 patients (suspect=25, probable=37) were evaluated for SARS. Patient ages ranged from 5.5 months to 17 years and 11.5 months (average, 6 years and 10 months) with a female-to-male ratio of 32:30. Forty-one patients (66.1%) were in close contact with other probable, suspect, or quarantined cases; 10 patients (16.1%) had recently traveled to WHO-designated affected areas within 10 days; and 7 patients (11.2%) were transferred from other hospitals that had SARS patients. Three patients, who did not have close/hospital contact or travel history to affected areas, were classified as SARS cases based on their clinical signs and symptoms and on the fact that they were living in an endemic area. The most prominent clinical presentations were fever, with a temperature over 38 C (100%), cough (62.9%), rhinorrhea (22.6%), myalgia (17.7%), chills (14.5%), and headache (11.3%). Other findings included sore throat (9.7%), gastrointestinal symptoms (9.7%), rigor (8.1%), and lethargy (6.5%). In general, fever and cough were the most common clinical presentations amongst younger pediatric SARS cases (age<10 years), whereas, in addition to these symptoms, headache, myalgia, sore throat, chills, and/or rigor were common in older patients (age{>=}10 years). The chest radiographs of 35.5% of patients were normal. The most prominent radiological findings that were observed in the remaining patients were areas of consolidation (45.2%), often peripheral with multifocal lesions in 22

  7. Severe acute respiratory syndrome (SARS): chest radiographic features in children

    International Nuclear Information System (INIS)

    Babyn, Paul S.; Gahunia, Harpal K.; Manson, David; Chu, Winnie C.W.; Metreweli, Constantine; Tsou, Ian Y.Y.; Wansaicheong, Gervais K.L.; Chee, Thomas S.G.; Kaw, Gregory J.L.; Allen, Upton; Bitnun, Ari; Read, Stanley; Cheng, Frankie W.T.; Fok, Tai-Fai; Hon, Ellis K.L.; Li, Albert M.; Ng, Pak-Cheung; Chiu, Man-Chun; Leung, Chi-Wai; Khong, Pek L.; Stringer, David A.

    2004-01-01

    We abstracted data (n=62) on the radiologic appearance and course of SARS in pediatric patients with suspect (n=25) or probable (n=37) SARS, diagnosed in five hospital sites located in three cities: Toronto, Singapore, and Hong Kong. Available chest radiographs and thoracic CTs were reviewed for the presence of the following radiographic findings: airspace disease, air bronchograms, airways inflammation and peribronchial thickening, interstitial disease, pleural effusion, and hilar adenopathy. A total of 62 patients (suspect=25, probable=37) were evaluated for SARS. Patient ages ranged from 5.5 months to 17 years and 11.5 months (average, 6 years and 10 months) with a female-to-male ratio of 32:30. Forty-one patients (66.1%) were in close contact with other probable, suspect, or quarantined cases; 10 patients (16.1%) had recently traveled to WHO-designated affected areas within 10 days; and 7 patients (11.2%) were transferred from other hospitals that had SARS patients. Three patients, who did not have close/hospital contact or travel history to affected areas, were classified as SARS cases based on their clinical signs and symptoms and on the fact that they were living in an endemic area. The most prominent clinical presentations were fever, with a temperature over 38 C (100%), cough (62.9%), rhinorrhea (22.6%), myalgia (17.7%), chills (14.5%), and headache (11.3%). Other findings included sore throat (9.7%), gastrointestinal symptoms (9.7%), rigor (8.1%), and lethargy (6.5%). In general, fever and cough were the most common clinical presentations amongst younger pediatric SARS cases (age<10 years), whereas, in addition to these symptoms, headache, myalgia, sore throat, chills, and/or rigor were common in older patients (age≥10 years). The chest radiographs of 35.5% of patients were normal. The most prominent radiological findings that were observed in the remaining patients were areas of consolidation (45.2%), often peripheral with multifocal lesions in 22

  8. Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

    Energy Technology Data Exchange (ETDEWEB)

    Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung [Samsung Medical Center, Seoul (Korea, Republic of); Chung, Seung Eun [Sangkye Paek Hospital, Seoul (Korea, Republic of)

    1996-12-15

    To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

  9. Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

    International Nuclear Information System (INIS)

    Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung; Chung, Seung Eun

    1996-01-01

    To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

  10. Angular relational signature-based chest radiograph image view classification.

    Science.gov (United States)

    Santosh, K C; Wendling, Laurent

    2018-01-22

    In a computer-aided diagnosis (CAD) system, especially for chest radiograph or chest X-ray (CXR) screening, CXR image view information is required. Automatically separating CXR image view, frontal and lateral can ease subsequent CXR screening process, since the techniques may not equally work for both views. We present a novel technique to classify frontal and lateral CXR images, where we introduce angular relational signature through force histogram to extract features and apply three different state-of-the-art classifiers: multi-layer perceptron, random forest, and support vector machine to make a decision. We validated our fully automatic technique on a set of 8100 images hosted by the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH), and achieved an accuracy close to 100%. Our method outperforms the state-of-the-art methods in terms of processing time (less than or close to 2 s for the whole test data) while the accuracies can be compared, and therefore, it justifies its practicality. Graphical Abstract Interpreting chest X-ray (CXR) through the angular relational signature.

  11. Usefulness of chest radiographs in first asthma attacks

    International Nuclear Information System (INIS)

    Gershel, J.C.; Goldman, H.S.; Stein, R.E.K.; Shelov, S.P.; Ziprkowski, M.

    1983-01-01

    To assess the value of routine chest radiography during acute first attacks of asthma, we studied 371 consecutive children over one year of age who presented with an initial episode of wheezing. Three hundred fifty children (94.3%) had radiographic findings that were compatible with uncomplicated asthma and were considered negative. Twenty-one (5.7%) had positive findings: atelectasis and pneumonia were noted in seven, segmental atelectasis in six, pneumonia in five, multiple areas of subsegmental atelectasis in two, and pneumomediastinum in one. The patients with positive films were more likely to have a respiratory rate above 60 or a pulse rate above 160 (P < 0.001), localized rales or localized decreased breath sounds before treatment (P < 0.01), and localized rales (P < 0.005) and localized wheezing (P < 0.02) after treatment; also, these patients were admitted to the hospital more often (P < 0.001). Ninety-five percent (20 of 21) of the children with positive films could be identified before treatment on the basis of a combination of tachypnea, tachycardia, fever, and localized rales or localized decreased breath sounds. Most first-time wheezers will not have positive radiographs; careful clinical evaluation should reveal which patients will have abnormal radiographs and will therefore benefit from the procedure. 20 references, 3 tables

  12. Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia.

    Science.gov (United States)

    Esayag, Yaacov; Nikitin, Irina; Bar-Ziv, Jacob; Cytter, Ruth; Hadas-Halpern, Irith; Zalut, Todd; Yinnon, Amos M

    2010-01-01

    To assess the diagnostic value of the chest radiograph for the diagnosis of pneumonia in bedridden patients, using non-contrast-enhanced high-resolution chest computed tomography (CT) as the gold standard. We prospectively evaluated bedridden patients hospitalized with moderate to high clinical probability of pneumonia. Chest radiographs were interpreted in a blinded fashion by 3 observers and classified as definite, normal, or uncertain for pneumonia. Chest CT was obtained within 12 hours of chest radiograph. We applied Bayesian analysis to assess the accuracy of chest radiograph in the diagnosis of pneumonia. In a 5-month period, 58 patients were evaluated, 31 (53%) were female. Their chest radiographs were interpreted as negative, uncertain, or positive for pneumonia in 31 (53%), 15 (26%), and 12 (21%) patients, respectively, while CT confirmed pneumonia in 11 (35%), 10 (67%), and in 10 (83%). The sensitivity of the chest radiograph to diagnose pneumonia was 65%, the specificity was 93%, the positive and negative predictive values were, respectively, 83% and 65%, while the overall accuracy was 69% (95% confidence interval, 50%-79%). In bedridden patients with suspected pneumonia, a normal chest radiograph does not rule out the diagnosis, hence, a chest CT scan might provide valuable diagnostic information. Copyright 2010 Elsevier Inc. All rights reserved.

  13. 78 FR 53645 - Black Lung Benefits Act: Standards for Chest Radiographs

    Science.gov (United States)

    2013-08-30

    ...-AA07 Black Lung Benefits Act: Standards for Chest Radiographs AGENCY: Office of Workers' Compensation... connection with claims filed under the Black Lung Benefits Act. The comment period closed on August 12, 2013..., 2013, OWCP published the direct final rule, Black Lung Benefits Act: Standards for Chest Radiographs...

  14. Chest radiographic pulmonary changes reflecting extrapulmonary involvement in paediatric HIV disease

    International Nuclear Information System (INIS)

    Pitcher, Richard D.; Goddard, Elizabeth; Hendricks, Marc; Lawrenson, John

    2009-01-01

    Respiratory infections are the commonest cause of pulmonary change on chest radiographs of HIV-infected children. However, HIV-related neurological, oropharyngeal, oesophageal, cardiac and haematological abnormalities may also manifest with pulmonary changes and must be considered in the interpretation of the chest radiograph in HIV-infected children. (orig.)

  15. Utility of Chest Computed Tomography after a "Normal" Chest Radiograph in Patients with Thoracic Stab Wounds.

    Science.gov (United States)

    Nguyen, Brian M; Plurad, David; Abrishami, Sadaf; Neville, Angela; Putnam, Brant; Kim, Dennis Y

    2015-10-01

    Chest computed tomography (CCT) is used to screen for injuries in hemodynamically stable patients with penetrating injury. We aim to determine the incidence of missed injuries detected on CCT after a negative chest radiograph (CXR) in patients with thoracic stab wounds. A 10-year retrospective review of a Level I trauma center registry was performed on patients with thoracic stab wounds. Patients who were hemodynamically unstable or did not undergo both CXR and CCT were excluded. Patients with a negative CXR were evaluated to determine if additional findings were diagnosed on CCT. Of 386 patients with stab wounds to the chest, 154 (40%) underwent both CXR and CCT. One hundred and fifteen (75%) had a negative screening CXR. CCT identified injuries in 42 patients (37%) that were not seen on CXR. Pneumothorax and/or hemothorax occurred in 40 patients (35%), of which 14 patients underwent tube thoracostomy. Two patients had hemopericardium on CCT and both required operative intervention. Greater than one-third of patients with a normal screening CXR were found to have abnormalities on CCT. Future studies comparing repeat CXR to CCT are required to further define the optimal diagnostic strategy in patients with stab wounds to chest after normal screening CXR.

  16. Assessment of congestive heart failure in chest radiographs

    International Nuclear Information System (INIS)

    Henriksson, L.; Sundin, A.; Smedby, Oe.; Albrektsson, P.

    1990-01-01

    The effect of observer variations and film-screen quality on the diagnosis of congestive heart failure based on chest radiographs was studied in 27 patients. For each patient, two films were exposed, one with the Kodak Lanex Medium system and one with the Agfa MR 400 system. The films were presented to three observers who assessed the presence of congestive heart failure on a three-graded scale. The results showed no significant difference between the two systems but large systematic differences between the observers. There were also differences between the two ratings by the same observer that could not be explained by the film-screen factor. It is concluded that the choice between these two systems is of little importance in view of the interobserver and intraobserver variability that can exist within the same department. (orig.)

  17. Temporal subtraction of chest radiographs compensating pose differences

    Science.gov (United States)

    von Berg, Jens; Dworzak, Jalda; Klinder, Tobias; Manke, Dirk; Kreth, Adrian; Lamecker, Hans; Zachow, Stefan; Lorenz, Cristian

    2011-03-01

    Temporal subtraction techniques using 2D image registration improve the detectability of interval changes from chest radiographs. Although such methods are well known for some time they are not widely used in radiologic practice. The reason is the occurrence of strong pose differences between two acquisitions with a time interval of months to years in between. Such strong perspective differences occur in a reasonable number of cases. They cannot be compensated by available image registration methods and thus mask interval changes to be undetectable. In this paper a method is proposed to estimate a 3D pose difference by the adaptation of a 3D rib cage model to both projections. The difference between both is then compensated for, thus producing a subtraction image with virtually no change in pose. The method generally assumes that no 3D image data is available from the patient. The accuracy of pose estimation is validated with chest phantom images acquired under controlled geometric conditions. A subtle interval change simulated by a piece of plastic foam attached to the phantom becomes visible in subtraction images generated with this technique even at strong angular pose differences like an anterior-posterior inclination of 13 degrees.

  18. Pneumothorax detection in chest radiographs using convolutional neural networks

    Science.gov (United States)

    Blumenfeld, Aviel; Konen, Eli; Greenspan, Hayit

    2018-02-01

    This study presents a computer assisted diagnosis system for the detection of pneumothorax (PTX) in chest radiographs based on a convolutional neural network (CNN) for pixel classification. Using a pixel classification approach allows utilization of the texture information in the local environment of each pixel while training a CNN model on millions of training patches extracted from a relatively small dataset. The proposed system uses a pre-processing step of lung field segmentation to overcome the large variability in the input images coming from a variety of imaging sources and protocols. Using a CNN classification, suspected pixel candidates are extracted within each lung segment. A postprocessing step follows to remove non-physiological suspected regions and noisy connected components. The overall percentage of suspected PTX area was used as a robust global decision for the presence of PTX in each lung. The system was trained on a set of 117 chest x-ray images with ground truth segmentations of the PTX regions. The system was tested on a set of 86 images and reached diagnosis accuracy of AUC=0.95. Overall preliminary results are promising and indicate the growing ability of CAD based systems to detect findings in medical imaging on a clinical level accuracy.

  19. Evaluation of a low-dose neonatal chest radiographic system

    International Nuclear Information System (INIS)

    Burton, E.M.; Kirks, D.R.; Strife, J.L.; Henry, G.C.; Kereiakes, J.G.

    1988-01-01

    A new low-dose chest radiographic system for use in the neonatal nursery was evaluated. This test system, composed of a Du Pont Kevlar fiber-front cassette, Quanta fast-detail screen, Cronex 4L film (wide latitude), and additional yttrium filtration (0.1 mm), reduced the radiation dose in neonatal chest radiography by 69% (0.9 vs 2.9 mrad [0.009 vs 0.029 mGy]) as compared with a conventional system without added yttrium filtration; the thyroid dose was reduced by 76% (0.9 vs 3.7 mrad [0.009 vs 0.037 mGy]). The cumulative dose reduction was achieved through a combination of factors, including (1) beam hardening by the added yttrium filter, (2) increased X-ray transmission through the Kevlar cassette, and (3) a fast film-screen combination. Scatter radiation at distances of 1 and 6 ft. (0.3 and 1.8 m) was negligible for both systems. Image sharpness was compared for the conventional system with and without added yttrium filtration and for the Kevlar system with yttrium. Although sharpness of bony detail was unchanged by adding yttrium filtration to the conventional system, a decrease in sharpness was noted with the Kevlar system. Because image sharpness was affected in the test system, we are not using the Kevlar-Cronex 4L system for mobile chest radiography in the neonatal intensive care unit, despite dose reductions. However, further study is recommended to determine if there is a slower film-screen combination with yttrium filtration that will not degrade image sharpness

  20. Chest Radiographs for Pediatric TB Diagnosis: Interrater Agreement and Utility

    Directory of Open Access Journals (Sweden)

    G. Kaguthi

    2014-01-01

    Full Text Available The chest radiograph (CXR is considered a key diagnostic tool for pediatric tuberculosis (TB in clinical management and endpoint determination in TB vaccine trials. We set out to compare interrater agreement for TB diagnosis in western Kenya. A pediatric pulmonologist and radiologist (experts, a medical officer (M.O, and four clinical officers (C.Os with basic training in pediatric CXR reading blindly assessed CXRs of infants who were TB suspects in a cohort study. C.Os had access to clinical findings for patient management. Weighted kappa scores summarized interrater agreement on lymphadenopathy and abnormalities consistent with TB. Sensitivity and specificity of raters were determined using microbiologically confirmed TB as the gold standard (n=8. A total of 691 radiographs were reviewed. Agreement on abnormalities consistent with TB was poor; k=0.14 (95% CI: 0.10–0.18 and on lymphadenopathy moderate k=0.26 (95% CI: 0.18–0.36. M.O [75% (95% CI: 34.9%–96.8%] and C.Os [63% (95% CI: 24.5%–91.5%] had high sensitivity for culture confirmed TB. TB vaccine trials utilizing expert agreement on CXR as a nonmicrobiologically confirmed endpoint will have reduced specificity and will underestimate vaccine efficacy. C.Os detected many of the bacteriologically confirmed cases; however, this must be interpreted cautiously as they were unblinded to clinical features.

  1. Diagnostic value of the chest radiograph in asymptomatic neonates with a cardiac murmur

    International Nuclear Information System (INIS)

    Oeppen, R.S.; Fairhurst, J.J.; Argent, J.D.

    2002-01-01

    AIM: To establish the diagnostic accuracy and diagnostic usefulness of the chest radiograph in asymptomatic neonates with cardiac murmurs. PATIENTS AND METHODS: The chest radiographs of 68 asymptomatic neonates with cardiac murmurs were analysed retrospectively. The radiographs were anonymized and then evaluated for the presence or absence of cardiac disease by six radiologists, three who regularly interpret neonatal chest radiographs and three who do so infrequently. The eventual diagnosis for each neonate and the impact of the chest radiograph and original report on patient management were established by review of the clinical case notes. RESULTS: The results for each observer were expressed in 2 x 2 contingency tables and statistical analysis was performed using Fisher's exact test. The radiologists who were experienced in reporting neonatal chest radiographs achieved statistically significant results (P = 0.003, P = 0.002 andP = 0.007) compared with those who were less experienced (P = 0.13, P = 0.16 andP = 0.09). Review of the case notes established that the chest radiograph and original report did not influence clinical management in any of the 68 cases studied. CONCLUSIONS: Radiologists who frequently report neonatal chest radiographs achieve high accuracy in differentiating cardiac from non-cardiac disease. However, inaccuracies are unavoidable as radiological evidence of cardiac disease is often not present. A false-positive result could cause undue anxiety while a false-negative report could result in the omission of further investigations. Furthermore, a chest radiograph is unlikely to provide the definitive diagnosis. Chest radiographs did not appear to influence patient management in this study and cannot be recommended in the initial evaluation of the asymptomatic neonate with a heart murmur. Oeppen, R.S. et al. (2002)

  2. Radiographic findings of primary lung cancer with delayed detection on chest radiographs

    International Nuclear Information System (INIS)

    Kim, Young Min; Kim, Jin Hwan; Jung, Bin Young; Jun, Kwang Jin; Jeong, Ki Ho; Kim, Ju Ok; Kim, Sun Young; Yang, Chang Kyu

    1999-01-01

    To analyze the causes of delayed detection of lung cancer on chest radiographs. We retrospectively reviewed 105 cases in which an initial diagnosis of lung cancer, based on an examination of plain radiographs, had been missed or misinterpreted. All occurred between October 1993 and April 1997. We reviewed the initial chest radiographs and compared the features noted with those seen on later chest radiographs and computed tomographic (CT) images. Undetected lung cancer was identified in 56 patients (56/105, 53.3%) It had been hidden by superimposed structures (41, 73.2%), overlapped by combined benign diseases (12, 21.4%), or the nodules were subtle (3, 5.4%). Of the 41 lung cancers hidden by a superimposed structure, the central type accounted for 29 (70.7%) and the peripheral type for 12 (29.3%). The 29 central type had been hidden by the left hilum (n=15), the right hilum (n=10), the heart (n=3), or a rib (n=1). The twelve peripheral type were hidden by a rib (n=7), the heart (n=2), the diaphragm (n=2), or the left hilum (n=1). Of the 12 lung cancers overlapped by combined benign diseases, pulmonary tuberculosis (n=6), pleural effusion (n=4), congestive heart failure (n=1), and diffuse interstitial lung disease (n=1) were present at the time of interpretation. The misinterpreted lung cancers were identified in 49 patients (49/105, 46.7%) and were seen to be combined with benign disease (16, 32.6%), or as obstructive pneumonia without a central mass (15, 30.6%), air-space consolidation (7, 14.3%), cavity (7, 14.3%), double lesion (2, 4.1%), or young age below 26 years (2,4.1%). Of the 16 lung cancers misinterpreted as combined disease, pulmonary tuberculosis (n=14) and pleural disease (n=2) had been initially diagnosed. Most commonly, lung cancer was missed or misinterpreted because it was hidden by a normal structure or combined with a benign disease. Perceptual errors can be reduced by appropriate techniques and the scrutiny of trouble spots such as the

  3. Analysis the findings of chest radiograph and CT scan in 217 acute thoracic trauma

    International Nuclear Information System (INIS)

    Huang Shaoying

    2005-01-01

    Objective: To evaluate chest radiograph and CT scan in assessing acute thoracic trauma. Methods: Retrospectively analyzed the findings of chest radiograph and CT scan in 217 cases of acute thoracic trauma and positive rate of each modality was compared. Results: The positive rate of rib and clavicle fracture was higher in chest radiograph than these in CT scan. But the positive rate of chest wall hematoma, mediastinum and subcutaneous emphysema, pneumothorax, hydropneumothorax, damage of lung parenchyma and traumatic pulmonary atelectasis was higher in CT scan than those in chest radiograph. Conclusion: The application of the combined imaging modalities improves assessing of acute thoracic trauma, because the imaging manifestation of the lesion is various. (authors)

  4. Effect of volume-oriented versus flow-oriented incentive spirometry on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly.

    Science.gov (United States)

    Lunardi, Adriana C; Porras, Desiderio C; Barbosa, Renata Cc; Paisani, Denise M; Marques da Silva, Cibele C B; Tanaka, Clarice; Carvalho, Celso R F

    2014-03-01

    Aging causes physiological and functional changes that impair pulmonary function. Incentive spirometry is widely used for lung expansion, but the effects of volume-oriented incentive spirometry (VIS) versus flow-oriented incentive spirometry (FIS) on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly are poorly understood. We compared VIS and FIS in elderly subjects and healthy adult subjects. Sixteen elderly subjects (9 women, mean ± SD age 70.6 ± 3.9 y, mean ± SD body mass index 23.8 ± 2.5 kg/m(2)) and 16 healthy adults (8 women, mean ± age 25.9 ± 4.3 y, mean ± body mass index 23.6 ± 2.4 kg/m(2)) performed quiet breathing, VIS, and FIS in randomized sequence. Chest wall kinematics (via optoelectronic plethysmography) and inspiratory muscle activity (via surface electromyography) were assessed simultaneously. Synchrony between the superior thorax and abdominal motion was calculated (phase angle). In the elderly subjects both types of incentive spirometry increased chest wall volumes similarly, whereas in the healthy adult subjects VIS increased the chest wall volume more than did FIS. FIS and VIS triggered similar lower thoracoabdominal synchrony in the elderly subjects, whereas in the healthy adults FIS induced lower synchrony than did VIS. FIS required more muscle activity in the elderly subjects to create an increase in chest wall volume. Incentive spirometry performance is influenced by age, and the differences between elderly and healthy adults response should be considered in clinical practice.

  5. COMPUTER-AIDED DETECTION OF ACINAR SHADOWS IN CHEST RADIOGRAPHS

    Directory of Open Access Journals (Sweden)

    Tao Xu

    2013-05-01

    Full Text Available Despite the technological advances in medical diagnosis, accurate detection of infectious tuberculosis (TB still poses challenges due to complex image features and thus infectious TB continues to be a public health problem of global proportions. Currently, the detection of TB is mainly conducted visually by radiologists examining chest radiographs (CXRs. To reduce the backlog of CXR examination and provide more precise quantitative assessment, computer-aided detection (CAD systems for potential lung lesions have been increasingly adopted and commercialized for clinical practice. CADs work as supporting tools to alert radiologists on suspected features that could have easily been neglected. In this paper, an effective CAD system aimed for acinar shadow regions detection in CXRs is proposed. This system exploits textural and photometric features analysis techniques which include local binary pattern (LBP, grey level co-occurrence matrix (GLCM and histogram of oriented gradients (HOG to analyze target regions in CXRs. Classification of acinar shadows using Adaboost is then deployed to verify the performance of a combination of these techniques. Comparative study in different image databases shows that the proposed CAD system delivers consistent high accuracy in detecting acinar shadows.

  6. System for pathology categorization and retrieval in chest radiographs

    Science.gov (United States)

    Avni, Uri; Greenspan, Hayit; Konen, Eli; Sharon, Michal; Goldberger, Jacob

    2011-03-01

    In this paper we present an overview of a system we have been developing for the past several years for efficient image categorization and retrieval in large radiograph archives. The methodology is based on local patch representation of the image content, using a bag of visual words approach and similarity-based categorization with a kernel based SVM classifier. We show an application to pathology-level categorization of chest x-ray data, the most popular examination in radiology. Our study deals with pathology detection and identification of individual pathologies including right and left pleural effusion, enlarged heart and cases of enlarged mediastinum. The input from a radiologist provided a global label for the entire image (healthy/pathology), and the categorization was conducted on the entire image, with no need for segmentation algorithms or any geometrical rules. An automatic diagnostic-level categorization, even on such an elementary level as healthy vs pathological, provides a useful tool for radiologists on this popular and important examination. This is a first step towards similarity-based categorization, which has a major clinical implications for computer-assisted diagnostics.

  7. Determining symptoms for chest radiographs in patients with swine flu (H1N1)

    International Nuclear Information System (INIS)

    Al-Nakshabandi, Nizar A.

    2011-01-01

    The question arises about the chest X-ray findings and clinical symptoms in swine flu and about the most important clinical finding when correlated with the chest radiograph. Should physicians order a chest X-ray in each patient suspected of having swine flu? There were 179 patients with a high suspicion of swine flu. All 179 patients had an initial chest radiograph. As many as 65 males (representing 56% of the projected study population) had a normal chest radiograph, while 35 males (representing 55.6% of the study population) had an abnormal chest X-ray. As many as 51 females (representing 44% of the population) had a normal chest X-ray, while 20 females (representing 44% of the study population) had abnormal chest X-rays. Polymerase chain reaction (PCR) was not a determining factor for normal vs. abnormal chest X-ray (CXR). Rapid antigen test was not a determining factor for normal vs. abnormal CXR. Fever was not a determining factor for normal vs. abnormal CXR. Cough appears to be a determining factor for normal vs. abnormal CXR. Sore throat appears to be a determining factor for normal vs. abnormal CXR. Chest pain was not a determining factor for normal vs. abnormal CXR. Presence of cough with PCR was statistically significant. In my opinion, chest radiographs in patients with suspected H1N1 should only be obtained if there is a cough or sore throat. Other symptoms associated with H1N1 do not warrant a chest radiograph unless absolutely necessary

  8. An abnormal chest radiograph in a 6-year-old boy

    International Nuclear Information System (INIS)

    Jaber, Tariq M.

    2004-01-01

    An unexpected finding in a chest radiograph of a child with upper respiratory symptoms is presented as a clinical quiz. The condition is discussed the relevant literature is reviewed and summarized. (author)

  9. Diagnosis of hydrostatic versus increased permeability pulmonary edema with chest radiographic criteria in critically ILL patients

    International Nuclear Information System (INIS)

    Aberle, D.R.; Wiener-Kronish, J.P.; Webb, W.R.; Matthay, M.A.

    1987-01-01

    To evaluate chest radiographic criteria in distinguishing mechanisms of pulmonary edema, the authors studied 45 intubated patients with extensive edema. Edema type was clinically classified by the ratio of alveolar edema-to-plasma protein concentration in association with compatible clinical/hemodynamic parameters. Chest films were scored as hydrostatic, permeability, or mixed by three readers in blinded fashion based on cardiac size, vascular pedicle width, distribution of edema, effusions, peribronchial cuffs, septal lines, or air bronchograms. Overall radiographic score accurately identified 87% of patients with hydrostatic edema but only 60% of those with permeability edema. Edema distribution was most discriminating, with a patchy peripheral pattern relatively specific for clinical permeability edema. Hydrostatic features on chest radiograph were common with permeability edema, including effusions (36%), widened pedicle (56%), cuffs (72%), or septa (40%). The authors conclude that the chest radiograph is limited in distinguishing edema mechanism in the face of extensive pulmonary edema

  10. Variations in the accessory structures of the clavicle: findings at chest radiographs and dry bones

    International Nuclear Information System (INIS)

    Chung, Min Suk; Suh, Kyung Jin; Joo, Kang; Chung, In Hyuk

    1995-01-01

    To evaluate normal variations and thus to avoid confusion in differentiation from lesions of the accessory structures (rhomboid fossa, foramen for supraclavicular nerve, conoid tubercle) of the clavicle in chest radiographs. We studied the variations of the clavicle in 300 chest radiographs (134 men, 166 women) and 355 dry bones (right 166, left 189;151 men, 74 women, 130 unknown sex). In chest radiographs, the incidence of the depressed rhomboid fossa was 229 cases (39.5%; male 52.0%, female 29.9%); the flat type was 329 cases (56.9%; male 45.7%, female 65.7%); and the elevated type was 20 cases (3.5%;male 2.4%, female 4.3%). In the dry bones, the incidence of the depressed rhomboid fossa was 129 cases (57.3%; male 59.6%, female 52.7%); the flat type was 65 cases (28.9%; male 24.5%, female 37.8%); and the elevated type was 31 cases (13.8%; male 15.9%, female 9.5%). The incidence of the foramen for supraclavicular nerve was 0.8% in chest radiographs, and 1.4% in the dry bones. The incidence of the elevated conoid tubercle was 65.1% (male 64.0%, female 65.9%) in chest radiographs, and 96.9% (male 95.4%, female 100.0%) in the dry bones. The incidence of the depressed rhomboid fossa in chest radiographs was higher in men and the right clavicle. The incidence of flat rhomboid fossa in chest radiographs decreased according to increase of age. The foramen for supraclavicular nerve was occasionally found ( 0.8% in chest radiographs; 1.4% in the dry bones)

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

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    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

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

    International Nuclear Information System (INIS)

    Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song

    2010-01-01

    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

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

    International Nuclear Information System (INIS)

    Lee, Son Youl; Choi, Yo Won; Jeon, Seok Chol; Heo, Jeong Nam; Park, Choong Ki

    2007-01-01

    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

  14. Chest radiographic findings of tsutsugamushi disease and murine typhus in Chunchon

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Heung Chul; Han, Tae Giun; Jang, Won Ho; Hwang, Woo Chul; Park, Man Soo; Lee, Myoung Gu; Kim, Yoon Won [School of Medicine, Hallym University, Chuncheon (Korea, Republic of); Park, Choong Ki [College of Medicine, Hanyang University, Guri (Korea, Republic of)

    1995-06-15

    To evaluate the chest radiographic findings of rickettsial disease including murine typhus and tsutsugamushi disease in Chunchon. Chest radiographic films of 81 cases diagnosed as rickettsial disease(55 cases of tsutsugamushi disease, 26 cases of murine typhus) by immunofluorescence test were retrospectively analyzed. Main serotypes of Rickettsia tsutsugamushi were Gilliam and Karp. Incidence rate of tsutsugamushi disease was 2.1 times greater than that of murine typhus. Chest radiographs were abnormal in 63.6% of tsutsugamushi disease, and in 30.8% of murine typhus. Radiographic findings were Kerly's B line, reticulonodular densities, hilar enlargement, pleural effusion, and splenomegaly in both entities, but pulmonary consolidation was only found in tsutsugamushi disease. The patients with the abnormal radiographic findings were statistically well correlated with cardiomegaly ({rho} < 0.01) and azygos engorgement ({rho} < 0.05), as compared to the patients with normal radiographic findings. Radiographic findings of both murine typhus and tsutsugamushi disease were interstitial pattern. But the chest radiographs in patients with tsutsugamushi disease showed more severe pattern with higher rate of abnormality.

  15. Chest radiographic findings of tsutsugamushi disease and murine typhus in Chunchon

    International Nuclear Information System (INIS)

    Kim, Heung Chul; Han, Tae Giun; Jang, Won Ho; Hwang, Woo Chul; Park, Man Soo; Lee, Myoung Gu; Kim, Yoon Won; Park, Choong Ki

    1995-01-01

    To evaluate the chest radiographic findings of rickettsial disease including murine typhus and tsutsugamushi disease in Chunchon. Chest radiographic films of 81 cases diagnosed as rickettsial disease(55 cases of tsutsugamushi disease, 26 cases of murine typhus) by immunofluorescence test were retrospectively analyzed. Main serotypes of Rickettsia tsutsugamushi were Gilliam and Karp. Incidence rate of tsutsugamushi disease was 2.1 times greater than that of murine typhus. Chest radiographs were abnormal in 63.6% of tsutsugamushi disease, and in 30.8% of murine typhus. Radiographic findings were Kerly's B line, reticulonodular densities, hilar enlargement, pleural effusion, and splenomegaly in both entities, but pulmonary consolidation was only found in tsutsugamushi disease. The patients with the abnormal radiographic findings were statistically well correlated with cardiomegaly (ρ < 0.01) and azygos engorgement (ρ < 0.05), as compared to the patients with normal radiographic findings. Radiographic findings of both murine typhus and tsutsugamushi disease were interstitial pattern. But the chest radiographs in patients with tsutsugamushi disease showed more severe pattern with higher rate of abnormality

  16. Chest radiographic findings of tsutsugamushi disease and murine typhus in Chunchon

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Heung Chul; Han, Tae Giun; Jang, Won Ho; Hwang, Woo Chul; Park, Man Soo; Lee, Myoung Gu; Kim, Yoon Won [School of Medicine, Hallym University, Chuncheon (Korea, Republic of); Park, Choong Ki [College of Medicine, Hanyang University, Guri (Korea, Republic of)

    1995-06-15

    To evaluate the chest radiographic findings of rickettsial disease including murine typhus and tsutsugamushi disease in Chunchon. Chest radiographic films of 81 cases diagnosed as rickettsial disease(55 cases of tsutsugamushi disease, 26 cases of murine typhus) by immunofluorescence test were retrospectively analyzed. Main serotypes of Rickettsia tsutsugamushi were Gilliam and Karp. Incidence rate of tsutsugamushi disease was 2.1 times greater than that of murine typhus. Chest radiographs were abnormal in 63.6% of tsutsugamushi disease, and in 30.8% of murine typhus. Radiographic findings were Kerly's B line, reticulonodular densities, hilar enlargement, pleural effusion, and splenomegaly in both entities, but pulmonary consolidation was only found in tsutsugamushi disease. The patients with the abnormal radiographic findings were statistically well correlated with cardiomegaly ({rho} < 0.01) and azygos engorgement ({rho} < 0.05), as compared to the patients with normal radiographic findings. Radiographic findings of both murine typhus and tsutsugamushi disease were interstitial pattern. But the chest radiographs in patients with tsutsugamushi disease showed more severe pattern with higher rate of abnormality.

  17. Black Lung Benefits Act: standards for chest radiographs. Direct final rule; request for comments.

    Science.gov (United States)

    2013-06-13

    Physicians and adjudicators use chest radiographs (X-rays) as a tool in evaluating whether a coal miner suffers from pneumoconiosis (black lung disease). Accordingly, the Department's regulations implementing the Black Lung Benefits Act allow the submission of radiographs in connection with benefit claims and set out quality standards for their performance. These standards are currently limited to film radiographs. In recent years, many medical facilities have phased out film radiography in favor of digital radiography. This direct final rule updates the existing film-radiograph standards and provides parallel standards for digital radiographs. This rule also updates outdated terminology and removes certain obsolete provisions.

  18. Limited value of interlaced ECG-gated radiography in the presence of a normal chest radiograph

    International Nuclear Information System (INIS)

    Chen, J.T.T.; Ravin, C.E.; Handel, D.

    1984-01-01

    Twenty-seven patients with normal posteroanterior and lateral chest radiographs, who were undergoing cardiac catheterization because of symptoms strongly suggesting coronary artery disease, also had posteroanterior and lateral interlaced electrocardiogram-gated radiographs made. In 14 patients, the interlaced radiography system underestimated (suggested hypokinesia) the wall motion, which was normal on cardiac catheterization. In two cases the system overestimated the wall motion, in two others it both under- and overestimated the motion, and in only nine cases was the correlation correct. These data suggest that the technique is of limited application, particularly in cases in which the routine chest radiographs are normal

  19. Increased opacity of left pericardiac area on chest radiograph : correlation with CT findings and its frequency

    International Nuclear Information System (INIS)

    Lee, Seung Ik; Kim, Jeung Sook; Kwak, Jin Young; Ryu, Chang Woo; Yoon, Sam Hyun

    1998-01-01

    The purpose of this study was to evaluate the incidence of extrapericardial fat in the left cardiac border, and with regard to left extrapericardial fat, to correlate chest radiographs with CT scans. This study involved 132 consecutive patients who underwent chest PA and lateral radiographs, and chest CT scans. According to the results of chest PA radiograph, patients were divided into three groups: those with a clear left cardiac border; those with an indistinct left cardiac border; and those with an indistinct left cardiac border with increased density; cardiophrenic angle, as seen on lateral radiograph, the presence of increased density in the anterior cardiophrenic angle, as seen on lateral radiographs was evaluated. On the basis of the results of CT scanning, patients were classified into four groups according to the amount of left extrapericardial fat : negative, minimum, moderate, and maximum. Left extrapericardial fat, as seen on CT, was correlated with the conspicuity of left cardiac border seen on PA radiograph and the presence of increased density in the anterior cardiophrenic angle, as seen on lateral radiograph. The conspicuousness of the left cardiac border, as seen on PA chest radiograph, correlated with the presence of left extrapericardial fat, as seen on CT, and was related to the amount of left extrapericardial fat. Increased density of the anterior cardiophrenic angle, as seen on lateral radiographs, correlated with the presence of left extrapericardial fat on CT, but the absence of increased density on lateral radiograph corresponds to the absence or a minimal amount of left extrapericardial fat, as seen on CT. (author). 8 refs., 4 tabs., 3 figs

  20. The role of the follow-up chest radiograph in suspected non-accidental injury

    Energy Technology Data Exchange (ETDEWEB)

    Anilkumar, Adikesavalu; Fender, Laura J; Broderick, Nigel J; Somers, John M; Halliday, Katharine E [Nottingham University Hospital NHS Trust, Department of Radiology, Queen' s Medical Centre, Nottingham (United Kingdom)

    2006-03-15

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  1. The role of the follow-up chest radiograph in suspected non-accidental injury

    International Nuclear Information System (INIS)

    Anilkumar, Adikesavalu; Fender, Laura J.; Broderick, Nigel J.; Somers, John M.; Halliday, Katharine E.

    2006-01-01

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  2. A computerized method for automated identification of erect posteroanterior and supine anteroposterior chest radiographs

    International Nuclear Information System (INIS)

    Kao, E-Fong; Chou, Ming-Chung; Lin, Wei-Chen; Hsu, Jui-Sheng; Jaw, Twei-Shiun; Liu, Gin-Chung

    2011-01-01

    A computerized scheme was developed for automated identification of erect posteroanterior (PA) and supine anteroposterior (AP) chest radiographs. The method was based on three features, the tilt angle of the scapula superior border, the tilt angle of the clavicle and the extent of radiolucence in lung fields, to identify the view of a chest radiograph. The three indices A scapula , A clavicle and C lung were determined from a chest image for the three features. Linear discriminant analysis was used to classify PA and AP chest images based on the three indices. The performance of the method was evaluated by receiver operating characteristic analysis. The proposed method was evaluated using a database of 600 PA and 600 AP chest radiographs. The discriminant performances Az of A scapula , A clavicle and C lung were 0.878 ± 0.010, 0.683 ± 0.015 and 0.962 ± 0.006, respectively. The combination of the three indices obtained an Az value of 0.979 ± 0.004. The results indicate that the combination of the three indices could yield high discriminant performance. The proposed method could provide radiologists with information about the view of chest radiographs for interpretation or could be used as a preprocessing step for analyzing chest images.

  3. Chest radiographic abnormalities in HIV-infected African children: a longitudinal study.

    Science.gov (United States)

    Pitcher, Richard D; Lombard, Carl J; Cotton, Mark F; Beningfield, Stephen J; Workman, Lesley; Zar, Heather J

    2015-09-01

    There is limited knowledge of chest radiographic abnormalities over time in HIV-infected children in resource-limited settings. To investigate the natural history of chest radiographic abnormalities in HIV-infected African children, and the impact of antiretroviral therapy (ART). Prospective longitudinal study of the association of chest radiographic findings with clinical and immunological parameters. Chest radiographs were performed at enrolment, 6-monthly, when initiating ART and if indicated clinically. Radiographic abnormalities were classified as normal, mild or moderate severity and considered persistent if present for 6 consecutive months or longer. An ordinal multiple logistic regression model assessed the association of enrolment and time-dependent variables with temporal radiographic findings. 258 children (median (IQR) age: 28 (13-51) months; median CD4+%: 21 (15-24)) were followed for a median of 24 (18-42) months. 70 (27%) were on ART at enrolment; 130 (50%) (median age: 33 (18-56) months) commenced ART during the study. 154 (60%) had persistent severe radiographic abnormalities, with median duration 18 (6-24) months. Among children on ART, 69% of radiographic changes across all 6-month transition periods were improvements, compared with 45% in those not on ART. Radiographic severity was associated with previous radiographic severity (OR=120.80; 95% CI 68.71 to 212.38), lack of ART (OR=1.72; 95% CI 1.29 to 2.27), enrolment age ART was beneficial, reducing the risk of radiographic deterioration or increasing the likelihood of radiological improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Development of a fully automated adaptive unsharp masking technique in digital chest radiograph

    International Nuclear Information System (INIS)

    Abe, Katsumi; Katsuragawa, Shigehiko; Sasaki, Yasuo

    1991-01-01

    We are developing a fully automated adaptive unsharp masking technique with various parameters depending on regional image features of a digital chest radiograph. A chest radiograph includes various regions such as lung fields, retrocardiac area and spine in which their texture patterns and optical densities are extremely different. Therefore, it is necessary to enhance image contrast of each region by each optimum parameter. First, we investigated optimum weighting factors and mask sizes of unsharp masking technique in a digital chest radiograph. Then, a chest radiograph is automatically divided into three segments, one for the lung field, one for the retrocardiac area, and one for the spine, by using histogram analysis of pixel values. Finally, high frequency components of the lung field and retrocardiac area are selectively enhanced with a small mask size and mild weighting factors which are previously determined as optimum parameters. In addition, low frequency components of the spine are enhanced with a large mask size and adequate weighting factors. This processed image shows excellent depiction of the lung field, retrocardiac area and spine simultaneously with optimum contrast. Our image processing technique may be useful for diagnosis of chest radiographs. (author)

  5. Postoperative chest radiographic changes after on- and off-pump coronary surgery

    International Nuclear Information System (INIS)

    Narayan, P.; Caputo, M.; Jones, J.; Al-Tai, S.; Angelini, G.D.; Wilde, P.

    2005-01-01

    AIM: A variety of chest radiograph abnormalities are recognized after coronary artery bypass grafting (CABG). This study analyzes the appearance of preoperative and postoperative chest radiographs in two groups of patients undergoing myocardial revascularization with or without the use of cardiopulmonary bypass (CPB). METHODS: Chest radiographs (preoperative and at 1 day, 6 days and 6 to 8 weeks post operatively) were analyzed according to a detailed protocol in cases of conventional CABG on CPB (n=60) or off-pump coronary artery bypass (OPCAB) (n=60) surgery. On each film 17 different major potential postoperative abnormalities were analyzed. RESULTS: Clinical findings were similar in the two groups. Patients undergoing OPCAB surgery had decreased blood loss, decreased red cell and platelet transfusion, significantly lower intubation time and required less postoperative inotropic support compared with patients undergoing CPB. The CPB group had a significantly higher incidence of left band atelectasis than the OPCAB group (37.6% vs 17.5%, p=0.01) at 6 days postoperatively. There was no other statistically significant difference in any of the 16 remaining major chest radiograph findings between the two groups. CONCLUSION: Although OPCAB surgery is associated with improved clinical outcome compared with conventional CABG surgery, the analysis of postoperative chest radiographs demonstrated only a minor benefit as shown by a reduced degree of left band atelectasis in the OPCAB group

  6. Postoperative chest radiographic changes after on- and off-pump coronary surgery

    Energy Technology Data Exchange (ETDEWEB)

    Narayan, P. [Bristol Heart Institute, Bristol Royal Infirmary, Bristol (United Kingdom); Caputo, M. [Bristol Heart Institute, Bristol Royal Infirmary, Bristol (United Kingdom); Jones, J. [Department of Radiology, Bristol Royal Infirmary, Bristol (United Kingdom); Al-Tai, S. [Department of Radiology, Bristol Royal Infirmary, Bristol (United Kingdom); Angelini, G.D. [Bristol Heart Institute, Bristol Royal Infirmary, Bristol (United Kingdom); Wilde, P. [Department of Radiology, Bristol Royal Infirmary, Bristol (United Kingdom)]. E-mail: peter.wilde@ubht.swest.nhs.uk

    2005-06-01

    AIM: A variety of chest radiograph abnormalities are recognized after coronary artery bypass grafting (CABG). This study analyzes the appearance of preoperative and postoperative chest radiographs in two groups of patients undergoing myocardial revascularization with or without the use of cardiopulmonary bypass (CPB). METHODS: Chest radiographs (preoperative and at 1 day, 6 days and 6 to 8 weeks post operatively) were analyzed according to a detailed protocol in cases of conventional CABG on CPB (n=60) or off-pump coronary artery bypass (OPCAB) (n=60) surgery. On each film 17 different major potential postoperative abnormalities were analyzed. RESULTS: Clinical findings were similar in the two groups. Patients undergoing OPCAB surgery had decreased blood loss, decreased red cell and platelet transfusion, significantly lower intubation time and required less postoperative inotropic support compared with patients undergoing CPB. The CPB group had a significantly higher incidence of left band atelectasis than the OPCAB group (37.6% vs 17.5%, p=0.01) at 6 days postoperatively. There was no other statistically significant difference in any of the 16 remaining major chest radiograph findings between the two groups. CONCLUSION: Although OPCAB surgery is associated with improved clinical outcome compared with conventional CABG surgery, the analysis of postoperative chest radiographs demonstrated only a minor benefit as shown by a reduced degree of left band atelectasis in the OPCAB group.

  7. Measurement of hemothorax amount in patients with non-penetrating chest trauma by supine chest AP radiograph

    International Nuclear Information System (INIS)

    Han, Heon; Yang, Joo Hyun; Na, Myung Hoon; Baik, Hee Jong

    1994-01-01

    To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coeffcient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax

  8. Measurement of hemothorax amount in patients with non-penetrating chest trauma by supine chest AP radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Han, Heon; Yang, Joo Hyun; Na, Myung Hoon; Baik, Hee Jong [Chung-Ang Gil Hospital, Incheon (Korea, Republic of)

    1994-10-15

    To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coeffcient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax.

  9. Radiographers' performance in chest X-ray interpretation: the Nigerian experience

    Science.gov (United States)

    Egbe, N O; Akpan, B E

    2015-01-01

    Objective: To assess the performance of Nigerian radiographers in interpretation of plain chest radiographs and to assess whether age, years since qualification and sector of practice are associated with performance. Methods: A test set of 50 radiographs containing 23 cases with no pathology (normal) and 27 abnormal cases (cardiopulmonary conditions) independently confirmed by 3 radiologists were presented to 51 radiographers in a random order. Readers independently evaluated radiographs for absence or presence of disease and stated the location, radiographic features and diagnosis. Readers self-reported their age, years since qualification and sector of practice. Receiver operating characteristic was used to assess the performance. Mann–Whitney U test was used to assess whether age, years since qualification and sector of practice were associated with performance. Results: Mean location sensitivity was 88.9 [95% confidence interval (CI), 0.787–0.980]. Mean sensitivity and specificity were 76.9 (95% CI, 0.658–0.864) and 79.8 (95% CI, 0.658–0.864), respectively. Age was not associated with performance (p = 0.07). Number of years qualified as radiographer (p = 0.005) and private practice (p = 0.004) were positively associated with performance. Conclusion: Nigerian radiographers can correctly report chest radiographs to a reasonable standard, and performance is associated with number of years since qualification and the sector of practice. Advances in knowledge: There are less than 300 radiologists serving a Nigerian population of about 170 million; therefore, X-ray interpretation by radiographers deserves consideration. Nigerian radiographers have potential to interpret chest X-ray in the clinical setting, and this may significantly improve radiology service delivery in this region. PMID:25966290

  10. Examination of the constancy of the medium optical density of conventional chest radiographs

    International Nuclear Information System (INIS)

    Stieve, F.E.; Rupp, N.; Niederhofer, F.; Gfirtner, H.

    2002-01-01

    Purpose: To determine whether the medium optical density of conventional chest radiographs is constant. Materials and Methods: 47 PA chest radiographs were digitized to measure the optical density and its dynamic range of normal and pathologically altered lungs. Results: For constant exposure factors and a correctly positioned region of interest, the medium optical density deviates only minimal despite differences in AP chest diameter, entry dose and dynamic range, and is largely independent of the pathologic pulmonary findings. Conclusion: Digitization of the radiograph enables the determination of the physical parameters used to operate the imaging system, such as medium optical density, image contrast, image latitude and density distribution, in accordance to the guidelines of the German Medical Association. If the region of interest encompasses the clinically relevant region of the lung, the measured value of the optical density corresponds with only minor variation to the average value of the entire lung region. (orig.) [de

  11. Reader performance in detection of pneumothorax on conventional chest films versus computed radiographs

    International Nuclear Information System (INIS)

    Elam, E.A.; Hillman, B.J.; Fajardo, L.L.

    1990-01-01

    This paper evaluates the suitability of digital radiography for the detection of pneumothoraces, we compared radiologist' performance in four interpretation settings: conventional film-screen (FS) chest radiographs; small-format (8 x 6.5-inch) computed radiography (CR) (Toshiba); large-format (14 x 17-inch) CR; and CR images viewed on a digital workstation. Twenty-three frontal-view chest radiographs with pneumothoraces and 22 other chest radiographs, either normal or showing miscellaneous abnormalities, were read by six board-certified radiologist in each interpretation setting. We compared the sensitivity, specificity, and receiver operating characteristic (ROC) performances they achieved among the interpretation settings with the use of sequential paired t tests. To date, four readers have completed their reading of both the FS and the small-format CR films

  12. Digital training platform for interpreting radiographic images of the chest.

    Science.gov (United States)

    McLaughlin, L; Woznitza, N; Cairns, A; McFadden, S L; Bond, R; Hughes, C M; Elsayed, A; Finlay, D; McConnell, J

    2018-05-01

    Time delays and errors exist which lead to delays in patient care and misdiagnosis. Reporting clinicians follow guidance to form their own search strategy. However, little research has tested these training guides. With the use of eye tracking technology and expert input we developed a digital training platform to be used in chest image interpretation learning. Two sections of a digital training platform were planned and developed; A) a search strategy training tool to assist reporters during their interpretation of images, and B) an educational tool to communicate the search strategies of expert viewers to trainees by using eye tracking technology. A digital training platform for use in chest image interpretation was created based on evidence within the literature, expert input and two search strategies previously used in clinical practice. Images and diagrams, aiding translation of the platform content, were incorporated where possible. The platform is structured to allow the chest image interpretation process to be clear, concise and methodical. A search strategy was incorporated within the tool to investigate its use, with the possibility that it could be recommended as an evidence based approach for use by reporting clinicians. Eye tracking, a checklist and voice recordings have been combined to form a multi-dimensional learning tool, which has never been used in chest image interpretation learning before. The training platform for use in chest image interpretation learning has been designed, created and digitised. Future work will establish the efficacy of the developed approaches. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Yoo, S.-Y.; Kim, J.H.; Eo, H.; Jeon, T.Y.; Shin, K.E.; Shin, W.S.; Jung, H.N.; Kim, Y.-J.

    2011-01-01

    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.

  14. 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.

  15. The importance of plain radiographic signs for emergency aortography in blunt chest trauma

    International Nuclear Information System (INIS)

    Schumacher, K.A.; Trost, K.; Bargon, G.

    1983-01-01

    A retrospective study of plain radiographic findings in 11 patients with traumatic rupture of the aorta was conducted, and the results compared with the incidence of numerous chest x-rays signs previously described in 294 cases of angiographically proven thoracic aorta dissection. It is concluded that positive plain radiographic signs obtained from patients with blunt chest trauma reveal high sensitivity and may thus be used as an indication for emergency aortography. However, since this procedure lacks 100% specificity even those patients with normal x-ray findings but clinically and/or anamnestically adequate thoracic trauma should be submitted to aortography. (orig.) [de

  16. An investigation on comprehensive evaluation and standard of image quality of high voltage chest radiograph

    International Nuclear Information System (INIS)

    Yan Shulin; Li Shuopeng; Zhao Bo; Niu Yantao

    1998-01-01

    Purpose: Based on clinical diagnostic demand, patient irradiation dose and imaging technical parameters, to establish a comprehensive evaluation method and standard in chest radiograph. Methods: (1) From 10 normal chest radiographs, the authors selected the evaluation area on thoracic PA (posteroanterior) radiographs and set up standard for diagnostic demand; (2) Using chest CT scans of 20 males and 20 females, the authors calculated the ratio of lung field to mediastinum; (3) Selecting 100 chest films using 125 kVp, the authors measured the standard density values of each evaluation area; (4) Body surface irradiation doses of 478 normal adults were measured. Results: (1) Based on diagnostic demand, the authors confirmed 7 evaluation areas and 4 physical evaluation factors. At the same time, evaluation standards were obtained; (2) Comprehensive evaluation methods were established; (3) Standard height, weight and body surface irradiation dose of Chinese normal adults were investigated preliminarily. Conclusion: Based on the concept of comprehensive evaluation, investigation on the evaluation methods and standard in chest PA radiograph was carried out which might be taken as the foundation for future approach on nation-wide basis

  17. Acute chest syndrome of sickle cell disease: radiographic and clinical analysis of 70 cases

    International Nuclear Information System (INIS)

    Martin, L.; Buonomo, C.

    1997-01-01

    Background. Acute chest syndrome (ACS) is a pulmonary illness with fever, chest pain, leukocytosis and new pulmonary opacity in a patient with sickle cell disease. It is a common reason for hospitalization in sickle cell patients, and a significant cause of mortality. The etiology of ACS is unclear. Lung or bone infarction and infection, among other possible causes, have been proposed. Objective. We reviewed the chest radiographs and medical records of 41 patients with 70 episodes of ACS and correlated the clinical and radiographic courses in an attempt to better characterize and understand the syndrome. Results. In 87 % of episodes, no identifiable etiology of ACS was found. This group of patients had a median age of 14 years and showed dramatic clinical and radiographic improvement within 24 h of therapy. In the remainder of episodes (13 %), an identifiable etiology was found, usually bacterial pneumonia. These patients were younger than the group without an identifiable etiology (median age 2 years) and had a prolonged radiographic course of illness. Conclusion. The chest radiographs of children with ACS without an identifiable etiology have an extremely typical appearance and evolution. Only in cases which do not have this typical pattern should infection be suspected as the underlying cause. (orig.). With 3 figs

  18. Hematogenous candida pneumonia in major burn patients: plain chest radiograph and thin-section CT findings

    International Nuclear Information System (INIS)

    Kim, Hyo Heon; Lee, Eil Seong; Shim, Ya Seong; Kim, Ji Hun; Suh, Hong Kil; Cho, Sin Young; Kim, Dae Sun; Lee, Kil Woo; Kang, Ik Won

    1995-01-01

    To describe plain radiographic and thin-section CT findings of hematogenous candida pneumonia in major burn patients. We reviewed nine cases of hematogenous candida pneumonia in major burn patients who had positive blood culture for candida and findings of pneumonia on plain chest radiograph. On five of nine cases, thin-section CT was done. We evaluated retrospectively nine cases for onset, the pattern, distribution, and size of lesions on plain chest radiograph and thin-section CT. On plain chest radiograph, randomly distributed 2-10 mm nodules were seen in six cases(66%) and randomly distributed 10-15 mm consolidations in remaining three cases(33%). Lesion occurred in 11th to 75th post-burn day(average, 34th post-burn day). Other findings were cardiomegaly in three cases, atelectasis in three cases, and pulmonary edema in one case. Thin-section CT showed variable shaped subpleural nodules in all five cases. The size of nodules were 1-5 mm in two cases(40%) and 5-10 mm(60%) in three cases. Feeding vessel signs were seen in two cases. Other findings were atelectasis in three cases, cardiomegaly in three cases, ground-glass opacity and interlobular septal thickenings by pulmonary edema in two cases. Plain chest radiographic findings of hematogenous candida pneumonia in major burn patients are randomly distributed nodules or consolidations of variable size. Thin-section CT findings are variable shaped subpleural nodules less than 1 cm

  19. Monitoring the monitors: tubes and lines on chest radiographs

    International Nuclear Information System (INIS)

    Wunderbaldinger, P. . patrick.wunderbaldinger@univie.ac.at

    2001-01-01

    Chest radiography is essential to evaluate the placement and position of tubes and lines in patients treated in intensive care units, such as central venous and arterial catheters, endotracheal and nasogastric tubes, thorax drains, cardiac pacemakers and defibrillators. Radiologic findings with respect to normal positioning, wrong positioning, and complications are described and illustrated. (author)

  20. Assessment of airway compression on chest radiographs in children with pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Richter-Joubert, Lisel; Andronikou, Savvas; Workman, Lesley; Zar, Heather J.

    2017-01-01

    Because small, pliable paediatric airways are easily compressed by enlarged lymph nodes, detection of radiographic airway compression might be an objective criterion for diagnosing pulmonary tuberculosis. To investigate the frequency and inter-observer agreement of airway compression on chest radiographs in children with pulmonary tuberculosis compared to those with a different lower respiratory tract infection. Chest radiographs of children with suspected pulmonary tuberculosis were read by two readers according to a standardised format and a third reader when there was disagreement. Radiographs of children with proven pulmonary tuberculosis were compared to those with a different lower respiratory tract infection. We evaluated frequency and location of radiographic airway compression. Findings were correlated with human immunodeficiency virus (HIV) status and age. We assessed inter-observer agreement using kappa statistics. We reviewed radiographs of 505 children (median age 25.9 months, interquartile range [IQR] 14.3-62.2). Radiographic airway compression occurred in 54/188 (28.7%) children with proven pulmonary tuberculosis and in 24/317 (7.6%) children with other types of lower respiratory tract infection (odds ratio [OR] 4.9; 95% confidence interval [CI] 2.9-8.3). A higher frequency of radiographic airway compression occurred in infants (22/101, or 21.8%) compared to older children (56/404, or 13.9%; OR 1.7; 95% CI 1.0-3.0). We found no association between airway compression and HIV infection. Inter-observer agreement ranged from none to fair (kappa of 0.0-0.4). There is a strong association between airway compression on chest radiographs and confirmed pulmonary tuberculosis. However this finding's clinical use as an objective criterion for diagnosis of pulmonary tuberculosis in children is limited by poor inter-observer agreement. (orig.)

  1. Assessment of airway compression on chest radiographs in children with pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Richter-Joubert, Lisel [Groote Schuur Hospital and University of Cape Town, Department of Radiology, Cape Town (South Africa); Andronikou, Savvas [Groote Schuur Hospital and University of Cape Town, Department of Radiology, Cape Town (South Africa); Bristol Royal Hospital for Children and the University of Bristol, Department of Paediatric Radiology, Bristol (United Kingdom); Workman, Lesley; Zar, Heather J. [University of Cape Town, Department of Paediatrics and Child Health and MRC Unit on Child and Adolescent Health, Red Cross War Memorial Children' s Hospital, Cape Town (South Africa)

    2017-09-15

    Because small, pliable paediatric airways are easily compressed by enlarged lymph nodes, detection of radiographic airway compression might be an objective criterion for diagnosing pulmonary tuberculosis. To investigate the frequency and inter-observer agreement of airway compression on chest radiographs in children with pulmonary tuberculosis compared to those with a different lower respiratory tract infection. Chest radiographs of children with suspected pulmonary tuberculosis were read by two readers according to a standardised format and a third reader when there was disagreement. Radiographs of children with proven pulmonary tuberculosis were compared to those with a different lower respiratory tract infection. We evaluated frequency and location of radiographic airway compression. Findings were correlated with human immunodeficiency virus (HIV) status and age. We assessed inter-observer agreement using kappa statistics. We reviewed radiographs of 505 children (median age 25.9 months, interquartile range [IQR] 14.3-62.2). Radiographic airway compression occurred in 54/188 (28.7%) children with proven pulmonary tuberculosis and in 24/317 (7.6%) children with other types of lower respiratory tract infection (odds ratio [OR] 4.9; 95% confidence interval [CI] 2.9-8.3). A higher frequency of radiographic airway compression occurred in infants (22/101, or 21.8%) compared to older children (56/404, or 13.9%; OR 1.7; 95% CI 1.0-3.0). We found no association between airway compression and HIV infection. Inter-observer agreement ranged from none to fair (kappa of 0.0-0.4). There is a strong association between airway compression on chest radiographs and confirmed pulmonary tuberculosis. However this finding's clinical use as an objective criterion for diagnosis of pulmonary tuberculosis in children is limited by poor inter-observer agreement. (orig.)

  2. Segmentation of lung fields using Chan-Vese active contour model in chest radiographs

    Science.gov (United States)

    Sohn, Kiwon

    2011-03-01

    A CAD tool for chest radiographs consists of several procedures and the very first step is segmentation of lung fields. We develop a novel methodology for segmentation of lung fields in chest radiographs that can satisfy the following two requirements. First, we aim to develop a segmentation method that does not need a training stage with manual estimation of anatomical features in a large training dataset of images. Secondly, for the ease of implementation, it is desirable to apply a well established model that is widely used for various image-partitioning practices. The Chan-Vese active contour model, which is based on Mumford-Shah functional in the level set framework, is applied for segmentation of lung fields. With the use of this model, segmentation of lung fields can be carried out without detailed prior knowledge on the radiographic anatomy of the chest, yet in some chest radiographs, the trachea regions are unfavorably segmented out in addition to the lung field contours. To eliminate artifacts from the trachea, we locate the upper end of the trachea, find a vertical center line of the trachea and delineate it, and then brighten the trachea region to make it less distinctive. The segmentation process is finalized by subsequent morphological operations. We randomly select 30 images from the Japanese Society of Radiological Technology image database to test the proposed methodology and the results are shown. We hope our segmentation technique can help to promote of CAD tools, especially for emerging chest radiographic imaging techniques such as dual energy radiography and chest tomosynthesis.

  3. Early detection of thoracic spine fracture in the multiple-trauma patient: Findings on the initial anteroposterior chest radiograph

    International Nuclear Information System (INIS)

    Lawrason, J.N.; Novelline, R.A.; Rhea, J.T.; DeLuca, S.A.; Sacknoff, R.

    1987-01-01

    In the unconscious, multiple-trauma patient, thoracic spine fractures may be initially overlooked due to a combination of immediate concern given to more obvious injuries and a failure to carefully scrutinize the initial, often anteroposterior (AP) and portable chest radiograph. In a recent review of their cases the authors retrospectively identified primary or secondary signs of thoracic spine fracture in 80% of the initial chest radiographs of multiple-trauma patients with this injury. This paper reviews these obvious and subtle, bony and soft-tissue AP chest radiograph signs of thoracic spine fracture and compare them with matching spine radiographs, tomography, and CT

  4. Reporting instructions significantly impact false positive rates when reading chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, John W.; Brennan, Patrick C.; Mello-Thoms, Claudia; Lewis, Sarah J. [The University of Sydney, Medical Image Optimisation and Perception Group, Discipline of Medical Radiation Sciences, Faculty of Health Sciences, Lidcombe, NSW (Australia)

    2016-10-15

    To determine the impact of specific reporting tasks on the performance of radiologists when reading chest radiographs. Ten experienced radiologists read a set of 40 postero-anterior (PA) chest radiographs: 21 nodule free and 19 with a proven solitary nodule. There were two reporting conditions: an unframed task (UFT) to report any abnormality and a framed task (FT) reporting only lung nodule/s. Jackknife free-response operating characteristic (JAFROC) figure of merit (FOM), specificity, location sensitivity and number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) decisions were used for analysis. JAFROC FOM for tasks showed a significant reduction in performance for framed tasks (P = 0.006) and an associated decrease in specificity (P = 0.011) but no alteration to the location sensitivity score. There was a significant increase in number of FP decisions made during framed versus unframed tasks for nodule-containing (P = 0.005) and nodule-free (P = 0.011) chest radiographs. No significant differences in TP were recorded. Radiologists report more FP decisions when given specific reporting instructions to search for nodules on chest radiographs. The relevance of clinical history supplied to radiologists is called into question and may induce a negative effect. (orig.)

  5. Computer-aided Detection of Lung Cancer on Chest Radiographs: Effect on Observer Performance

    NARCIS (Netherlands)

    de Hoop, Bartjan; de Boo, Diederik W.; Gietema, Hester A.; van Hoorn, Frans; Mearadji, Banafsche; Schijf, Laura; van Ginneken, Bram; Prokop, Mathias; Schaefer-Prokop, Cornelia

    2010-01-01

    Purpose: To assess how computer-aided detection (CAD) affects reader performance in detecting early lung cancer on chest radiographs. Materials and Methods: In this ethics committee-approved study, 46 individuals with 49 computed tomographically (CT)-detected and histologically proved lung cancers

  6. Reporting instructions significantly impact false positive rates when reading chest radiographs

    International Nuclear Information System (INIS)

    Robinson, John W.; Brennan, Patrick C.; Mello-Thoms, Claudia; Lewis, Sarah J.

    2016-01-01

    To determine the impact of specific reporting tasks on the performance of radiologists when reading chest radiographs. Ten experienced radiologists read a set of 40 postero-anterior (PA) chest radiographs: 21 nodule free and 19 with a proven solitary nodule. There were two reporting conditions: an unframed task (UFT) to report any abnormality and a framed task (FT) reporting only lung nodule/s. Jackknife free-response operating characteristic (JAFROC) figure of merit (FOM), specificity, location sensitivity and number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) decisions were used for analysis. JAFROC FOM for tasks showed a significant reduction in performance for framed tasks (P = 0.006) and an associated decrease in specificity (P = 0.011) but no alteration to the location sensitivity score. There was a significant increase in number of FP decisions made during framed versus unframed tasks for nodule-containing (P = 0.005) and nodule-free (P = 0.011) chest radiographs. No significant differences in TP were recorded. Radiologists report more FP decisions when given specific reporting instructions to search for nodules on chest radiographs. The relevance of clinical history supplied to radiologists is called into question and may induce a negative effect. (orig.)

  7. Neonatal chest image quality addressed through training to enhance radiographer awareness

    Directory of Open Access Journals (Sweden)

    Hesta Friedrich-Nel

    2018-03-01

    Full Text Available Background: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to produce an image of optimal quality using optimal exposure techniques without repeating exposures, to keep neonatal radiation dose to a minimum.   Objectives: The aim of the study was to determine whether radiographers were producing optimal quality chest images and, if not, whether additional training could contribute to reaching this goal in the Free State Province of South Africa.   Methods: Neonatal chest image quality was determined in the Neonatal Intensive Care Unit by using a checklist based on and compiled from published guidelines to evaluate the quality of 450 randomly-selected images. Thereafter, a training programme was designed, based on the evaluation criteria of the checklist and image quality areas identified. The training also referred to positioning techniques that should be applied to ensure optimal image quality. After presentation of the training, 450 newly-produced neonatal chest images were evaluated. These images were selected through purposive sampling as this evaluation only included images of participating radiographers who completed the training.   Results: Image quality that showed significant improvement included a reduction in electrocardiogram lines superimposed on chest anatomy, a tendency to centre closer to thoracic vertebra four, and visible four-sided collimation on images. Image quality areas with no significant enhancement were the absence of lead markers and radiation shielding.   Conclusion: The study has shown that a training programme has the potential to improve neonatal chest image quality.

  8. Chest radiographic staging in allergic bronchopulmonary aspergillosis: relationship with immunological findings.

    LENUS (Irish Health Repository)

    Kiely, J L

    2012-02-03

    The question of whether a chest radiographic severity staging system could be correlated with standard blood\\/serum diagnostic indices in allergic bronchopulmonary aspergillosis (ABPA) was addressed in 41 patients. Asthma and positive Aspergillus fumigatus (AF) serology were considered essential diagnostic inclusion criteria. Eosinophil count, serum immunoglobulin (Ig)E and immediate skin hypersensitivity were also tested to grade patients as "definite" or "likely" ABPA. Definite cases had all five of these factors present, whereas likely cases had three or more. Chest radiographs were examined by experienced radiologists blinded to the clinical data. The six-stage radiographic score (0-5) was based on the severity and duration of changes seen: stage 0: normal; stage 1: transient hyperinflation; stage 2: transient minor changes; stage 3: transient major changes; stage 4: permanent minor changes; and stage 5: permanent major changes. Significant positive correlations (p<0.05) were observed between peak AF titres (expressed as an index), peak eosinophil count and radiographic severity stage. When considered as subgroups, these correlations approached, but did not reach, significance for the group with "likely" ABPA (n=28), but in the group with definite ABPA (n=13), there was a high correlation between radiographic score and peak AF index (r=0.59), as well as peak eosinophil count (r=0.62). This study suggests that the peak Aspergillus fumigatus index and eosinophil counts correlate best with the severity of radiographic stages in allergic bronchopulmonary aspergillosis. This chest radiographic staging system may be useful in the clinical assessment and management of patients with allergic bronchopulmonary aspergillosis, particularly in those patients with more severe radiographic stages.

  9. Phantom development for radiographic image optimization of chest, skull and pelvis examination for nonstandard patient

    International Nuclear Information System (INIS)

    Pina, D.R.; Duarte, S.B.; Ghilardi Netto, T.; Morceli, J.

    2009-01-01

    The construction of the adapted patient equivalent phantom (APEP) to simulate the X-ray scattering and absorption by chest, skull and pelvis of nonstandard patient in conventional radiographic equipment is presented. This APEP system is associated to the pre-existing realistic-analytic phantom (RAP) [Pina, D.R., Duarte, S.B., Ghilardi Netto, T., Trad, C. S., Brochi, M.A.C., Oliveira, S.C. de, 2004. Optimization of standard patient radiographic images for chest, skull and pelvis exams in conventional X-ray equipment. Phys. Med. Biol. 49, N215-N226] forming the coupled phantom (RAP-APEP), which is used to establish an optimization process of radiographic images of chest, skull and pelvis for nonstandard patients. A chart of the optimized radiographic technique is established covering a wide range of nonstandard patient thickness, and offering a dose reduction in comparison with those techniques currently used. Different validation processes were applied to confirm the improving of the radiographic image quality when techniques of the established chart are used

  10. Prototype system for enhancement of frontal chest radiographs using eigenimage processing

    International Nuclear Information System (INIS)

    Butler, A.; Bones, P.; Hurrell, M.

    2008-01-01

    A prototype system is described for enhancement of radiographic images in the eigen domain. The images chosen to enhance are frontal chest radiographs. This class of images has been chosen because it is both a clinically important examination and an example of the high-resolution images used within radiology. The enhancement method is based on principal components analysis, a multivariate statistical technique first used within image processing for face recognition. The method requires a training set of normal images to identify normal patterns of variance. The enhancement process then removes these normal patterns of variance, often increasing the relative intensity of pathologies. Enhanced images presented in this paper include a range of common pathologies found on chest radiographs. Details of implementation, computing expense and possible applications within radiology are discussed.

  11. Computer-aided Detection Fidelity of Pulmonary Nodules in Chest Radiograph

    Directory of Open Access Journals (Sweden)

    Nikolaos Dellios

    2017-01-01

    Full Text Available Aim: The most ubiquitous chest diagnostic method is the chest radiograph. A common radiographic finding, quite often incidental, is the nodular pulmonary lesion. The detection of small lesions out of complex parenchymal structure is a daily clinical challenge. In this study, we investigate the efficacy of the computer-aided detection (CAD software package SoftView™ 2.4A for bone suppression and OnGuard™ 5.2 (Riverain Technologies, Miamisburg, OH, USA for automated detection of pulmonary nodules in chest radiographs. Subjects and Methods: We retrospectively evaluated a dataset of 100 posteroanterior chest radiographs with pulmonary nodular lesions ranging from 5 to 85 mm. All nodules were confirmed with a consecutive computed tomography scan and histologically classified as 75% malignant. The number of detected lesions by observation in unprocessed images was compared to the number and dignity of CAD-detected lesions in bone-suppressed images (BSIs. Results: SoftView™ BSI does not affect the objective lesion-to-background contrast. OnGuard™ has a stand-alone sensitivity of 62% and specificity of 58% for nodular lesion detection in chest radiographs. The false positive rate is 0.88/image and the false negative (FN rate is 0.35/image. From the true positive lesions, 20% were proven benign and 80% were malignant. FN lesions were 47% benign and 53% malignant. Conclusion: We conclude that CAD does not qualify for a stand-alone standard of diagnosis. The use of CAD accompanied with a critical radiological assessment of the software suggested pattern appears more realistic. Accordingly, it is essential to focus on studies assessing the quality-time-cost profile of real-time (as opposed to retrospective CAD implementation in clinical diagnostics.

  12. Detection of lung cancer on the chest radiograph: a study on observer performance

    International Nuclear Information System (INIS)

    Quekel, Lorentz G.B.A.; Kessels, Alphons G.H.; Goei, Reginald; Engelshoven, Joseph M.A. van

    2001-01-01

    Study objectives: to study the validity and observers consistency in the detection of lung cancer on the chest radiograph. Materials and methods: the chest radiographs of 100 clinical cases were interpreted by 14 observers. The radiographs were obtained from 30 patients with initially missed but histopathologically proven non-small cell lung cancer (NSCLC), 35 patients with other cardiopulmonary diseases and 35 patients with no abnormalities. The observers consisted of ten experienced radiologists, two-experienced chest physicians and two residents in radiology. All observers were unaware of the study design. The validity and observer consistency was determined for each observer. Results: the mean sensitivity and specificity of the ten radiologists were 0.36 and 0.90. For the two chest physicians, the mean sensitivity and specificity were 0.29 and 0.96. For the two residents in radiology, mean sensitivity and specificity were 0.25 and 0.94. The mean interobserver kappa and mean intraobserver kappa for the radiologists were 0.38 and 0.54. For the two chest physicians, the mean interobserver kappa was 0.43, while the intraobserver kappa was 0.59. For the two residents in radiology, mean interobserver kappa was 0.35 and the intraobserver kappa was 0.42. There was no significant relation between the consistency parameters and validity parameters. The interobserver and intraobserver kappa values showed good correlation. Conclusion: the validity of the chest radiograph and observers consistency in the detection of nodular lung cancer varies widely. The level of experience is likely to influence the diagnostic performance

  13. 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)

  14. Accuracy of chest radiographs in the emergency diagnosis of heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Studler, Ueli; Kretzschmar, Martin; Steinbrich, Wolfgang [University Hospital Basel, Department of Radiology, Basel (Switzerland); Christ, Michael; Breidthardt, Tobias; Noveanu, Markus; Perruchoud, Andre P.; Mueller, Christian [University Hospital Basel, Department of Internal Medicine, Basel (Switzerland); Schoetzau, Andreas [Institute of Biostatistics, Basel (Switzerland)

    2008-08-15

    The purpose of this study was to determine the diagnostic accuracy of chest radiographic findings of heart failure (HF) in current patients presenting with dyspnea in the emergency department. In a secondary analysis of the BASEL study, initial chest radiographs of 277 patients with acute dyspnea were evaluated by two radiologists blinded to the adjudicated diagnosis (56% had the final diagnosis of HF). Predefined radiographic criteria of HF were used. Statistical analysis included receiver-operating characteristic (ROC) analysis and calculation of a logistic regression model including B-type natriuretic peptide (BNP) levels. The reader's overall impression showed the highest area under the ROC curve for the diagnosis of HF in both supine and erect patient positions (0.855 and 0.857). Among individual radiographic findings, peribronchial cuffing in the supine position (0.829) showed the highest accuracies. The lowest accuracy was found for the vascular pedicle width in the supine position (0.461). Logistic regression analysis showed no significant differences between the reader's overall impression, the radiographic model, and BNP testing. In our study, the combination of radiographic features provided valuable information and was of comparable accuracy as BNP-testing for the diagnosis of HF. (orig.)

  15. The oblique interface in the right cardiophrenic angle: chest radiographic-CT correlation

    International Nuclear Information System (INIS)

    Kim, Jeung Sook; Lee, Kyung Soo; Choo, Sung Wook; Choo, In Wook

    1996-01-01

    An oblique interface in the right cardiophrenic angle, extending superomedially from right retrocardiac or supradiaphragmatic region inferolaterally to peridiaphragmatic region, is occasionally observed on posteroanterior chest radiograph. The aim of this study was to evaluate the frequency of visualization of the interface on chest radiographs and to elucidate its nature on radiographic-CT correlation. Posteroanterior chest radiographs from 300 consecutive subjects were analyzed to evaluate the frequency and demographic data about an oblique interface in the right cardiophrenic angle. Thin-section CT scans(1-mm collimation and 5-mm intervals) were obtained from the subjects with positive interface on chest radiograph for assessment of the nature of the interface. The demographic data in the subjects with and without the interface were tested statistically to note any difference between two groups. Oblique interface in the right cardiophrenic angle was present in 29 subjects(9.7%) on chest radiograph. The age of the subjects with positive interface(13 men and 16 women) ranged from 19 to 70 years(mean±SD, 47±12.7 years) whereas the age of the subjects without the interface from 16 to 82 years (mean±SD, 50±9.1 years)(p>0.1). The body weight of the subjects with the interface ranged from 41 to 72 Kg(mean±SD, 60±8.0Kg) whereas the body weight of the subjects without the interface from 41 to 85Kg(mean±SD, 63±10.1Kg)(p>0.1). On CT scan, it was formed due to contact between the epipericardial fat and the right middle lobe of the lung in 27 subjects(93%) and between the inferior vena cava and the medial basal segment of the right lower lobe of the lung in two(7%). Oblique interface in the right cardiophrenic angle is occasionally visualized on chest radiograph. It is formed due to contact between the right middle lobe of the lung and pericardial fat in most cases. The frequency of visualization of the interface has no relationship to age and body weight of the

  16. Interpretation of chest radiographs with a high-resolution (2,000 x 2,000 x 12 bit) display

    International Nuclear Information System (INIS)

    Cox, G.G.

    1989-01-01

    This paper presents an evaluation of high-resolution (2K x 2Kx 12 bit) display for interpretation of chest radiographs. Three radiologists chose a total of 165 chest radiographs to ensure representation of nine signs: apical pleural scarring, chronic obstructive pulmonary disease, interstitial processes, atelectasis, pneumothorax, hilar mass, pleural effusion, pneumonia, and nodules. Each chest film was digitized to 4Kx 4Kx 12 bit and averaged to 2Kx 2Kx 12 bit and printed on a laser film printer. The 2K x 2K x 12-bit images were displayed and interactively windowed on a 2K x 2K x 12-bit high-resolution gray-scale cathode ray tube display. Six radiologists, none of whom participated in the case selection process, then interpreted a mixture of the screen film chest radiographs, the laser printed 2K chest radiographs, and the high resolution displayed 2K images

  17. Local-global classifier fusion for screening chest radiographs

    Science.gov (United States)

    Ding, Meng; Antani, Sameer; Jaeger, Stefan; Xue, Zhiyun; Candemir, Sema; Kohli, Marc; Thoma, George

    2017-03-01

    Tuberculosis (TB) is a severe comorbidity of HIV and chest x-ray (CXR) analysis is a necessary step in screening for the infective disease. Automatic analysis of digital CXR images for detecting pulmonary abnormalities is critical for population screening, especially in medical resource constrained developing regions. In this article, we describe steps that improve previously reported performance of NLM's CXR screening algorithms and help advance the state of the art in the field. We propose a local-global classifier fusion method where two complementary classification systems are combined. The local classifier focuses on subtle and partial presentation of the disease leveraging information in radiology reports that roughly indicates locations of the abnormalities. In addition, the global classifier models the dominant spatial structure in the gestalt image using GIST descriptor for the semantic differentiation. Finally, the two complementary classifiers are combined using linear fusion, where the weight of each decision is calculated by the confidence probabilities from the two classifiers. We evaluated our method on three datasets in terms of the area under the Receiver Operating Characteristic (ROC) curve, sensitivity, specificity and accuracy. The evaluation demonstrates the superiority of our proposed local-global fusion method over any single classifier.

  18. Digital chest radiography: flat-panel detectors or conventional radiographs

    International Nuclear Information System (INIS)

    Schaefer-Prokop, C.; Uffmann, M.; Sailer, J.; Kabalan, N.; Herold, C.; Prokop, M.

    2003-01-01

    Flat panel detectors are characterized by improved handling and increased dose efficiency. This allows for increasing of work flow efficiency and for reducing the exposure dose by about 50% compared to current systems with a sensitivity of 400. Whether the increased dose efficiency should be used to reduce acquisition dose or to increase image quality in the chest, will be shown by further clinical experience and will be also determined by the subjective preference of the radiologists. The decreased level of image noise opens new perspectives for image processing that way that elaborated multifrequency processing allows for optimizing the display of very small and low contrast structures that was so far limited by overlying image noise. Specialized applications of dual energy subtraction and temporal subtraction will also profit by the new detector technology and will be further driven forward in context with applications such as computed assisted diagnosis even though this is currently not yet broadly applied. Storage phosphor radiography still represents an important alternative technique based on its larger flexibility with respect to equipment configuration, its broader application options in intensive care and emergency radiology and due to economic reasons. These facts are further underlined by the fact that image quality also in storage phosphor radiography could be constantly increased by improving detector technology and image processing and consequently has a high standard. (orig.) [de

  19. Localizing tuberculosis in chest radiographs with deep learning

    Science.gov (United States)

    Xue, Zhiyun; Jaeger, Stefan; Antani, Sameer; Long, L. Rodney; Karargyris, Alexandros; Siegelman, Jenifer; Folio, Les R.; Thoma, George R.

    2018-03-01

    Chest radiography (CXR) has been used as an effective tool for screening tuberculosis (TB). Because of the lack of radiological expertise in resource-constrained regions, automatic analysis of CXR is appealing as a "first reader". In addition to screening the CXR for disease, it is critical to highlight locations of the disease in abnormal CXRs. In this paper, we focus on the task of locating TB in CXRs which is more challenging due to the intrinsic difficulty of locating the abnormality. The method is based on applying a convolutional neural network (CNN) to classify the superpixels generated from the lung area. Specifically, it consists of four major components: lung ROI extraction, superpixel segmentation, multi-scale patch generation/labeling, and patch classification. The TB regions are located by identifying those superpixels whose corresponding patches are classified as abnormal by the CNN. The method is tested on a publicly available TB CXR dataset which contains 336 TB images showing various manifestations of TB. The TB regions in the images were marked by radiologists. To evaluate the method, the images are split into training, validation, and test sets with all the manifestations being represented in each set. The performance is evaluated at both the patch level and image level. The classification accuracy on the patch test set is 72.8% and the average Dice index for the test images is 0.67. The factors that may contribute to misclassification are discussed and directions for future work are addressed.

  20. Radiographic, CT and MRI spectrum of hydatid disease of the chest: a pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Sinner, W.N. von [Dept. of Radiology MBC28, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1993-01-01

    Thirty patients with thoracic hydatidosis (Echinococcus granulosus) were studied. The hydatid cysts were located in the lung parenchyma (70%), mediastinum (6.7%), inside the heart (10%), the pleurae (10%) and the chest wall (3.3%). Complications of thoracic hydatid cysts, such as rupture, infection, pleural involvement, spread and calcifications are presented. Computed tomography (CT) without and/or with contrast enhancement was performed in all patients (30). Findings from conventional chest radiographs were compared with CT and confirmed by pathology (30). In 10 cases (33.3%), magnetic resonance imaging was also performed. The diagnostic spectrum of hydatid cysts, including variations and developmental stages, is presented in this pictorial essay. (orig.)

  1. Validation of the plain chest radiograph for epidemiologic studies of airflow obstruction

    International Nuclear Information System (INIS)

    Musk, A.W.

    1982-01-01

    The chest radiographs of 125 industrial workers from rural New South Wales were examined for overinflated lungs, with and without attenuated midzonal vessels. Although the mean values of a comprehensive range of pulmonary function tests in the whole group were within normal limits, the nine subjects whose radiographs showed overinflated lungs and attenuated vessels had significantly impaired pulmonary function in comparison with 85 subjects with normal radiographs. The mean values for these nine subjects, expressed as a percentage of the mean value for subjects with normal radiographs, were: forced expiratory volume in 1 second, 75%; total lung capacity, 107%; residual volume, 143%; transpulmonary pressure at maximum inspiration, 60%; static deflation compliance, 158%; lung volume at transpulmonary pressure 10 cm H 2 O, 132%; transfer factor, 79%; and transfer factor/alveolar volume, 77%. Similar results were obtained by a second observer. Those subjects with overinflation but no vascular attenuation had significantly larger mean values for vital capacity and alveolar volume but no significant difference in total lung capacity or other tests of the mechanical properties of the lungs. Agreement on the presence of a positive sign between the two observers expressed as a percentage of those considered positive by either was 81% for overinflation and 62% for attenuated midzonal vessels. The results indicate that in groups of subjects with normal-average values of pulmonary function, the plain chest radiograph may provide information concerning pulmonary structure that is reflected in tests of function

  2. Imaging of implants on chest radiographs: a radiological perspective

    International Nuclear Information System (INIS)

    Burney, K.; Thayur, N.; Husain, S.A.; Martin, R.P.; Wilde, P.

    2007-01-01

    Endovascular and percutaneous techniques have emerged as alternatives to surgical management in the treatment for a wide range of congenital and acquired cardiac, non-vascular and vascular conditions. Consequently, there has been an increasing use of implants such as closure devices, vascular stents (coronary, aortic, pulmonary and superior vena cava) and non-vascular stents like oesophageal and tracheo-bronchial stents. A large number of percutaneously sited implants are used for treating congenital cardiac anomalies such as atrial septal defects (ASD), ventricular septal defects (VSD), and patent ductus arteriosus (PDA). These implants take many shapes and forms. The aim of this review is to demonstrate the radiographic appearances of the various types of cardiovascular, bronchial and oesophageal implants that are visible on plain films. A brief outline of the aims and indications of various implant procedures, the general appearance of the commonest types of implants, and the radiological procedures are discussed. All radiologists are likely to come across implanted devices in plain film reporting. Imaging can be useful in identifying the device, assessing the position, integrity, and for the identification of complications related directly to the implant

  3. Imaging of implants on chest radiographs: a radiological perspective

    Energy Technology Data Exchange (ETDEWEB)

    Burney, K [Department of Clinical Radiology, Bristol Royal Infirmary (United Kingdom); Thayur, N [Department of Clinical Radiology, Bristol Royal Infirmary (United Kingdom); Husain, S A [Department of Respiratory Medicine, Bristol Royal Infirmary (United Kingdom); Martin, R P [Department of Cardiology, Bristol Royal Hospital for Children, Bristol (United Kingdom); Wilde, P [Department of Clinical Radiology, Bristol Royal Infirmary (United Kingdom)

    2007-03-15

    Endovascular and percutaneous techniques have emerged as alternatives to surgical management in the treatment for a wide range of congenital and acquired cardiac, non-vascular and vascular conditions. Consequently, there has been an increasing use of implants such as closure devices, vascular stents (coronary, aortic, pulmonary and superior vena cava) and non-vascular stents like oesophageal and tracheo-bronchial stents. A large number of percutaneously sited implants are used for treating congenital cardiac anomalies such as atrial septal defects (ASD), ventricular septal defects (VSD), and patent ductus arteriosus (PDA). These implants take many shapes and forms. The aim of this review is to demonstrate the radiographic appearances of the various types of cardiovascular, bronchial and oesophageal implants that are visible on plain films. A brief outline of the aims and indications of various implant procedures, the general appearance of the commonest types of implants, and the radiological procedures are discussed. All radiologists are likely to come across implanted devices in plain film reporting. Imaging can be useful in identifying the device, assessing the position, integrity, and for the identification of complications related directly to the implant.

  4. Diagnostic significance of gallium lung uptake in patients with normal chest radiographs

    International Nuclear Information System (INIS)

    MacMahon, H.; Bekerman, C.

    1978-01-01

    Nine patients were encountered with normal chest radiographs, but diffuse bilateral lung uptake of 67 Ga-citrate. They were divided into three groups. The first consisted of 6 patients who had lymphoma or leukemia and had had multiple cycles of chemotherapy. Here, abnormal uptake may have resulted from a toxic effect of the drugs or from a low-grade, subclinical infectious process. The 2 patients in the second group were drug addicts and a subradiographic interstitial inflammatory reaction was probably responsible for abnormal uptake. The last patient had diffuse uptake of 67 Ga-citrate throughout the lungs two weeks before lymphomatous infiltrates became radiographically visible

  5. Evaluation of pneumonia in children: comparison of MRI with fast imaging sequences at 1.5T with chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Yikilmaz, Ali; Koc, Ali; Coskun, Abdulhakim (Dept. of Radiology, Erciyes Medical School, Kayseri (Turkey)); Ozturk, Mustafa K (Dept. of Pediatric Infectious Diseases, Erciyes Medical School, Kayseri (Turkey)); Mulkern, Robert V; Lee, Edward Y (Dept. of Radiology and Dept. of Medicine, Pulmonary Div., Children' s Hospital Boston and Harvard Medical School, Boston (United States)), email: Edward.lee@childrens.harvard.edu

    2011-10-15

    Background Although there has been a study aimed at magnetic resonance imaging (MRI) evaluation of pneumonia in children at a low magnetic field (0.2T), there is no study which assessed the efficacy of MRI, particularly with fast imaging sequences at 1.5T, for evaluating pneumonia in children. Purpose To investigate the efficacy of chest MRI with fast imaging sequences at 1.5T for evaluating pneumonia in children by comparing MRI findings with those of chest radiographs. Material and Methods This was an Institutional Review Board-approved, HIPPA-compliant prospective study of 40 consecutive pediatric patients (24 boys, 16 girls; mean age 7.3 years +- 6.6 years) with pneumonia, who underwent PA and lateral chest radiographs followed by MRI within 24 h. All MRI studies were obtained in axial and coronal planes with two different fast imaging sequences: T1-weighted FFE (Fast Field Echo) (TR/TE: 83/4.6) and T2-weighted B-FFE M2D (Balanced Fast Field Echo Multiple 2D Dimensional) (TR/TE: 3.2/1.6). Two experienced pediatric radiologists reviewed each chest radiograph and MRI for the presence of consolidation, necrosis/abscess, bronchiectasis, and pleural effusion. Chest radiograph and MRI findings were compared with Kappa statistics. Results All consolidation, lung necrosis/abscess, bronchiectasis, and pleural effusion detected with chest radiographs were also detected with MRI. There was statistically substantial agreement between chest radiographs and MRI in detecting consolidation (k = 0.78) and bronchiectasis (k = 0.72) in children with pneumonia. The agreement between chest radiographs and MRI was moderate for detecting necrosis/abscess (k = 0.49) and fair for detecting pleural effusion (k = 0.30). Conclusion MRI with fast imaging sequences is comparable to chest radiographs for evaluating underlying pulmonary consolidation, bronchiectasis, necrosis/abscess, and pleural effusion often associated with pneumonia in children

  6. Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

    Energy Technology Data Exchange (ETDEWEB)

    Lanzman, Rotem S.; Blondin, Dirk; Furst, Gunter; Scherer, Axel; R Miese, Falk; Kroepil, Patric [University of Duesseldorf, Medical Faculty, 40225 Duesseldorf (Germany); Winter, Joachim [University Hospital Duesseldorf, 40225 Duesseldorf (Germany); Abbara, Suhny [Massachusetts General Hospital, Boston, MA (US)

    2011-10-15

    Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein.

  7. Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

    International Nuclear Information System (INIS)

    Lanzman, Rotem S.; Blondin, Dirk; Furst, Gunter; Scherer, Axel; R Miese, Falk; Kroepil, Patric; Winter, Joachim; Abbara, Suhny

    2011-01-01

    Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein.

  8. Computer-Aided Detection of Malignant Lung Nodules on Chest Radiographs: Effect on Observers' Performance

    International Nuclear Information System (INIS)

    Lee, Kyung Hee; Goo, Jin Mo; Park, Chang Min; Lee, Hyun Ju; Jin, Kwang Nam

    2012-01-01

    To evaluate the effect of computer-aided detection (CAD) system on observer performance in the detection of malignant lung nodules on chest radiograph. Two hundred chest radiographs (100 normal and 100 abnormal with malignant solitary lung nodules) were evaluated. With CT and histological confirmation serving as a reference, the mean nodule size was 15.4 mm (range, 7-20 mm). Five chest radiologists and five radiology residents independently interpreted both the original radiographs and CAD output images using the sequential testing method. The performances of the observers for the detection of malignant nodules with and without CAD were compared using the jackknife free-response receiver operating characteristic analysis. Fifty-nine nodules were detected by the CAD system with a false positive rate of 1.9 nodules per case. The detection of malignant lung nodules significantly increased from 0.90 to 0.92 for a group of observers, excluding one first-year resident (p = 0.04). When lowering the confidence score was not allowed, the average figure of merit also increased from 0.90 to 0.91 (p = 0.04) for all observers after a CAD review. On average, the sensitivities with and without CAD were 87% and 84%, respectively; the false positive rates per case with and without CAD were 0.19 and 0.17, respectively. The number of additional malignancies detected following true positive CAD marks ranged from zero to seven for the various observers. The CAD system may help improve observer performance in detecting malignant lung nodules on chest radiographs and contribute to a decrease in missed lung cancer.

  9. Foreign object detection and removal to improve automated analysis of chest radiographs

    International Nuclear Information System (INIS)

    Hogeweg, Laurens; Sánchez, Clara I.; Melendez, Jaime; Maduskar, Pragnya; Ginneken, Bram van; Story, Alistair; Hayward, Andrew

    2013-01-01

    Purpose: Chest radiographs commonly contain projections of foreign objects, such as buttons, brassier clips, jewellery, or pacemakers and wires. The presence of these structures can substantially affect the output of computer analysis of these images. An automated method is presented to detect, segment, and remove foreign objects from chest radiographs.Methods: Detection is performed using supervised pixel classification with a kNN classifier, resulting in a probability estimate per pixel to belong to a projected foreign object. Segmentation is performed by grouping and post-processing pixels with a probability above a certain threshold. Next, the objects are replaced by texture inpainting.Results: The method is evaluated in experiments on 257 chest radiographs. The detection at pixel level is evaluated with receiver operating characteristic analysis on pixels within the unobscured lung fields and an A z value of 0.949 is achieved. Free response operator characteristic analysis is performed at the object level, and 95.6% of objects are detected with on average 0.25 false positive detections per image. To investigate the effect of removing the detected objects through inpainting, a texture analysis system for tuberculosis detection is applied to images with and without pathology and with and without foreign object removal. Unprocessed, the texture analysis abnormality score of normal images with foreign objects is comparable to those with pathology. After removing foreign objects, the texture score of normal images with and without foreign objects is similar, while abnormal images, whether they contain foreign objects or not, achieve on average higher scores.Conclusions: The authors conclude that removal of foreign objects from chest radiographs is feasible and beneficial for automated image analysis

  10. Subtle pulmonary nodules: detection and identification with storage phosphor radiographs and conventional chest films

    International Nuclear Information System (INIS)

    Scheck, R.J.; Schaetzl, M.; Kandziora, C.; Panzer, M.; Rienmueller, R.

    1994-01-01

    To determine the value of digital storagephosphor radiography (SR) on the detection and identification of subtle lung nodules, postero-anterior (PA) and lateral (LAT) film-screen (FR) chest radiographs were compared with isodose SR images of 45 patients with metastatic malignancies. The SR postprocessing was done with a particular mode previously optimized for routine chest radiography. Pulmonary metastases were found in 34 patients and were proved or excluded by CT (n=28) or longterm follow-up FR (n=17). Chest images were divided into four regions for evaluation of image quality, number of lung nodules per region and marked pulmonary structures by receiver-operating characteristics (ROC) analysis (45 patients; 125 nodules; 2810 observations; five readers). Of the nodules selected for an ROC study 82% were 0.5-1.0 cm in diameter. Overall image quality was rated better for FR concerning lung fields (PA) and mediastinum/hilum (LAT). More lung-field nodules were detected on FR than on SR chest images. Use of FR was superior to SR in the general identification of nodules (PA chest), especially concerning intermediate and subtle abnormalities, whereas there was no significant difference for LAT chest images. Our results show, that currently FR still has advantages over SR in the detection and identification of subtle lung nodules in routine clinical radiography. (orig.)

  11. Accuracy of the interpretation of chest radiographs for the diagnosis of paediatric pneumonia.

    Directory of Open Access Journals (Sweden)

    Mohamed A Elemraid

    Full Text Available World Health Organization (WHO radiological classification remains an important entry criterion in epidemiological studies of pneumonia in children. We report inter-observer variability in the interpretation of 169 chest radiographs in children suspected of having pneumonia.An 18-month prospective aetiological study of pneumonia was undertaken in Northern England. Chest radiographs were performed on eligible children aged ≤16 years with clinical features of pneumonia. The initial radiology report was compared with a subsequent assessment by a consultant cardiothoracic radiologist. Chest radiographic changes were categorised according to the WHO classification.There was significant disagreement (22% between the first and second reports (kappa = 0.70, P<0.001, notably in those aged <5 years (26%, kappa = 0.66, P<0.001. The most frequent sources of disagreement were the reporting of patchy and perihilar changes.This substantial inter-observer variability highlights the need for experts from different countries to create a consensus to review the radiological definition of pneumonia in children.

  12. Chest radiographic findings of scrub typhus: an analysis of 160 cases occurred in Ulsan area

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Hwa; Oh, Dong Heon; Kim, Ki Sung; Woo, Je Ho; Kwon, Jung Hyeok [Dong Kang General Hospital, Ulsan (Korea, Republic of)

    1993-03-15

    Scrub typhus (Tsutsugamushi disease) is an acute febrile systemic illness caused by Rickettsia Tsutsugamushi that is transmitted to humans by the bite of larval-stage trombiculid mites (chiggers). The authors analyzed chest radiographic findings of scrub typhus in 160 patients in Ulsan area. One hundred and eight (67.5%) of 160 patients showed abnormal findings which included lung lesions in 108 patients (67.5%), cardiomegaly in 37 patients (23.1%), lymphadenopathy in 25 patients (15.6%) and pleural effusion in 11 patients (6.9%). Among the lung lesions, interstitial patterns were seen in 107 patients (66.9%), mostly fine or medium reticulonodular, and air-space patterns in 14 patients (8.8%) and combined interstitial and air-space patterns in 13 patients (8.1%). Sixty-four patients (40%) had combined chest radiographic findings. The typical chest radiographic findings of scrub typhus would be helpful in evaluation of the causes of acute febrile illness that occur during late fall in the endemic area.

  13. Chest radiographic findings of scrub typhus: an analysis of 160 cases occurred in Ulsan area

    International Nuclear Information System (INIS)

    Kim, Ok Hwa; Oh, Dong Heon; Kim, Ki Sung; Woo, Je Ho; Kwon, Jung Hyeok

    1993-01-01

    Scrub typhus (Tsutsugamushi disease) is an acute febrile systemic illness caused by Rickettsia Tsutsugamushi that is transmitted to humans by the bite of larval-stage trombiculid mites (chiggers). The authors analyzed chest radiographic findings of scrub typhus in 160 patients in Ulsan area. One hundred and eight (67.5%) of 160 patients showed abnormal findings which included lung lesions in 108 patients (67.5%), cardiomegaly in 37 patients (23.1%), lymphadenopathy in 25 patients (15.6%) and pleural effusion in 11 patients (6.9%). Among the lung lesions, interstitial patterns were seen in 107 patients (66.9%), mostly fine or medium reticulonodular, and air-space patterns in 14 patients (8.8%) and combined interstitial and air-space patterns in 13 patients (8.1%). Sixty-four patients (40%) had combined chest radiographic findings. The typical chest radiographic findings of scrub typhus would be helpful in evaluation of the causes of acute febrile illness that occur during late fall in the endemic area

  14. Community-Acquired Pneumonia Visualized on CT Scans but Not Chest Radiographs: Pathogens, Severity, and Clinical Outcomes.

    Science.gov (United States)

    Upchurch, Cameron P; Grijalva, Carlos G; Wunderink, Richard G; Williams, Derek J; Waterer, Grant W; Anderson, Evan J; Zhu, Yuwei; Hart, Eric M; Carroll, Frank; Bramley, Anna M; Jain, Seema; Edwards, Kathryn M; Self, Wesley H

    2018-03-01

    The clinical significance of pneumonia visualized on CT scan in the setting of a normal chest radiograph is uncertain. In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens present, and outcomes of patients with pneumonia visualized on a CT scan but not on a concurrent chest radiograph (CT-only pneumonia) and those with pneumonia visualized on a chest radiograph. All patients underwent chest radiography; the decision to obtain CT imaging was determined by the treating clinicians. Chest radiographs and CT images were interpreted by study-dedicated thoracic radiologists blinded to the clinical data. The study population included 2,251 adults with CAP; 2,185 patients (97%) had pneumonia visualized on chest radiography, whereas 66 patients (3%) had pneumonia visualized on CT scan but not on concurrent chest radiography. Overall, these patients with CT-only pneumonia had a clinical profile similar to those with pneumonia visualized on chest radiography, including comorbidities, vital signs, hospital length of stay, prevalence of viral (30% vs 26%) and bacterial (12% vs 14%) pathogens, ICU admission (23% vs 21%), use of mechanical ventilation (6% vs 5%), septic shock (5% vs 4%), and inhospital mortality (0 vs 2%). Adults hospitalized with CAP who had radiological evidence of pneumonia on CT scan but not on concurrent chest radiograph had pathogens, disease severity, and outcomes similar to patients who had signs of pneumonia on chest radiography. These findings support using the same management principles for patients with CT-only pneumonia and those with pneumonia seen on chest radiography. Copyright © 2017 American College of Chest Physicians. All rights reserved.

  15. Are chest radiographs justified in pre-employment examinations. Presentation of legal position and medical evidence based on 1760 cases

    International Nuclear Information System (INIS)

    Ladd, S.C.; Krause, U.; Ladd, M.E.

    2006-01-01

    The legal and medical basis for chest radiographs as part of pre-employment examinations (PEE) at a University Hospital is evaluated. The radiographs are primarily performed to exclude infectious lung disease. A total of 1760 consecutive chest radiographs performed as a routine part of PEEs were reviewed retrospectively. Pathologic findings were categorized as ''nonrelevant'' or ''relevant.'' No positive finding with respect to tuberculosis or any other infectious disease was found; 94.8% of the chest radiographs were completely normal. Only five findings were regarded as ''relevant'' for the individual. No employment-relevant diagnosis occurred. The performance of chest radiography as part of a PEE is most often not justified. The practice is expensive, can violate national and European law, and lacks medical justification. (orig.) [de

  16. Chest Radiographic Findings in Primary Pulmonary Tuberculosis: Observations from High School Outbreaks

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Won Jung; Kwon, O Jung; Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Jeong, Yeon Joo [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Kim, Hee Jin; Lew, Woo Jin [Korean Institute of Tuberculosis, Seoul (Korea, Republic of); Cho, En Hi [4Korea Centers for Disease Control and Prevention, Seoul (Korea, Republic of)

    2010-12-15

    To describe the radiographic findings of primary pulmonary tuberculosis (TB) in previously healthy adolescent patients. The Institutional Review Board approved this retrospective study, with a waiver of informed consent from the patients. TB outbreaks occurred in 15 senior high schools and chest radiographs from 58 students with identical strains of TB were analyzed by restriction fragment length polymorphism analysis by two independent observers. Lesions of nodule(s), consolidation, or cavitation in the upper lung zones were classified as typical TB. Mediastinal lymph node enlargement; lesions of nodule(s), consolidation, or cavitation in lower lung zones; or pleural effusion were classified as atypical TB. Inter-observer agreement for the presence of each radiographic finding was examined by kappa statistics. Of 58 patients, three (5%) had normal chest radiographs. Cavitary lesions were present in 25 (45%) of 55 students. Lesions with upper lung zone predominance were observed in 27 (49%) patients, whereas lower lung zone predominance was noted in 18 (33%) patients. The remaining 10 (18%) patients had lesions in both upper and lower lung zones. Pleural effusion was not observed in any patient, nor was the mediastinal lymph node enlargement. Hilar lymph node enlargement was seen in only one (2%) patient. Overall, 37 (67%) students had the typical form of TB, whereas 18 (33%) had TB lesions of the atypical form. The most common radiographic findings in primary pulmonary TB by recent infection in previously healthy adolescents are upper lung lesions, which were thought to be radiographic findings of reactivation pulmonary TB by remote infection

  17. Association between spirometry controlled chest CT scores using computer-animated biofeedback and clinical markers of lung disease in children with cystic fibrosis

    DEFF Research Database (Denmark)

    Kongstad, Thomas; Green, Kent; Buchvald, Frederik

    2017-01-01

    Background: Computed tomography (CT) of the lungs is the gold standard for assessing the extent of structural changes in the lungs. Spirometry-controlled chest CT (SCCCT) has improved the usefulness of CT by standardising inspiratory and expiratory lung volumes during imaging. This was a single...... (expressed as % of maximum score) to quantify different aspects of structural lung changes including bronchiectasis, airway wall thickening, mucus plugging, opacities, cysts, bullae and gas trapping. Clinical markers consisted of outcomes from pulmonary function tests, microbiological cultures from sputum......-centre cross-sectional study in children with cystic fibrosis (CF). Using SCCCT we wished to investigate the association between the quantity and extent of structural lung changes and pulmonary function outcomes, and prevalence of known CF lung pathogens. Methods: CT images were analysed by CF-CT scoring...

  18. Spirometry reference values in the Brazilian population.

    Science.gov (United States)

    Rufino, R; Costa, C H; Lopes, A J; Maiworm, A I; Maynard, K; Silva, L M R A; Dias, R M

    2017-03-02

    The aim of the present study was to provide new spirometry reference equations in a sample of the Brazilian population for the following parameters: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak of expiratory flow (PEF), forced expiratory flow at 50% (FEF50%), 75% average vital capacity (FEF25-75%), and average forced expiratory flow time (FEFT). This was a prospective study using results from chest radiographs, electrocardiograms, and questionnaires to investigate the participants' respiratory symptoms, sedentarism, and comorbidities (Charlson comorbidity index). From December 2010 to July 2014, individuals were randomly selected from various locations in the state of Rio de Janeiro. All individuals were examined by a single technician in the morning at the laboratory, and performed the spirometry with the same spirometer. Spirometry values were tabulated for the creation of three equation models: linear regression, logarithmic regression, and logarithms through a method that incorporates the lambda, median, and coefficient of variation (LMS method). Initially, 7003 individuals from both genders were contacted, and 454 were recruited. The data from the new equations were compared with one Brazilian and eight international equations, resulting in a high correlation (r>0.9). The values derived from the LMS method and linear regression were very similar (P>0.5), and both could be used to acquire the reference values for Brazilian spirometry. Data derived from the equations of this study were different from the current Brazilian equation, which could be justified by the different method used.

  19. Computed radiography versus mobile direct radiography for bedside chest radiographs: impact of dose on image quality and reader agreement

    NARCIS (Netherlands)

    de Boo, D. W.; Weber, M.; Deurloo, E. E.; Streekstra, G. J.; Freling, N. J.; Dongelmans, D. A.; Schaefer-Prokop, C. M.

    2011-01-01

    To asses the image quality and potential for dose reduction of mobile direct detector (DR) chest radiography as compared with computed radiography (CR) for intensive care unit (ICU) chest radiographs (CXR). Three groups of age-, weight- and disease-matched ICU patients (n=114 patients; 50 CXR per

  20. Development and evaluation of a new chest radiograph reading and recording system for epidemiological surveys of tuberculosis and lung disease

    NARCIS (Netherlands)

    den Boon, S.; Bateman, E. D.; Enarson, D. A.; Borgdorff, M. W.; Verver, S.; Lombard, C. J.; Irusen, E.; Beyers, N.; White, N. W.

    2005-01-01

    OBJECTIVE: The development and evaluation of a new chest radiograph reading and recording system (CRRS) for community surveys of tuberculosis (TB) and lung disease. DESIGN: An experienced pulmonologist read 2608 chest X-rays (CXRs) performed as part of a TB prevalence survey using the newly

  1. Chest radiographic appearances in adult inpatients admitted with swine flu infection: local experience in Melbourne

    International Nuclear Information System (INIS)

    Pirakalathanan, Janu; Lau, Kenneth K.; Joosten, Simon A.

    2013-01-01

    The influenza A virus (H1N1) pandemic began in Mexico in March 2009. As of July 2009, there were 5298 reported cases in Australia including 10 deaths. The aim of this review is to demonstrate the local chest radiographic findings in adult inpatients with proven H1N1, to assess the radiological disease progression and resolution, and to evaluate whether the severity of chest X-rays findings had a bearing on the length of admission and need for intensive care admission. Eleven H1N1 patients (5 males and 6 females, mean age of 36), presenting with cough (64%), fever (55%) and shortness of breath (55%), were admitted to our hospital between 13 August and 1 November 2010. Details of radiographic features, risk factors, clinical course including length of stay, doubling time of consolidation and time for 50% resolution of consolidation were recorded and analysed. Seventy-three per cent of our patients presented with bilateral mid and/or lower zone alveolar consolidation. One patient with underlying cystic fibrosis had only bilateral upper zone consolidation. No pleural effusion, lymphadenopathy or cardiomegaly was noted on any of the plain chest radiographs. The mean doubling time of consolidation was 1.5 days. The mean time for 50% resolution of consolidation after antiviral treatment was 10.5 days. The average length of stay in hospital was 22 days. Ninety-one per cent of our patients required intensive-care unit admission with 50% of those requiring intubation. Rapid progression of bilateral mid and lower zone air-space opacities in relatively young unwell patients, with lack of pleural effusion, pericardial effusion or lymphadenopathy on plain radiographs, should raise the clinical suspicion of H1N1 infection. Patients requiring hospital admission usually show slow clinical and radiological improvement, and require prolonged hospital stays.

  2. Findings chest radiograph and CT in mediastinitis: effcacy of CT in patients with delayed diagnosis

    International Nuclear Information System (INIS)

    Son, Eun Ju; Hong, Yong Kook; Choe, Kyu Ok

    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 symptoms

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

    Science.gov (United States)

    Dietz, Kelly R; Zhang, Lei; Seidel, Frank G

    2015-08-01

    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 chest diameter on digital chest radiograph with the tables and graphs in our study.

  4. Survey of image quality and radiographic technique of pediatric chest examinations performed in Latin America

    International Nuclear Information System (INIS)

    Khoury, H.; Mora, P.; Defaz, M.Y.; Blanco, S.; Leyton, F.; Benavente, T.; Ortiz Lopez, P.; Ramirez, R.

    2008-01-01

    This work presents the results of a survey of entrance surface air kerma values (K e ), image quality and radiographic exposure parameters used in pediatric chest examinations performed in Latin America. This study is part of the activities of the IAEA Regional Project RLA/9/057 whose objective is to optimize the radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. The survey was performed in nine hospitals in Argentina (1), Brazil (4), Chile (1), Costa Rica (1), Peru (1) and Ecuador (1). The study group consisted of 462 pediatric patients (Group I- from two days to one year, Group II- from four to six years of age) undergoing chest PA/AP examinations. At the time of the examination the exposure parameters (kVp, mAs, focal-spot-to-film distance, etc.) and patient information (gender, height, weight and age) were recorded. The radiographic image quality was evaluated by the local radiologist based on the European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Pediatrics. The results showed that the exposure parameters used on newborn patients were in the majority outside the 60-65kV range recommended by the European Guidelines for a good radiographic practice. In the case of examinations of patients with age between 4 to 6 years, 80% were performed with a peak tube voltage within the 60-80 kV range, as recommended by the European Guidelines. It was found that none of countries fully comply with the European Guidelines on Quality Criteria and those criteria No. 2 and No. 3 (reproduction of the chest without rotation) received the lowest scores. Probably this occurs because there are no proper patient immobilization devices. The Ke values, for both patient groups, showed a wide dispersion, ranged from 10 μGy to 160μGy for the newborn patients and from 20μGy to 240μGy for infant patients. It is possible to conclude that, in the participating Latin American countries on this project

  5. Digitizing pediatric chest radiographs: comparison of low-cost, commercial off-the-shelf technologies

    International Nuclear Information System (INIS)

    Ruess, L.; Shiels, K.C.; Cho, K.H.; O'Connor, S.C.; Uyehara, C.F.T.; Person, D.A.; Whitton, R.K.

    2001-01-01

    Objective: To compare low-cost, off-the-shelf technology for digitizing pediatric chest radiographs. Materials and methods: Forty pediatric chest radiographs (hard copy), each with a single abnormality, were digitized using a commercial film digitizer and two low-cost methods: a digital camera and a flatbed scanner. A stratified, randomized, block design was used where 20 readers evaluated 40 different images to determine the ability to accurately detect the abnormality. Readers then rated all 160 images (40 images x 4 methods) for conspicuity of the abnormality and overall image quality. Results: Abnormalities were correctly identified on 82.3 % of hard copy images, 82.9 % of flatbed scanner images, 74.3 % of film digitizer images, and 69.7 % of digital camera images (p flatbed scanner > film digitizer > digital camera images. Conclusion: A low-cost flatbed scanner yielded digital pediatric chest images which were significantly superior to digital camera images While flatbed scanner images were interpreted with the equivalent diagnostic accuracy of hard copy images, they were rated lower for image quality and lesion conspicuity. (orig.)

  6. Analysis of biological tissues in infant chest for the development of an equivalent radiographic phantom

    International Nuclear Information System (INIS)

    Pina, D. R.; Souza, Rafael T. F.; Duarte, Sergio B.; Alvarez, Matheus; Miranda, Jose R. A.

    2012-01-01

    Purpose: The main purpose of the present study was to determine the amounts of different tissues in the chest of the newborn patient (age ≤1 year), with the aim of developing a homogeneous phantom chest equivalent. This type of phantom is indispensable in the development of optimization procedures for radiographic techniques, including dosimetric control, which is a crucial aspect of pediatric radiology. The authors present a systematic set of procedures, including a computational algorithm, to estimate the amounts of tissues and thicknesses of the corresponding simulator material plates used to construct the phantom. Methods: The Gaussian fit of computed tomographic (CT) analysis was applied to classify and quantify different biological tissues. The methodology is summarized with a computational algorithm, which was used to quantify tissues through automated CT analysis. The thicknesses of the equivalent homogeneous simulator material plates were determined to construct the phantom. Results: A total of 180 retrospective CT examinations with anterior-posterior diameter values ranging 8.5-13.0 cm were examined. The amounts of different tissues were evaluated. The results provided elements to construct a phantom to simulate the infant chest in the posterior-anterior or anterior-posterior (PA/AP) view. Conclusions: To our knowledge, this report represents the first demonstration of an infant chest phantom dedicated to the radiology of children younger than one year. This phantom is a key element in the development of clinical charts for optimizing radiographic technique in pediatric patients. Optimization procedures for nonstandard patients were reported previously [Pina et al., Phys. Med. Biol. 49, N215-N226 (2004) and Pina et al., Appl. Radiat. Isot. 67, 61-69 (2009)]. The constructed phantom represents a starting point to obtain radiologic protocols for the infant patient.

  7. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Lima, F.R.A. [Centro regional de Ciencias Nucleares, CRCN/CNEN, Rua Conego Barata, 999, Tamarineira, Recife, PE (Brazil); Kramer, R.; Vieira, J.W.; Khoury, H.J. [Departamento de Energia Nuclear, DEN/UFPE, Cidade Universitaria, Recife, PE (Brazil)]. E-mail: falima@cnen.gov.br

    2004-07-01

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  8. Novel Method to Improve Radiologist Agreement in Interpretation of Serial Chest Radiographs in the ICU

    Directory of Open Access Journals (Sweden)

    Denise A Castro

    2015-01-01

    Full Text Available Objectives: To determine whether a novel method and device, called a variable attenuation plate (VAP, which equalizes chest radiographic appearance and allows for synchronization of manual image windowing with comparison studies, would improve consistency in interpretation. Materials and Methods: Research ethics board approved the prospective cohort pilot study, which included 50 patients in the intensive care unit (ICU undergoing two serial chest radiographs with a VAP placed on each one of them. The VAP allowed for equalization of density and contrast between the patients′ serial chest radiographs. Three radiologists interpreted all the studies with and without the use of VAP. Kappa and percent agreement was used to calculate agreement between radiologists′ interpretations with and without the plate. Results: Radiologist agreement was substantially higher with the VAP method, as compared to that with the non-VAP method. Kappa values between Radiologists A and B, A and C, and B and C were 46%, 55%, and 51%, respectively, which improved to 73%, 81%, and 66%, respectively, with the use of VAP. Discrepant report impressions (i.e., one radiologist′s impression of unchanged versus one or both of the other radiologists stating improved or worsened in their impression ranged from 24 to 28.6% without the use of VAP and from 10 to 16% with the use of VAP (χ2 = 7.454, P < 0.01. Opposing views (i.e., one radiologist′s impression of improved and one of the others stating disease progression or vice versa were reported in 7 (12% cases in the non-VAP group and 4 (7% cases in the VAP group (χ2 = 0.85, P = 0.54. Conclusion: Numerous factors play a role in image acquisition and image quality, which can contribute to poor consistency and reliability of portable chest radiographic interpretations. Radiologists′ agreement of image interpretation can be improved by use of a novel method consisting of a VAP and associated software and has the potential

  9. Cardiac pacemaker lead placement: Do you need a lateral chest radiograph?

    Energy Technology Data Exchange (ETDEWEB)

    Sonnex, Emer, E-mail: sonnex@ualberta.c [Department of Radiology and Diagnostic Imaging, University of Alberta Hospitals, Edmonton, Alberta (Canada); Coulden, Richard [Department of Radiology and Diagnostic Imaging, University of Alberta Hospitals, Edmonton, Alberta (Canada)

    2010-08-15

    We present a case of an uneventful dual chamber permanent pacemaker (PPM) implantation which, on the follow-up chest radiograph (CXR), was reported as good lead tip placement and no complications. The patient was re-admitted 7 months later. The PA CXR appearances were unchanged but, in the lateral projection, the ventricular lead tip was projected posteriorly within the heart, most likely within the LV. This was confirmed by CT showing the ventricular lead tip within the LV having passed through a patent foramen ovale (PFO).

  10. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    International Nuclear Information System (INIS)

    Lima, F.R.A.; Kramer, R.; Vieira, J.W.; Khoury, H.J.

    2004-01-01

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  11. Computer-aided detection of lung nodules in digital chest radiographs

    International Nuclear Information System (INIS)

    Giger, M.L.; Doi, K.; MacMahon, H.M.

    1986-01-01

    The authors are developing an automated method to detect lung nodules by eliminating the ''camouflaging: effect of the lung background. In order to increase the conspicuity of the nodules, we created, from a single chest radiograph, two images: one in which the signal-to-noise ratio (S/N) of the nodule is maximized and another in which that S/N is suppressed. The difference between these two processed images was subjected to feature-extraction technique in order to isolate the nodules. The detection accuracy of the computer-aided detection scheme, as compared with unaided radiologists' performance, was determined using receiver operating characteristic curve analysis

  12. Aspergillus infection of the respiratory tract after lung transplantation: chest radiographic and CT findings

    International Nuclear Information System (INIS)

    Diederich, S.; Scadeng, M.; Flower, C.D.R.; Dennis, C.; Stewart, S.

    1998-01-01

    The objective of our study was to assess radiographic and CT findings in lung transplant patients with evidence of Aspergillus colonization or infection of the airways and correlate the findings with clinical, laboratory, bronchoalveolar lavage, biopsy and autopsy findings. The records of 189 patients who had undergone lung transplantation were retrospectively reviewed for evidence of Aspergillus colonization or infection of the airways. Aspergillus was demonstrated by culture or microscopy of sputum or bronchoalveolar lavage fluid or histologically from lung biopsies or postmortem studies in 44 patients (23 %). Notes and radiographs were available for analysis in 30 patients. In 12 of the 30 patients (40 %) chest radiographs remained normal. In 11 of 18 patients with abnormal radiographs pulmonary abnormalities were attributed to invasive pulmonary aspergillosis (IPA) in the absence of other causes for pulmonary abnormalities (8 patients) or because of histological demonstration of IPA (3 patients). In these 11 patients initial radiographic abnormalities were focal areas of patchy consolidation (8 patients), ill-defined pulmonary nodules (2 patients) or a combination of both (1 patient). In some of the lesions cavitation was demonstrated subsequently. At CT a ''halo'' of decreased density was demonstrated in some of the nodules and lesion morphology and location were shown more precisely. Demonstration of Aspergillus from the respiratory tract after lung transplantation does not necessarily reflect IPA but may represent colonization of the airways or semi-invasive aspergillosis. The findings in patients with IPA did not differ from those described in the literature in other immunocompromised patients, suggesting that surgical disruption of lymphatic drainage and nervous supply or effects of preservation and transport of the transplant lung do not affect the radiographic appearances. (orig.)

  13. Potential usefulness of a video printer for producing secondary images from digitized chest radiographs

    Science.gov (United States)

    Nishikawa, Robert M.; MacMahon, Heber; Doi, Kunio; Bosworth, Eric

    1991-05-01

    Communication between radiologists and clinicians could be improved if a secondary image (copy of the original image) accompanied the radiologic report. In addition, the number of lost original radiographs could be decreased, since clinicians would have less need to borrow films. The secondary image should be simple and inexpensive to produce, while providing sufficient image quality for verification of the diagnosis. We are investigating the potential usefulness of a video printer for producing copies of radiographs, i.e. images printed on thermal paper. The video printer we examined (Seikosha model VP-3500) can provide 64 shades of gray. It is capable of recording images up to 1,280 pixels by 1,240 lines and can accept any raster-type video signal. The video printer was characterized in terms of its linearity, contrast, latitude, resolution, and noise properties. The quality of video-printer images was also evaluated in an observer study using portable chest radiographs. We found that observers could confirm up to 90 of the reported findings in the thorax using video- printer images, when the original radiographs were of high quality. The number of verified findings was diminished when high spatial resolution was required (e.g. detection of a subtle pneumothorax) or when a low-contrast finding was located in the mediastinal area or below the diaphragm (e.g. nasogastric tubes).

  14. Detection of pulmonary metastatic nodules: usefulness of low-dose multidetector CT in comparison with chest radiograph

    International Nuclear Information System (INIS)

    Kim, Ki Nam; Lee, Ki Nam; Yang, Doo Kyung; Lee, Soo Keol

    2006-01-01

    We wanted to evaluate the usefulness of low-dose multidetector CT for the detection and follow-up of pulmonary metastatic nodules in patients suffering with malignancy. We retrospectively reviewed the conventional chest radiographs and low-dose multidetector CT (low-dose CT) scans of 81 patients who had been under the diagnosis of malignancy. We reviewed the detection of pulmonary nodules and we counted the number of nodules detected by each method. The nodules were confirmed by surgical operation and by the radiologic criteria. The accuracy, sensitivity, specificity and positive and negative predictive values of each method for detecting metastatic nodules were compared with χ 2 tests. Low-dose CT depicted more nodules than did chest radiograph, and the indeterminate nodules seen on chest radiograph may be clearly benign on low-dose CT (eg. calcified granulomas or bony lesions). The accuracy of low-dose CT (75.3%) was significantly higher than that of chest radiograph (49.4%) for the detection for metastatic nodules (ρ < 0.05). Low-dose CT may provide better information than does chest radiograph for diagnosing pulmonary metastasis

  15. Does the Use of a Checklist Help Medical Students in the Detection of Abnormalities on a Chest Radiograph?

    Science.gov (United States)

    Kok, Ellen M; Abed, Abdelrazek; Robben, Simon G F

    2017-12-01

    The interpretation of chest radiographs is a complex task that is prone to diagnostic error, especially for medical students. The aim of this study is to investigate the extent to which medical students benefit from the use of a checklist regarding the detection of abnormalities on a chest radiograph. We developed a checklist based on literature and interviews with experienced thorax radiologists. Forty medical students in the clinical phase assessed 18 chest radiographs during a computer test, either with (n = 20) or without (n = 20) the checklist. We measured performance and asked participants for feedback using a survey. Participants that used a checklist detected more abnormalities on images with multiple abnormalities (M = 50.1%) than participants that could not use a checklist (M = 41.9%), p = 0.04. The post-experimental survey shows that on average, participants considered the checklist helpful (M = 3.25 on a five-point scale), but also time consuming (M = 3.30 on a five-point scale). In conclusion, a checklist can help medical students to detect abnormalities in chest radiographs. Moreover, students tend to appreciate the use of a checklist as a helpful tool during the interpretation of a chest radiograph. Therefore, a checklist is a potentially important tool to improve radiology education in the medical curriculum.

  16. Questionnaire-based study showed that neonatal chest radiographs could be reliably interpreted using the WhatsApp messaging application.

    Science.gov (United States)

    Gross, Itai; Langer, Yshia; Pasternak, Yehonatan; Abu Ahmad, Wiessam; Eventov-Friedman, Smadar; Koplewitz, Benjamin Z

    2018-06-11

    We surveyed whether clinicians used the WhatsApp messaging application to view neonatal chest radiographs and asked a sub-sample to compare them with computer screen viewings. The study was conducted at three university-affiliated medical centres in Israel from June-December 2016. Questionnaires on using smartphones for professional purposes were completed by 68/71 paediatric residents and 20/28 neonatologists. In addition, 11 neonatologists viewed 20 chest radiographs on a computer screen followed by a smartphone and 10 viewed the same radiographs in the opposite order, separated by a washout period of two months. After another two months, five from each group viewed the same radiographs on a computer screen. Different interpretations between viewing modes were assessed. Most respondents used WhatsApp to send chest radiographs for consultation: 82% of the paediatric residents and 80% of the neonatologists. The mean number of inconsistencies in diagnosis was 3.7/20 between two computer views and 2.9/20 between computer and smartphone views (p=0.88) and the disease severity means were 3.7/20 and 2.85/20, respectively (p=0.94). Neonatologists using WhatsApp only determined umbilical line placement in 80% of cases. WhatsApp was reliable for preliminary interpretation of neonatal chest radiographs, but caution was needed when assessing umbilical lines. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Paediatric Northern Score centile charts for the chest radiograph in cystic fibrosis

    International Nuclear Information System (INIS)

    McCormick, J.; Conway, S.P.; Mehta, A.

    2007-01-01

    Aim: To create the first national centile charts for the chest radiograph Northern Score using the UK Cystic Fibrosis (CF) Database (UKCFD). Materials and methods: All active patients for 2002 from the UKCFD were analysed in 1-year cohorts from 0 to 18 years. Northern Score results from the annual review forms were used to construct centile lines for the 5th, 25th, 50th, 75th, 95th centiles. Results: There were 1806 patients with recorded Northern Score data for 2002 (927 male patients, male:female ratio 1.05). The centile chart demonstrates a quasi-linear rise throughout childhood. A Northern Score in excess of age in years equates to >95th centile in school-aged CF patients. Conclusion: This centile chart provides a disease-specific reference range for monitoring individual patients or for evaluating therapeutic change using the dominant chest radiograph scoring system in the UK. Patients, parents and clinicians may find these useful during the annual review process

  18. Pneumothorax detection in chest radiographs using local and global texture signatures

    Science.gov (United States)

    Geva, Ofer; Zimmerman-Moreno, Gali; Lieberman, Sivan; Konen, Eli; Greenspan, Hayit

    2015-03-01

    A novel framework for automatic detection of pneumothorax abnormality in chest radiographs is presented. The suggested method is based on a texture analysis approach combined with supervised learning techniques. The proposed framework consists of two main steps: at first, a texture analysis process is performed for detection of local abnormalities. Labeled image patches are extracted in the texture analysis procedure following which local analysis values are incorporated into a novel global image representation. The global representation is used for training and detection of the abnormality at the image level. The presented global representation is designed based on the distinctive shape of the lung, taking into account the characteristics of typical pneumothorax abnormalities. A supervised learning process was performed on both the local and global data, leading to trained detection system. The system was tested on a dataset of 108 upright chest radiographs. Several state of the art texture feature sets were experimented with (Local Binary Patterns, Maximum Response filters). The optimal configuration yielded sensitivity of 81% with specificity of 87%. The results of the evaluation are promising, establishing the current framework as a basis for additional improvements and extensions.

  19. Radiologic-anatomic correlation of thoracic vertebrae and rib shadows in chest digital radiograph

    International Nuclear Information System (INIS)

    Yamaguchi, Isao; Itoh, Harumi

    2007-01-01

    The purpose of this study was to provide an introduction to parsing the radiologic appearance of thoracic vertebrae and ribs. In the study, the radiologic-anatomic correlation technique was applied to promote further understanding of normal chest radiographs. The thoracic vertebrae and ribs of chest radiographs were compared with each macroscopic radiologic and computed tomography (CT) image. The rib parsed the linear shadow of the body of the rib. The macroscopic and radiologic images of thoracic vertebrae and ribs were evaluated to explain their normal radiologic findings. The results of such correlation were summarized as follows: The lamina of the vertebral arch was visualized due to anterior rotation of the upper thoracic vertebrae. The density ratio of the thoracic-vertebrae shadow was almost the same in the vertebral body and vertebral arch. The linear shadow superimposed on the rib corresponded to the inferior margin of the rib. The radiologic-anatomic correlation technique was useful to evaluate normal radiologic findings, and the study was useful to radiological technologists. (author)

  20. Computer-aided detection (CAD) of lung nodules and small tumours on chest radiographs

    International Nuclear Information System (INIS)

    De Boo, D.W.; Prokop, M.; Uffmann, M.; Ginneken, B. van; Schaefer-Prokop, C.M.

    2009-01-01

    Detection of focal pulmonary lesions is limited by quantum and anatomic noise and highly influenced by variable perception capacity of the reader. Multiple studies have proven that lesions - missed at time of primary interpretation - were visible on the chest radiographs in retrospect. Computer-aided diagnosis (CAD) schemes do not alter the anatomic noise but aim at decreasing the intrinsic limitations and variations of human perception by alerting the reader to suspicious areas in a chest radiograph when used as a 'second reader'. Multiple studies have shown that the detection performance can be improved using CAD especially for less experienced readers at a variable amount of decreased specificity. There seem to be a substantial learning process for both, experienced and inexperienced readers, to be able to optimally differentiate between false positive and true positive lesions and to build up sufficient trust in the capabilities of these systems to be able to use them at their full advantage. Studies so far focussed on stand-alone performance of the CAD schemes to reveal the magnitude of potential impact or on retrospective evaluation of CAD as a second reader for selected study groups. Further research is needed to assess the performance of these systems in clinical routine and to determine the trade-off between performance increase in terms of increased sensitivity and decreased inter-reader variability and loss of specificity and secondary indicated follow-up examinations for further diagnostic workup.

  1. Chest Radiographic Findings of Novel Swine-Origin Influenza A (H1N1) Virus Infection in Children

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Hong, Eun Sook; Paik, Sang Hyun; Park, Seong Jin; Cha, Jang Gyu; Lee, Hae Kyung [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Jang, Yun Woo [Dept. of Radiology, Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2011-06-15

    To analyze chest radiographic findings in children infected with laboratory confirmed novel swine-origin influenza A (H1N1) virus. Three hundred seventy-two out of 2,014 children with laboratory confirmed H1N1 infection and who also underwent a chest radiograph from September to November 2009 were enrolled in this study. Patients were divided into in-patients, out-patients, and patients with co-infections and further subdivided into with underlying disease and without underlying disease as well as age (<2 years old, 2-5 years, 5-10 years, 10-18 years old). The initial radiographs were evaluated for radiographic findings and the anatomic distribution of abnormalities. The initial radiographs were abnormal in 154 (41.39%) patients. The predominant radiographic findings were peribronchial wall opacity found in 85 (22.84%) patients and hyperinflation observed in 69 (18.54%) patients. Further, 75 (71.42%) patients exhibited central predominance and the right lower lung zone was also commonly involved. There were statistically significant differences in the radiological findings between in-patient and out-patient groups. However, there were no significant differences in the radiographic findings between in-patients and the co-infection group with respect the presence of underlying disease and age. Initial radiographs of children with laboratory confirmed H1N1 virus were abnormal in 41.39% of cases. The common radiographic findings included peribronchial opacities, hyperinflation, lower lung zonal distribution, and central predominance

  2. Incidental finding of unilateral isolated aplasia of serratus anterior muscle and winged scapula on chest radiograph: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Sung; Park, Hyun Jin; Ko, Jeong Min [Dept. of Radiology, St. Vincent' s Hospital, College of Medicine, The Catholic University of Korea, Suwon (Korea, Republic of)

    2014-10-15

    The isolated aplasia of the serratus anterior muscle with winging of scapula is very rare, and only a few cases are reported. Here, we present a case of a 30-year-old Korean male who initially presented with a left flank pain. His physical exam did not show any significant finding in his right shoulder. However, his chest radiograph showed absence of right serratus anterior muscle and slightly elevated and medially rotated right scapula. Subsequent CT scan showed the right serratus anterior muscle aplasia and medial winging of the right scapula. This case is unique in two aspects. First, the combination of abnormalities is different from the typical congenital abnormalities involving shoulder girdle, such as Sprengel deformity or Poland syndrome. Secondly, this was incidentally diagnosed with chest radiograph, without clinical impression. Careful reading of chest radiograph can help the radiologists to detect such clinically silent abnormalities.

  3. Incidental finding of unilateral isolated aplasia of serratus anterior muscle and winged scapula on chest radiograph: A case report

    International Nuclear Information System (INIS)

    Choi, Joon Sung; Park, Hyun Jin; Ko, Jeong Min

    2014-01-01

    The isolated aplasia of the serratus anterior muscle with winging of scapula is very rare, and only a few cases are reported. Here, we present a case of a 30-year-old Korean male who initially presented with a left flank pain. His physical exam did not show any significant finding in his right shoulder. However, his chest radiograph showed absence of right serratus anterior muscle and slightly elevated and medially rotated right scapula. Subsequent CT scan showed the right serratus anterior muscle aplasia and medial winging of the right scapula. This case is unique in two aspects. First, the combination of abnormalities is different from the typical congenital abnormalities involving shoulder girdle, such as Sprengel deformity or Poland syndrome. Secondly, this was incidentally diagnosed with chest radiograph, without clinical impression. Careful reading of chest radiograph can help the radiologists to detect such clinically silent abnormalities.

  4. Studies on computer-aided diagnosis systems for chest radiographs and mammograms (in Japanese)

    International Nuclear Information System (INIS)

    Hara, Takeshi

    2001-01-01

    This thesis describes computer-aided diagnosis (CAD) systems for chest radiographs and mammograms. Preprocessing and imaging processing methods for each CAD system include dynamic range compression and region segmentation technique. A new pattern recognition technique combines genetic algorithms with template matching methods to detect lung nodules. A genetic algorithm was employed to select the optimal shape of simulated nodular shadows to be compared with real lesions on digitized chest images. Detection performance was evaluated using 332 chest radiographs from the database of the Japanese Society of Radiological Technology. Our average true-positive rate was 72.8% with an average of 11 false-positive findings per image. A new detection method using high resolution digital images with 0.05 mm sampling is also proposed for the mammogram CAD system to detect very small microcalcifications. An automated classification method uses feature extraction based on fractal dimension analysis of masses. Using over 200 cases to evaluate the detection of mammographic masses and calcifications, the detection rate of masses and microcalcifications were 87% and 96% with 1.5 and 1.8 false-positive findings, respectively. The classification performance on benign vs malignant lesions, the Az values that were defined by the areas under the ROC curves derived from classification schemes of masses and microcalcifications were 0.84 and 0.89. To demonstrate the practicality of these CAD systems in a computer-network environment, we propose to use the mammogram CAD system via the Internet and WWW. A common gateway interface and server-client approach for the CAD system via the Internet will permit display of the CAD results on ordinary computers

  5. 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

  6. 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)

  7. Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents

    International Nuclear Information System (INIS)

    Andronikou, Savvas; Lambert, Elena; Hilder, Lucy; Halton, Jarred; Crumley, Iona; Kosack, Cara; Lyttle, Mark D.

    2017-01-01

    National guidance from the United Kingdom and the United States on community-acquired pneumonia in children states that chest radiographs are not recommended routinely in uncomplicated cases. The main reason in the ambulatory setting is that there is no evidence of a substantial impact on clinical outcomes. However clinical practice and adherence to guidance is multifactorial and includes the clinical context (developed vs. developing world), the confidence of the attending physician, the changing incidence of complications (according to the success of immunisation programs), the availability of alternative imaging (and its relationship to perceived risks of radiation) and the reliability of the interpretation of imaging. In practice, chest radiographs are performed frequently for suspected pneumonia in children. Time pressures facing clinicians at the front line, difficulties in distinguishing which children require admission, restricted bed numbers for admissions, imaging-resource limitations, perceptions regarding risk from procedures, novel imaging modalities and the probability of other causes for the child's presentation all need to be factored into a guideline. Other drivers that often weigh in, depending on the setting, include cost-effectiveness and the fear of litigation. Not all guidelines designed for the developed world can therefore be applied to the developing world, and practice guidelines require regular review in the context of new information. In addition, radiologists must improve radiographic diagnosis of pneumonia, reach consensus on the interpretive terminology that clarifies their confidence regarding the presence of pneumonia and act to replace one imaging technique with another whenever there is proof of improved accuracy or reliability. (orig.)

  8. Bone suppression increases the visibility of invasive pulmonary aspergillosis in chest radiographs.

    Directory of Open Access Journals (Sweden)

    Steven Schalekamp

    Full Text Available Chest radiographs (CXR are an important diagnostic tool for the detection of invasive pulmonary aspergillosis (IPA in critically ill patients, but their diagnostic value is limited by a poor sensitivity. By using advanced image processing, the aim of this study was to increase the value of chest radiographs in the diagnostic work up of neutropenic patients who are suspected of IPA.The frontal CXRs of 105 suspected cases of IPA were collected from four institutions. Radiographs could contain single or multiple sites of infection. CT was used as reference standard. Five radiologists and two residents participated in an observer study for the detection of IPA on CXRs with and without bone suppressed images (ClearRead BSI 3.2; Riverain Technologies. The evaluation was performed separately for the right and left lung, resulting in 78 diseased cases (or lungs and 132 normal cases (or lungs. For each image, observers scored the likelihood of focal infectious lesions being present on a continuous scale (0-100. The area under the receiver operating characteristics curve (AUC served as the performance measure. Sensitivity and specificity were calculated by considering only the lungs with a suspiciousness score of greater than 50 to be positive.The average AUC for only CXRs was 0.815. Performance significantly increased, to 0.853, when evaluation was aided with BSI (p = 0.01. Sensitivity increased from 49% to 66% with BSI, while specificity decreased from 95% to 90%.The detection of IPA in CXRs can be improved when their evaluation is aided by bone suppressed images. BSI improved the sensitivity of the CXR examination, outweighing a small loss in specificity.

  9. Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas; Lambert, Elena; Hilder, Lucy [University of Bristol, Department of Paediatric Radiology, Bristol Royal Hospital for Children, Bristol (United Kingdom); CRICBristol, Bristol (United Kingdom); Halton, Jarred; Crumley, Iona; Kosack, Cara [Medecins Sans Frontieres, Diagnostic Network, Amsterdam (Netherlands); Lyttle, Mark D. [Bristol Royal Hospital for Children, Emergency Department, Bristol (United Kingdom); University of the West of England, Faculty of Health and Life Sciences, Bristol (United Kingdom)

    2017-10-15

    National guidance from the United Kingdom and the United States on community-acquired pneumonia in children states that chest radiographs are not recommended routinely in uncomplicated cases. The main reason in the ambulatory setting is that there is no evidence of a substantial impact on clinical outcomes. However clinical practice and adherence to guidance is multifactorial and includes the clinical context (developed vs. developing world), the confidence of the attending physician, the changing incidence of complications (according to the success of immunisation programs), the availability of alternative imaging (and its relationship to perceived risks of radiation) and the reliability of the interpretation of imaging. In practice, chest radiographs are performed frequently for suspected pneumonia in children. Time pressures facing clinicians at the front line, difficulties in distinguishing which children require admission, restricted bed numbers for admissions, imaging-resource limitations, perceptions regarding risk from procedures, novel imaging modalities and the probability of other causes for the child's presentation all need to be factored into a guideline. Other drivers that often weigh in, depending on the setting, include cost-effectiveness and the fear of litigation. Not all guidelines designed for the developed world can therefore be applied to the developing world, and practice guidelines require regular review in the context of new information. In addition, radiologists must improve radiographic diagnosis of pneumonia, reach consensus on the interpretive terminology that clarifies their confidence regarding the presence of pneumonia and act to replace one imaging technique with another whenever there is proof of improved accuracy or reliability. (orig.)

  10. Interpretation of chest radiographs in both cancer and other critical care patients with acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Sema Yilmaz

    2013-04-01

    Full Text Available Acute respiratory distress syndrome is a clinical, pathophysiological and radiographic pattern that has signs of pulmonary edema occur without elevated pulmonary venous pressures. Clinical presentation and progression of acute respiratory distress syndrome are followed by frequently ordered portable chest X-ray in critically ill patients. We evaluated chest radiographs of ten cancer and other six critical care pediatric patients. The parenchymal imaging of lung in patients with cancer was reported the same as that of other critically ill children despite underlying pathophysiological variations in our investigation. [Cukurova Med J 2013; 38(2.000: 270-273

  11. Inter- and intra-observer variability in the assessment of atelectasis and consolidation in neonatal chest radiographs

    International Nuclear Information System (INIS)

    Bloomfield, F.H.; Teele, R.L.; Voss, M.; Knight, D.B.; Harding, J.E.

    1999-01-01

    Background. Radiology is an essential part of neonatal intensive care. Interpretation of chest radiographs frequently contributes to respiratory management of neonates, but there has been little assessment of the consistency of this interpretation. Objective. To assess the inter- and intra-observer variability for the reporting of atelectasis and/or consolidation in neonatal chest radiographs. Materials and methods. A total of 585 chest radiographs from the 220 babies ventilated in our nursery over a 2-year period were coded by two radiologists for generalised, lobar and segmental atelectasis and/or consolidation. Two months later one of the radiologists re-coded a random sample of these films (n = 117, 20 %). Agreement was assessed by the kappa statistic and by proportions of agreement for normality and abnormality. Results. The reported incidence of focal atelectasis was low (5-6 %). Focal changes of any nature were found in 21-26 % of films. Inter-observer agreement was fair to moderate (kappa = 0.25-0.44). Intra-observer agreement was mostly moderate to good (kappa = 0.38-0.66). Conclusion. The poor inter-observer agreement for the diagnosis of pulmonary parenchymal abnormalities on chest radiographs of neonates receiving intensive care suggests that abnormalities should be described rather than diagnoses given or that a list of differential diagnoses be offered. When research involves radiographic interpretation, the potential lack of consistency in reporting abnormalities must be borne in mind. (orig.)

  12. 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.

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

    International Nuclear Information System (INIS)

    Lanza, Cecilia; Fabrizzi, Giancarlo; Russo, Marco

    2006-01-01

    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.)

  14. 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.)

  15. A comparison of the Shwachman, Chrispin-Norman and Brasfield methods for scoring of chest radiographs of patients with cystic fibrosis

    NARCIS (Netherlands)

    te Meerman, G J; Dankert-Roelse, J; Martijn, A; van Woerden, H H

    1985-01-01

    Three systems are described for chest radiograph scoring in cystic fibrosis patients: the Shwachman-Kulczycki, the Chrispin-Norman and the Brasfield method. Sixty chest radiographs of 39 patients of different ages have been independently scored by two radiologists according to the three methods. No

  16. Unsupervised segmentation of lung fields in chest radiographs using multiresolution fractal feature vector and deformable models.

    Science.gov (United States)

    Lee, Wen-Li; Chang, Koyin; Hsieh, Kai-Sheng

    2016-09-01

    Segmenting lung fields in a chest radiograph is essential for automatically analyzing an image. We present an unsupervised method based on multiresolution fractal feature vector. The feature vector characterizes the lung field region effectively. A fuzzy c-means clustering algorithm is then applied to obtain a satisfactory initial contour. The final contour is obtained by deformable models. The results show the feasibility and high performance of the proposed method. Furthermore, based on the segmentation of lung fields, the cardiothoracic ratio (CTR) can be measured. The CTR is a simple index for evaluating cardiac hypertrophy. After identifying a suspicious symptom based on the estimated CTR, a physician can suggest that the patient undergoes additional extensive tests before a treatment plan is finalized.

  17. Automatic, anatomically selective, artifact-free enhancement of digital chest radiographs

    International Nuclear Information System (INIS)

    Sezan, M.I.; Tekalp, A.M.; Schaetzing, R.

    1988-01-01

    The authors propose a technique for automatic, anatomically selective, artifact-free enhancement of digital chest radiographs. Anatomically selective enhancement is motivated by the different enhancement requirements of the lung field and the mediastinum. A recent peak detection algorithm is applied to the image histogram to automatically determine a gray-level threshold between the lung and mediastinum fields. The gray-level threshold facilitates anatomically selective gray-scale modification and unsharp masking. Further, in an attempt to suppress possible white-band artifacts due to unsharp masking at sharp edges, local-contrast adaptivity is incorporated into anatomically selective unsharp masking by designing an anatomy-sensitive emphasis parameter that varied asymmetrically with positive and negative values of the local image contrast

  18. Chest radiographs in acquired antibody deficiency syndrome with chronic granulomatous inflammation

    International Nuclear Information System (INIS)

    Qaiyumi, S.A.A.; Peest, D.; Galanski, M.; Medizinische Hochschule Hannover

    1990-01-01

    Ten cases of acquired antibody deficiency syndrome with chronic granulomatous infection were diagnosed in our hospital during the past 10 years. We were able to perform a retrospective analysis of the initial and follow-up chest radiographs in 8 of these patients. The following pathological findings could be demonstrated: 1. increased bronchovascular markings in the basal lung fields, 2. reticular densities in the middle and basal lung fields, 3. confluent nodular densities of varying size in the periphery of the basal and middle fields, 4. pulmonary infiltrates in the middle and lower lobes, 5. hilar node enlargement of moderate extent. Findings 2, 3 and 5 completely disappeared under steroid therapy whereas 1 showed only partial recovery. If both the radiologic and serologic findings are considered, it is possible to differentiate this disease from sarcoidosis. (orig.) [de

  19. Effectiveness of embolization for management of hemoptysis pulmonary tuberculosis: comparison of chest radiographic study and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sang Chul; Kim, Yong Ju; Park, Joong Wha; Lee Myeong Sub; Kim Dong Jin; Hong In Soo [Yonsei Univ. College of Medicine, Wonju (Korea, Republic of)

    2001-01-01

    To compare the effectiveness of embolization of the bronchial artery embolization for the management of hemoptysis in pulmonary tuberculosis cases with the severity of lung parenchymal injury and pleural infiltration, as seen on plain chest radiographs, and with the findings of angiography of the branchial artery. Among 265 patients with hemoptysis due to pulmonary tuberculosis, the findings of plain chest radiography and angiography of the bronchial artery were comparatively analyzed in the 206 for whom the results of follow up were available. The chest radiographin findings were classified as follows: Type I refers to simple pulmonary tuberculosis; Type II includes cases in which pulmonary tuberculosis is complicated by bronchiectasis, aspergillosis, or cavitation; Type III si either Types I or II acompainted by pleural in filtrates limited to the lung apex, and Type IV includes cases in which pleural infiltrates have extended beyond the apex in the whole the lung. Bronchial angiographic findings were divided into four groups: Group I consists of cases which show abnormalities of only the bronchial artery; Group II includes those in which abnormalities are seen in the bronchial artery and either the internal mammary or an intercostal artery; Group III comprises cases which belong to Group I or II and which a bronch of the subclavian artery is abnormal, and Group IV includes those in which abnormalities occur in at least two branches of the subclavian artery, or there is direct visualization of hypervascularity of this vessel. The initial post-embolic hemostatic effect and the results of follow up were studied over a six-month period. As compared with simple pulmonary tuberculosis (Type I), we found that as the severity of pleural infiltration and complications revealed by plain chest radiographs increased (Type II, III, IV), so did the severity of the manifestation of systemic collateral arteries other than the bronchial artery, as depicted by increased on

  20. Effectiveness of embolization for management of hemoptysis pulmonary tuberculosis: comparison of chest radiographic study and angiography

    International Nuclear Information System (INIS)

    Shin, Sang Chul; Kim, Yong Ju; Park, Joong Wha; Lee Myeong Sub; Kim Dong Jin; Hong In Soo

    2001-01-01

    To compare the effectiveness of embolization of the bronchial artery embolization for the management of hemoptysis in pulmonary tuberculosis cases with the severity of lung parenchymal injury and pleural infiltration, as seen on plain chest radiographs, and with the findings of angiography of the branchial artery. Among 265 patients with hemoptysis due to pulmonary tuberculosis, the findings of plain chest radiography and angiography of the bronchial artery were comparatively analyzed in the 206 for whom the results of follow up were available. The chest radiographin findings were classified as follows: Type I refers to simple pulmonary tuberculosis; Type II includes cases in which pulmonary tuberculosis is complicated by bronchiectasis, aspergillosis, or cavitation; Type III si either Types I or II acompainted by pleural in filtrates limited to the lung apex, and Type IV includes cases in which pleural infiltrates have extended beyond the apex in the whole the lung. Bronchial angiographic findings were divided into four groups: Group I consists of cases which show abnormalities of only the bronchial artery; Group II includes those in which abnormalities are seen in the bronchial artery and either the internal mammary or an intercostal artery; Group III comprises cases which belong to Group I or II and which a bronch of the subclavian artery is abnormal, and Group IV includes those in which abnormalities occur in at least two branches of the subclavian artery, or there is direct visualization of hypervascularity of this vessel. The initial post-embolic hemostatic effect and the results of follow up were studied over a six-month period. As compared with simple pulmonary tuberculosis (Type I), we found that as the severity of pleural infiltration and complications revealed by plain chest radiographs increased (Type II, III, IV), so did the severity of the manifestation of systemic collateral arteries other than the bronchial artery, as depicted by increased on

  1. Segmentation of anatomical structures in chest radiographs using supervised methods: a comparative study on a public database

    DEFF Research Database (Denmark)

    van Ginneken, Bram; Stegmann, Mikkel Bille; Loog, Marco

    2006-01-01

    classification method that employs a multi-scale filter bank of Gaussian derivatives and a k-nearest-neighbors classifier. The methods have been tested on a publicly available database of 247 chest radiographs, in which all objects have been manually segmented by two human observers. A parameter optimization...

  2. The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low

    NARCIS (Netherlands)

    Graat, Marleen E.; Choi, Goda; Wolthuis, Esther K.; Korevaar, Johanna C.; Spronk, Peter E.; Stoker, Jaap; Vroom, Margreeth B.; Schultz, Marcus J.

    2006-01-01

    INTRODUCTION: The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care

  3. Cavity contour segmentation in chest radiographs using supervised learning and dynamic programming

    Energy Technology Data Exchange (ETDEWEB)

    Maduskar, Pragnya, E-mail: pragnya.maduskar@radboudumc.nl; Hogeweg, Laurens; Sánchez, Clara I.; Ginneken, Bram van [Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen, 6525 GA (Netherlands); Jong, Pim A. de [Department of Radiology, University Medical Center Utrecht, 3584 CX (Netherlands); Peters-Bax, Liesbeth [Department of Radiology, Radboud University Medical Center, Nijmegen, 6525 GA (Netherlands); Dawson, Rodney [University of Cape Town Lung Institute, Cape Town 7700 (South Africa); Ayles, Helen [Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT (United Kingdom)

    2014-07-15

    Purpose: Efficacy of tuberculosis (TB) treatment is often monitored using chest radiography. Monitoring size of cavities in pulmonary tuberculosis is important as the size predicts severity of the disease and its persistence under therapy predicts relapse. The authors present a method for automatic cavity segmentation in chest radiographs. Methods: A two stage method is proposed to segment the cavity borders, given a user defined seed point close to the center of the cavity. First, a supervised learning approach is employed to train a pixel classifier using texture and radial features to identify the border pixels of the cavity. A likelihood value of belonging to the cavity border is assigned to each pixel by the classifier. The authors experimented with four different classifiers:k-nearest neighbor (kNN), linear discriminant analysis (LDA), GentleBoost (GB), and random forest (RF). Next, the constructed likelihood map was used as an input cost image in the polar transformed image space for dynamic programming to trace the optimal maximum cost path. This constructed path corresponds to the segmented cavity contour in image space. Results: The method was evaluated on 100 chest radiographs (CXRs) containing 126 cavities. The reference segmentation was manually delineated by an experienced chest radiologist. An independent observer (a chest radiologist) also delineated all cavities to estimate interobserver variability. Jaccard overlap measure Ω was computed between the reference segmentation and the automatic segmentation; and between the reference segmentation and the independent observer's segmentation for all cavities. A median overlap Ω of 0.81 (0.76 ± 0.16), and 0.85 (0.82 ± 0.11) was achieved between the reference segmentation and the automatic segmentation, and between the segmentations by the two radiologists, respectively. The best reported mean contour distance and Hausdorff distance between the reference and the automatic segmentation were

  4. Cavity contour segmentation in chest radiographs using supervised learning and dynamic programming

    International Nuclear Information System (INIS)

    Maduskar, Pragnya; Hogeweg, Laurens; Sánchez, Clara I.; Ginneken, Bram van; Jong, Pim A. de; Peters-Bax, Liesbeth; Dawson, Rodney; Ayles, Helen

    2014-01-01

    Purpose: Efficacy of tuberculosis (TB) treatment is often monitored using chest radiography. Monitoring size of cavities in pulmonary tuberculosis is important as the size predicts severity of the disease and its persistence under therapy predicts relapse. The authors present a method for automatic cavity segmentation in chest radiographs. Methods: A two stage method is proposed to segment the cavity borders, given a user defined seed point close to the center of the cavity. First, a supervised learning approach is employed to train a pixel classifier using texture and radial features to identify the border pixels of the cavity. A likelihood value of belonging to the cavity border is assigned to each pixel by the classifier. The authors experimented with four different classifiers:k-nearest neighbor (kNN), linear discriminant analysis (LDA), GentleBoost (GB), and random forest (RF). Next, the constructed likelihood map was used as an input cost image in the polar transformed image space for dynamic programming to trace the optimal maximum cost path. This constructed path corresponds to the segmented cavity contour in image space. Results: The method was evaluated on 100 chest radiographs (CXRs) containing 126 cavities. The reference segmentation was manually delineated by an experienced chest radiologist. An independent observer (a chest radiologist) also delineated all cavities to estimate interobserver variability. Jaccard overlap measure Ω was computed between the reference segmentation and the automatic segmentation; and between the reference segmentation and the independent observer's segmentation for all cavities. A median overlap Ω of 0.81 (0.76 ± 0.16), and 0.85 (0.82 ± 0.11) was achieved between the reference segmentation and the automatic segmentation, and between the segmentations by the two radiologists, respectively. The best reported mean contour distance and Hausdorff distance between the reference and the automatic segmentation were

  5. Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice?

    International Nuclear Information System (INIS)

    Hurlen, Petter; Borthne, Arne; Dahl, Fredrik A.; Østbye, Truls; Gulbrandsen, Pål

    2012-01-01

    Objectives: To assess the impact of a Picture Archiving and Communication System (PACS) on the diagnostic accuracy of the interpretation of chest radiology examinations in a “real life” radiology setting. Materials and methods: During a period before PACS was introduced to radiologists, when images were still interpreted on film and reported on paper, images and reports were also digitally stored in an image database. The same database was used after the PACS introduction. This provided a unique opportunity to conduct a blinded retrospective study, comparing sensitivity (the main outcome parameter) in the pre and post-PACS periods. We selected 56 digitally stored chest radiograph examinations that were originally read and reported on film, and 66 examinations that were read and reported on screen 2 years after the PACS introduction. Each examination was assigned a random number, and both reports and images were scored independently for pathological findings. The blinded retrospective score for the original reports were then compared with the score for the images (the gold standard). Results: Sensitivity was improved after the PACS introduction. When both certain and uncertain findings were included, this improvement was statistically significant. There were no other statistically significant changes. Conclusion: The result is consistent with prospective studies concluding that diagnostic accuracy is at least not reduced after PACS introduction. The sensitivity may even be improved.

  6. Radiation safety education reduces the incidence of adult fingers on neonatal chest radiographs

    International Nuclear Information System (INIS)

    Sahota, N; Burbridge, B E; Duncan, M D

    2014-01-01

    A previous audit revealed a high frequency of adult fingers visualised on neonatal intensive care unit (NICU) chest radiographs—representing an example of inappropriate occupational radiation exposure. Radiation safety education was provided to staff and we hypothesised that the education would reduce the frequency of adult fingers visualised on NICU chest radiographs. Two cross-sectional samples taken before and after the administration of the education were compared. We examined fingers visualised directly in the beam, fingers in the direct beam but eliminated by technologists editing the image, and fingers under the cones of the portable x-ray machine. There was a 46.2% reduction in fingers directly in the beam, 50.0% reduction in fingers directly in the beam but cropped out, and 68.4% reduction in fingers in the coned area. There was a 57.1% overall reduction in adult fingers visualised, which was statistically significant (Z value − 7.48, P < 0.0001). This study supports radiation safety education in minimising inappropriate occupational radiation exposure. (paper)

  7. Chest Wall Constriction after the Nuss Procedure Identified from Chest Radiograph and Multislice Computed Tomography Shortly after Removal of the Bar.

    Science.gov (United States)

    Chang, Pei-Yeh; Zeng, Qi; Wong, Kin-Sun; Wang, Chao-Jan; Chang, Chee-Jen

    2016-01-01

    This study radiographically examined the changes in the chest walls of patients with pectus excavatum (PE) after Nuss bar removal, to define the deformation caused by the bar and stabilizer. In the first part of the study, we compared the changes in chest radiographs of patients with PE to a preoperation PE control group. In the second part, we used multislice computed tomography (CT) scans to provide three-dimensional reconstructions with which to evaluate the changes to the thoracic wall. Part 1 From June 2006 to August 2011, 1,125 patients with PE who had posteroanterior chest radiographs taken before undergoing the Nuss procedure at four hospitals were enrolled as a preoperative control group. At the same time, 203 patients who had the bar removed were enrolled as the study group. The maximum dimensions of the outer boundary of the first to ninth rib pairs (R1-R9, rib pair width), chest height, and chest width were measured. Part 2 Thirty-one consecutive patients with PE (20 males and 11 females) who underwent Nuss bar removal were evaluated 7 to 30 days after operation. During this period, a further 34 patients with PE who had undergone CT imaging before bar insertion were evaluated and compared with the postoperative group. Part 1 The width of the lower ribs (R4-R9) after bar removal was significantly less than in the age-matched controls. The ribs adjacent to the bar (R5-R7) showed the greatest restriction. The width of the upper ribs (R1-R3) 2 to 3 years after bar placement did not differ significantly from the controls. Patients who were operated on after 10 years of age had less of a restrictive effect. Three years of bar placement resulted in more restriction than a 2-year period, particularly in patients younger than 10 years old. Part 2: A significant constriction of the chest wall was observed in 13 patients after removal of the Nuss bar. Constriction at ribs 5 to 8 was found to be present adjacent to the site of bar insertion. However

  8. The presence of radiological features on chest radiographs: How well do clinicians agree?

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, M. [Department of Child Health, School of Medicine, Cardiff University (United Kingdom); Lawson, Z. [Department of Child Health, School of Medicine, Cardiff University (United Kingdom); Department of Primary Care and Public Health, School of Medicine, Cardiff University (United Kingdom); Morris, S.; Evans, A.; Harrison, S.; Isaac, R. [Department of Paediatric Radiology, University Hospital of Wales, Cardiff (United Kingdom); Crocker, J. [Department of Primary Care and Public Health, School of Medicine, Cardiff University (United Kingdom); Powell, C., E-mail: powellc7@cardiff.ac.uk [Department of Child Health, School of Medicine, Cardiff University (United Kingdom)

    2012-07-15

    Aim: To compare levels of agreement amongst paediatric clinicians with those amongst consultant paediatric radiologists when interpreting chest radiographs (CXRs). Materials and methods: Four paediatric radiologists used picture archiving and communication system (PACS) workstations to evaluate the presence of five radiological features of infection, independently in each of 30 CXRs. The radiographs were obtained over 1 year (2008) from children with fever and signs of respiratory distress, aged 6 months to <16 years. The same CXRs were interpreted a second time by the paediatric radiologists and by 21 clinicians with varying experience levels, using the Web 1000 viewing system and a projector. Intra- and interobserver agreement within groups, split by grade and specialty, were analysed using free-marginal multi-rater kappa. Results: Normal CXRs were identified consistently amongst all 25 participants. The four paediatric radiologists showed high levels of intraobserver agreement between methods (kappa scores between 0.53 and 1.00) and interobserver agreement for each method (kappa scores between 0.67 and 0.96 for PACS assessment). The 21 clinicians showed varying levels of agreement from 0.21 to 0.89. Conclusion: Paediatric radiologists showed high levels of agreement for all features. In general, the clinicians had lower levels of agreement than the radiologists. This study highlights the need for improved training in interpreting CXRs for clinicians and the timely reporting of CXRs by radiologists to allow appropriate patient management.

  9. Improvement in Detection of Wrong-Patient Errors When Radiologists Include Patient Photographs in Their Interpretation of Portable Chest Radiographs.

    Science.gov (United States)

    Tridandapani, Srini; Olsen, Kevin; Bhatti, Pamela

    2015-12-01

    This study was conducted to determine whether facial photographs obtained simultaneously with radiographs improve radiologists' detection rate of wrong-patient errors, when they are explicitly asked to include the photographs in their evaluation. Radiograph-photograph combinations were obtained from 28 patients at the time of portable chest radiography imaging. From these, pairs of radiographs were generated. Each unique pair consisted of one new and one old (comparison) radiograph. Twelve pairs of mismatched radiographs (i.e., pairs containing radiographs of different patients) were also generated. In phase 1 of the study, 5 blinded radiologist observers were asked to interpret 20 pairs of radiographs without the photographs. In phase 2, each radiologist interpreted another 20 pairs of radiographs with the photographs. Radiologist observers were not instructed about the purpose of the photographs but were asked to include the photographs in their review. The detection rate of mismatched errors was recorded along with the interpretation time for each session for each observer. The two-tailed Fisher exact test was used to evaluate differences in mismatch detection rates between the two phases. A p value of error detection rates without (0/20 = 0%) and with (17/18 = 94.4%) photographs were different (p = 0.0001). The average interpretation times for the set of 20 radiographs were 26.45 (SD 8.69) and 20.55 (SD 3.40) min, for phase 1 and phase 2, respectively (two-tailed Student t test, p = 0.1911). When radiologists include simultaneously obtained photographs in their review of portable chest radiographs, there is a significant improvement in the detection of labeling errors. No statistically significant difference in interpretation time was observed. This may lead to improved patient safety without affecting radiologists' throughput.

  10. Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma.

    Science.gov (United States)

    Wilkerson, R Gentry; Stone, Michael B

    2010-01-01

    Supine anteroposterior (AP) chest radiographs in patients with blunt trauma have poor sensitivity for the identification of pneumothorax. Ultrasound (US) has been proposed as an alternative screening test for pneumothorax in this population. The authors conducted an evidence-based review of the medical literature to compare sensitivity of bedside US and AP chest radiographs in identifying pneumothorax after blunt trauma. MEDLINE and EMBASE databases were searched for trials from 1965 through June 2009 using a search strategy derived from the following PICO formulation of our clinical question: patients included adult (18 + years) emergency department (ED) patients in whom pneumothorax was suspected after blunt trauma. The intervention was thoracic ultrasonography for the detection of pneumothorax. The comparator was the supine AP chest radiograph during the initial evaluation of the patient. The outcome was the diagnostic performance of US in identifying the presence of pneumothorax in the study population. The criterion standard for the presence or absence of pneumothorax was computed tomography (CT) of the chest or a rush of air during thoracostomy tube placement (in unstable patients). Prospective, observational trials of emergency physician (EP)-performed thoracic US were included. Trials in which the exams were performed by radiologists or surgeons, or trials that investigated patients suffering penetrating trauma or with spontaneous or iatrogenic pneumothoraces, were excluded. The methodologic quality of the studies was assessed. Qualitative methods were used to summarize the study results. Data analysis consisted of test performance (sensitivity and specificity, with 95% confidence intervals [CIs]) of thoracic US and supine AP chest radiography. Four prospective observational studies were identified, with a total of 606 subjects who met the inclusion and exclusion criteria. The sensitivity and specificity of US for the detection of pneumothorax ranged from

  11. HIV-positive patients in Pusan servitude : clinical and chest radiographic findings

    International Nuclear Information System (INIS)

    Son, Young Keun; Kim, Kun Il

    2001-01-01

    To analyze the clinical and chest radiolographic findings of HIV-positive in Pusan survitude. We reviewed the medical records of 74 admission cases of 41 HIV-positive patients (38 mem and 3 women), confirmed in NIH and admitted to our hospital between May 1990 and September 1997. We evaluated the clinical findings including the pulmonary disease diagnosed at each admission, and using the pattern approach assessed the radiographic findings in 63 cases available among 74 admission cases. For statistical analysis the Pearson Chi-Square test was used, and the chest CT findings available in 19 cases among 17 patients were also evaluated. In all cases the mode of transmission was sexual contact, and they were more frequently contacted with foreigners (73%) than koreans (27%). During the follow-up period, pulmonary diseases were diagnosed in 52 (70%) of 74 admission cases. The diagnoses were pneumocystis cabrini pneumonia (PCP, n=15), pneumonia(n=15), pulmonary tuberculosis(n=15), combined infection with PCP and pulmonary tuberculosis(n=5), and combined infection with PCP and bacterial pneumonia(n=1). The count of CD4+ lymphocyte in 33 of 55 available admissions cases was less than 50 cells/mm?. In 28 patients(68%) who died, the time between confirmation of HIV-positive status to death ranged from 2 to 81 (mean, 39) months. Chest radiographs of 46 available admission cases (73%) showed the followingabnormal findings: interstitial opacities(n=26), consolidation(n=17), single or multiple nodules (n=9), hilar or mediastinal lymph node enlargement(n=10), pleural effusion(n=8), cyst(n=2), mass(n=1), and pericardial effusion(n=1). Diffuse ground glass opacity was observed in eight (89%) of nine PCP cases (p<0.05), and in cases of pulmonary tubercolosis, hilar or mediastinal lymph node enlargement was frequent (p<0.05). Pulmonary diseases in HIV-positive patients in Pusan servitude were diagnosed during follow-up in 70% of cases. The majority of these diseases were infectious

  12. HIV-positive patients in Pusan servitude : clinical and chest radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Son, Young Keun; Kim, Kun Il [Pusan National Univ. College of Medicine, Pusan (Korea, Republic of)

    2001-04-01

    To analyze the clinical and chest radiolographic findings of HIV-positive in Pusan survitude. We reviewed the medical records of 74 admission cases of 41 HIV-positive patients (38 mem and 3 women), confirmed in NIH and admitted to our hospital between May 1990 and September 1997. We evaluated the clinical findings including the pulmonary disease diagnosed at each admission, and using the pattern approach assessed the radiographic findings in 63 cases available among 74 admission cases. For statistical analysis the Pearson Chi-Square test was used, and the chest CT findings available in 19 cases among 17 patients were also evaluated. In all cases the mode of transmission was sexual contact, and they were more frequently contacted with foreigners (73%) than koreans (27%). During the follow-up period, pulmonary diseases were diagnosed in 52 (70%) of 74 admission cases. The diagnoses were pneumocystis cabrini pneumonia (PCP, n=15), pneumonia(n=15), pulmonary tuberculosis(n=15), combined infection with PCP and pulmonary tuberculosis(n=5), and combined infection with PCP and bacterial pneumonia(n=1). The count of CD4+ lymphocyte in 33 of 55 available admissions cases was less than 50 cells/mm?. In 28 patients(68%) who died, the time between confirmation of HIV-positive status to death ranged from 2 to 81 (mean, 39) months. Chest radiographs of 46 available admission cases (73%) showed the followingabnormal findings: interstitial opacities(n=26), consolidation(n=17), single or multiple nodules (n=9), hilar or mediastinal lymph node enlargement(n=10), pleural effusion(n=8), cyst(n=2), mass(n=1), and pericardial effusion(n=1). Diffuse ground glass opacity was observed in eight (89%) of nine PCP cases (p<0.05), and in cases of pulmonary tubercolosis, hilar or mediastinal lymph node enlargement was frequent (p<0.05). Pulmonary diseases in HIV-positive patients in Pusan servitude were diagnosed during follow-up in 70% of cases. The majority of these diseases were infectious

  13. Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

    International Nuclear Information System (INIS)

    Samei, Ehsan; Lin, Yuan; Choudhury, Kingshuk R.; Page McAdams, H.

    2014-01-01

    Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual quality assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable ranges

  14. Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

    Energy Technology Data Exchange (ETDEWEB)

    Samei, Ehsan, E-mail: samei@duke.edu [Carl E. Ravin Advanced Imaging Laboratories, Departments of Radiology, Physics, Biomedical Engineering, Electrical and Computer Engineering, Medical Physics Graduate Program, Duke Clinical Imaging Physics Group, Duke University, Durham, North Carolina 27710 (United States); Lin, Yuan [Carl E. Ravin Advanced Imaging Laboratories, Departments of Radiology and Physics, Duke University, Durham, North Carolina 27710 (United States); Choudhury, Kingshuk R. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology and Biostatistics and Bioinformatics, Duke University, Durham, North Carolina 27710 (United States); Page McAdams, H. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University, Durham, North Carolina 27710 (United States)

    2014-11-01

    Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual quality assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable ranges

  15. Ultrasound and supine chest radiograph in road traffic accident patients: a reliable and convenient way to diagnose pleural effusion

    International Nuclear Information System (INIS)

    Mumtaz, U.; Zahur, Z.; Raza, M.A.

    2017-01-01

    Background: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard. Methods: This study was conducted in PIMS and PAEC General Hospital, Islamabad from 1st January to 15th December 2015. The current study examined total of 80 trauma (blunt and penetrating) patients coming to emergency departments of both hospitals specifically those who had road traffic accident history. Their portable bed side ultrasound and supine chest radiograph were performed for assessing pleural effusion and subsequently CT scan chest was done for confirmation as it's a gold standard. Results: Using CT findings as gold standard the sensitivity, specificity, positive predictive value and negative predictive value was assessed for both ultrasonography and chest radiography and found to be 88.23%,100%, 100%, 40% and 77.94%, 100%, 100%, 55.55% respectively with diagnostic accuracy of ultrasound 90% as compared to 81.25% for supine chest x-rays when compared with gold standard. Conclusion: Ultrasound and chest x-ray can be used as a useful and suitable adjunct to CT in road traffic accident patients as these are easily available, non-invasive, no contrast required, can be performed on bed side and carries no or little radiation risk. (author)

  16. Morphometric Comparison of Clavicle Outlines from 3D Bone Scans and 2D Chest Radiographs: A Short-listing Tool to Assist Radiographic Identification of Human Skeletons

    Energy Technology Data Exchange (ETDEWEB)

    Stephan, Carl N.; Amidan, Brett G.; Trease, Harold E.; Guyomarch, Pierre; Pulsipher, Trenton C.; Byrd, John E.

    2014-03-01

    This paper describes a computerized clavicle identification system, primarily designed to resolve the identities of unaccounted for US soldiers who fought in the Korean War. Elliptical Fourier analysis is used to quantify the clavicle outline shape from skeletons and postero-anterior antemortem chest radiographs to rank individuals in terms of metric distance. Similar to leading fingerprint identification systems, shortlists of the top matching candidates are extracted for subsequent human visual assessment. Two independent tests of the computerized system using 17 field-recovered skeletons and 409 chest radiographs demonstrate that true positive matches are captured within the top 5% of the sample 75% of the time. These results are outstanding given the eroded state of some field-recovered skeletons and the faintness of the 1950’s photoflurographs. These methods enhance the capability to resolve several hundred cold cases for which little circumstantial information exists and current DNA and dental record technologies cannot be applied.

  17. Spirometry reference values in the Brazilian population

    Directory of Open Access Journals (Sweden)

    R. Rufino

    Full Text Available The aim of the present study was to provide new spirometry reference equations in a sample of the Brazilian population for the following parameters: forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, FEV1/FVC ratio, peak of expiratory flow (PEF, forced expiratory flow at 50% (FEF50%, 75% average vital capacity (FEF25-75%, and average forced expiratory flow time (FEFT. This was a prospective study using results from chest radiographs, electrocardiograms, and questionnaires to investigate the participants' respiratory symptoms, sedentarism, and comorbidities (Charlson comorbidity index. From December 2010 to July 2014, individuals were randomly selected from various locations in the state of Rio de Janeiro. All individuals were examined by a single technician in the morning at the laboratory, and performed the spirometry with the same spirometer. Spirometry values were tabulated for the creation of three equation models: linear regression, logarithmic regression, and logarithms through a method that incorporates the lambda, median, and coefficient of variation (LMS method. Initially, 7003 individuals from both genders were contacted, and 454 were recruited. The data from the new equations were compared with one Brazilian and eight international equations, resulting in a high correlation (r>0.9. The values derived from the LMS method and linear regression were very similar (P>0.5, and both could be used to acquire the reference values for Brazilian spirometry. Data derived from the equations of this study were different from the current Brazilian equation, which could be justified by the different method used.

  18. Does reporting of plain chest radiographs affect the immediate management of patients admitted to a medical assessment unit?

    International Nuclear Information System (INIS)

    Grosvenor, L.J.; Verma, R.; O'Brien, R.; Entwisle, J.J.; Finlay, D.

    2003-01-01

    AIM: The purpose of our study was to investigate whether reporting of plain chest radiographs affects immediate management of patients admitted to a medical assessment unit. MATERIALS AND METHODS: During a 3 month period we prospectively evaluated 200 patients who had a plain chest radiograph on admission. After the post on-call ward round, an independent medical specialist registrar reviewed the notes, retrieving relevant clinical details. The plain chest films were reported independently by a trainee radiologist and consultant, reaching a consensus report. RESULTS: There was 93% agreement between trainee and consultant radiologists (95% CI=89-96%). Seventy percent had documented reports by the on-call medical team. There was disagreement between radiology and medical reports in 49% of reported films (95% CI=40-57%). The radiologist's report led to a direct change in the immediate management of 22 patients (11%). CONCLUSION: Only 70% of films had documented reports in the clinical notes despite this being a legal requirement. Radiology reporting does cause a direct change in patient management. Chest radiographs of patients admitted to a medical admissions unit should be reported by a radiologist with the minimum of delay

  19. Usefulness of computerized method for lung nodule detection on digital chest radiographs using similar subtraction images from different patients

    International Nuclear Information System (INIS)

    Aoki, Takatoshi; Oda, Nobuhiro; Yamashita, Yoshiko; Yamamoto, Keiji; Korogi, Yukunori

    2012-01-01

    Purpose: The purpose of this study is to evaluate the usefulness of a novel computerized method to select automatically the similar chest radiograph for image subtraction in the patients who have no previous chest radiographs and to assist the radiologists’ interpretation by presenting the “similar subtraction image” from different patients. Materials and methods: Institutional review board approval was obtained, and the requirement for informed patient consent was waived. A large database of approximately 15,000 normal chest radiographs was used for searching similar images of different patients. One hundred images of candidates were selected according to two clinical parameters and similarity of the lung field in the target image. We used the correlation value of chest region in the 100 images for searching the most similar image. The similar subtraction images were obtained by subtracting the similar image selected from the target image. Thirty cases with lung nodules and 30 cases without lung nodules were used for an observer performance test. Four attending radiologists and four radiology residents participated in this observer performance test. Results: The AUC for all radiologists increased significantly from 0.925 to 0.974 with the CAD (P = .004). When the computer output images were available, the average AUC for the residents was more improved (0.960 vs. 0.890) than for the attending radiologists (0.987 vs. 0.960). Conclusion: The novel computerized method for lung nodule detection using similar subtraction images from different patients would be useful to detect lung nodules on digital chest radiographs, especially for less experienced readers.

  20. Application of Phase Congruency for Discriminating Some Lung Diseases Using Chest Radiograph

    Directory of Open Access Journals (Sweden)

    Omar Mohd Rijal

    2015-01-01

    Full Text Available A novel procedure using phase congruency is proposed for discriminating some lung disease using chest radiograph. Phase congruency provides information about transitions between adjacent pixels. Abrupt changes of phase congruency values between pixels may suggest a possible boundary or another feature that may be used for discrimination. This property of phase congruency may have potential for deciding between disease present and disease absent where the regions of infection on the images have no obvious shape, size, or configuration. Five texture measures calculated from phase congruency and Gabor were shown to be normally distributed. This gave good indicators of discrimination errors in the form of the probability of Type I Error (δ and the probability of Type II Error (β. However, since 1 −  δ is the true positive fraction (TPF and β is the false positive fraction (FPF, an ROC analysis was used to decide on the choice of texture measures. Given that features are normally distributed, for the discrimination between disease present and disease absent, energy, contrast, and homogeneity from phase congruency gave better results compared to those using Gabor. Similarly, for the more difficult problem of discriminating lobar pneumonia and lung cancer, entropy and homogeneity from phase congruency gave better results relative to Gabor.

  1. Chest Radiograph Findings in Childhood Pneumonia Cases From the Multisite PERCH Study.

    Science.gov (United States)

    Fancourt, Nicholas; Deloria Knoll, Maria; Baggett, Henry C; Brooks, W Abdullah; Feikin, Daniel R; Hammitt, Laura L; Howie, Stephen R C; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; Murdoch, David R; Scott, J Anthony G; Thea, Donald M; Awori, Juliet O; Barger-Kamate, Breanna; Chipeta, James; DeLuca, Andrea N; Diallo, Mahamadou; Driscoll, Amanda J; Ebruke, Bernard E; Higdon, Melissa M; Jahan, Yasmin; Karron, Ruth A; Mahomed, Nasreen; Moore, David P; Nahar, Kamrun; Naorat, Sathapana; Ominde, Micah Silaba; Park, Daniel E; Prosperi, Christine; Wa Somwe, Somwe; Thamthitiwat, Somsak; Zaman, Syed M A; Zeger, Scott L; O'Brien, Katherine L

    2017-06-15

    Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)-defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia). At admission, each case underwent a standardized assessment of clinical signs and pneumonia risk factors by trained health personnel, and a CXR was taken that was interpreted using the standardized WHO methodology. CXRs were categorized as abnormal (consolidation and/or other infiltrate), normal, or uninterpretable. CXRs were interpretable in 3587 (85%) cases, of which 1935 (54%) were abnormal (site range, 35%-64%). Cases with abnormal CXRs were more likely than those with normal CXRs to have hypoxemia (45% vs 26%), crackles (69% vs 62%), tachypnea (85% vs 80%), or fever (20% vs 16%) and less likely to have wheeze (30% vs 38%; all P pneumonia cases with abnormal CXRs were more likely to have signs typically associated with pneumonia. However, CXR-normal cases were common, and clinical signs considered indicative of pneumonia were present in substantial proportions of these cases. CXR-consolidation cases represent a group with an increased likelihood of death at 30 days post-discharge. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  2. Are daily routine chest radiographs useful in critically ill, mechanically ventilated patients? A randomized study.

    Science.gov (United States)

    Clec'h, Christophe; Simon, Paul; Hamdi, Aïcha; Hamza, Lilia; Karoubi, Philippe; Fosse, Jean-Philippe; Gonzalez, Frédéric; Vincent, François; Cohen, Yves

    2008-02-01

    Whether chest radiographs (CXRs) in mechanically ventilated patients should be routinely obtained or only when an abnormality is anticipated remains debated. We aimed to compare the diagnostic, therapeutic and outcome efficacy of a restrictive prescription of CXRs with that of a routine prescription, focusing on delayed diagnoses and treatments potentially related to the restrictive prescription. Randomized controlled trial. Intensive care unit of the Avicenne Teaching Hospital, Bobigny, France. All consecutive patients mechanically ventilated for > or = 48h between January and June 2006. Patients were randomly assigned to have daily routine CXRs (routine prescription group) or clinically indicated CXRs (restrictive prescription group). For each CXR, a questionnaire was completed addressing the reason for the CXR, the new findings, and any subsequent therapeutic intervention. The endpoints were the rates of new findings, the rates of new findings that prompted therapeutic intervention, the rate of delayed diagnoses, and mortality. Eighty-four patients were included in the routine prescription group and 81 in the restrictive prescription group. The rates of new findings and the rates of new findings that prompted therapeutic intervention in the restrictive prescription group and in the routine prescription group were 66% vs. 7.2% (p < 0.0001), and 56.4% vs. 5.5% (p < 0.0001) respectively. The rate of delayed diagnoses in the restrictive prescription group was 0.7%. Mortality was similar. Restrictive use of CXRs in mechanically ventilated patients was associated with better diagnostic and therapeutic efficacies without impairing outcome.

  3. Accuracy of an automated system for tuberculosis detection on chest radiographs in high-risk screening.

    Science.gov (United States)

    Melendez, J; Hogeweg, L; Sánchez, C I; Philipsen, R H H M; Aldridge, R W; Hayward, A C; Abubakar, I; van Ginneken, B; Story, A

    2018-05-01

    Tuberculosis (TB) screening programmes can be optimised by reducing the number of chest radiographs (CXRs) requiring interpretation by human experts. To evaluate the performance of computerised detection software in triaging CXRs in a high-throughput digital mobile TB screening programme. A retrospective evaluation of the software was performed on a database of 38 961 postero-anterior CXRs from unique individuals seen between 2005 and 2010, 87 of whom were diagnosed with TB. The software generated a TB likelihood score for each CXR. This score was compared with a reference standard for notified active pulmonary TB using receiver operating characteristic (ROC) curve and localisation ROC (LROC) curve analyses. On ROC curve analysis, software specificity was 55.71% (95%CI 55.21-56.20) and negative predictive value was 99.98% (95%CI 99.95-99.99), at a sensitivity of 95%. The area under the ROC curve was 0.90 (95%CI 0.86-0.93). Results of the LROC curve analysis were similar. The software could identify more than half of the normal images in a TB screening setting while maintaining high sensitivity, and may therefore be used for triage.

  4. A study on computer-aided diagnosis based on temporal subtraction of sequential chest radiographs (in Japanese)

    International Nuclear Information System (INIS)

    Kano, Akiko

    2001-01-01

    An automated digital image subtraction technique for use with pairs of temporally sequential chest radiographs has been developed to aid radiologists in the detection of interval changes. Automated image registration based on nonlinear geometric warping is performed prior to subtraction in order to deal with complicated radiographic misregistration. Processing includes global matching, to achieve rough registration between the entire lung fields in the two images, and local matching, based on a cross-correlation method, to determine local shift values for a number of small regions. A proper warping of x,y-coordinates is determined by fitting two-dimensional polynomials to the distributions of the shift values. One image is warped and then subtracted from the other. The resultant subtraction images were able to enhance the conspicuity of various types of interval changes. Improved global matching based on a weighted template matching method achieved robust registration even with photofluorographs taken in chest mass screening programs, which had previously presented us with a relatively large number of poor-registration images. The new method was applied to 129 pairs of chest mass screening images, and offered registration accuracy as good as manual global matching. An observer test using 114 cases including 57 lung cancer cases presented better sensitivity and specificity on average compared to conventional comparison readings. In addition, newly developed image processing that eliminates the rib edge artifacts in subtraction images was applied to 26 images having pathological interval changes; results showed the potential for application to automated schemes for the detection of interval change patterns. With its capacity to improve the diagnostic accuracy of chest radiographs, the chest temporal subtraction technique promises to become an important element of computer-aided diagnosis (CAD) systems

  5. Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

    International Nuclear Information System (INIS)

    Makri, T; Yakoumakis, E; Papadopoulou, D; Gialousis, G; Theodoropoulos, V; Sandilos, P; Georgiou, E

    2006-01-01

    Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 μGy and 43 ± 19 μGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 μSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 μJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 μSv (males)/17.2 ± 7.6 μSv (females) and 29.7 ± 13.2 μJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods

  6. Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

    Science.gov (United States)

    Makri, T.; Yakoumakis, E.; Papadopoulou, D.; Gialousis, G.; Theodoropoulos, V.; Sandilos, P.; Georgiou, E.

    2006-10-01

    Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 µGy and 43 ± 19 µGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 µSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 µJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 µSv (males)/17.2 ± 7.6 µSv (females) and 29.7 ± 13.2 µJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods.

  7. Development of a world wide web-based interactive education program to improve detectability of pulmonary nodules on chest radiographs

    International Nuclear Information System (INIS)

    Ohm, Joon Young; Kim, Jin Hwan; Kim, Sung Soo; Han, Ki Tae; Ahn, Young Seob; Shin, Byung Seok; Bae, Kyongtae T.

    2007-01-01

    To design and develop a World Wide Web-based education program that will allow trainees to interactively learn and improve the diagnostic capability of detecting pulmonary nodules on chest radiographs. Chest radiographs with known diagnosis were retrieved and selected from our institutional clinical archives. A database was constructed by sorting radiographs into three groups: normal, nodule, and false positive (i.e., nodule-like focal opacity). Each nodule was assigned with the degree of detectability: easy, intermediate, difficult, and likely missed. Nodules were characterized by their morphology (well-defined, ill-defined, irregular, faint) and by other associated pathologies or potentially obscuring structures. The Web site was organized into four sections: study, test, record and information. The Web site allowed a user interactively to undergo the training section appropriate to the user's diagnostic capability. The training was enhanced by means of clinical and other pertinent radiological findings included in the database. The outcome of the training was tested with clinical test radiographs that presented nodules or false positives with varying diagnostic difficulties. A World Wide Web-based education program is a promising technique that would allow trainees to interactively learn and improve the diagnostic capability of detecting and characterizing pulmonary nodules

  8. Computerized detection of vertebral compression fractures on lateral chest radiographs: Preliminary results with a tool for early detection of osteoporosis

    International Nuclear Information System (INIS)

    Kasai, Satoshi; Li Feng; Shiraishi, Junji; Li Qiang; Doi, Kunio

    2006-01-01

    Vertebral fracture (or vertebral deformity) is a very common outcome of osteoporosis, which is one of the major public health concerns in the world. Early detection of vertebral fractures is important because timely pharmacologic intervention can reduce the risk of subsequent additional fractures. Chest radiographs are used routinely for detection of lung and heart diseases, and vertebral fractures can be visible on lateral chest radiographs. However, investigators noted that about 50% of vertebral fractures visible on lateral chest radiographs were underdiagnosed or under-reported, even when the fractures were severe. Therefore, our goal was to develop a computerized method for detection of vertebral fractures on lateral chest radiographs in order to assist radiologists' image interpretation and thus allow the early diagnosis of osteoporosis. The cases used in this study were 20 patients with severe vertebral fractures and 118 patients without fractures, as confirmed by the consensus of two radiologists. Radiologists identified the locations of fractured vertebrae, and they provided morphometric data on the vertebral shape for evaluation of the accuracy of detecting vertebral end plates by computer. In our computerized method, a curved search area, which included a number of vertebral end plates, was first extracted automatically, and was straightened so that vertebral end plates became oriented horizontally. Edge candidates were enhanced by use of a horizontal line-enhancement filter in the straightened image, and a multiple thresholding technique, followed by feature analysis, was used for identification of the vertebral end plates. The height of each vertebra was determined from locations of identified vertebral end plates, and fractured vertebrae were detected by comparison of the measured vertebral height with the expected height. The sensitivity of our computerized method for detection of fracture cases was 95% (19/20), with 1.03 (139/135) false

  9. Standardized Interpretation of Chest Radiographs in Cases of Pediatric Pneumonia From the PERCH Study.

    Science.gov (United States)

    Fancourt, Nicholas; Deloria Knoll, Maria; Barger-Kamate, Breanna; de Campo, John; de Campo, Margaret; Diallo, Mahamadou; Ebruke, Bernard E; Feikin, Daniel R; Gleeson, Fergus; Gong, Wenfeng; Hammitt, Laura L; Izadnegahdar, Rasa; Kruatrachue, Anchalee; Madhi, Shabir A; Manduku, Veronica; Matin, Fariha Bushra; Mahomed, Nasreen; Moore, David P; Mwenechanya, Musaku; Nahar, Kamrun; Oluwalana, Claire; Ominde, Micah Silaba; Prosperi, Christine; Sande, Joyce; Suntarattiwong, Piyarat; O'Brien, Katherine L

    2017-06-15

    Chest radiographs (CXRs) are a valuable diagnostic tool in epidemiologic studies of pneumonia. The World Health Organization (WHO) methodology for the interpretation of pediatric CXRs has not been evaluated beyond its intended application as an endpoint measure for bacterial vaccine trials. The Pneumonia Etiology Research for Child Health (PERCH) study enrolled children aged 1-59 months hospitalized with WHO-defined severe and very severe pneumonia from 7 low- and middle-income countries. An interpretation process categorized each CXR into 1 of 5 conclusions: consolidation, other infiltrate, both consolidation and other infiltrate, normal, or uninterpretable. Two members of a 14-person reading panel, who had undertaken training and standardization in CXR interpretation, interpreted each CXR. Two members of an arbitration panel provided additional independent reviews of CXRs with discordant interpretations at the primary reading, blinded to previous reports. Further discordance was resolved with consensus discussion. A total of 4172 CXRs were obtained from 4232 cases. Observed agreement for detecting consolidation (with or without other infiltrate) between primary readers was 78% (κ = 0.50) and between arbitrators was 84% (κ = 0.61); agreement for primary readers and arbitrators across 5 conclusion categories was 43.5% (κ = 0.25) and 48.5% (κ = 0.32), respectively. Disagreement was most frequent between conclusions of other infiltrate and normal for both the reading panel and the arbitration panel (32% and 30% of discordant CXRs, respectively). Agreement was similar to that of previous evaluations using the WHO methodology for detecting consolidation, but poor for other infiltrates despite attempts at a rigorous standardization process. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  10. Computerized classification of suspicious regions in chest radiographs using subregion Hotelling observers

    International Nuclear Information System (INIS)

    Baydush, Alan H.; Catarious, David M. Jr.; Lo, Joseph Y.; Abbey, Craig K.; Floyd, Carey E. Jr.

    2001-01-01

    We propose to investigate the use of subregion Hotelling observers (SRHOs) in conjunction with perceptrons for the computerized classification of suspicious regions in chest radiographs for being nodules requiring follow up. Previously, 239 regions of interest (ROIs), each containing a suspicious lesion with proven classification, were collected. We chose to investigate the use of SRHOs as part of a multilayer classifier to determine the presence of a nodule. Each SRHO incorporates information about signal, background, and noise correlation for classification. For this study, 225 separate Hotelling observers were set up in a grid across each ROI. Each separate observer discriminates an 8 by 8 pixel area. A round robin sampling scheme was used to generate the 225 features, where each feature is the output of the individual observers. These features were then rank ordered by the magnitude of the weights of a perceptron. Once rank ordered, subsets of increasing number of features were selected to be used in another perceptron. This perceptron was trained to minimize mean squared error and the output was a continuous variable representing the likelihood of the region being a nodule. Performance was evaluated by receiver operating characteristic (ROC) analysis and reported as the area under the curve (A Z ). The classifier was optimized by adding additional features until the A Z declined. The optimized subset of observers then were combined using a third perceptron. A subset of 80 features was selected which gave an A Z of 0.972. Additionally, at 98.6% sensitivity, the classifier had a specificity of 71.3% and increased the positive predictive value from 60.7% to 84.1%. Preliminary results suggest that using SRHOs in combination with perceptrons can provide a successful classification scheme for pulmonary nodules. This approach could be incorporated into a larger computer aided detection system for decreasing false positives

  11. Detection of small pulmonary nodules on chest radiographs: efficacy of dual-energy subtraction technique using flat-panel detector chest radiography

    International Nuclear Information System (INIS)

    Oda, S.; Awai, K.; Funama, Y.; Utsunomiya, D.; Yanaga, Y.; Kawanaka, K.; Nakaura, T.; Hirai, T.; Murakami, R.; Nomori, H.; Yamashita, Y.

    2010-01-01

    Aim: To investigate the effect of a double-exposure dual-energy subtraction (DES) technique on the diagnostic performance of radiologists detecting small pulmonary nodules on flat-panel detector (FPD) chest radiographs. Materials and methods: Using FPD radiography 41 sets of chest radiographs were obtained from 26 patients with pulmonary nodules measuring ≤20 mm and from 15 normal participants. Each dataset included standard and corresponding DES images. There were six non-solid, 10 part-solid, and 10 solid nodules. The mean size of the 26 nodules was 15 ± 4.8 mm. Receiver operating characteristic (ROC) analysis was performed to compare the performance of the eight board-certified radiologists. Results: For the eight radiologists, the mean value of the area under the ROC curve (AUC) without and with DES images was 0.62 ± 0.05 and 0.68 ± 0.05, respectively; the difference was statistically significant (p = 0.02). For part-solid nodules, the difference of the mean AUC value was statistically significant (AUC = 0.61 ± 0.07 versus 0.69 ± 0.05; p < 0.01); for non-solid nodules it was not (AUC = 0.62 ± 0.1 versus 0.61 ± 0.09; p = 0.73), and for solid nodules it was not (AUC = 0.75 ± 0.1 versus 0.78 ± 0.08; p = 0.23). For nodules with overlapping bone shadows, the difference of the mean AUC value was statistically significant (p = 0.03), for nodules without overlapping, it was not (p = 0.26). Conclusion: Use of a double-exposure DES technique at FPD chest radiography significantly improved the diagnostic performance of radiologists to detect small pulmonary nodules.

  12. 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.

  13. Inter-observer variation in the interpretation of chest radiographs for pneumonia in community-acquired lower respiratory tract infections

    International Nuclear Information System (INIS)

    Hopstaken, R.M.; Witbraad, T.; Engelshoven, J.M.A. van; Dinant, G.J.

    2004-01-01

    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 (κ=0.20) or Streptococcus pneumoniae (κ=-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

  14. Early detection of interstitial pneumonia by WXGa-citrate scintigraphy. Cases of abnormal pulmonary WXGa uptake with normal chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Shinsaku; Mikami, Riichiro; Ryujin, Yoshitada

    1985-04-01

    In this paper we report our recent experience indicating usefulness of WXGa-citrate scintigraphy in 4 cases with inflammatory pulmonary diseases. These cases showed abnormal pulmonary WXGa uptake with normal chest radiographs. The first case with malignant lymphoma and the second one with lung cancer suffered from pulmonary infection following secondary immuno-insufficiency due to radiotherapy and chemotherapy. Pneumocystis carinii was suspected as causative agent in the first case, and gram negative bacilli in the second case. The third case with lung cancer developed radiation pneumonia after radiotherapy. The fourth case with acute bronchitis developed drug induced interstitial pneumonia presumably due to minocycline administration. It is concluded that WXGa-citrate scintigraphy is more sensitive for early detection of interstitial pneumonia than routine chest radiography.

  15. Development of a computerized method for identifying the posteroanterior and lateral views of chest radiographs by use of a template matching technique

    International Nuclear Information System (INIS)

    Arimura, Hidetaka; Katsuragawa, Shigehiko; Li Qiang; Ishida, Takayuki; Doi, Kunio

    2002-01-01

    In picture archiving and communications systems (PACS) or digital archiving systems, the information on the posteroanterior (PA) and lateral views for chest radiographs is often not recorded or is recorded incorrectly. However, it is necessary to identify the PA or lateral view correctly and automatically for quantitative analysis of chest images for computer-aided diagnosis. Our purpose in this study was to develop a computerized method for correctly identifying either PA or lateral views of chest radiographs. Our approach is to examine the similarity of a chest image with templates that represent the average chest images of the PA or lateral view for various types of patients. By use of a template matching technique with nine template images for patients of different size in two steps, correlation values were obtained for determining whether a chest image is either a PA or a lateral view. The templates for PA and lateral views were prepared from 447 PA and 200 lateral chest images. For a validation test, this scheme was applied to 1,000 test images consisting of 500 PA and 500 lateral chest radiographs, which are different from training cases. In the first step, 924 (92.4%) of the cases were correctly identified by comparison of the correlation values obtained with the three templates for medium-size patients. In the second step, the correlation values with the six templates for small and large patients were compared, and all of the remaining unidentifiable cases were identified correctly

  16. Pilot study of the radiodiagnostic quality control in Habana (Cuba). Dosimetric results in chest and spin cords radiographs

    International Nuclear Information System (INIS)

    Saez Nunnez, D.G.; Borroto Valdes, M.; Mesa Hernandez, M.; Risco Reyma, L. del; Borras, C

    1998-01-01

    This paper presents the results of a quality control pilot study in diagnostic radiology carried out in 10 hospitals of Havana City, Cuba. The study included dosimetric determinations for two common radiographic protections: posterior-anterior chest and lateral lumbosacral spine. A total of 21 x-ray units and 12 dark rooms were evaluated. The deficiencies related to film processing, as well as other problems associated with the dark room are presented. The most significant problems related to equipment were: the lack of reproducibility and linearity of the x-ray generator and the non-coincidence of radiation and light fields. A great variability of the entrance surface dose for the same type of patient was recorded. Organ doses and effective dose for each radiographic projection were calculated for a reference patient. A plan of corrective actions to solve the deficiencies was implemented. It was decided to develop a national quality control program in diagnostic radiology. (Author) 12 refs

  17. Super-resolution convolutional neural network for the improvement of the image quality of magnified images in chest radiographs

    Science.gov (United States)

    Umehara, Kensuke; Ota, Junko; Ishimaru, Naoki; Ohno, Shunsuke; Okamoto, Kentaro; Suzuki, Takanori; Shirai, Naoki; Ishida, Takayuki

    2017-02-01

    Single image super-resolution (SR) method can generate a high-resolution (HR) image from a low-resolution (LR) image by enhancing image resolution. In medical imaging, HR images are expected to have a potential to provide a more accurate diagnosis with the practical application of HR displays. In recent years, the super-resolution convolutional neural network (SRCNN), which is one of the state-of-the-art deep learning based SR methods, has proposed in computer vision. In this study, we applied and evaluated the SRCNN scheme to improve the image quality of magnified images in chest radiographs. For evaluation, a total of 247 chest X-rays were sampled from the JSRT database. The 247 chest X-rays were divided into 93 training cases with non-nodules and 152 test cases with lung nodules. The SRCNN was trained using the training dataset. With the trained SRCNN, the HR image was reconstructed from the LR one. We compared the image quality of the SRCNN and conventional image interpolation methods, nearest neighbor, bilinear and bicubic interpolations. For quantitative evaluation, we measured two image quality metrics, peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). In the SRCNN scheme, PSNR and SSIM were significantly higher than those of three interpolation methods (pmethods without any obvious artifacts. These preliminary results indicate that the SRCNN scheme significantly outperforms conventional interpolation algorithms for enhancing image resolution and that the use of the SRCNN can yield substantial improvement of the image quality of magnified images in chest radiographs.

  18. Cardiothoracic ratio on chest radiograph in pediatric heart disease: How does it correlate with heart volumes at magnetic resonance imaging?

    Energy Technology Data Exchange (ETDEWEB)

    Grotenhuis, Heynric B. [The University of Toronto, Division of Cardiology, Department of Paediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto (Canada); Zhou, Cheng; Isaac, Kathryn V. [The University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto (Canada); Tomlinson, George [University of Toronto, Department of Medicine, Toronto General Hospital and Mt. Sinai Hospital, Toronto (Canada); Seed, Mike; Grosse-Wortmann, Lars; Yoo, Shi-Joon [The University of Toronto, Division of Cardiology, Department of Paediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto (Canada); The University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto (Canada)

    2015-10-15

    The cardiothoracic ratio by chest radiograph is widely used as a marker of cardiac size. The purpose of this study is to correlate cardiothoracic ratio and cardiac volumes as measured by cardiovascular magnetic resonance (MR) in common structural and myopathic heart disease with increased cardiac size due to volume overload or hypertrophy. A retrospective single center study was performed in all patients between 2007 and 2013 with repaired tetralogy of Fallot (TOF), aortic regurgitation, isolated left-to-right shunt and hypertrophic cardiomyopathy (HCM) who underwent cardiovascular MR and chest radiograph within 6 months of each other. Cardiothoracic ratios by chest radiograph (frontal and lateral) were compared to cardiac volumes (indexed for body surface area) by cardiovascular MR. One hundred twenty-seven patients (mean age: 11.2 ± 5.5 years) were included in this study (76 with TOF, 23 with isolated left-to-right shunt, 16 with aortic regurgitation and 12 with HCM). Frontal cardiothoracic ratio of all groups correlated with indexed right ventricular (RV) end-diastolic volume (EDVI) (r = 0.40, P < 0.01) and indexed total heart volume (THVI) (r = 0.27, P < 0.01). In TOF patients, frontal cardiothoracic ratio correlated with RVEDVI (r = 0.34, P < 0.01; coefficient of variation = 27.6%), indexed RV end-systolic volume (ESVI) (r = 0.44, P < 0.01; coefficient of variation = 33.3%) and THVI (r = 0.35, P < 0.01; coefficient of variation = 19.6%), although RV volumes and THVI showed widespread variation given the high coefficients of variation. In patients with aortic regurgitation, frontal cardiothoracic ratio correlated with left ventricular (LV) EDVI (r = 0.50, P = 0.047), but not with THVI and aortic regurgitant fraction, and widespread variation for LV EDVI (coefficient of variation = 19.2%), LV ESVI (coefficient of variation = 32.5%) and THVI (coefficient of variation = 13.6%) was also observed. Frontal cardiothoracic ratio was not correlated with cardiac volumes

  19. Complications related to osteopenia in the thoracic spine on admission chest radiographs of substance abuse detoxification patients

    International Nuclear Information System (INIS)

    Haramati, L.B.; Alterman, D.D.; Israel, G.M.; Haramati, N.; Mallavurapu, R.

    1998-01-01

    Objective. To assess the prevalence of complications related to osteopenia in the thoracic spine (anterior wedging and fish vertebrae) of patients admitted for substance abuse detoxification. Design and patients. We retrospectively identified 150 sequential patients admitted to our drug and alcohol detoxification ward in whom posteroanterior and lateral admission chest radiographs and clinical charts were available for review. There were 116 men and 34 women with a mean age of 37 years (range 19-67 years). Thirty-eight patients were admitted for drug detoxification, 37 for alcohol detoxification, and 75 for drug and alcohol detoxification. These patients were compared with 66 age- and sex-matched controls from our hospital's employee health service. Two radiologists reviewed all chest radiographs for the presence of anterior wedging and fish vertebrae in the thoracic spine and other nonspinal fractures. Serum calcium and inorganic phosphorus levels were recorded for the substance abuse detoxification patients. Results. Forty-nine percent (n=73) of detoxification patients had complications of osteopenia in the thoracic spine including: anterior wedging (n=47), fish vertebrae (n=21), or both (n=5). Twenty-four percent (n=36) of patients had an elevated serum inorganic phosphorus level and one patient had an elevated serum calcium level. Patients with anterior wedging or fish vertebrae included: 45% (n=45) of patients below age 40 years, 35% (n=12) of women, 41% (n=15) of drug detoxification patients, 58% (n=22) of alcohol detoxification patients, 48% (n=36) of drug and alcohol detoxification patients, and 47% (n=17) of patients with elevated serum inorganic phosphorus (P=NS). Six percent (n=9) of our study population had nonspinal fractures on their chest radiographs. Twenty-one percent (n=14) of controls had complications of osteopenia in the thoracic spine (all anterior wedging). This prevalence differed significantly (P<0.05, chi-squared) from the study population

  20. Development and image quality assessment of a contrast-enhancement algorithm for display of digital chest radiographs

    International Nuclear Information System (INIS)

    Rehm, K.

    1992-01-01

    This dissertation presents a contrast-enhancement algorithm Artifact-Suppressed Adaptive Histogram Equalization (ASAHE). This algorithm was developed as part of a larger effort to replace the film radiographs currently used in radiology departments with digital images. Among the expected benefits of digital radiology are improved image management and greater diagnostic accuracy. Film radiographs record X-ray transmission data at high spatial resolution, and a wide dynamic range of signal. Current digital radiography systems record an image at reduced spatial resolution and with coarse sampling of the available dynamic range. These reductions have a negative impact on diagnostic accuracy. The contrast-enhancement algorithm presented in this dissertation is designed to boost diagnostic accuracy of radiologists using digital images. The ASAHE algorithm is an extension of an earlier technique called Adaptive Histogram Equalization (AHE). The AHE algorithm is unsuitable for chest radiographs because it over-enhances noise, and introduces boundary artifacts. The modifications incorporated in ASAHE suppress the artifacts and allow processing of chest radiographs. This dissertation describes the psychophysical methods used to evaluate the effects of processing algorithms on human observer performance. An experiment conducted with anthropomorphic phantoms and simulated nodules showed the ASAHE algorithm to be superior for human detection of nodules when compared to a computed radiography system's algorithm that is in current use. An experiment conducted using clinical images demonstrating pneumothoraces (partial lung collapse) indicated no difference in human observer accuracy when ASAHE images were compared to computed radiography images, but greater ease of diagnosis when ASAHE images were used. These results provide evidence to suggest that Artifact-Suppressed Adaptive Histogram Equalization can be effective in increasing diagnostic accuracy and efficiency

  1. Reduction of adult fingers visualized on pediatric intensive care unit (PICU) chest radiographs after radiation technologist and PICU staff radiation safety education

    International Nuclear Information System (INIS)

    Tynan, J.R.; Duncan, M.D.; Burbridge, B.E.

    2009-01-01

    A recent publication from our centre revealed a disturbing finding of a significant incidence of adult fingers seen on the pediatric intensive care unit (PICU) chest radiographs. This is inappropriate occupational exposure to diagnostic radiation. We hypothesized that the incidence of adult fingers on PICU chest radiographs would decline after radiation safety educational seminars were given to the medical radiation technologists and PICU staff. The present study's objectives were addressed by using a pretest-posttest design. Two cross-sectional PICU chest radiograph samples, taken before and after the administration of radiation safety education for our medical radiation technologists and PICU staff, were compared by using a χ 2 test. There was a 61.2% and 76.9% reduction in extraneous adult fingers, directly exposed to the x-ray beam and those seen in the coned regions of the film, respectively, on PICU chest radiographs (66.7% reduction overall). This reduction was statistically significant (χ2 = 20.613, P < .001). Limiting unnecessary occupational radiation exposure is a critical issue in radiology. There was a statistically and clinically significant association between radiation safety education and the decreased number of adult fingers seen on PICU chest radiographs. This study provides preliminary evidence in favour of the benefit of radiation safety seminars. (author)

  2. Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography

    OpenAIRE

    Matsumoto, Shokei; Sekine, Kazuhiko; Funabiki, Tomohiro; Orita, Tomohiko; Shimizu, Masayuki; Hayashida, Kei; Kazamaki, Taku; Suzuki, Tatsuya; Kishikawa, Masanobu; Yamazaki, Motoyasu; Kitano, Mitsuhide

    2016-01-01

    Backgraound An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomography suite. We previously reported a method to detect occult pneumothorax using oblique chest radiography (OXR). Several authors have also reported that ultrasonography is an effective technique for detecting occult pneumothorax. The aim of this study was to evaluate the useful...

  3. A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study

    International Nuclear Information System (INIS)

    Taylor, Emma; Haven, Kathryn; Reed, Peter; Bissielo, Ange; Harvey, Dave; McArthur, Colin; Bringans, Cameron; Freundlich, Simone; Ingram, R. Joan H.; Perry, David; Wilson, Francessa; Milne, David; Modahl, Lucy; Huang, Q. Sue; Gross, Diane; Widdowson, Marc-Alain; Grant, Cameron C.

    2015-01-01

    The term severe acute respiratory infection (SARI) encompasses a heterogeneous group of respiratory illnesses. Grading the severity of SARI is currently reliant on indirect disease severity measures such as respiratory and heart rate, and the need for oxygen or intensive care. With the lungs being the primary organ system involved in SARI, chest radiographs (CXRs) are potentially useful for describing disease severity. Our objective was to develop and validate a SARI CXR severity scoring system. We completed validation within an active SARI surveillance project, with SARI defined using the World Health Organization case definition of an acute respiratory infection with a history of fever, or measured fever of ≥ 38 °C; and cough; and with onset within the last 10 days; and requiring hospital admission. We randomly selected 250 SARI cases. Admission CXR findings were categorized as: 1 = normal; 2 = patchy atelectasis and/or hyperinflation and/or bronchial wall thickening; 3 = focal consolidation; 4 = multifocal consolidation; and 5 = diffuse alveolar changes. Initially, four radiologists scored CXRs independently. Subsequently, a pediatrician, physician, two residents, two medical students, and a research nurse independently scored CXR reports. Inter-observer reliability was determined using a weighted Kappa (κ) for comparisons between radiologists; radiologists and clinicians; and clinicians. Agreement was defined as moderate (κ > 0.4–0.6), good (κ > 0.6–0.8) and very good (κ > 0.8–1.0). Agreement between the two pediatric radiologists was very good (κ = 0.83, 95 % CI 0.65–1.00) and between the two adult radiologists was good (κ = 0.75, 95 % CI 0.57–0. 93). Agreement of the clinicians with the radiologists was moderate-to-good (pediatrician:κ = 0.65; pediatric resident:κ = 0.69; physician:κ = 0.68; resident:κ = 0.67; research nurse:κ = 0.49, medical students: κ = 0.53 and κ = 0.56). Agreement between clinicians was good-to-very good

  4. 78 FR 35575 - Black Lung Benefits Act: Standards for Chest Radiographs

    Science.gov (United States)

    2013-06-13

    ... toll-free number). Only comments of ten or fewer pages, including a Fax cover sheet and attachments, if... have different fee structures for film and digital radiographs. Instead, standard medical coding...

  5. Evolution of Entrance Surface Doses and Image Quality in Pediatric Chest Radiographs

    International Nuclear Information System (INIS)

    Campello, A.C.; Marques, D.T.; Medeiros, C.B.; Carvalho, P.P.; Khoury, H.J.; Azevedo, A.C.P.

    2006-01-01

    This work presents the results of a survey about image quality, radiographic techniques and patient doses in a large public hospital located in the city of Recife, Brazil. It was detected that the quality criteria are not fully reached and represent 70% of the agreement with recommendations from the European Community. Concerning the radiographic techniques the kV is in accordance with international recommendations in 90% if the examinations while the exposure time is 72%. The results also show that the dose values change in the range from 0.020 to 0.250 mGy. The variability is mainly caused by the disparity on the radiographic techniques employed in the examinations as well as by the radiographer's expertise. It could be concluded that the ALARA principle is not being applied in the hospital, which becomes a concern in terms of public health. (author)

  6. Efficacy study of the digital image processing with varying pixel size at A/D conversion of the chest radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Inamoto, Kazuo; Tanaka, Shinichi; Miura, Takashi; Takahashi, Akira; Iwata, Tetsuya

    1984-12-01

    In the study for development of medical image archiving system, we made experiments in the field of conversion of a X-ray picture to a digital form. Three sets of chest radiograph were selected for the study of digitalization by reading different pixel size (150-300 m) in the method of A/D conversion using a drum scanner and again reconstructed to an analog form after D/A conversion. These copy films of different pixel size were shown and evaluated by 48 volunteer doctors to choose a favorite picture. It did not always follow that the most favorite picture was the finest one using the smallest pixel size. This discrepancy was further analyzed by measurement of a density histogram. By comparison studies of density curves in the same ROI of different pixel size pictures, it was concluded that their choices were dependent on not only fineness but also contrast of an output image after D/A conversion. Often better contrast picture was a key to the selection more than the pixel size. This indicates that digital storing radiographs will be possibly regenerated to the real image by the skillful operation of pixel size and contrast of a radiograph. The results will contribute to the process of recording analog X-ray picture by a digital form in the medical image archiving system.

  7. A comparison of the Shwachman, Chrispin-Norman and Brasfield methods for scoring of chest radiographs of patients with cystic fibrosis

    International Nuclear Information System (INIS)

    Meerman, G.J. te; Dankert-Roelse, J.; Rijksuniversiteit Groningen; Martijn, A.; Woerden, H.H. van

    1985-01-01

    Three systems are described for chest radiograph scoring in cystic fibrosis patients: the Shwachman-Kulczycki, the Chrispin-Norman and the Brasfield method. Sixty chest radiographs of 39 patients of different ages have been independently scored by two radiologists according to the three methods. No statistical differences between the methods could be demonstrated. The Chrispin-Norman method is recommended as the best choice because differences in scoring appeared better interpretable. A significant increase in precision could be achieved by combining the scores of the three methods. (orig.)

  8. Improved detection of pulmonary nodules on energy-subtracted chest radiographs with a commercial computer-aided diagnosis software: comparison with human observers

    International Nuclear Information System (INIS)

    Szucs-Farkas, Zsolt; Patak, Michael A.; Yuksel-Hatz, Seyran; Ruder, Thomas; Vock, Peter

    2010-01-01

    To retrospectively analyze the performance of a commercial computer-aided diagnosis (CAD) software in the detection of pulmonary nodules in original and energy-subtracted (ES) chest radiographs. Original and ES chest radiographs of 58 patients with 105 pulmonary nodules measuring 5-30 mm and images of 25 control subjects with no nodules were randomized. Five blinded readers evaluated firstly the original postero-anterior images alone and then together with the subtracted radiographs. In a second phase, original and ES images were analyzed by a commercial CAD program. CT was used as reference standard. CAD results were compared to the readers' findings. True-positive (TP) and false-positive (FP) findings with CAD on subtracted and non-subtracted images were compared. Depending on the reader's experience, CAD detected between 11 and 21 nodules missed by readers. Human observers found three to 16 lesions missed by the CAD software. CAD used with ES images produced significantly fewer FPs than with non-subtracted images: 1.75 and 2.14 FPs per image, respectively (p=0.029). The difference for the TP nodules was not significant (40 nodules on ES images and 34 lesions in non-subtracted radiographs, p = 0.142). CAD can improve lesion detection both on energy subtracted and non-subtracted chest images, especially for less experienced readers. The CAD program marked less FPs on energy-subtracted images than on original chest radiographs. (orig.)

  9. Chest radiographic findings and complications of the temporary implantation of the Jarvik-7 artificial heart while patients await orthotopic heart transplantation

    International Nuclear Information System (INIS)

    Sadler, L.; Fuhrman, C.; Hardesty, R.; Griffith, B.

    1987-01-01

    At the University of Pittsburgh, the authors have had 15 patients in whom Jarvik-7 hearts were implanted as a temporary measure while the patients awaited suitable donors for cardiac transplantation. The paper presents a brief description of the Jarvik-7 artificial heart, factors affecting patient selection, and the radiographic appearance of a normally functioning Jarvik-7 heart, and reviews the chest radiographic complications seen in this patient group, along with eventual patient outcome

  10. Experimental analysis of motion artifacts in chest radiographs with the AMBER system

    International Nuclear Information System (INIS)

    Boetticher, H. von; Hofmann, K.; Luska, G.

    1999-01-01

    The prerequisites, mechanisms and principles of motion artifacts in AMBER radiographs were analysed. The experiments were performed using metronomes, a moving conventional mammography phantom, and arrangements of oscillating coil spring, spheroid and grid elements. A diagnostic dosimeter and TLDs, respectively, were used to measure exposure times and doses. The deree of distortion in AMBER radiographs depends on the direction of the object movement relative to the AMBER fan beam in a complex manner. The size of the motion artifacts depends on the local exposure time. The maximum value of this time is 75 ms and thus 1.5 times higher than specified by the manufacturer. To interpret AMBER radiographs possible system specific artifacts have to be considered to avoid misinterpretations of potentially significant details. (orig.) [de

  11. Practical measurement of radiation dose in pediatric radiology: use of the dose-area product on digital fluoroscopy and neonatal chest radiographs

    International Nuclear Information System (INIS)

    Chateil, J.F.; Rouby, C.; Brun, M.; Labessan, C.; Diard, F.

    2004-01-01

    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 2 and 125.41 cGy.cm 2 . The range was between 76.43, and 150.62 cGy.cm 2 for UGIs and between 49.06 and 83.33 cGy.cm 2 for IVUs. For neonate chest radiographs, DAP calculations were between 0.29 and 0.99 cGy.cm 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)

  12. A Retrospective Analysis of the Clinical Impact of 939 Chest Radiographs Using the Medical Records

    International Nuclear Information System (INIS)

    Geijer, M.; Ivarsson, L.; Gothlin, J.H.

    2012-01-01

    Objective. Between one-third and half of all radiology examinations worldwide are probably chest studies. The aim of the current study was to retrospectively evaluate the clinical influence of chest radiography. Methods. In a tertiary referral hospital, 939 consecutive daytime chest radiography examinations were evaluated. The outcome was classified as normal, incidental, or pathologic. The referring physicians reaction to radiologic outcome was classified as highly expected, moderately expected, or unexpected. The influence on the patients' treatment was divided into four groups from major to no influence. Results. In all, 71.6% of the studies had a highly expected outcome. Moderately expected or unexpected outcomes were noted in 36.6% of 500 pathologic examinations. Unexpected outcome was noted in 11.6% of all studies. The radiologic outcome influenced treatment in 65.4% of patients where pathology was demonstrated. Patients with normal or incidental findings had treatment influenced in 1/3 of the cases. Unexpected findings influenced treatment more than moderately expected findings. When radiological findings were highly expected, treatment was influenced in less than half of the cases. Surprisingly few chest radiology examinations were commented upon in the medical records

  13. Paediatric frontal chest radiograph screening with fine-tuned convolutional neural networks

    CSIR Research Space (South Africa)

    Gerrand, Jonathan D

    2017-07-01

    Full Text Available of fine-tuned convolutional neural networks (CNN). We use two popular CNN models that are pre-trained on a large natural image dataset and two distinct datasets containing paediatric and adult radiographs respectively. Evaluation is performed using a 5...

  14. Gradual progression of intrapulmonary lymph nodes associated with usual interstitial pneumonia in progressive systemic sclerosis on chest radiographs and CT

    Energy Technology Data Exchange (ETDEWEB)

    Ohm, Joon Young; Chung, Myung Hee; Kim, Seon Mun [The Catholic Univ. of Korea, Seoul (Korea, Republic of); Kim, Yong Hyun [The Catholic Univ. of Korea, Bucheon (Korea, Republic of)

    2012-10-15

    A 40 year old female visited the clinic for evaluation of Raynaud's phenomenon for a period of four years. The initial chest radiograph showed a fine reticular density and ground glass opacity with lower lobe predominance. These findings are consistent interstitial fibrosis. Additionally, high resolution CT showed multiple, small, coexisting nodular opacities, ranging from 3 to 7 mm in size in both lungs. These nodules grew up to 1.5 cm and showed moderate enhancement. Because of the rareness of intrapulmonary lymph node in patient of progressive systemic sclerosis, we couldn't exclude the possibility of malignancy. These nodules are turned out to be intrapulmonary lymph nodes on video assisted thoracoscopic lung biopsy.

  15. The additional value of the lateral chest radiograph for the detection of small pulmonary nodules-a ROC analysis.

    Science.gov (United States)

    Kluthke, Robin Alexander; Kickuth, Ralph; Bansmann, Paul Martin; Tüshaus, Carolin; Adams, Stephan; Liermann, Dieter; Kirchner, Johannes

    2016-11-01

    For the past 30 years, many authors have described different advantages of the use of the additional lateral chest radiograph. However, some radiologic departments gave up performing the lateral view recently. A potential reason for this might be a lack of evidence for any diagnostic benefit of the additional lateral view of the thorax in recent studies. The objective of this study was to evaluate the diagnostic benefit of the additional lateral view for the detection of small pulmonary nodules compared with CT examinations as a gold standard. The patient population consisted of 45 patients with SPN and 45 patients without SPN. Four radiologists with varying experience in the assessment of thoracic imaging first examined the sole posteroanterior (PA) projection. After a few days, they were instructed to examine the PA and the additional lateral view. A receiver-operating characteristic analysis was accomplished to compare the documented results. The mean Az value of the sole PA view was 0.75 and 0.77 by the combination of PA and additional lateral view. So, there was no significant difference between the detectable Az values (Δ = 0.02; p = 0.384). With a cut-off value of >3, the additional view even reduced the sensitivity by averaging to 5.6%. The decrease of sensitivity by using the additional view was most detectable within the group of more experienced radiologists. The additional lateral view of the chest provides no diagnostic benefit in the detection of small pulmonary nodules in comparison with the sole PA projection. Nevertheless, the results of the present study must not be understood as a general evaluation of the benefits of the lateral radiograph per se, because we did not examine other relevant issues (i.e. cardiac failure, lung parenchyma diseases or abnormalities in hilar anatomy). Advances in knowledge: Our study demonstrates a lack of evidence for any diagnostic benefit of the additional lateral view of the thorax in detecting SPN.

  16. Estimation of absorbed dose by newborn patients subjected to chest radiographs

    International Nuclear Information System (INIS)

    Bunick, Ana P.; Schelin, Hugo R.; Denyak, Valeriy

    2016-01-01

    The aim of this study is to present an estimate of the effective dose received by newborn patients hospitalized in NICU and subjected to X-ray examinations of the chest in the AP projection. Initially, were followed examinations chest X-rays performed on newborn patients and subsequently, simulated in a newborn simulator object. The ESAK values obtained by TLDs were used to calculate the effective dose obtained at each examination by Caldose_X software. The estimated values for the effective dose in the simulated exams in this study range from 2,3μSv the 10,7μSv. The results achieved are, generally, inferior to those reported for similar previous studies. (author)

  17. Quality assurance: using the exposure index and the deviation index to monitor radiation exposure for portable chest radiographs in neonates

    International Nuclear Information System (INIS)

    Cohen, Mervyn D.; Cooper, Matt L.; Piersall, Kelly; Apgar, Bruce K.

    2011-01-01

    Many methods are used to track patient exposure during acquisition of plain film radiographs. A uniform international standard would aid this process. To evaluate and describe a new, simple quality-assurance method for monitoring patient exposure. This method uses the ''exposure index'' and the ''deviation index,'' recently developed by the International Electrotechnical Commission (IEC) and American Association of Physicists in Medicine (AAPM). The deviation index measures variation from an ideal target exposure index value. Our objective was to determine whether the exposure index and the deviation index can be used to monitor and control exposure drift over time. Our Agfa workstation automatically keeps a record of the exposure index for every patient. The exposure index and deviation index were calculated on 1,884 consecutive neonatal chest images. Exposure of a neonatal chest phantom was performed as a control. Acquisition of the exposure index and calculation of the deviation index was easily achieved. The weekly mean exposure index of the phantom and the patients was stable and showed <10% change during the study, indicating no exposure drift during the study period. The exposure index is an excellent tool to monitor the consistency of patient exposures. It does not indicate the exposure value used, but is an index to track compliance with a pre-determined target exposure. (orig.)

  18. Quality assurance: using the exposure index and the deviation index to monitor radiation exposure for portable chest radiographs in neonates

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, Mervyn D. [Indiana University School of Medicine, Department of Radiology, Riley Children' s Hospital, Indianapolis, IN (United States); Riley Hospital for Children, Department of Radiology, Indianapolis, IN (United States); Cooper, Matt L.; Piersall, Kelly [Indiana University School of Medicine, Department of Radiology, Riley Children' s Hospital, Indianapolis, IN (United States); Apgar, Bruce K. [Agfa HealthCare Corporation, Greenville, SC (United States)

    2011-05-15

    Many methods are used to track patient exposure during acquisition of plain film radiographs. A uniform international standard would aid this process. To evaluate and describe a new, simple quality-assurance method for monitoring patient exposure. This method uses the ''exposure index'' and the ''deviation index,'' recently developed by the International Electrotechnical Commission (IEC) and American Association of Physicists in Medicine (AAPM). The deviation index measures variation from an ideal target exposure index value. Our objective was to determine whether the exposure index and the deviation index can be used to monitor and control exposure drift over time. Our Agfa workstation automatically keeps a record of the exposure index for every patient. The exposure index and deviation index were calculated on 1,884 consecutive neonatal chest images. Exposure of a neonatal chest phantom was performed as a control. Acquisition of the exposure index and calculation of the deviation index was easily achieved. The weekly mean exposure index of the phantom and the patients was stable and showed <10% change during the study, indicating no exposure drift during the study period. The exposure index is an excellent tool to monitor the consistency of patient exposures. It does not indicate the exposure value used, but is an index to track compliance with a pre-determined target exposure. (orig.)

  19. A computer-aided diagnosis system to detect pathologies in temporal subtraction images of chest radiographs

    Science.gov (United States)

    Looper, Jared; Harrison, Melanie; Armato, Samuel G.

    2016-03-01

    Radiologists often compare sequential radiographs to identify areas of pathologic change; however, this process is prone to error, as human anatomy can obscure the regions of change, causing the radiologists to overlook pathology. Temporal subtraction (TS) images can provide enhanced visualization of regions of change in sequential radiographs and allow radiologists to better detect areas of change in radiographs. Not all areas of change shown in TS images, however, are actual pathology. The purpose of this study was to create a computer-aided diagnostic (CAD) system that identifies which regions of change are caused by pathology and which are caused by misregistration of the radiographs used to create the TS image. The dataset used in this study contained 120 images with 74 pathologic regions on 54 images outlined by an experienced radiologist. High and low ("light" and "dark") gray-level candidate regions were extracted from the images using gray-level thresholding. Then, sampling techniques were used to address the class imbalance problem between "true" and "false" candidate regions. Next, the datasets of light candidate regions, dark candidate regions, and the combined set of light and dark candidate regions were used as training and testing data for classifiers by using five-fold cross validation. Of the classifiers tested (support vector machines, discriminant analyses, logistic regression, and k-nearest neighbors), the support vector machine on the combined candidates using synthetic minority oversampling technique (SMOTE) performed best with an area under the receiver operating characteristic curve value of 0.85, a sensitivity of 85%, and a specificity of 84%.

  20. Computed radiography versus mobile direct radiography for bedside chest radiographs: Impact of dose on image quality and reader agreement

    International Nuclear Information System (INIS)

    De Boo, D.W.; Weber, M.; Deurloo, E.E.; Streekstra, G.J.; Freling, N.J.; Dongelmans, D.A.; Schaefer-Prokop, C.M.

    2011-01-01

    Aim: To asses the image quality and potential for dose reduction of mobile direct detector (DR) chest radiography as compared with computed radiography (CR) for intensive care unit (ICU) chest radiographs (CXR). Methods and materials: Three groups of age-, weight- and disease-matched ICU patients (n = 114 patients; 50 CXR per acquisition technique) underwent clinically indicated bedside CXR obtained with either CR (single read-out powder plates) or mobile DR (GOS-TFT detectors) at identical or 50% reduced dose (DR 50% ). Delineation of anatomic structures and devices used for patient monitoring, overall image quality and disease were scored by four readers. In 12 patients pairs of follow-up CR and DR images were available, and in 15 patients pairs of CR and DR 50% images were available. In these pairs the overall image quality was also compared side-by-side. Results: Delineation of anatomy in the mediastinum was scored better with DR or DR 50% than with CR. Devices used for patient monitoring were seen best with DR, with DR 50% being superior to CR. In the side-by-side comparison, the overall image quality of DR and DR 50% was rated better than CR in 96% (46/48) and 87% (52/60), respectively. Inter-observer agreement for the assessment of pathology was fair for CR and DR 50% (κ = 0.33 and κ = 0.39, respectively) and moderate for DR (κ = 0.48). Conclusion: Mobile DR units offer better image quality than CR for bedside chest radiography and allow for 50% dose reduction. Inter-observer agreement increases with image quality and is superior with DR, while DR 50% and CR are comparable.

  1. Can ultrasound extended emergency (EFAST) replace the chest radiograph in the initial approach to trauma?

    International Nuclear Information System (INIS)

    Aguirre Jimenez, Marcela

    2010-01-01

    The sensitivity diagnosed between ultrasound Extended emergency (EFAST) and portable radiography was compared. Life-threatening pathologies are detected in the initial approach to trauma, through an analysis comparative between EFAST and portable chest radiography. So, the need or not both studies or if the use of EFAST as the only diagnostic method in primary evaluation of trauma can be limited. The study has concluded that the EFAST can be used as the only tool for polytrauma patients, although in this analysis the sample has been very small [es

  2. Absorbed doses received by patients submitted to chest radiographs in hospitals of the city of Sao Paulo, Brazil

    International Nuclear Information System (INIS)

    Freitas, Marcelo Baptista de

    2000-01-01

    Medical irradiation contributes with a significant amount to the dose received by the population. Here, this contribution was evaluated in a survey of absorbed doses received by patients submitted to chest radiological examinations (postero-anterior (PA) and lateral (LAT) projections) in hospitals of the city of Sao Paulo. Due to the variety of equipment and procedures used in radiological examinations, a selection of hospitals was made (12, totalizing 27 X-ray facilities), taking into account their representativeness as medical institutions in the city, in terms of characteristics and number of radiographs carried out. An anthropomorphic phantom, provided with thermoluminescent dosemeters (TLD-1 00), was irradiated simulating the patient, and the radiographic image quality was evaluated. Absorbed doses were determined to the thoracic region (entrance and exit skin and lung doses), and to some important organs from the radiation protection point of view (lens of the eye, thyroid and gonads). The great variation on the exposure parameters (kV, mA.s, beam size) leads to a large interval of entrance skin doses-ESD (coefficients of variation, CV, of 60% and 76%, for PA and LAT projections, respectively, were found) and of organ doses (CV of 60% and 46%. for thyroid and lung respectively). Mean values of ESD for LAT and PA projections were 0.22 and 0.98 mGy, respectively. The average absorbed doses per exam (PA and LAT) to thyroid and lung, 0.15 and 0.24 mGy respectively,showed that the thyroid was irradiated by the primary beam in many cases. Values of lens of the eye and gonad absorbed doses were below 30 μGy. Comparison of the lung doses obtained in this study with values in the literature, calculated by Monte Carlo simulation, showed good agreement. On the other hand, the comparison shows significant differences in the dose values to organs outside the chest region (thyroid, lens of eye and gonads). The effective dose calculated for a chest examination, PA and LAT

  3. Training and Validating a Deep Convolutional Neural Network for Computer-Aided Detection and Classification of Abnormalities on Frontal Chest Radiographs.

    Science.gov (United States)

    Cicero, Mark; Bilbily, Alexander; Colak, Errol; Dowdell, Tim; Gray, Bruce; Perampaladas, Kuhan; Barfett, Joseph

    2017-05-01

    Convolutional neural networks (CNNs) are a subtype of artificial neural network that have shown strong performance in computer vision tasks including image classification. To date, there has been limited application of CNNs to chest radiographs, the most frequently performed medical imaging study. We hypothesize CNNs can learn to classify frontal chest radiographs according to common findings from a sufficiently large data set. Our institution's research ethics board approved a single-center retrospective review of 35,038 adult posterior-anterior chest radiographs and final reports performed between 2005 and 2015 (56% men, average age of 56, patient type: 24% inpatient, 39% outpatient, 37% emergency department) with a waiver for informed consent. The GoogLeNet CNN was trained using 3 graphics processing units to automatically classify radiographs as normal (n = 11,702) or into 1 or more of cardiomegaly (n = 9240), consolidation (n = 6788), pleural effusion (n = 7786), pulmonary edema (n = 1286), or pneumothorax (n = 1299). The network's performance was evaluated using receiver operating curve analysis on a test set of 2443 radiographs with the criterion standard being board-certified radiologist interpretation. Using 256 × 256-pixel images as input, the network achieved an overall sensitivity and specificity of 91% with an area under the curve of 0.964 for classifying a study as normal (n = 1203). For the abnormal categories, the sensitivity, specificity, and area under the curve, respectively, were 91%, 91%, and 0.962 for pleural effusion (n = 782), 82%, 82%, and 0.868 for pulmonary edema (n = 356), 74%, 75%, and 0.850 for consolidation (n = 214), 81%, 80%, and 0.875 for cardiomegaly (n = 482), and 78%, 78%, and 0.861 for pneumothorax (n = 167). Current deep CNN architectures can be trained with modest-sized medical data sets to achieve clinically useful performance at detecting and excluding common pathology on chest radiographs.

  4. Computer-aided diagnosis of pneumoconiosis abnormalities extracted from chest radiographs scanned with a CCD scanner

    International Nuclear Information System (INIS)

    Abe, Koji; Minami, Masahide; Nakamura, Munehiro

    2011-01-01

    This paper presents a computer-aided diagnosis for pneumoconiosis radiographs obtained with a common charge-coupled devices (CCD) scanner. Since the current computer-aided diagnosis systems of pneumoconiosis are not practical for medical doctors due to high costs of usage for a special scanner, we propose a novel system which measures abnormalities of pneumoconiosis from lung images obtained with a common CCD scanner. Experimental results of discriminations between normal and abnormal cases for 56 right-lung images including 6 standard pneumoconiosis images have shown that the proposed abnormalities are well extracted according to the standards of pneumoconiosis categories. (author)

  5. 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.

  6. Characterization of interstitial lung disease in chest radiographs using SOM artificial neural network

    International Nuclear Information System (INIS)

    Azevedo-Marques, P.M. de; Ambrosio, P.E.; Pereira, R.R. Jr.; Valini, R. de A.; Salomao, S.C.

    2007-01-01

    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.)

  7. Fundamental imaging characteristics of a slot-scan digital chest radiographic system

    International Nuclear Information System (INIS)

    Samei, Ehsan; Saunders, Robert S.; Lo, Joseph Y.; Dobbins, James T. III; Jesneck, Jonathan L.; Floyd, Carey E.; Ravin, Carl E.

    2004-01-01

    Our purpose in this study was to evaluate the fundamental image quality characteristics of a new slot-scan digital chest radiography system (ThoraScan, Delft Imaging Systems/Nucletron, Veenendaal, The Netherlands). The linearity of the system was measured over a wide exposure range at 90, 117, and 140 kVp with added Al filtration. System uniformity and reproducibility were established with an analysis of images from repeated exposures. The modulation transfer function (MTF) was evaluated using an established edge method. The noise power spectrum (NPS) and the detective quantum efficiency (DQE) of the system were evaluated at the three kilo-voltages over a range of exposures. Scatter fraction (SF) measurements were made using a posterior beam stop method and a geometrical chest phantom. The system demonstrated excellent linearity, but some structured nonuniformities. The 0.1 MTF values occurred between 3.3-3.5 mm -1 . The DQE(0.15) and DQE(2.5) were 0.21 and 0.07 at 90 kVp, 0.18 and 0.05 at 117 kVp, and 0.16 and 0.03 at 140 kVp, respectively. The system exhibited remarkably lower SFs compared to conventional full-field systems with anti-scatter grid, measuring 0.13 in the lungs and 0.43 in the mediastinum. The findings indicated that the slot-scan design provides marked scatter reduction leading to high effective DQE (DQE eff ) of the system and reduced patient dose required to achieve high image quality

  8. Short-term impact of pictorial posters and a crash course on radiographic errors for improving the quality of paediatric chest radiographs in an unsupervised unit - a pilot study for quality-assurance outreach

    International Nuclear Information System (INIS)

    Tebogo Hlabangana, Linda; Andronikou, Savvas

    2015-01-01

    Chest radiography is the most commonly performed diagnostic X-ray examination. The radiation dose to the patient for this examination is relatively low but because of its frequent use, the contribution to the collective dose is considerable. Optimized image quality not only allows for more accurate diagnosis but also supports radiation protection, which is particularly important in children. To determine whether the introduction of a poster of technical errors in paediatric radiography accompanied by a short lecture (crash course) for radiographers on common errors can sustainably decrease the number and rate of these errors in an unsupervised radiology department (without a paediatric-trained radiologist or paediatric-trained radiography personnel). We conducted a pilot study for quality-assurance outreach, with retrospective and prospective components, in the paediatric radiology department of a teaching hospital. The technical errors in frontal chest radiographs performed in the unit were assessed by quality-assurance analysis using a customized tick-sheet. The review was performed before and after an intervention that involved a half-hour crash course and poster displays in the department. We compared the rate of technical errors made before and after the intervention. There was statistically significant improvement in quality of radiographs (P 2 months after the intervention. A simple intervention of a crash course and poster placement resulted in improved quality of paediatric chest radiographs. A decline in quality after 2 months suggests the need to repeat this or another type of intervention regularly. (orig.)

  9. Chest radiography in supporting the diagnosis of asthma in children with persistent cough.

    Science.gov (United States)

    Halaby, Claudia; Feuerman, Martin; Barlev, Dan; Pirzada, Melodi

    2014-03-01

    To establish whether chest radiographic findings suggestive of lower airway obstruction (LAO) disease support the diagnosis of asthma in pediatric patients with persistent cough in an outpatient setting. 180 patient charts were reviewed. The patients were children aged 1 to 18 years referred over a 3-year period to a pediatric pulmonary subspecialty clinic for evaluation of cough lasting ≥ 4 weeks. Chest radiographic images obtained after the initial evaluation of 90 patients diagnosed with cough-variant asthma and 90 patients diagnosed with persistent cough from nonasthma origins were compared with radiologic findings of a control group consisting of patients with a positive tuberculin skin test and no respiratory symptoms. Increased peribronchial markings/peribronchial cuffing and hyperinflation were considered radiographically suggestive findings of LAO disease. Children diagnosed with cough-variant asthma at the initial evaluation had higher rates of chest radiographic findings suggestive of LAO disease (30.00%) than children with persistent cough from other causes (17.80%) or those with a positive tuberculin skin test and no respiratory symptoms (8.16%) (overall P value = 0.0063). They also had higher rates of spirometry abnormalities suggestive of an LAO defect. Children with chest radiographic findings suggestive of LAO disease were found to be younger than those with normal chest radiographic findings (5.0 ± 2.7 years vs 8.6 ± 4.7 years; P < 0.0001). This study suggests that chest radiographic findings indicative of an LAO in correlation with the clinical presentation can support the diagnostic suspicion of asthma, especially in younger children unable to perform spirometry.

  10. The value of routine chest radiographs in a paediatric intensive care unit: a prospective study

    International Nuclear Information System (INIS)

    Valk, J.W.; Ploetz, F.B.; Schuerman, F.A.B.A.; Vught, H. van; Kramer, P.P.G.; Beek, E.J.A.

    2001-01-01

    Background. In many paediatric intensive care units (PICUs) chest X-ray films (CXRs) are required as part of the daily examination or after completion of invasive procedures. Objective. First, to evaluate if the American College of Radiology (ACR) guidelines for adult patients are appropriate for paediatric pa- tients. Second, to assess the diagnostic efficacy of the CXRs. Materials and methods. One-hundred-seventy-four CXRs acquired in 74 patients, either routinely or after invasive procedures, were analysed. The indication of the obtained CXRs, or the absence of indication in patients in whom no CXRs was taken, was compared with ACR guidelines. The position of medical devices was evaluated. Changes in cardiopulmonary status were noted. Results. Sixty-seven percent of the CXRs were in accordance with the ACR guidelines, and in 74 % of pa- tients in whom no CXRs were taken this was also in accordance with these guidelines. Sixteen percent of the endotracheal tubes, 23 % of central venous lines and 15 % of nasogastric tubes were malpositioned. Changes in cardiopulmonary status, after the initial film, were noted in 63 %. Conclusions. The indications for the majority of CXRs in our PICU appeared to be in accordance with ACR guidelines. The high percentage of malpositioned tubes and lines and the number of cardiopulmonary changes on CXRs in a PICU underline the value of these films. Adjustments of the ACR guidelines for particular groups of paediatric patients may limit the number of CXRs taken and may further increase diagnostic efficacy. (orig.)

  11. Pneumothorax size measurements on digital chest radiographs: Intra- and inter- rater reliability.

    Science.gov (United States)

    Thelle, Andreas; Gjerdevik, Miriam; Grydeland, Thomas; Skorge, Trude D; Wentzel-Larsen, Tore; Bakke, Per S

    2015-10-01

    Detailed and reliable methods may be important for discussions on the importance of pneumothorax size in clinical decision-making. Rhea's method is widely used to estimate pneumothorax size in percent based on chest X-rays (CXRs) from three measure points. Choi's addendum is used for anterioposterior projections. The aim of this study was to examine the intrarater and interrater reliability of the Rhea and Choi method using digital CXR in the ward based PACS monitors. Three physicians examined a retrospective series of 80 digital CXRs showing pneumothorax, using Rhea and Choi's method, then repeated in a random order two weeks later. We used the analysis of variance technique by Eliasziw et al. to assess the intrarater and interrater reliability in altogether 480 estimations of pneumothorax size. Estimated pneumothorax sizes ranged between 5% and 100%. The intrarater reliability coefficient was 0.98 (95% one-sided lower-limit confidence interval C 0.96), and the interrater reliability coefficient was 0.95 (95% one-sided lower-limit confidence interval 0.93). This study has shown that the Rhea and Choi method for calculating pneumothorax size has high intrarater and interrater reliability. These results are valid across gender, side of pneumothorax and whether the patient is diagnosed with primary or secondary pneumothorax. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Chest radiographic features of lymphocytic interstitial pneumonitis in HIV-infected children

    Energy Technology Data Exchange (ETDEWEB)

    Pitcher, R.D., E-mail: pitcher@iafrica.co [Division of Paediatric Radiology, Red Cross War Memorial Children' s Hospital, Department of Radiation Medicine, University of Cape Town (South Africa); Beningfield, S.J. [Division of Radiology, New Groote Schuur Hospital and University of Cape Town (South Africa); Zar, H.J. [Department of Paediatric Pulmonology, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, University of Cape Town (South Africa)

    2010-02-15

    Aim: To review the radiological features of biopsy-proven lymphocytic interstitial pneumonitis (LIP) in human immunodeficiency virus (HIV)-infected children and establish whether these are based on systematic radiological analysis, and to investigate whether more specific radiological diagnostic criteria can be developed. Materials and methods: A Medline search of English-language articles on the radiological features of biopsy-proven LIP in HIV-infected children was conducted for the period 1982 to 2007 inclusive. Radiological findings were compared with the Centers for Disease Control and Prevention (CDC) criteria for a presumptive diagnosis of LIP. Results: Pulmonary pathology was recorded as 'diffuse' and 'bilateral' in 125 (97.6%) of 128 reported cases of LIP. Twenty-five different terms were used to describe the pulmonary parenchyma. In 96 (75%), the terminology was consistent with CDC diagnostic criteria. Radiological evolution was documented in 43 (33.5%). Persistent focal opacification superimposed on diffuse pulmonary nodularity was demonstrated in 10 (7.8%). The method of radiological evaluation was described in six (4.6%). In no instance was the terminology defined. Conclusion: The radiological features of LIP have not been systematically analysed. However, CDC criteria remain reliable, allowing diagnosis of at least 75% of cases. The sensitivity of these criteria may be increased by including cases with persistent focal pulmonary opacification superimposed on diffuse nodularity. Longitudinal studies utilizing standardized radiographic analysis are needed to elucidate the natural history of LIP.

  13. Chest radiographic features of lymphocytic interstitial pneumonitis in HIV-infected children

    International Nuclear Information System (INIS)

    Pitcher, R.D.; Beningfield, S.J.; Zar, H.J.

    2010-01-01

    Aim: To review the radiological features of biopsy-proven lymphocytic interstitial pneumonitis (LIP) in human immunodeficiency virus (HIV)-infected children and establish whether these are based on systematic radiological analysis, and to investigate whether more specific radiological diagnostic criteria can be developed. Materials and methods: A Medline search of English-language articles on the radiological features of biopsy-proven LIP in HIV-infected children was conducted for the period 1982 to 2007 inclusive. Radiological findings were compared with the Centers for Disease Control and Prevention (CDC) criteria for a presumptive diagnosis of LIP. Results: Pulmonary pathology was recorded as 'diffuse' and 'bilateral' in 125 (97.6%) of 128 reported cases of LIP. Twenty-five different terms were used to describe the pulmonary parenchyma. In 96 (75%), the terminology was consistent with CDC diagnostic criteria. Radiological evolution was documented in 43 (33.5%). Persistent focal opacification superimposed on diffuse pulmonary nodularity was demonstrated in 10 (7.8%). The method of radiological evaluation was described in six (4.6%). In no instance was the terminology defined. Conclusion: The radiological features of LIP have not been systematically analysed. However, CDC criteria remain reliable, allowing diagnosis of at least 75% of cases. The sensitivity of these criteria may be increased by including cases with persistent focal pulmonary opacification superimposed on diffuse nodularity. Longitudinal studies utilizing standardized radiographic analysis are needed to elucidate the natural history of LIP.

  14. CT saber-sheath trachea. Correlation with clinical, chest radiographic and functional findings

    International Nuclear Information System (INIS)

    Trigaux, J.P.; Hermes, G.; Dubois, P.; Beers, B. van; Delaunois, L.; Jamart, J.

    1994-01-01

    The diagnosis of saber-sheath trachea is easy at CT due to its cross-sectional imaging, but the significance of this CT sign has not been evaluated in the diagnosis of chronic obstructive pulmonary disease (COPD). Various signs of COPD were compared between a series of 20 patients with a saber-sheath trachea at CT (tracheal index ≤66%) and a group of 20 pneumologic control patients without saber-sheath trachea (tracheal index ≥70%). These signs include clinical and standard radiographic indices of COPD, sternum-spine distance and 3 functional tests of COPD: forced expiratory volume in one second, carbon monoxide diffusing lung capacity, and funtional residual capacity (FRC). A significant difference was found between the 2 groups, concerning the values of FRC and of sternum-spine distance (p -2 ). The tracheal index was significantly correlated with the FRC values and with the sternum-spine distance. No other significant difference was observed. It is concluded that saber-sheath trachea is basically a sign of hyperinflation. (orig./MG)

  15. A study on findings from simple chest radiographs without any clinical symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan College, Ansan (Korea, Republic of)

    2007-06-15

    In this study, the analysis on findings from simple chest radiography (CXR) test with total 1,669 subjects without any special clinical symptom came to the following conclusions: In terms of the general characteristics of subjects hereof, male and female group accounted for 55.2% and 44.8% respectively out of all 1,669 people. Pulmonary disease cases amounted to 249 persons (14.9%) out of all subjects. In the analysis on prevalence rate by age distribution, it was noted that the older age led to the more number of diseases, which was demonstrated by age 34 or younger (6.1%), age 35 {approx} 39 (9.7%), age 40 {approx} 49 (13.3%), and age 50 or older (30.8%). In regard of pulmonary disease alone, the region of onset was represented primarily by right upper lobe, which was followed by both upper lobe and left upper lobe, respectively. In terms of disease types, it was found that most cases were represented by pulmonary nodule (55.0%), which was followed by cardiomegaly (24.5%), CP angle blunting (4.8%), scoliosis (4.6%) tortuous aorta (2.8%), bronchial luminal dilatation(2.4%), and pleural thickening (2.0%). However, dextrocardia, cystic dilation of bronchus, cavitary lesion, and lung collapse accounted for relatively low rate (0.4% respectively). In terms of disease types by sex, it was found that male group accounted for higher percentage of having cardiomegaly, tortuous aorta and scoliosis than the former. In terms of disease types by age distribution, it was noted that age 34 or younger group accounted for higher percentage of scoliosis than any other age groups, while age 40 {approx} 49 group, age 35 {approx} 39 group, and age 50 or older group represented the case of CP angle blunting, pulmonary nodule, and cardiomegaly/tortuous aorta, respectively.

  16. A study on findings from simple chest radiographs without any clinical symptoms

    International Nuclear Information System (INIS)

    Kim, Ham Gyum

    2007-01-01

    In this study, the analysis on findings from simple chest radiography (CXR) test with total 1,669 subjects without any special clinical symptom came to the following conclusions: In terms of the general characteristics of subjects hereof, male and female group accounted for 55.2% and 44.8% respectively out of all 1,669 people. Pulmonary disease cases amounted to 249 persons (14.9%) out of all subjects. In the analysis on prevalence rate by age distribution, it was noted that the older age led to the more number of diseases, which was demonstrated by age 34 or younger (6.1%), age 35 ∼ 39 (9.7%), age 40 ∼ 49 (13.3%), and age 50 or older (30.8%). In regard of pulmonary disease alone, the region of onset was represented primarily by right upper lobe, which was followed by both upper lobe and left upper lobe, respectively. In terms of disease types, it was found that most cases were represented by pulmonary nodule (55.0%), which was followed by cardiomegaly (24.5%), CP angle blunting (4.8%), scoliosis (4.6%) tortuous aorta (2.8%), bronchial luminal dilatation(2.4%), and pleural thickening (2.0%). However, dextrocardia, cystic dilation of bronchus, cavitary lesion, and lung collapse accounted for relatively low rate (0.4% respectively). In terms of disease types by sex, it was found that male group accounted for higher percentage of having cardiomegaly, tortuous aorta and scoliosis than the former. In terms of disease types by age distribution, it was noted that age 34 or younger group accounted for higher percentage of scoliosis than any other age groups, while age 40 ∼ 49 group, age 35 ∼ 39 group, and age 50 or older group represented the case of CP angle blunting, pulmonary nodule, and cardiomegaly/tortuous aorta, respectively

  17. Spirometry in children.

    Science.gov (United States)

    Jat, Kana Ram

    2013-06-01

    Respiratory disorders are responsible for considerable morbidity and mortality in children. Spirometry is a useful investigation for diagnosing and monitoring a variety of paediatric respiratory diseases, but it is underused by primary care physicians and paediatricians treating children with respiratory disease. We now have a better understanding of respiratory physiology in children, and newer computerised spirometry equipment is available with updated regional reference values for the paediatric age group. This review evaluates the current literature for indications, test procedures, quality assessment, and interpretation of spirometry results in children. Spirometry may be useful for asthma, cystic fibrosis, congenital or acquired airway malformations and many other respiratory diseases in children. The technique for performing spirometry in children is crucial and is discussed in detail. Most children, including preschool children, can perform acceptable spirometry. Steps for interpreting spirometry results include identification of common errors during the test by applying acceptability and repeatability criteria and then comparing test parameters with reference standards. Spirometry results depict only the pattern of ventilation, which may be normal, obstructive, restrictive, or mixed. The diagnosis should be based on both clinical features and spirometry results. There is a need to encourage primary care physicians and paediatricians treating respiratory diseases in children to use spirometry after adequate training.

  18. Short-term impact of pictorial posters and a crash course on radiographic errors for improving the quality of paediatric chest radiographs in an unsupervised unit - a pilot study for quality-assurance outreach

    Energy Technology Data Exchange (ETDEWEB)

    Tebogo Hlabangana, Linda; Andronikou, Savvas [University of the Witwatersrand, Department of Diagnostic Radiology, Johannesburg (South Africa)

    2014-08-17

    Chest radiography is the most commonly performed diagnostic X-ray examination. The radiation dose to the patient for this examination is relatively low but because of its frequent use, the contribution to the collective dose is considerable. Optimized image quality not only allows for more accurate diagnosis but also supports radiation protection, which is particularly important in children. To determine whether the introduction of a poster of technical errors in paediatric radiography accompanied by a short lecture (crash course) for radiographers on common errors can sustainably decrease the number and rate of these errors in an unsupervised radiology department (without a paediatric-trained radiologist or paediatric-trained radiography personnel). We conducted a pilot study for quality-assurance outreach, with retrospective and prospective components, in the paediatric radiology department of a teaching hospital. The technical errors in frontal chest radiographs performed in the unit were assessed by quality-assurance analysis using a customized tick-sheet. The review was performed before and after an intervention that involved a half-hour crash course and poster displays in the department. We compared the rate of technical errors made before and after the intervention. There was statistically significant improvement in quality of radiographs (P < 0.0083) performed immediately after the intervention. There was a statistically significant decline in the quality of radiographs performed >2 months after the intervention. A simple intervention of a crash course and poster placement resulted in improved quality of paediatric chest radiographs. A decline in quality after 2 months suggests the need to repeat this or another type of intervention regularly. (orig.)

  19. The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions

    International Nuclear Information System (INIS)

    Laya, Bernard F.; Goske, Marilyn J.; Morrison, Stuart; Reid, Janet R.; Swischuck, Leonard; Ey, Elizabeth H.; Murphy, Daniel J.; Lieber, Michael; Obuchowski, Nancy

    2006-01-01

    Congenital heart disease (CHD) is a significant cause of morbidity and mortality in pediatric patients. Traditional teaching holds that specific types of CHD can be diagnosed on the chest radiograph (CXR) through pattern recognition. To determine the accuracy of radiologists in detecting CHD on the CXR. This study was a blinded retrospective review of chest radiographs from 281 patients (<12 years) by five pediatric radiologists from three institutions. Thirteen groups were evaluated that included 12 categories of CHD and a control group of patients without heart disease. Radiographs were assessed for heart size, heart and mediastinal shape and vascularity. Clinical information, angiography, echocardiograms and surgery were used as the gold standard for definitive diagnosis. The average accuracy of the five readers in distinguishing normal from CHD patients was 78% (range of 72% to 82%). The overall measure of accuracy in distinguishing specific congenital cardiac lesions among 13 groups of patients was 71% (range of 63% to 79%). CXR alone is not diagnostic of specific cardiac lesions, with a low accuracy of only 71%. We believe that less emphasis should be placed on the use of radiographs alone in diagnosing specific congenital cardiac lesions. (orig.)

  20. Characteristic scapular and rib changes on chest radiographs of children with ADA-deficiency SCIDS in the first year of life.

    Science.gov (United States)

    Manson, David; Diamond, Lauren; Oudjhane, Kamaldine; Hussain, Faisal Bin; Roifman, Chaim; Grunebaum, Eyal

    2013-03-01

    We describe radiographic changes in the ribs and scapulae seen in the first 6 months of life in children with ADA (adenosine deaminase) deficiency severe combined immundeficiency syndrome (SCIDS). We suggest that these changes are reversible with appropriate enzyme replacement therapy. The purpose of this study was to describe characteristic rib and scapular radiographic changes in infants with ADA-deficiency SCIDS. This was a retrospective review of chest radiographs of nine children with ADA-deficiency SCIDS performed in the first year of life by two experienced pediatric radiologists. A control cohort of unaffected children was used for comparison. All children with ADA-deficiency SCIDS manifested unusual scapular spurring and anterior rib cupping. None of the control children manifested these changes. Characteristic and reversible scapular and rib changes in the correct clinical setting should suggest an early diagnosis of ADA deficiency, prompting appropriate diagnostic and therapeutic measures.

  1. The role of hip and chest radiographs in osteoporotic evaluation among south Indian women population: a comparative scenario with DXA.

    Science.gov (United States)

    Kumar, D Ashok; Anburajan, M

    2014-05-01

    Osteoporosis is recognized as a worldwide skeletal disorder problem. In India, the older as well as postmenopausal women population suffering from osteoporotic fractures has been a common issue. Bone mineral density measurements gauged by dual-energy X-ray absorptiometry (DXA) are used in the diagnosis of osteoporosis. (1) To evaluate osteoporosis in south Indian women by radiogrammetric method in a comparative perspective with DXA. (2) To assess the capability of KJH; Anburajan's Empirical formula in the prediction of total hip bone mineral density (T.BMD) with estimated Hologic T.BMD. In this cross-sectional design, 56 south Indian women were evaluated. These women were randomly selected from a health camp. The patients with secondary bone diseases were excluded. The standard protocol was followed in acquiring BMD of the right proximal femur by DPX Prodigy (DXA Scanner, GE-Lunar Corp., USA). The measured Lunar Total hip BMD was converted into estimated Hologic Total hip BMD. In addition, the studied population underwent chest and hip radiographic measurements. Combined cortical thickness of clavicle has been used in KJH; Anburajan's Empirical formula to predict T.BMD and compared with estimated Hologic T.BMD by DXA. The correlation coefficients exhibited high significance. The combined cortical thickness of clavicle and femur shaft of total studied population was strongly correlated with DXA femur T.BMD measurements (r = 0.87, P < 0.01 and r = 0.45, P < 0.01) and it is also having strong correlation with low bone mass group (r = 0.87, P < 0.01 and r = 0.67, P < 0.01) KJH; Anburajan's Empirical formula shows significant correlation with estimated Hologic T.BMD (r = 0.88, P < 0.01) in total studied population. The empirical formula was identified as better tool for predicting osteoporosis in total population and old-aged population with a sensitivity (88.8 and 95.6 %), specificity (89.6 and 90.9 %), positive predictive value (88.8 and 95.6 %) and negative

  2. Spectrum of Radiological Findings in Leptospirosis on Chest Radiograph and Ultrasonography-Study during Epidemics in South Gujarat Region of India

    Directory of Open Access Journals (Sweden)

    Mona Shastri

    2017-10-01

    Full Text Available Introduction: Leptospirosis is an acute generalised infectious disease caused by any of the group of spirochetes of the genus Leptospira. The disease can involve many organs mainly liver, central nervous system, kidneys, skeletal muscle, and lungs. Diagnosis can be done on the basis of epidemiological, clinical and laboratory features. As the disease has varied manifestations, it is frequently misdiagnosed even in areas of high prevalence. A delay in diagnosis can leads to severe form of disease and development of its complications. Aim: To find out involvement of thoracic and abdominal organs in each and every patient with the help of chest radiographs and Ultrasonography (USG of abdomen and thorax. Also, to put together the radiological spectrum of pulmonary manifestations, and other system involvement in leptospirosis during epidemics in south Gujarat region and their role in early diagnosis and follow up of patients. Materials and Methods: Study was carried out for 3 years. Total 380 patients of suspected leptospirosis were referred during epidemic during months of July to October in year 2008, 2009 and 2010 for confirmation of diagnosis and management. Total 275 patients were confirmed for leptospirosis by serological test (ELISA during first and second week of illness which was included in our study. All 275 patients were evaluated with chest radiographs and ultrasound of chest and abdomen. Those patients which are clinically suspected for leptospirosis but were serologically negative were excluded. Results: Out of 275 confirmed patients of leptospirosis, 54 patients had signs of pulmonary haemorrhage on chest radiograph (19.65%. Out of these 54 patients 50 (which accounts 92% of pulmonary hemorrhage patients and 18% of total 275 patients died due to severe pulmonary haemorrhage and respiratory distress. Pleural effusion was diagnosed on X-ray chest in 10 patients but it was found in 68 patients on USG. Signs of acute renal disease were

  3. The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low.

    Science.gov (United States)

    Graat, Marleen E; Choi, Goda; Wolthuis, Esther K; Korevaar, Johanna C; Spronk, Peter E; Stoker, Jaap; Vroom, Margreeth B; Schultz, Marcus J

    2006-02-01

    The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care for intensive care unit (ICU) patients. This was a prospective observational study conducted in a 28-bed, mixed medical-surgical ICU of a university hospital. Over a 5-month period, 2,457 daily routine CXRs were done in 754 consecutive ICU patients. The majority of these CXRs did not reveal any new predefined major finding. In only 5.8% of daily routine CXRs (14.3% of patients) was one or more new and unexpected abnormality encountered, including large atelectases (24 times in 20 patients), large infiltrates (23 in 22), severe pulmonary congestion (29 in 25), severe pleural effusion (13 in 13), pneumothorax/pneumomediastinum (14 in 13), and malposition of the orotracheal tube (32 in 26). Fewer than half of the CXRs with a new and unexpected finding were ultimately clinically relevant; in only 2.2% of all daily routine CXRs (6.4% of patients) did these radiologic abnormalities result in a change to therapy. Subgroup analysis revealed no differences between medical and surgical patients with regard to the incidence of new and unexpected findings on daily routine CXRs and the effect of new and unexpected CXR findings on daily care. In the ICU, daily routine CXRs seldom reveal unexpected, clinically relevant abnormalities, and they rarely prompt action. We propose that this diagnostic examination be abandoned in ICU patients.

  4. High resolution CT in children with cystic fibrosis: correlation with pulmonary functions and radiographic scores

    Energy Technology Data Exchange (ETDEWEB)

    Demirkazik, Figen Basaran E-mail: demirkaz@dialup.ankara.edu.tr; Ariyuerek, O. Macit; Oezcelik, Ugur; Goecmen, Ayhan; Hassanabad, Hossein K.; Kiper, Nural

    2001-01-01

    Objective: To compare the high resolution CT (HRCT) scores of the Bhalla system with pulmonary function tests and radiographic and clinical points of the Shwachman-Kulczycki clinical scoring system. Methods: HRCT of the chest was obtained in 40 children to assess the role of HRCT in evaluating bronchopulmonary pathology in children with cystic fibrosis (CF). The HRCT severity scores of the Bhalla system were compared with chest radiographic and clinical points of the Shwachman-Kulczycki scoring system and pulmonary function tests. Only 14 of the patients older than 6 years cooperated with spirometry. Results: HRCT scores correlated well with radiographic points (r=0.80, P<0.0001) and clinical points (r=0.67, P<0.0001) of the Shwachman-Kulczycki system, FVC (r=0.71 P=0.004) and FEV{sub 1} (r=0.66, P=0.01). Although radiographic points correlated significantly with FVC (r=0.61, P=0.02) and FEV{sub 1} (r=0.56, P=0.04), HRCT provides a more precise scoring than the chest X-ray. Conclusion: The HRCT scoring system may provide a sensitive method of monitoring pulmonary disease status and may replace the radiographic scoring in the Shwachman-Kulczycki system. It may be helpful especially in follow-up of small children too young to cooperate with spirometry.

  5. High resolution CT in children with cystic fibrosis: correlation with pulmonary functions and radiographic scores

    International Nuclear Information System (INIS)

    Demirkazik, Figen Basaran; Ariyuerek, O. Macit; Oezcelik, Ugur; Goecmen, Ayhan; Hassanabad, Hossein K.; Kiper, Nural

    2001-01-01

    Objective: To compare the high resolution CT (HRCT) scores of the Bhalla system with pulmonary function tests and radiographic and clinical points of the Shwachman-Kulczycki clinical scoring system. Methods: HRCT of the chest was obtained in 40 children to assess the role of HRCT in evaluating bronchopulmonary pathology in children with cystic fibrosis (CF). The HRCT severity scores of the Bhalla system were compared with chest radiographic and clinical points of the Shwachman-Kulczycki scoring system and pulmonary function tests. Only 14 of the patients older than 6 years cooperated with spirometry. Results: HRCT scores correlated well with radiographic points (r=0.80, P 1 (r=0.66, P=0.01). Although radiographic points correlated significantly with FVC (r=0.61, P=0.02) and FEV 1 (r=0.56, P=0.04), HRCT provides a more precise scoring than the chest X-ray. Conclusion: The HRCT scoring system may provide a sensitive method of monitoring pulmonary disease status and may replace the radiographic scoring in the Shwachman-Kulczycki system. It may be helpful especially in follow-up of small children too young to cooperate with spirometry

  6. Quantification of pneumothorax volume on chest radiographs: comparison between the collins' and the axel's methods with three-dimensional CT as the standard of reference

    International Nuclear Information System (INIS)

    Lee, Chang Keun; Kim, Hyung Jin; Lee, Kyung Hee; Kim, Joung Taek; Kim, Kwang Ho; Suh, Chang Hae; Han, Heon

    1999-01-01

    The purpose of this study was twofold. In a preliminary study, we evaluated the accuracy of 3-D (three-dimensional) CT for the estimation of pneumothorax volume and for providing the optimal postprocessing method for clinical study. In the clinical study, we determined which of the two methods, Collins' and Axel's, was more accurate for the estimation of pneumothorax volume, as seen on chest radiographs, using 3-D CT as the standard of reference. In the preliminary study, 3-D CT was applied to phantoms and to four patients with pneumothorax using two different postprocessing methods, manual contour delineation and thresholding. In the clinical study, 3-D CT was performed in 13 patients with pneumothorax. For the purpose of evaluating conventional radiographs, a localizer scan was used for comparing the accuracy of Collins' method with that of Axel's method, with 3-D CT as the standard of reference. The preliminary study revealed that 3-D CT estimated pneumothorax volume with great accuracy and that manual contour delineation and thresholding measured volume equally well. Because of the shorter postprocessing time required with thresholding than with manual contour delineation (5 min versus 30 min), the former was used during clinical study. The results of this indicated close correlation between the measurements obtained using Collins' method on chest radiographs and those obtained by 3-D CT(r=0.95, p 0.05). 3-D CT can estimate pneumothorax volume with great accuracy. Collins' method is superior to Axel's method for the quantification of pneumothorax volume as seen on chest radiographs

  7. Clavicle Chest Cage Angle Difference: Is It a Radiographic and Clinical Predictor of Postoperative Shoulder Imbalance in Lenke I Adolescent Idiopathic Scoliosis?

    Science.gov (United States)

    Han, Xiao; Liu, Zhen; Qiu, Yong; Sha, Shifu; Yan, Huang; Jin, Mengran; Zhu, Zezhang

    2016-09-01

    A retrospective study. To evaluate the effect of preoperative clavicle chest cage angle difference (CCAD) on postoperative radiographic shoulder imbalance, cosmetic shoulder balance, patient's satisfaction, and surgeon's fulfillment in Lenke I adolescent idiopathic scoliosis (AIS). CCAD is a novel predictor of postoperative radiographic shoulder imbalance in AIS. However, radiographic shoulder balance does not always correspond to cosmetic shoulder balance. Forty-four Lenke I AIS patients treated with posterior spinal fusion with a minimum 2-year follow-up were analyzed. Shoulder height difference (SHD) and CCAD were measured on anteroposterior standing radiographs. The inner shoulder height (SHi) and the outer shoulder height (SHo) were measured using the patients' photographs. The patients' satisfaction and the surgeons' fulfillment were evaluated using a questionnaire. A receiver operative characteristic curve analysis was performed to explore the threshold values of preoperative CCAD in the prediction of the final follow-up radiographic shoulder imbalance, patients' satisfaction, and surgeons' fulfillment. At the final follow-up, the preoperative CCAD was significantly greater in patients with unbalanced shoulders (SHD ≥1 cm). For cosmetic shoulder balance at the final follow-up, there was no significant difference in preoperative CCAD between Group 1i (SHi ≥1 cm, n = 14) and Group 2i (SHi imbalance, patients' satisfaction, and surgeons' fulfillment was 5.5°. CCAD is a good radiographic predictor for postoperative radiographic shoulder imbalance in Lenke I AIS patients. Moreover, it is also associated with the patients' satisfaction and surgeons' fulfillment postoperatively. However, CCAD cannot predict postoperative cosmetic shoulder balance. 4.

  8. The Development of Expertise in Radiology: In Chest Radiograph Interpretation, "Expert" Search Pattern May Predate "Expert" Levels of Diagnostic Accuracy for Pneumothorax Identification.

    Science.gov (United States)

    Kelly, Brendan S; Rainford, Louise A; Darcy, Sarah P; Kavanagh, Eoin C; Toomey, Rachel J

    2016-07-01

    Purpose To investigate the development of chest radiograph interpretation skill through medical training by measuring both diagnostic accuracy and eye movements during visual search. Materials and Methods An institutional exemption from full ethical review was granted for the study. Five consultant radiologists were deemed the reference expert group, and four radiology registrars, five senior house officers (SHOs), and six interns formed four clinician groups. Participants were shown 30 chest radiographs, 14 of which had a pneumothorax, and were asked to give their level of confidence as to whether a pneumothorax was present. Receiver operating characteristic (ROC) curve analysis was carried out on diagnostic decisions. Eye movements were recorded with a Tobii TX300 (Tobii Technology, Stockholm, Sweden) eye tracker. Four eye-tracking metrics were analyzed. Variables were compared to identify any differences between groups. All data were compared by using the Friedman nonparametric method. Results The average area under the ROC curve for the groups increased with experience (0.947 for consultants, 0.792 for registrars, 0.693 for SHOs, and 0.659 for interns; P = .009). A significant difference in diagnostic accuracy was found between consultants and registrars (P = .046). All four eye-tracking metrics decreased with experience, and there were significant differences between registrars and SHOs. Total reading time decreased with experience; it was significantly lower for registrars compared with SHOs (P = .046) and for SHOs compared with interns (P = .025). Conclusion Chest radiograph interpretation skill increased with experience, both in terms of diagnostic accuracy and visual search. The observed level of experience at which there was a significant difference was higher for diagnostic accuracy than for eye-tracking metrics. (©) RSNA, 2016 Online supplemental material is available for this article.

  9. Chest radiographic findings and complications of the temporary implantation of the Jarvik-7 artificial heart while awaiting orthotopic heart transplantation: Experience with five cases

    International Nuclear Information System (INIS)

    Sadler, L.R.; Fuhrman, C.R.; Hardesty, R.A.; Griffith, B.P.

    1986-01-01

    The Jarvik-7 artificial heart was originally introduced as a therapeutic alternative to cardiac transplantation in patients with endstage refractory cardiac disease. Its use has been expanded to those patients awaiting cardiac transplantation in whom death is impending and for whom a suitable donor match is unavailable. At Presbyterian-University Hospital of Pittsburgh five patients have had Jarvik-7 hearts implanted as a temporary measure while awaiting compatible donors for cardiac transplantation. The authors believe this is the largest patient group to undergo this procedure at a single institution. They present a brief description of the Jarvik-7 heart, the clinical factors affecting patient selection, and the radiographic appearance of a normally functioning Jarvik-7 heart, and review the chest radiographic complications seen in the patient group, along with eventual patient outcome

  10. Spirometry in Greenland

    DEFF Research Database (Denmark)

    Nielsen, Lasse Overballe; Olsen, Sequssuna; Jarbøl, D. E.

    2016-01-01

    be common. International guidelines recommend the usage of spirometry as a golden standard for diagnosing COPD. The current number of spirometries performed among patients treated with medication targeting obstructive pulmonary disease in Greenland remains unexplored. Objective. To estimate the prevalence...... of patients aged 50 years or above treated with medication targeting obstructive pulmonary disease and the extent to which spirometry was performed among them within 2 years. Design. An observational, cross-sectional study based on the review of data obtained from electronic medical records in Greenland...... of the identified users of medication targeting obstructive pulmonary disease. Information on age, gender, town and spirometry was registered for each patient within the period from October 2013 to October 2015. Results. The prevalence of patients treated with medication targeting obstructive pulmonary disease aged...

  11. Radiographic evaluations

    International Nuclear Information System (INIS)

    Williams, J.L.

    1988-01-01

    The author describes how to: perform a systematic evaluation of a chest radiograph; state the classic radiographic description of hyaline membrane disease; list the conditions that cause hyperaeration and describe the radiologic feature of hyperaeration; describe the radiograph of a patient with a congenital diaphragmatic hernia; identify optimum placement of an endotracheal tube, gastric feeding tube, and umbilical artery catheter on a radiograph; differentiate between pulmonary interstitial air and hyaline membrane disease; select radiographic features that would indicate the presence of a tension pneumothorax; describe a lateral decubitus projection and state the type of problem it is most often used to identify; explain the procedure used in obtaining a lateral neck radiograph and list two problems that may require this view; and describe the radiograph of a patient with cystic fibrosis

  12. Comparison of gated radionuclide scans and chest radiographs. Assessment of left ventricular impairment in patients with coronary disease.

    Science.gov (United States)

    Bianco, J A; Reinke, D B; Makey, D G; Shafer, R B

    1980-03-01

    Diagnostic efficacy of gated cardiac blood pool imaging was studied in 41 consecutive patients with LV ejection fractions (LVEF) less than or equal to 0.50. Eighty percent of patients were receiving therapy for LV failure at the time of the study. All patients had documented coronary-artery disease (CAD). Chest x-ray films were interpreted blindly by a senior radiologist. Cardiothoracic ratio of less than or equal to 0.50 was recorded as normal. Radionuclide assessment of LV function contributes importantly to the diagnostic and screening value of chest x-ray films. Patients with coronary disease and clinical evidence of heart failure should have radioisotopic studies even if chest x-ray film findings are normal. In patients with coronary artery disease and enlarged LV on chest films, radionuclide study of left ventricular performance aids in defining LV impairment, and in the prognostication of subsequent clinical course.

  13. The difference in the appearance of proximal humeral epiphyseal ossification center on chest radiograph between the preterm and full-term infants

    International Nuclear Information System (INIS)

    Park, Hee Hong; Kim, Seung Cheol; Chang, Young Pyo; Park, Jin Young; Kwon, Ho Jang; Lee, Jee Young; Yoo, Dong Soo; Kim, You Me; Jeong, Chun Keun; Lee, Young Seok

    1997-01-01

    To assess the difference in the appearance of the proximal humeral epiphyseal ossification center, as seen on chest radiograph, between preterm and full-term infants at the same corrected ages. Forty two preterm infants born at 26--35 weeks of gestational age and 218 normal full-term infants born at 38-42 weeks were investigated. Because of various perinatal problems, the preterm infants were treated at a neonatal intensive care unit. Proximal humeral epiphyseal ossification centers were evaluated from chest radiographs, and in cases of preterm infants, the corrected age of 0 month was defined as postconceptional 40 weeks. In preterm infants, the numbers of chest radiographs obtained were 42 at 0 month, 40 at 1 month, 37 at 2 months and 36 at 3 months of corrected age, while in those who were full-term, the numbers were 103 cases at 0 month, 42 at 1 month, 42 at 2 months and 31 at 3 months of age In the preterm group, alkaline phosphatase, calcium, phosphorus levels and simple wrist radiographs were checked. We then evaluated the difference of appearance of the proximal humeral epiphyseal ossification center between preterm and full-term infants at the same corrected ages, as well as the difference between causative diseases, between the normal and abnormal serologic group and between the normal and abnormal wrist group in preterm infants at the same corrected ages. Using Fisher's exact test, the data were analysed. The incidences of the proximal humeral epiphyseal ossification center in preterm infants were 2.4% (1/42) at 0 month, 20.0% (8/40) at 1 month, 43.2% (16/37) at 2 months and 69.4%(25/36) at 3 months; in full-term infants, the figures were 24.3% (25/103) at 0 month, 66.7%(28/42) at 1 month, 83.3% (35/42) at 2 months and 90.3% (28/31) at 3 months. At 0, 1, and 2 months, the incidences were thus seen to be lower in preterm than in full-term infants(p 0.05). In preterm infants, there were no statistical differences between causative diseases, between the

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

    International Nuclear Information System (INIS)

    Wells, J; Zhang, L; Samei, E

    2015-01-01

    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"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 segmentation

  15. Spirometry in primary care

    Science.gov (United States)

    Coates, Allan L; Graham, Brian L; McFadden, Robin G; McParland, Colm; Moosa, Dilshad; Provencher, Steeve; Road, Jeremy

    2013-01-01

    Canadian Thoracic Society (CTS) clinical guidelines for asthma and chronic obstructive pulmonary disease (COPD) specify that spirometry should be used to diagnose these diseases. Given the burden of asthma and COPD, most people with these diseases will be diagnosed in the primary care setting. The present CTS position statement was developed to provide guidance on key factors affecting the quality of spirometry testing in the primary care setting. The present statement may also be used to inform and guide the accreditation process for spirometry in each province. Although many of the principles discussed are equally applicable to pulmonary function laboratories and interpretation of tests by respirologists, they are held to a higher standard and are outside the scope of the present statement. PMID:23457669

  16. Quality of routine spirometry tests in Dutch general practices

    Science.gov (United States)

    Schermer, Tjard RJ; Crockett, Alan J; Poels, Patrick JP; van Dijke, Jacob J; Akkermans, Reinier P; Vlek, Hans F; Pieters, Willem R

    2009-01-01

    Background Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. Aim To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. Design of study Analysis of routine spirometry test records. Setting Fifteen general practices which had a working agreement with a local hospital pulmonary function laboratory for spirometry assessment regarding test quality and interpretation. Method Spirometry tests were judged by a pulmonary function technician and a chest physician. Proportions of test adequacy were analysed using markers for manoeuvre acceptability and test reproducibility derived from the 1994 American Thoracic Society spirometry guideline. Associations between quality markers and age, sex, and severity of obstruction were examined using logistic regression. Results Practices performed a mean of four (standard deviation = 2) spirometry tests per week; 1271 tests from 1091 adult patients were analysed; 96.4% (95% confidence interval [CI] = 95.6 to 97.2) of all tests consisted of ≥3 blows. With 60.6% of tests, forced expiratory time was the marker with the lowest acceptability rate. An overall 38.8% (95% CI = 36.0 to 41.6) of the tests met the acceptability as well as reproducibility criteria. Age, sex, and severity of obstruction were associated with test quality markers. Conclusion The quality of routine spirometry tests was better than in previous reports from primary care research settings, but there is still substantial room for improvement. Sufficient duration of forced expiratory time is the quality marker with the highest rate of inadequacy. Primary care professionals should be aware of patient characteristics that may diminish the quality of their spirometry tests. Further research is needed to establish to what extent spirometry tests that are inadequate, according to stringent international expert criteria

  17. Computer assisted spirometry.

    Science.gov (United States)

    Hansen, D J; Toy, V M; Deininger, R A; Collopy, T K

    1983-06-01

    Three of the most popular microcomputers, the TRS-80 Model I, the APPLE II+, and the IBM Personal Computer were connected to a spirometer for data acquisition and analysis. Simple programs were written which allow the collection, analysis and storage of the data produced during spirometry. Three examples demonstrate the relative ease for automating spirometers.

  18. An automated patient recognition method based on an image-matching technique using previous chest radiographs in the picture archiving and communication system environment

    International Nuclear Information System (INIS)

    Morishita, Junji; Katsuragawa, Shigehiko; Kondo, Keisuke; Doi, Kunio

    2001-01-01

    An automated patient recognition method for correcting 'wrong' chest radiographs being stored in a picture archiving and communication system (PACS) environment has been developed. The method is based on an image-matching technique that uses previous chest radiographs. For identification of a 'wrong' patient, the correlation value was determined for a previous image of a patient and a new, current image of the presumed corresponding patient. The current image was shifted horizontally and vertically and rotated, so that we could determine the best match between the two images. The results indicated that the correlation values between the current and previous images for the same, 'correct' patients were generally greater than those for different, 'wrong' patients. Although the two histograms for the same patient and for different patients overlapped at correlation values greater than 0.80, most parts of the histograms were separated. The correlation value was compared with a threshold value that was determined based on an analysis of the histograms of correlation values obtained for the same patient and for different patients. If the current image is considered potentially to belong to a 'wrong' patient, then a warning sign with the probability for a 'wrong' patient is provided to alert radiology personnel. Our results indicate that at least half of the 'wrong' images in our database can be identified correctly with the method described in this study. The overall performance in terms of a receiver operating characteristic curve showed a high performance of the system. The results also indicate that some readings of 'wrong' images for a given patient in the PACS environment can be prevented by use of the method we developed. Therefore an automated warning system for patient recognition would be useful in correcting 'wrong' images being stored in the PACS environment

  19. Spirometry of healthy adult South African men | Louw | South African ...

    African Journals Online (AJOL)

    An exhaustive questionnaire and radiographic screening process was used to identify a healthy population. Spirometry was performed using two calibrated instruments, a sleeve sealed piston spirometer (Autolink) and a bellows spirometer (Vitalograph). The methodological guidelines of the American Thoracic Society were ...

  20. A Rare Cause of Right-Sided Air Bubble on Chest Radiograph: Intrathoracic Gastric Volvulus Related to Morgagni Hernia

    Directory of Open Access Journals (Sweden)

    Abdurrahman Sahin

    2017-03-01

    Full Text Available Morgagni hernia is a rare disorder in adulthood, and most of the cases are asymptomatic. Symptomatic cases are extremely rare and present with life-threatening complications. Early diagnosis and surgery are lifesaving. We hereby present an adult case of symptomatic Morgagni hernia. Diaphragmatic herniation of the stomach and mesenteroaxial rotation led to intrathoracic gastric volvulus in this case. A right-sided air bubble on a chest radiogram was the only finding leading to the suspicion of diaphragmatic hernia. Computed tomography in the diagnosis of diaphragmatic hernias is of great importance.

  1. Lateral chest radiographic findings in lobar collapse of the left lung : the distance between both upper lobe bronchi

    International Nuclear Information System (INIS)

    Chin, G. H.; Sung, D. W.; Yoon, Y.; Kim, H. C.

    1996-01-01

    To evaluate the distance between both upper love bronchi on lateral radiographs and its change in left upper or lower lobe collapse. 144 true lateral radiographs were analyzed on which both upper lobe bronchi were clearly identified. They included 116 normal cases, 11 cases of left upper lobe collapse, 13 of left lower lobe collapse, and 4 cases of left lower lobe lobectomy. Line A was drawn parallel to the vertebral end plate through the upper margin of the lift upper lobe bronchus. Line B was drawn parallel to line A through the upper margin of the right upper love bronchus. The shortest distance between line A and line B was measured as the distance between both upper lobe bronchi. In normal cases, the mean value of the distance was 2.19 cm ± S.D. 0.37 cm on right and on right and 2.16 cm ± S.D. 0.40 cm on left lateral radiographs ; these results were not significantly different(P=0.79). In cases of collapse, the mean value of the distance was 0.43 cm ± S.D. 0.99 cm in upper lobe collapse and 3.56 cm ± S.D. 0.72 cm in lower lobe collapse, results which were significantly different from those of normal cases(p<0.01). In eight cases(73%) of left upper lobe collapse, the distance was less than 1 cm and in 10 cases(77%) of left lower lobe collapse, the distance was more than 3 cm. The distance between both upper lobe bronchi varies markedly in case of lobar collapse. A distance of less than 1 cm suggests collapse of the left upper lobe and a distance more than 3 cm suggests collapse of the left lower lobe

  2. Paired maximum inspiratory and expiratory plain chest radiographs for assessment of airflow limitation in chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Takashi, E-mail: tkino@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Kawayama, Tomotaka, E-mail: kawayama_tomotaka@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Imamura, Youhei, E-mail: mamura_youhei@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Sakazaki, Yuki, E-mail: sakazaki@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Hirai, Ryo, E-mail: hirai_ryou@kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Ishii, Hidenobu, E-mail: shii_hidenobu@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Suetomo, Masashi, E-mail: jin_t_f_c@yahoo.co.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Matsunaga, Kazuko, E-mail: kmatsunaga@kouhoukai.or.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Azuma, Koichi, E-mail: azuma@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Fujimoto, Kiminori, E-mail: kimichan@med.kurume-u.ac.jp [Department of Radiology, Kurume University School of Medicine, Kurume (Japan); Hoshino, Tomoaki, E-mail: hoshino@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan)

    2015-04-15

    Highlights: •It is often to use computed tomography (CT) scan for diagnosis of chronic obstructive pulmonary disease. •CT scan is more expensive and higher. •A plane chest radiography more simple and cheap. Moreover, it is useful as detection of pulmonary emphysema, but not airflow limitation. •Our study demonstrated that the maximum inspiratory and expiratory plane chest radiography technique could detect severe airflow limitations. •We believe that the technique is helpful to diagnose the patients with chronic obstructive pulmonary disease. -- Abstract: Background: The usefulness of paired maximum inspiratory and expiratory (I/E) plain chest radiography (pCR) for diagnosis of chronic obstructive pulmonary disease (COPD) is still unclear. Objectives: We examined whether measurement of the I/E ratio using paired I/E pCR could be used for detection of airflow limitation in patients with COPD. Methods: Eighty patients with COPD (GOLD stage I = 23, stage II = 32, stage III = 15, stage IV = 10) and 34 control subjects were enrolled. The I/E ratios of frontal and lateral lung areas, and lung distance between the apex and base on pCR views were analyzed quantitatively. Pulmonary function parameters were measured at the same time. Results: The I/E ratios for the frontal lung area (1.25 ± 0.01), the lateral lung area (1.29 ± 0.01), and the lung distance (1.18 ± 0.01) were significantly (p < 0.05) reduced in COPD patients compared with controls (1.31 ± 0.02 and 1.38 ± 0.02, and 1.22 ± 0.01, respectively). The I/E ratios in frontal and lateral areas, and lung distance were significantly (p < 0.05) reduced in severe (GOLD stage III) and very severe (GOLD stage IV) COPD as compared to control subjects, although the I/E ratios did not differ significantly between severe and very severe COPD. Moreover, the I/E ratios were significantly correlated with pulmonary function parameters. Conclusions: Measurement of I/E ratios on paired I/E pCR is simple and

  3. Paired maximum inspiratory and expiratory plain chest radiographs for assessment of airflow limitation in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Kinoshita, Takashi; Kawayama, Tomotaka; Imamura, Youhei; Sakazaki, Yuki; Hirai, Ryo; Ishii, Hidenobu; Suetomo, Masashi; Matsunaga, Kazuko; Azuma, Koichi; Fujimoto, Kiminori; Hoshino, Tomoaki

    2015-01-01

    Highlights: •It is often to use computed tomography (CT) scan for diagnosis of chronic obstructive pulmonary disease. •CT scan is more expensive and higher. •A plane chest radiography more simple and cheap. Moreover, it is useful as detection of pulmonary emphysema, but not airflow limitation. •Our study demonstrated that the maximum inspiratory and expiratory plane chest radiography technique could detect severe airflow limitations. •We believe that the technique is helpful to diagnose the patients with chronic obstructive pulmonary disease. -- Abstract: Background: The usefulness of paired maximum inspiratory and expiratory (I/E) plain chest radiography (pCR) for diagnosis of chronic obstructive pulmonary disease (COPD) is still unclear. Objectives: We examined whether measurement of the I/E ratio using paired I/E pCR could be used for detection of airflow limitation in patients with COPD. Methods: Eighty patients with COPD (GOLD stage I = 23, stage II = 32, stage III = 15, stage IV = 10) and 34 control subjects were enrolled. The I/E ratios of frontal and lateral lung areas, and lung distance between the apex and base on pCR views were analyzed quantitatively. Pulmonary function parameters were measured at the same time. Results: The I/E ratios for the frontal lung area (1.25 ± 0.01), the lateral lung area (1.29 ± 0.01), and the lung distance (1.18 ± 0.01) were significantly (p < 0.05) reduced in COPD patients compared with controls (1.31 ± 0.02 and 1.38 ± 0.02, and 1.22 ± 0.01, respectively). The I/E ratios in frontal and lateral areas, and lung distance were significantly (p < 0.05) reduced in severe (GOLD stage III) and very severe (GOLD stage IV) COPD as compared to control subjects, although the I/E ratios did not differ significantly between severe and very severe COPD. Moreover, the I/E ratios were significantly correlated with pulmonary function parameters. Conclusions: Measurement of I/E ratios on paired I/E pCR is simple and

  4. Noncontact spirometry with a webcam

    Science.gov (United States)

    Liu, Chenbin; Yang, Yuting; Tsow, Francis; Shao, Dangdang; Tao, Nongjian

    2017-05-01

    We present an imaging-based method for noncontact spirometry. The method tracks the subtle respiratory-induced shoulder movement of a subject, builds a calibration curve, and determines the flow-volume spirometry curve and vital respiratory parameters, including forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow rate. We validate the accuracy of the method by comparing the data with those simultaneously recorded with a gold standard reference method and examine the reliability of the noncontact spirometry with a pilot study including 16 subjects. This work demonstrates that the noncontact method can provide accurate and reliable spirometry tests with a webcam. Compared to the traditional spirometers, the present noncontact spirometry does not require using a spirometer, breathing into a mouthpiece, or wearing a nose clip, thus making spirometry test more easily accessible for the growing population of asthma and chronic obstructive pulmonary diseases.

  5. Computer-aided diagnostic scheme for the detection of lung nodules on chest radiographs: Localized search method based on anatomical classification

    International Nuclear Information System (INIS)

    Shiraishi, Junji; Li Qiang; Suzuki, Kenji; Engelmann, Roger; Doi, Kunio

    2006-01-01

    We developed an advanced computer-aided diagnostic (CAD) scheme for the detection of various types of lung nodules on chest radiographs intended for implementation in clinical situations. We used 924 digitized chest images (992 noncalcified nodules) which had a 500x500 matrix size with a 1024 gray scale. The images were divided randomly into two sets which were used for training and testing of the computerized scheme. In this scheme, the lung field was first segmented by use of a ribcage detection technique, and then a large search area (448x448 matrix size) within the chest image was automatically determined by taking into account the locations of a midline and a top edge of the segmented ribcage. In order to detect lung nodule candidates based on a localized search method, we divided the entire search area into 7x7 regions of interest (ROIs: 64x64 matrix size). In the next step, each ROI was classified anatomically into apical, peripheral, hilar, and diaphragm/heart regions by use of its image features. Identification of lung nodule candidates and extraction of image features were applied for each localized region (128x128 matrix size), each having its central part (64x64 matrix size) located at a position corresponding to a ROI that was classified anatomically in the previous step. Initial candidates were identified by use of the nodule-enhanced image obtained with the average radial-gradient filtering technique, in which the filter size was varied adaptively depending on the location and the anatomical classification of the ROI. We extracted 57 image features from the original and nodule-enhanced images based on geometric, gray-level, background structure, and edge-gradient features. In addition, 14 image features were obtained from the corresponding locations in the contralateral subtraction image. A total of 71 image features were employed for three sequential artificial neural networks (ANNs) in order to reduce the number of false-positive candidates. All

  6. Early detection of drug-induced pneumonitis by gallium-67 lung scan in six patients with normal chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, H; Sawa, H; Takashima, S [Osaka City Univ. (Japan). Hospital

    1981-06-01

    Increased pulmonary accumulation of Gallium-67-citrate was observed in 6 patients (4 with malignant lymphoma, 1 with uterine cancer and 1 with acute myelocytic leukemia) preceding the appearance of any abnormal findings in both chest X-ray and blood gas data. All of them had received multiple courses of chemotherapy. In these patients, the anticancer drugs were administered for 13 to 22 weeks (mean 15 weeks). One patient with malignant lymphoma showed abnormal /sup 67/Ga lung uptake greater than hepatic activity, 3 patients (malignant lymphoma, 2 and uterine cancer, 1) visualized abnormal /sup 67/Ga lung uptake equal to hepatic activity and 2 cases (malignant lymphoma, 1 and acute myelocytic leukemia, 1) demonstrated abnormal accumulation of /sup 67/Ga in the lung greater than background activity. In 4 patients (3 with malignant lymphoma and 1 with uterine cancer) out of 6, transbronchial lung biopsy obtained after the /sup 67/Ga scans showed non-specific interstitial pneumonitis with infiltration of lymphocytes and macrophages compatible with drug-induced pneumonitis. In the other 2 patients, cytology and cultures were negative and follow up /sup 67/Ga lung scans revealed a reduction in intensity of uptake after treatment with corticosteroid. Therefore, we considered that the /sup 67/Ga lung scan was useful for early detection of drug-induced pneumonitis.

  7. CT of chest trauma

    International Nuclear Information System (INIS)

    Goodman, P.C.

    1986-01-01

    There appears to be a limited role for computed tomography in the evaluation of chest trauma. The literature contains few papers specifically addressing the use of CT in the setting of chest trauma. Another series of articles relates anecdotal experiences in this regard. This paucity of reports attests to the remarkable amount of information present on conventional chest radiographs as well as the lack of clear indications for CT in the setting of chest trauma. In this chapter traumatic lesions of various areas of the thorax are discussed. The conventional radiographic findings are briefly described and the potential or proven application of CT is addressed

  8. Pulmonary involvement in rheumatoid arthritis: evaluation by radiography and spirometry *

    Science.gov (United States)

    Kawassaki, Alexandre Melo; Pereira, Daniel Antunes Silva; Uliana Kay, Fernando; Laurindo, Ieda Maria Magalhães; Carvalho, Carlos Roberto Ribeiro; Kairalla, Ronaldo Adib

    2015-01-01

    Abstract Objective: To determine whether simple diagnostic methods can yield relevant disease information in patients with rheumatoid arthritis (RA). Methods: Patients with RA were randomly selected for inclusion in a cross-sectional study involving clinical evaluation of pulmonary function, including pulse oximetry (determination of SpO2, at rest), chest X-ray, and spirometry. Results: A total of 246 RA patients underwent complete assessments. Half of the patients in our sample reported a history of smoking. Spirometry was abnormal in 30% of the patients; the chest X-ray was abnormal in 45%; and the SpO2 was abnormal in 13%. Normal chest X-ray, spirometry, and SpO2 were observed simultaneously in only 41% of the RA patients. A history of smoking was associated with abnormal spirometry findings, including evidence of obstructive or restrictive lung disease, and with abnormal chest X-ray findings, as well as with an interstitial pattern on the chest X-ray. Comparing the patients in whom all test results were normal (n = 101) with those in whom abnormal test results were obtained (n = 145), we found a statistically significant difference between the two groups, in terms of age and smoking status. Notably, there were signs of airway disease in nearly half of the patients with minimal or no history of tobacco smoke exposure. Conclusions: Pulmonary involvement in RA can be identified through the use of a combination of diagnostic methods that are simple, safe, and inexpensive. Our results lead us to suggest that RA patients with signs of lung involvement should be screened for lung abnormalities, even if presenting with no respiratory symptoms. PMID:26398753

  9. Risk for COPD with Obstruction of Active Smokers with Normal Spirometry and Reduced Diffusion Capacity

    Science.gov (United States)

    Kaner, Robert J.; Sanders, Abraham; Vincent, Thomas L.; Mezey, Jason G.; Crystal, Ronald G.

    2016-01-01

    Background Smokers are assessed for COPD using spirometry, with COPD defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as airflow limitation not fully reversible with bronchodilators. There is a subset of smokers with normal spirometry (by GOLD criteria), who have a low diffusion capacity (DLCO), a parameter linked to emphysema and small airway disease. The natural history of these “normal spirometry/low DLCO” smokers is unknown. Methods From a cohort of 1570 smokers in the New York City metropolitian area, all of whom had normal spirometry, two groups were randomly selected for lung function follow-up: smokers with normal spirometry/normal DLCO (n=59) and smokers with normal spirometry/low DLCO (n=46). All had normal history, physical examination, CBC, urinalysis, HIV status, α1-antitrypsin level, chest X-ray, FEV1, FVC, FEV1/FVC ratio and total lung capacity (TLC). Throughout the study, all continued to be active smokers. Findings In the normal spirometry/normal DLCO group assessed over 45 ± 20 months, 3% developed GOLD-defined COPD. In contrast, in the normal spirometry/low DLCO group, followed over 41 ± 31 months, 22% developed GOLD-defined COPD. Interpretation Despite appearing “normal” by GOLD, smokers with normal spirometry but low DLCO are at significant risk for developing COPD with obstruction to airflow. PMID:26541521

  10. Can routine chest radiography be used to diagnose mild COPD? A nested case-control study.

    Science.gov (United States)

    den Harder, A M; Snoek, A M; Leiner, T; Suyker, W J; de Heer, L M; Budde, R P J; Lammers, J W J; de Jong, P A; Gondrie, M J A

    2017-07-01

    To determine whether mild stage chronic obstructive pulmonary disease (COPD) can be detected on chest radiography without substantial overdiagnosis. A retrospective nested case-control study (case:control, 1:1) was performed in 783 patients scheduled for cardiothoracic surgery who underwent both spirometry and a chest radiograph preoperative. Diagnostic accuracy of chest radiography for diagnosing mild COPD was investigated using objective measurements and overall appearance specific for COPD on chest radiography. Inter-observer variability was investigated and variables with a kappa >0.40 as well as baseline characteristics were used to make a diagnostic model which was aimed at achieving a high positive predictive value (PPV). Twenty percent (155/783) had COPD. The PPV of overall appearance specific for COPD alone was low (37-55%). Factors in the diagnostic model were age, type of surgery, gender, distance of the right diaphragm apex to the first rib, retrosternal space, sternodiaphragmatic angle, maximum height right diaphragm (lateral view) and subjective impression of COPD (using both views). The model resulted in a PPV of 100%, negative predictive value (NPV) of 82%, sensitivity of 10% and specificity of 100% with an area under the curve of 0.811. Detection of mild COPD without substantial overdiagnosis was not feasible on chest radiographs in our cohort. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Digital chest radiography

    DEFF Research Database (Denmark)

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

    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...

  12. Classification of radiological errors in chest radiographs, using support vector machine on the spatial frequency features of false- negative and false-positive regions

    Science.gov (United States)

    Pietrzyk, Mariusz W.; Donovan, Tim; Brennan, Patrick C.; Dix, Alan; Manning, David J.

    2011-03-01

    Aim: To optimize automated classification of radiological errors during lung nodule detection from chest radiographs (CxR) using a support vector machine (SVM) run on the spatial frequency features extracted from the local background of selected regions. Background: The majority of the unreported pulmonary nodules are visually detected but not recognized; shown by the prolonged dwell time values at false-negative regions. Similarly, overestimated nodule locations are capturing substantial amounts of foveal attention. Spatial frequency properties of selected local backgrounds are correlated with human observer responses either in terms of accuracy in indicating abnormality position or in the precision of visual sampling the medical images. Methods: Seven radiologists participated in the eye tracking experiments conducted under conditions of pulmonary nodule detection from a set of 20 postero-anterior CxR. The most dwelled locations have been identified and subjected to spatial frequency (SF) analysis. The image-based features of selected ROI were extracted with un-decimated Wavelet Packet Transform. An analysis of variance was run to select SF features and a SVM schema was implemented to classify False-Negative and False-Positive from all ROI. Results: A relative high overall accuracy was obtained for each individually developed Wavelet-SVM algorithm, with over 90% average correct ratio for errors recognition from all prolonged dwell locations. Conclusion: The preliminary results show that combined eye-tracking and image-based features can be used for automated detection of radiological error with SVM. The work is still in progress and not all analytical procedures have been completed, which might have an effect on the specificity of the algorithm.

  13. The Role of Incentive Spirometry in Primary Spontaneous Pneumothorax.

    Science.gov (United States)

    Pribadi, Rabbinu R; Singh, Gurmeet; Rumende, Cleopas M

    2016-01-01

    Pneumothorax is the presence of air in the pleural space. Its management consists of noninvasive and invasive therapies and it is determined based on clinical manifestations, type and size of pneumothorax. We present a case of a patient with diagnosis of primary spontaneous pneumothorax treated with incentive spirometry (noninvasive therapy). A 20 year old man came to respirology clinic with chief complaint of shortness of breath. He was recently diagnosed with left pneumothorax based on previous chest X-ray in another health care facilities and was advised to undergo tube thoracostomy but he refused the procedure. On physical examination, vital signs were normal. Chest X-ray showed 33% of pneumothorax or 1.2 cm. He was asked to perform incentive spirometry therapy at home. During 12 days of therapy, shortness of breath slowly disappeared and on repeated chest X-ray, it showed minimal pneumothorax in the left upper hemithorax. Noninvasive treatment such as incentive spirometry can be considered in patient with minimal symptoms and no signs of life-threatening respiratory distress.

  14. Estimation of entrance dose on chest radiographs according to the exposure index on Computerized Radiology System: preliminary results; Estimativa de dose de entrada a partir do indice de exposicao em sistema CR: resultados preliminares

    Energy Technology Data Exchange (ETDEWEB)

    Donomai, Luana Kaoru; Jornada, Tiago da Silva; Daros, Kellen Adriana Curci, E-mail: luana.donomai@gmail.com, E-mail: tiagosjornada@gmail.com, E-mail: daros.kellen@unifesp.br [Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil)

    2014-07-01

    Digital radiology has improved image quality in radiographs in comparison to screen/film systems though the visual control of the quantity of radiation involved on these exams became more demanding due to the low perception of over and underexposed images. Therefore, this study aims to analyze the exposure index (EI) from chest examinations and relate them to the entrance skin dose. Indices from 29 patients and kerma entrance dose were correlated. A correlation coefficient equal to 0,6881 was calculated. EI and entrance dose are correlated positive and moderately, indicating the relevance to deepen the subject. (author)

  15. Digital platform for improving non-radiologists' and radiologists' interpretation of chest radiographs for suspected tuberculosis - a method for supporting task-shifting in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Semakula-Katende, Namakula S.; Lucas, Susan [University of the Witwatersrand, Department of Radiology, Faculty of Health Sciences, Witwatersrand (South Africa); Andronikou, Savvas [University of Bristol, Department of Radiology/CRIC Bristol, Bristol (United Kingdom); Bristol Royal Hospital for Children, Department of Radiology, Bristol (United Kingdom)

    2016-09-15

    Shifting X-ray interpretation to non-radiologists can help to address radiologist shortages in developing countries. To determine the change in accuracy of non-radiologists and radiologists for the radiographic diagnosis of paediatric tuberculosis after a short skill-development course. Participants interpreted 15 paediatric chest radiographs before and after a 30-minute course using three possible responses: (1) diagnostic for tuberculosis, (2) abnormal but inconclusive for diagnosis of tuberculosis and (3) normal. We compared proportions of correct diagnoses, sensitivity, and specificity, before and after the course. We included 256 participants comprising 229 non-radiologists (134 radiographers, 32 paediatricians, 39 Medecins Sans Frontieres clinicians and 24 physicians including paediatricians) and 27 radiologists. Mean change proportions of correct diagnosis ranged from -27% to 53% for individuals and 9% to 20% for groups. All groups showed a statistically significant improvement. Mean change in diagnostic sensitivity ranged from -38% to 100% for individuals and from 16% to 41% for groups. All groups showed a statistically significant improvement. Mean change in specificity ranged from -57% to 57% for individuals and from -15% to -4% for groups. The decrease was statistically significant for physicians, paediatricians and radiographers. The course resulted in increased correct diagnoses and improved sensitivity at the expense of specificity. (orig.)

  16. Telemedical Education: Teaching Spirometry on the Internet.

    Science.gov (United States)

    Lum, Esther H.; Gross, Thomas J.

    1999-01-01

    Describes the development and evaluation of an Internet-based tutorial for teaching spirometry interpretation to nonpulmonologists. Concludes that computer-based tutorials can effectively train off-site practitioners in spirometry interpretation. Contains 23 references. (Author/WRM)

  17. Risk of COPD with obstruction in active smokers with normal spirometry and reduced diffusion capacity.

    Science.gov (United States)

    Harvey, Ben-Gary; Strulovici-Barel, Yael; Kaner, Robert J; Sanders, Abraham; Vincent, Thomas L; Mezey, Jason G; Crystal, Ronald G

    2015-12-01

    Smokers are assessed for chronic obstructive pulmonary disease (COPD) using spirometry, with COPD defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as airflow limitation that is not fully reversible with bronchodilators. There is a subset of smokers with normal spirometry (by GOLD criteria), who have a low diffusing capacity of the lung for carbon monoxide (DLCO), a parameter linked to emphysema and small airway disease. The natural history of these "normal spirometry/low DLCO" smokers is unknown.From a cohort of 1570 smokers in the New York City metropolitian area, all of whom had normal spirometry, two groups were randomly selected for lung function follow-up: smokers with normal spirometry/normal DLCO (n=59) and smokers with normal spirometry/low DLCO (n=46). All had normal history, physical examination, complete blood count, urinalysis, HIV status, α1-antitrypsin level, chest radiography, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio and total lung capacity. Throughout the study, all continued to be active smokers.In the normal spirometry/normal DLCO group assessed over 45±20 months, 3% developed GOLD-defined COPD. In contrast, in the normal spirometry/low DLCO group, followed over 41±31 months, 22% developed GOLD-defined COPD.Despite appearing "normal" according to GOLD, smokers with normal spirometry but low DLCO are at significant risk of developing COPD with obstruction to airflow. Copyright ©ERS 2015.

  18. Radiology of blunt chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Shulman, H.S.; Samuels, T.H. (Sunnybrook Medical Centre, Toronto, Ontario (Canada))

    1983-09-01

    Chest injuries and related complications prove fatal in over half of the victims of multiple trauma. The radiologist's responsibility is twofold: a) to recognize key radiographic signs and b) to guide the clinician in the radiologic investigation and management of the patient. The important diagnoses to be recognized from radiographs are pneumothorax, aortic rupture, bronhcial rupture and diaphragmatic rupture.

  19. Estimation of absorbed dose by newborn patients subjected to chest radiographs; Estimativa de dose efetiva para radiografias do torax em pediatria neonatal

    Energy Technology Data Exchange (ETDEWEB)

    Bunick, Ana P. [Faculdades Pequeno Principe, Curitiba, PR (Brazil); Schelin, Hugo R. [Instituto de Pesquisa Pele Pequeno Principe, Curitiba, PR (Brazil); Denyak, Valeriy [Hospital Infantil Pequeno Principe, Curitiba, PR (Brazil)

    2016-07-01

    The aim of this study is to present an estimate of the effective dose received by newborn patients hospitalized in NICU and subjected to X-ray examinations of the chest in the AP projection. Initially, were followed examinations chest X-rays performed on newborn patients and subsequently, simulated in a newborn simulator object. The ESAK values obtained by TLDs were used to calculate the effective dose obtained at each examination by Caldose{sub X} software. The estimated values for the effective dose in the simulated exams in this study range from 2,3μSv the 10,7μSv. The results achieved are, generally, inferior to those reported for similar previous studies. (author)

  20. [Spirometry in the GP-Office].

    Science.gov (United States)

    Gonzalez, Leander; Stolz, Daiana

    2016-02-17

    Spirometry is an important diagnostic tool, which, with correct implementation, detects possible obstructive or restrictive lung diseases. However, it is important to note that only part of the lung function is measured by spirometry. For instance, total lung volume and residual volume, both useful in detecting pulmonary emphysema, are not measured. Therefore, in case of pathological spirometry or suspected restrictive lung disease, further tests such as body plethysmography with diffusion measurement should be carried out.

  1. Prediction equations for spirometry in adults from northern India.

    Science.gov (United States)

    Chhabra, S K; Kumar, R; Gupta, U; Rahman, M; Dash, D J

    2014-01-01

    limits of normal and standardised residuals for these parameters. The equations were found to be valid on the test dataset, and therefore, may be extended to general population. Comparison with the 1960s equations revealed lack of good agreement, and substantially higher predicted FVC with the current equations, especially in the forty-years-plus age group, in both males and females. Even in the age group upto 40 years, the level of agreement was clinically not acceptable. Validated prediction equations have been developed for spirometry variables in adults of north Indian origin using the current ATS/ERS spirometry standardisation recommendations. The equations suggest an improvement in the lung health of the population over time in the middle-aged and the elderly. These equations should address a long-felt unmet need and enable a more appropriate evaluation of spirometry data in different chest diseases in Indian subjects.

  2. Trauma of the chest

    International Nuclear Information System (INIS)

    Reuter, M.

    1996-01-01

    This paper describes the typical radiologic findings in chest trauma, and the value of conventional radiography, CT, MRI, and aortography is discussed. Conventional radiography rather than cross-sectional imaging is the mainstay in diagnosing thoracic trauma. During the critical phase with often concomitant shock, pelvic and spinal injuries tailored raiographic views or even upright chest radiographs are impractical. The severely traumatized patient is usually radiographed in the supine position and suboptimal roentgenograms may have to be accepted for several reasons. It is well documented that many abnormalities detected on CT were not apparent on conventional radiographs, but CT is reserved for hemodynamical stable patients. Nevertheless certain situations like aortic rupture require further evaluation by CT and aortography. (orig./MG)

  3. Pocket atlas of radiographic anatomy

    International Nuclear Information System (INIS)

    Moeller, T.B.; Reif, E.; Stark, P.

    1993-01-01

    The 'Pocket Atlas of Radiographic Anatomy' presents 170 radiographs of the various body regions of adults, showing only the normal radiographic anatomy. Each radiograph is supplemented on the opposite page by a drawing of the particular body region. There is no commenting text, but the drawings are provided with captions in English. The atlas is a useful guide for interpreting radiographs. The pictures are arranged in chapters entitled as follows: Skeletal Imaging (skull, spine, upper extremity), lower extremity; Miscellaneous Plain Films (chest, mammogram, trachea, lung tomograms); Contrast Examinations (gastrointestinal tract, intravenous contrast examinations, arthrography, angiography); Special Examinations (myelograms, lymphangiograms, bronchograms, sialograms). (UWA). 348 figs [de

  4. 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.

  5. Interpretation of neonatal chest radiography

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung

    2016-01-01

    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

  6. Absorbed doses received by patients submitted to chest radiographs in hospitals of the city of Sao Paulo, Brazil; Doses absorvidas pelos pacientes submetidos a radiografias toracicas em hospitais do municipio de Sao Paulo

    Energy Technology Data Exchange (ETDEWEB)

    Freitas, Marcelo Baptista de

    2000-07-01

    Medical irradiation contributes with a significant amount to the dose received by the population. Here, this contribution was evaluated in a survey of absorbed doses received by patients submitted to chest radiological examinations (postero-anterior (PA) and lateral (LAT) projections) in hospitals of the city of Sao Paulo. Due to the variety of equipment and procedures used in radiological examinations, a selection of hospitals was made (12, totalizing 27 X-ray facilities), taking into account their representativeness as medical institutions in the city, in terms of characteristics and number of radiographs carried out. An anthropomorphic phantom, provided with thermoluminescent dosemeters (TLD-1 00), was irradiated simulating the patient, and the radiographic image quality was evaluated. Absorbed doses were determined to the thoracic region (entrance and exit skin and lung doses), and to some important organs from the radiation protection point of view (lens of the eye, thyroid and gonads). The great variation on the exposure parameters (kV, mA.s, beam size) leads to a large interval of entrance skin doses-ESD (coefficients of variation, CV, of 60% and 76%, for PA and LAT projections, respectively, were found) and of organ doses (CV of 60% and 46%. for thyroid and lung respectively). Mean values of ESD for LAT and PA projections were 0.22 and 0.98 mGy, respectively. The average absorbed doses per exam (PA and LAT) to thyroid and lung, 0.15 and 0.24 mGy respectively,showed that the thyroid was irradiated by the primary beam in many cases. Values of lens of the eye and gonad absorbed doses were below 30 {mu}Gy. Comparison of the lung doses obtained in this study with values in the literature, calculated by Monte Carlo simulation, showed good agreement. On the other hand, the comparison shows significant differences in the dose values to organs outside the chest region (thyroid, lens of eye and gonads). The effective dose calculated for a chest examination, PA and

  7. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    Prosch, H.; Negrin, L.

    2014-01-01

    Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.) [de

  8. Five tips for good office spirometry

    African Journals Online (AJOL)

    Spirometry is critical for the correct diagnosis of chronic obstructive pulmonary disease (COPD) and is part of the severity classification. It ultimately guides treatment choices. When per forming spirometry on a COPD patient, one expects a flow volume loop to have some degree of obstruction. To obtain and confirm this result ...

  9. Radiographic outcomes among South African coal miners.

    Science.gov (United States)

    Naidoo, Rajen N; Robins, Thomas G; Solomon, A; White, Neil; Franzblau, Alfred

    2004-10-01

    This study, the first to document the prevalence of pneumoconiosis among a living South African coal mining cohort, describes dose-response relationships between coal workers' pneumoconiosis and respirable dust exposure, and relationships between pneumoconiosis and both lung function deterioration and respiratory symptoms. A total of 684 current miners and 188 ex-miners from three bituminous-coal mines in Mpumalanga, South Africa, was studied. Chest radiographs were read according to the International Labour Organization (ILO) classification by two experienced readers, one an accredited National Institute for Occupational Safety and Health (NIOSH) "B" reader. Interviews were conducted to assess symptoms, work histories (also obtained from company records), smoking, and other risk factors. Spirometry was performed by trained technicians. Cumulative respirable dust exposure (CDE) estimates were constructed from historical company-collected sampling and researcher-collected personal dust measurements. kappa-Statistics compared the radiographic outcomes predicted by the two readers. An average profusion score was used in the analysis for the outcomes of interest. Because of possible confounding by employment status, most analyses were stratified on current and ex-miner status. The overall prevalence of pneumoconiosis was low (2%-4%). The degree of agreement between the two readers for profusion was moderate to high (kappa=0.58). A significant association (Pminers only. A significant (Pminers with pneumoconiosis than among those without. Logistic regression models showed no significant relationships between pneumoconiosis and symptoms. The overall prevalence of pneumoconiosis, although significantly associated with CDE, was low. The presence of pneumoconiosis is associated with meaningful health effects, including deterioration in lung function. Intervention measures that control exposure are indicated, to reduce these functional effects.

  10. Spirometry is underused in the diagnosis and monitoring of patients with chronic obstructive pulmonary disease (COPD)

    Science.gov (United States)

    Yu, Wai Cho; Fu, Sau Nga; Tai, Emily Lai-bun; Yeung, Yiu Cheong; Kwong, Kwok Chu; Chang, Yui; Tam, Cheuk Ming; Yiu, Yuk Kwan

    2013-01-01

    Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in a district in Hong Kong. It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Of 126 patients who underwent spirometry, six (4.8%) did not have COPD. Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1 was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. The only independent factor predicting spirometry done ever was absence of old pulmonary tuberculosis and follow-up at respiratory specialist clinic. Age, sex, smoking status, comorbidities, duration of COPD, percentage predicted FEV1, body mass index, 6-minute walking distance, and Medical Research Council dyspnea score were not predictive. We conclude that spirometry is underused in general but especially by nonrespiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed. PMID:24009418

  11. Exposição de pacientes e qualidade da imagem em radiografias de tórax: uma avaliação crítica Patients exposure and imaging quality in chest radiographs: a critical evaluation

    Directory of Open Access Journals (Sweden)

    Adelaja Otolorin Osibote

    2007-04-01

    Full Text Available OBJETIVO: Foi realizada avaliação da dose de entrada na pele, da dose efetiva e da qualidade da imagem em radiografias de tórax de pacientes adultos. MATERIAIS E MÉTODOS: O estudo realizou-se em oito hospitais, sendo sete públicos (dois filantrópicos e um particular nos municípios de Angra dos Reis, Cabo Frio, Campos dos Goytacazes, Itaperuna, Niterói, Recife e Rio de Janeiro. Foram avaliadas a dose de entrada na pele e a dose efetiva de 735 radiografias de tórax nas incidências póstero-anterior/ântero-posterior e perfil. No que se refere aos critérios de imagem, foram avaliadas 44 radiografias. RESULTADOS: Constatou-se variação de até nove vezes nos valores da dose de entrada na pele e de até seis vezes na dose efetiva para um mesmo tipo de projeção. Os valores das técnicas radiográficas também apresentaram grandes discrepâncias. A qualidade das imagens também não é boa, pois foi obtido valor médio de presença dos critérios de apenas 55%. CONCLUSÃO: Há necessidade de melhoria/padronização de procedimentos em radiologia convencional, o que pode ser atingido se for implantado um programa de controle e garantia de qualidade no setor de radiologia, incluindo o treinamento dos técnicos, a aferição do desempenho dos equipamentos emissores de radiação e o controle sensitométrico do sistema de processamento radiográfico.OBJECTIVE: Entrance skin dose, effective dose, and imaging quality in chest radiographs of adult patients have been evaluated. MATERIALS AND METHODS: The study has been developed in eight institutions - seven public hospitals (two of them philanthropic institutions and one private - in the cities of Agra dos Reis, Cabo Frio, Campos dos Goytacazes, Itaperuna, Niterói, Recife and Rio de Janeiro. Entrance skin dose and effective dose have been evaluated in 735 chest radiographs obtained in posteroanterior/anteroposterior and lateral projections. As regards imaging criteria, 44 radiographs have been

  12. Detectability of T1a lung cancer on digital chest radiographs: an observer-performance comparison among 2-megapixel general-purpose, 2-megapixel medical-purpose, and 3-megapixel medical-purpose liquid-crystal display (LCD) monitors.

    Science.gov (United States)

    Yabuuchi, Hidetake; Matsuo, Yoshio; Kamitani, Takeshi; Jinnnouchi, Mikako; Yonezawa, Masato; Yamasaki, Yuzo; Nagao, Michinobu; Kawanami, Satoshi; Okamoto, Tatsuro; Sasaki, Masayuki; Honda, Hiroshi

    2015-08-01

    There has been no comparison of detectability of small lung cancer between general and medical LCD monitors or no comparison of detectability of small lung cancer between solid and part-solid nodules. To compare the detectabilities of T1a lung cancer on chest radiographs on three LCD monitor types: 2-megapixel (MP) for general purpose (General), 2-MP for medical purpose (Medical), and 3-MP-Medical. Radiographs from forty patients with T1aN0M0 primary lung cancer (27 solid nodules, 13 part-solid nodules) and 60 patients with no abnormalities on both chest X-ray and computed tomography (CT) were consecutively collected. Five readers assessed 100 cases for each monitor. The observations were analyzed using receiver operating characteristic (ROC) analysis. A jackknife method was used for statistical analysis. A P value of General, 2-MP-Medical, and 3-MP-Medical LCD monitors were 0.86, 0.89, and 0.89, respectively; there were no significant differences among them. The average AUC for part-solid nodule detection using a 2-MP-General, 2-MP-Medical, and 3-MP-Medical LCD monitors were 0.77, 0.86, and 0.89, respectively. There were significant differences between the 2-MP-General and 2-MP-Medical LCD monitors (P = 0.043) and between the 2-MP-General and 3-MP-Medical LCD monitors (P = 0.027). There was no significant difference between the 2-MP-Medical and 3-MP-Medical LCD monitors. The average AUC for solid nodule detection using a 2-MP-General, 2-MP-Medical, and 3-MP-Medical LCD monitors were 0.90, 0.90, and 0.88, respectively; there were no significant differences among them. The mean AUC values for all and part-solid nodules of the low-experienced readers were significantly lower than those of the high-experienced readers with the 2 M-GP color LCD monitor (P general-purpose LCD monitor was significantly lower than those using medical-purpose LCD monitors. © The Foundation Acta Radiologica 2014.

  13. Comparison of the image quality of digital radiography system and film screen system - Radiologist' rating of the visibility of normal anatomic - Structures in chest PA, Skull radiograph and K. U. B

    International Nuclear Information System (INIS)

    Song, Kounn Sik; Kim, Young Goo; Lee, Jong Beum; Kim, Kun Sang

    1987-01-01

    Digital image acquisition and display is widely used in computed tomography, ultrasonography, digital subtraction angiography, nuclear medicine and magnetic resonance image. But most of the radiological examinations performed in radiology department are made by using conventional system. The development of the digital radiography system is essential if totally digitized radiology department is desired. The advantages of digitizing the radiographic information are usually discussed in terms of PACS (picture archiving and communication system), furthermore there are many other advantages such as contrast modification, spatial filtering subtraction and superimposition of the images through the image processing by computer. Currently several approaches are under development or in clinical use, the most promising approach is the use of imaging plate composed of photostimulate phosphors such as barium fluorohalide crystal read with a He-Ne laser to produce digital radiographic images. Another promising approach is scan projection radiography. The authors performed the clinical study of comparing the image qualities of digital radiography system using scanning laser luminescence (FCR) and conventional film-screen system in chest PA, skull radiography and K. U. B. in terms of the visibility of the normal anatomic structure rating those (qualities) on a scale of 0 to 3 and obtained the following results. Normal contrast digital images are comparable to conventional film-screen images, but the images of high frequency enhancement is far superior to conventional film-screen especially in peripherally located structures such as skin, subcutaneous fat, musculoskeletal systems, nasal bone, inner and outer table of the skull including the diploic space, paranasal sinuses, nasopharynx and larynx, trachea and main bronchi, mediastinal structures, retrocardiac and subphrenic vascular markings. Another promising aspects of digital radiography system is its wide exposure latitude and

  14. The value of spirometry and exercise challenge test to diagnose and monitor children with asthma.

    Science.gov (United States)

    van den Wijngaart, Lara S; Roukema, Jolt; Merkus, Peter Jfm

    2015-03-01

    Asthma is defined as a chronic inflammatory disease of the airways with characteristic symptoms including recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. It may result in abnormalities of ventilator function, which can be assessed by different pulmonary function tests. In this case report, we present a 15-year-old boy with asthma and illustrate the value and limitations of spirometry and exercise challenge test in daily practice.

  15. [Spirometry - basic examination of the lung function].

    Science.gov (United States)

    Kociánová, Jana

    Spirometry is one of the basic internal examination methods, similarly as e.g. blood pressure measurement or ECG recording. It is used to detect or assess the extent of ventilatory disorders. Indications include respiratory symptoms or laboratory anomalies, smoking, inhalation risks and more. Its performance and evaluation should be among the basic skills of pulmonologists, internists, alergologists, pediatricians and sports physicians. The results essentially influence the correct diagnosing and treatment method. Therefore spirometry must be performed under standardized conditions and accurately and clearly assessed to enable answering clinical questions.Key words: acceptability - calibration - contraindication - evaluation - indication - parameters - spirometry - standardization.

  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. Pediatric digital chest imaging.

    Science.gov (United States)

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  18. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

  19. [A comparison of chest radiographs between patients with pulmonary Mycobacterium kansasii infection and those with Mycobacterium tuberculosis infection in the initial stage of disease].

    Science.gov (United States)

    Inoue, Eri; Senoo, Mami; Nagayama, Naohiro; Masuda, Kimihiko; Matsui, Hirotoshi; Tamura, Atsuhisa; Nagai, Hideaki; Akagawa, Shinobu; Toyoda, Emiko; Oota, Ken

    2013-08-01

    To elucidate the differences in affected lung segments between patients with pulmonary M. kansasii infection and those with M. tuberculosis infection in the initial stage of disease, we examined chest radiography images and CT scans. The initial stage of disease was defined as the period when less than one-sixth of the total lung area was affected by the infection, as visualized on chest radiography and CT. One hundred eighty-four patients were diagnosed with M.kansasii infection between 1996 and 2010 and 835 patients, with M.tuberculosis infection between 2008 and 2009 at our hospital. The diagnosis was made on the basis of the results of sputum culture and/or bronchial washing. After excluding the patients with underlying lung diseases such as chronic pulmonary emphysema, interstitial pneumonia, and old pulmonary tuberculosis as well as those in advanced stages, 24 patients with M. kansasii infection and 62 patients with M. tuberculosis infection were included in this study. The affected segments of the lungs and the rates of cavity development were determined by using CT scans. In patients with M.kansasii, 17 had an infected right lung, while 7 had an infected left lung. Additionally, in patients with M.tuberculosis, 58 had an infected right lung, 3 had an infected left lung, and 1 had a bilateral infection. In patients infected with M. kansasii, the upper lobes were affected in 22 cases and the lower lobes in 3 cases. In patients infected with M. tuberculosis, the upper, middle, and lower lobes and the lingular segment were affected in 41, 8, 24, and 1 cases, respectively. Upper lobe lesions were seen more frequently in patients with M. kansasii infection than in those with M. tuberculosis infection (p formation was identified more frequently in patients infected with M. kansasii (91.7%) than in those infected with M. tuberculosis (32.3%) (p < 0.001). Cavitary lesions were more frequently localized to the apical, posterior, and apico-posterior regions (S1, S2

  20. Virtual respiratory system for interactive e-learning of spirometry

    Directory of Open Access Journals (Sweden)

    W. Tomalak

    2008-04-01

    Full Text Available Progress in computer simulation technology offers new possibilities for modern medicine. On one hand – virtual organs can help to create animal or human models for research, on the other hand – e-learning or distant learning through Internet is now possible. The aim of our work was to create a system for interactive learning of spirometry (SILS, enabling students or physicians to observe spirometric measurements (flow-volume modified by setting level and kind of abnormalities within the respiratory system. SILS is based on a virtual respiratory system presented previously in several papers. Its main features are: separation of the lungs and chest; anatomical division of the lungs; division of airway resistance into transmural pressure dependent (Rp and lung volume dependent (Rv parts. The one mathematical formula that represents Rp describes both flow limitation (forced expiration and dependence of Raw on lungs volume (small airflows. The output of system are spirometric parameters (as FEV1, FVC, FEV1%FVC and a flow–volume loop constructed according to results of simulation of forced expiration for the chosen abnormality kind and level. As a result – this system may be used in teaching process in medical schools and postgraduate education. We offer access to a basic version of SILS for students and physicians at: www.spirometry.ibib.waw.pl and www.zpigichp.edu.pl. As we expect feedback from users, it is possible to modify user interface or model features to comply with users' requests.

  1. CT findings of chest trauma

    International Nuclear Information System (INIS)

    Kim, Young Tong; Kim Young Il

    1998-01-01

    Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 persons under 40 years of age. Most pleural, pulmonary, mediastinal, and diaphragmatic injuries are not seen on conventional chest radiographs, or are underestimated. In patients with chest trauma, CT scanning is an effective and sensitive method of detecting thoracic injuries and provides accurate information regarding their pattern and extent. (author). 5 refs., 17 figs

  2. Chest MRI

    Science.gov (United States)

    ... resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI Patient Instructions ... Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  3. Radiographic assessment of venous catheter position in children: Value of the lateral view

    International Nuclear Information System (INIS)

    Stark, D.D.; Brasch, R.C.; Gooding, C.A.

    1984-01-01

    Frontal chest radiographs can be misleading in the evaluation of central venous catheter placement. Lateral chest radiographs were obtained, in addition to the standard frontal radiographs, in 25 young children. In five (20%) of the children, the catheters were found to be malpositioned, and the frontal radiograph showed evidence of the abnormality in all five. The lateral radiographs also showed evidence of the abnormality in all five children; however, in three of the five, the lateral radiographs provided additional, more specific, diagnostic information. The lateral chest radiographs also demonstrated satisfactory catheter positioning in three other children in whom the frontal radiographs suggested abnormal positioning. Accurate assessment of catheter position was possible in all patients using both frontal and lateral chest radiographs. Injection of contrast material was not necessary to locate malpositioned catheters. Lateral radiographs are recommended whenever an abnormal catheter position is suspected clinically or from findings on the routine frontal radiograph. (orig.)

  4. Radiographic findings in immunodeficiency

    International Nuclear Information System (INIS)

    Obregon, R.; Lynch, D.A.; Cink, T.M.; Newell, J.D.; Kirkpatrick, C.

    1991-01-01

    This paper reviews the chest radiographs and high-resolution CT (HRCT) scans in patients with immunodeficiency disorders and define the role of HRCT. Thirty-three cases were retrospectively graded according to the consensus of two radiologists. Patients with HIV seropositivity and asthma were excluded. HRCT was performed in 12 cases with standard techniques. Diagnoses included common variable hypogammaglobulinemia (n = 19), X-linked agammaglobulinemia (n = 4), chronic mucocutaneous candidiasis (n = 4), and selective immunoglobulin g deficiencies (n = 2). Chest radiographs showed bronchiectasis in 11 of 33 cases with a predominant lower lobe distribution (82%). Nodules were present in six cases and mucus plugs in four cases. HRCT showed bronchiectasis in nine of 12 cases; in five of these nine cases, bronchiectasis was not apparent on chest radiographs. Other HRCT findings included segmental air trapping (four of 12), mucus plugs (three of 12), hazy consolidation (four of 12), nodules (five of 12), and bronchiolectasis (two of 12). Therapy was altered in seven of 12 cases in which HRCT was performed. Most pertinent to clinical management were the presence of a thymoma (n = 1) and severe focal of diffuse bronchiectasis

  5. The chest

    International Nuclear Information System (INIS)

    Berdon, W.E.

    1985-01-01

    Radiographic interpretation of chest films of newborns in respiratory distress remains one of the most difficult aspects of pediatric radiology. Complex pulmonary and cardiac adjustments to extrauterine life are rapidly taking place. The small, fluid-filled fetal lung must rid itself of fluid and fill with air. The high vascular resistance of the fetal pulmonary bed and the open ductus arteriosus allow shunting of blood in both directions. Films taken in this period of time may show lungs that resemble those seen in congestive heart failure or fluid overload. When these findings are observed in infants who may appear dusky or even cyanotic, the result may be the diagnosis of disease in normal infants passing through a stormy transition period. To make things worse, the films are taken as portable surpine films, usually in an isolette in the intensive care unit (ICU). The phase of respiration is difficult, if not impossible, to control, and lateral films are usually not obtained. Many of the infants are on assisted ventilation either by tube or nasal prongs-nasal continuous positive airway pressure (CPAP)-and lungs can appear over-inflated or whited out, depending on the pressures used and the phase of the respiratory cycle. Prolonged crying itself can make lungs appear semiopaque; the next breath may show such a dramatic reinflation that it is hard to believe the two films are of the same infant, made only seconds apart. Is the heart large? Or is it the thymus? Are the lungs ''wet''? Is there infection? Is there pulmonary vascular engorgement? Why are these films so hard to interpret? They have no easy answers. The radiologist must realize that the neonatal intensive care personnel, armed though they may be with blood gas values, are no better at interpreting films. If anything, they read into them what they wish to see

  6. Regionally adaptive histogram equalization of the chest

    International Nuclear Information System (INIS)

    Sherrier, R.H.; Johnson, G.A.

    1986-01-01

    Advances in digital chest radiography have resulted in the acquisition of high-quality digital images of the human chest. With these advances, there arises a genuine need for image processing algorithms, specific to chest images. The author has implemented the technique of histogram equalization, noting the problems encountered when it is adapted to chest images. These problems have been successfully solved with a regionally adaptive histogram equalization method. Histograms are calculated locally and then modified according to both the mean pixel value of a given region and certain characteristics of the cumulative distribution function. The method allows certain regions of the chest radiograph to be enhanced differentially

  7. Feasibility of spirometry testing in preschool children.

    Science.gov (United States)

    Kampschmidt, Jordan C; Brooks, Edward G; Cherry, Debra C; Guajardo, Jesus R; Wood, Pamela R

    2016-03-01

    The primary purpose of this study was to evaluate the feasibility of obtaining acceptable and reproducible spirometry data in preschool aged children (3-5 years) by technicians without prior experience with spirometry. Two technicians were trained to perform spirometry testing (ndd Easy on-PC) and to administer standardized questionnaires. Preschool aged children were enrolled from two Head Start centers and a local primary care clinic. Subjects were trained in proper spirometry technique and tested until at least two acceptable efforts were obtained or the subject no longer produced acceptable efforts. 200 subjects were enrolled: mean age 4.0 years (± 0.7 SD); age distribution: 51 (25.5%) 3 years old, 103 (51.5%) 4 years old, and 46 (23%) 5 years old. Fifty-six percent male and 75% Hispanic. One hundred thirty (65%) subjects produced at least one acceptable effort on their first visit: 23 (45%) for 3 years old, 67 (65%) for 4 years old, and 40 (87%) for 5 years old. The number of acceptable efforts correlated with age (r = 0.29, P spirometry results from the preschool aged children; the number of acceptable efforts correlated significantly with age. © 2015 Wiley Periodicals, Inc.

  8. Radiography of the chest and upper airway

    International Nuclear Information System (INIS)

    Sharko, G.A.; Wilmot, D.M.

    1987-01-01

    The techniques of radiography of the chest in all pediatric-age groups differ only slightly from those used in adult radiography. The technologist's principal challenge, however, relates to optimum handling of the patient with respect to positioning and radiation protection. The hints provided in this chapter should permit the conscientious radiographer to obtain high quality radiographs on all pediatric patients

  9. The radiology of blunt chest trauma

    International Nuclear Information System (INIS)

    Shulman, H.S.; Samuels, T.H.

    1983-01-01

    Chest injuries and related complications prove fatal in over half of the victims of multiple trauma. The radiologist's responsibility is twofold: a) to recognize key radiographic signs and b) to guide the clinician in the radiologic investigation and management of the patient. The important diagnoses to be recognized from radiographs are pneumothorax, aortic rupture, bronhcial rupture and diaphragmatic rupture

  10. Indications for chest CT. Retrospective study of cases with normal chest CT

    International Nuclear Information System (INIS)

    Obata, Shiro

    1995-01-01

    The usefulness of computed tomography (CT) in thoracic radiology is now well appreciated, and the number of chest CTs has greatly increased. There are, however, many chest CT cases that are completely or almost completely normal. Indications for chest CT should be re-evaluated considering the cost and radiation exposure associated with the examination. Reviewing the reports of 4930 chest CT examinations performed in three hospitals during the period of two years, the author found 620 (12.6%) negative CT examinations. In 312 of the 620, the CT was requested because of 'abnormal shadow' on chest radiograph. When the same chest radiographs were re-evaluated by two radiologists, no abnormality was noted in 257 cases (82.4%). CT examinations were considered justified in only 55 cases (17.6%). There was a significant difference in the frequency of normal chest CT examinations between the university hospital and two other hospitals. The causes of false positive interpretation of chest radiographs were analyzed, and it was felt that fundamental knowledge necessary to interpret chest radiographs was lacking. The importance of close cooperation between clinicians and radiologists should be emphasized. (author)

  11. Pulmonary effects of synthetic marijuana: chest radiography and CT findings.

    Science.gov (United States)

    Berkowitz, Eugene A; Henry, Travis S; Veeraraghavan, Srihari; Staton, Gerald W; Gal, Anthony A

    2015-04-01

    The purpose of this article is to present the first chest radiographic and CT descriptions of organizing pneumonia in response to smoking synthetic marijuana. Chest radiographs showed a diffuse miliary-micronodular pattern. Chest CT images showed diffuse centrilobular nodules and tree-in-bud pattern and a histopathologic pattern of organizing pneumonia with or without patchy acute alveolar damage. This distinct imaging pattern should alert radiologists to include synthetic marijuana abuse in the differential diagnosis.

  12. Psychogenic Dyspnea and Therapeutic Chest Radiograph

    Science.gov (United States)

    Kaufman, Kenneth R.; Endres, Jennifer K.; Kaufman, Nathaniel D.

    2007-01-01

    Conversion disorders, the physical expression of unresolved psychological pain, can be associated with mourning. This case report is third in a series of articles by the authors on childhood mourning reflecting the effects of multiple losses (K. R. Kaufman & N. D. Kaufman, 2005; K. R. Kaufman & N. D. Kaufman, 2006). In this case report, perception…

  13. UTILITY OF ROUTINE CHEST RADIOGRAPHS IN KENYA

    African Journals Online (AJOL)

    2014-07-07

    Jul 7, 2014 ... following exposure to ionising radiation. Several epidemiological studies have confirmed this relationship especially in areas that have experienced nuclear disasters. Tronko et alhas described radiation induced thyroid cancer in Ukraine following the. Chernobyl nuclear accident (7). One author has vividly ...

  14. [Quality scale for preschool spirometry interpretation].

    Science.gov (United States)

    Gatto, Francisca; Bedregal, Paula; Ubilla, Carlos; Barrientos, Hortensia; Caussade, Solange

    2017-02-01

    Since 2007, there are international guidelines for implementation and interpretation of spirometry in preschool children. A percentage of these patients cannot obtain maneuvers that meet all eligibility criteria. The objective of this study was to develop a quality scale for interpreting these partially acceptable spirometry. Delphi methodology was used, which allows to reach consensus among experts analyzing a defined problem. We invited to participate pediatric pneumologists dedicated to lung function and who participated actively in scientific specialty societies in Chile. Successive rounds were conducted with questionnaires about criteria used to assess spirometry in preschool children. These criteria define the acceptability of spirometric maneuvers according to international guidelines. Proposed quality grades were “very good”, “good”, “fair” and “bad”. Thirteen of the 15 invited experts accepted our invitation. In the first round 9 disagreed with the degree of “regular” quality. In the second round this was removed and 11 experts answered, 9 of them agreed with the use of this new version. The most contentious criterion was the end of expiration. Most experts agreed with the final scale, using “very good”, “good” and “bad” judgments. This would help to improve the performance of spirometry in children between 2 and 5 years.

  15. The European Respiratory Society spirometry tent

    DEFF Research Database (Denmark)

    Maio, Sara; Sherrill, Duane L; MacNee, William

    2012-01-01

    In order to raise public awareness of the importance of early detection of airway obstruction and to enable many people who had not been tested previously to have their lung function measured, the European Lung Foundation and the European Respiratory Society (ERS) organised a spirometry testing...

  16. 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.

  17. Development and evaluation of a computer-aided diagnostic scheme for lung nodule detection in chest radiographs by means of two-stage nodule enhancement with support vector classification

    International Nuclear Information System (INIS)

    Chen Sheng; Suzuki, Kenji; MacMahon, Heber

    2011-01-01

    Purpose: To develop a computer-aided detection (CADe) scheme for nodules in chest radiographs (CXRs) with a high sensitivity and a low false-positive (FP) rate. Methods: The authors developed a CADe scheme consisting of five major steps, which were developed for improving the overall performance of CADe schemes. First, to segment the lung fields accurately, the authors developed a multisegment active shape model. Then, a two-stage nodule-enhancement technique was developed for improving the conspicuity of nodules. Initial nodule candidates were detected and segmented by using the clustering watershed algorithm. Thirty-one shape-, gray-level-, surface-, and gradient-based features were extracted from each segmented candidate for determining the feature space, including one of the new features based on the Canny edge detector to eliminate a major FP source caused by rib crossings. Finally, a nonlinear support vector machine (SVM) with a Gaussian kernel was employed for classification of the nodule candidates. Results: To evaluate and compare the scheme to other published CADe schemes, the authors used a publicly available database containing 140 nodules in 140 CXRs and 93 normal CXRs. The CADe scheme based on the SVM classifier achieved sensitivities of 78.6% (110/140) and 71.4% (100/140) with averages of 5.0 (1165/233) FPs/image and 2.0 (466/233) FPs/image, respectively, in a leave-one-out cross-validation test, whereas the CADe scheme based on a linear discriminant analysis classifier had a sensitivity of 60.7% (85/140) at an FP rate of 5.0 FPs/image. For nodules classified as ''very subtle'' and ''extremely subtle,'' a sensitivity of 57.1% (24/42) was achieved at an FP rate of 5.0 FPs/image. When the authors used a database developed at the University of Chicago, the sensitivities was 83.3% (40/48) and 77.1% (37/48) at an FP rate of 5.0 (240/48) FPs/image and 2.0 (96/48) FPs /image, respectively. Conclusions: These results compare favorably to those described for

  18. Spirometry quality in adults with very severe lung function impairment.

    Science.gov (United States)

    Torre-Bouscoulet, Luis; Velázquez-Uncal, Mónica; García-Torrentera, Rogelio; Gochicoa-Rangel, Laura; Fernández-Plata, Rosario; Enright, Paul; Pérez-Padilla, Rogelio

    2015-05-01

    Some technologists worry that patients with very severe lung disease are unable to complete several spirometry maneuvers, which require considerable effort. We retrospectively selected all spirometry tests with an FEV1 30,000 subjects tested during the 3-y period) had adequate quality spirometry. Subjects with airway obstruction were less likely to meet FVC repeatability goals. A poor spirometry quality grade was associated with a very low FVC and a low body mass index, but not older age. Severe lung disease should not be used as an excuse for not meeting spirometry quality goals. Copyright © 2015 by Daedalus Enterprises.

  19. Spirometry use in children hospitalized with asthma.

    Science.gov (United States)

    Tan, Chee Chun; McDowell, Karen M; Fenchel, Matthew; Szczesniak, Rhonda; Kercsmar, Carolyn M

    2014-05-01

    Asthma is the most common chronic disorder of childhood and continues to be a leading cause of pediatric hospital admission. The National Asthma Education and Prevention Program (NAEPP) recommends that spirometry be obtained for asthma patients upon hospital admission, after bronchodilation during the acute phase of asthma symptoms, and at least one additional time before discharge from the hospital. The objectives of this study were to describe the use of spirometry in children hospitalized with asthma and to determine association of pulmonary function with future exacerbations. A retrospective cohort study design was utilized involving review of medical records of children ≥5 years old admitted with asthma to Cincinnati Children's Hospital Medical Center from September 1, 2009 to March 31, 2011. Hospitalization or emergency department (ED) visits were identified by the ICD-9-CM codes of having either a primary diagnosis of asthma (493) or a respiratory illness (460-496) plus a secondary diagnosis of asthma. Asthma re-exacerbation was defined as either having an ED visit or hospitalization for asthma that occurred within 3 months after the index hospitalization. All spirometries were performed in a pediatric pulmonary function laboratory. Among 1,037 admissions included in this study, 89 (8.6%) had spirometry that was recommended by a consulting asthma specialist and usually performed on the day of discharge. Spirometries for forty-five of these patients (54.9%) met all acceptability and repeatability criteria of the American Thoracic Society. Patients who performed acceptable spirometry were significantly older (12.4 ± 3.8 vs. 10.7 ± 3.0 years; P = 0.041). The average forced expiratory volume in the first second (FEV1 ) was 84.4 ± 19.7% predicted; forced vital capacity (FVC) was 98.1 ± 16.0% predicted; FEV1 /FVC was 74.6 ± 9.6%; forced expiratory flow at 25-75% (FEF25-75 ) was 61.2 ± 30.1% predicted. Ten patients (22%) who

  20. A method to detect occult pneumothorax with chest radiography.

    Science.gov (United States)

    Matsumoto, Shokei; Kishikawa, Masanobu; Hayakawa, Koichi; Narumi, Atsushi; Matsunami, Katsutoshi; Kitano, Mitsuhide

    2011-04-01

    Small pneumothoraces are often not visible on supine screening chest radiographs because they develop anteriorly to the lung. These pneumothoraces are termed occult. Occult pneumothoraces account for an astonishingly high 52% to 63% of all traumatic pneumothoraces. A 19-year-old obese woman was involved in a head-on car accident. The admission anteroposterior chest radiographs were unremarkable. Because of the presence of right chest tenderness and an abrasion, we suspected the presence of a pneumothorax. Thus, we decided to take a supine oblique chest radiograph of the right side of the thorax, which clearly revealed a visceral pleural line, consistent with a diagnosis of traumatic pneumothorax. A pneumothorax may be present when a supine chest radiograph reveals either an apparent deepening of the costophrenic angle (the "deep sulcus sign") or the presence of 2 diaphragm-lung interfaces (the "double diaphragm sign"). However, in practice, supine chest radiographs have poor sensitivity for occult pneumothoraces. Oblique chest radiograph is a useful and fast screening tool that should be considered for cases of blunt chest trauma, especially when transport of critically ill patients to the computed tomographic suite is dangerous or when imminent transfer to another hospital is being arranged and early diagnosis of an occult pneumothorax is essential. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  1. Endobronchial Tuberculosis and Chest Radiography

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Sasani

    2016-03-01

    Full Text Available Endobronchial tuberculosis and chest radiography I read, with interest, the article entitled “Clinical and Para-clinical Presentations of Endobronchial Tuberculosis” by Ahmadi Hoseini H. S. et al. (1 published in this journal. I would like to focus on some details about the chest X-ray of patients as elaborated by the authors in the results section. Accordingly, the findings of chest radiography in the available patients were as follows: pulmonary consolidation (75%, reduced pulmonary volume (20%, and hilar adenopathy (10%. This is an incomplete statement because the authors did not explain whether there was any normal chest radiography in the study population. In addition, it is not clear whether the X-ray examinations of the patients were normal, how many abnormal plain films yielded the presented data. On the other hand, the fact that the studied patients had no normal chest radiography is  controversial since in the literature, 10-20% of the patients with endobronchial tuberculosis are reported to have normal chest X-ray (2, 3. In fact, this is one of the problems in the diagnosis of the disease, as well as a potential cause of delayed diagnosis and treatment of the patients. Therefore, the absence of normal chest radiographs is in contrast to the available literature, and if not an error, it could be a subject of further investigation.

  2. Image processing in digital chest radiography

    International Nuclear Information System (INIS)

    Manninen, H.; Partanen, K.; Lehtovirta, J.; Matsi, P.; Soimakallio, S.

    1992-01-01

    The usefulness of digital image processing of chest radiographs was evaluated in a clinical study. In 54 patients, chest radiographs in the posteroanterior projection were obtained by both 14 inch digital image intensifier equipment and the conventional screen-film technique. The digital radiographs (512x512 image format) viewed on a 625 line monitor were processed in 3 different ways: 1.standard display; 2.digital edge enhancement for the standard display; 3.inverse intensity display. The radiographs were interpreted independently by 3 radiologists. Diagnoses were confirmed by CT, follow-up radiographs and clinical records. Chest abnormalities of the films analyzed included 21 primary lung tumors, 44 pulmonary nodules, 16 cases with mediastinal disease, 17 with pneumonia /atelectasis. Interstitial lung disease, pleural plaques, and pulmonary emphysema were found in 30, 18 and 19 cases respectively. Sensitivity of conventional radiography when averaged overall findings was better than that of digital techniques (P<0.001). Differences in diagnostic accuracy measured by sensitivity and specificity between the 3 digital display modes were small. Standard image display showed better sensitivity for pulmonary nodules (0.74 vs 0.66; P<0.05) but poorer specificity for pulmonary emphysema (0.85 vs 0.93; P<0.05) compared with inverse intensity display. It is concluded that when using 512x512 image format, the routine use of digital edge enhancement and tone reversal at digital chest radiographs is not warranted. (author). 12 refs.; 4 figs.; 2 tabs

  3. Chest radiology

    International Nuclear Information System (INIS)

    Reed, J.C.

    1990-01-01

    This book is a reference in plain chest film diagnosis provides a thorough background in the differential diagnosis of 22 of the most common radiologic patterns of chest disease. Each chapter is introduced with problem cases and a set of questions, followed by a tabular listing of the appropriate differential considerations. The book emphasizes plain films, CT and some MR scans are integrated to demonstrate how these modalities enhance the work of a case

  4. Computed tomography of chest trauma

    International Nuclear Information System (INIS)

    Dinkel, E.; Uhl, H.; Reinbold, W.D.; Wimmer, B.; Wenz, W.

    1987-01-01

    Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal, if aortic laceration is clinically suspected. Despite all technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for selected problems in the traumatized patient. (orig.) [de

  5. Computed tomography of chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Dinkel, E.; Uhl, H.; Reinbold, W.D.; Wimmer, B.; Wenz, W.

    1987-09-01

    Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal, if aortic laceration is clinically suspected. Despite all technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for selected problems in the traumatized patient.

  6. Reference values of spirometry for Finnish adults.

    Science.gov (United States)

    Kainu, A; Timonen, K L; Toikka, J; Qaiser, B; Pitkäniemi, J; Kotaniemi, J T; Lindqvist, A; Vanninen, E; Länsimies, E; Sovijärvi, A R A

    2016-09-01

    Diagnostic assessment of lung function necessitates up-to-date reference values. The aim of this study was to estimate reference values for spirometry for the Finnish population between 18 and 80 years and to compare them with the existing Finnish, European and the recently published global GLI2012 reference values. Spirometry was performed for 1380 adults in the population-based FinEsS studies and for 662 healthy non-smoking volunteer adults. Detailed predefined questionnaire screening of diseases and symptoms, and quality control of spirometry yielded a sample of 1000 native Finns (387 men) healthy non-smokers aged 18-83 years. Sex-specific reference values, which are estimated using the GAMLSS method and adjusted for age and height, are provided. The predicted values for lung volumes are larger than those obtained by GLI2012 prediction for the Caucasian subgroup for forced vital capacity (FVC) by an average 6·2% and 5·1% and forced expiratory volume in 1 s (FEV1) by an average 4·2% and 3·0% in men and women, respectively. GLI2012 slightly overestimated the ratio FEV1/FVC with an age-dependent trend. Most reference equations from other European countries, with the exception of the Swiss SAPALDIA study, showed an underestimation of FVC and FEV1 to varying degrees, and a slight overestimation of FEV1/FVC. This study offers up-to-date reference values of spirometry for native Finns with a wide age range. The GLI2012 predictions seem not to be suitable for clinical use for native Finns due to underestimation of lung volumes. © 2015 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

  7. Radiographic testing

    International Nuclear Information System (INIS)

    Kuster, J.

    1978-01-01

    In view of great differencies in X-ray transmission it is more difficult to get optimum radiographs of plastics and especially of reinforced plastics than for example of metals. A procedure will be reported how to get with little effort optimum radiographs especially also in the range of long wave-length radiation corresponding 10 to 25 kV.P. (orig.) [de

  8. [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. Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.

  9. Chest X-Ray (Chest Radiography)

    Science.gov (United States)

    ... Resources Professions Site Index A-Z X-ray (Radiography) - Chest Chest x-ray uses a very small dose ... Radiography? What is a Chest X-ray (Chest Radiography)? The chest x-ray is the most commonly performed diagnostic ...

  10. Assessment of five different guideline indication criteria for spirometry, including modified GOLD criteria, in order to detect COPD: data from 5,315 subjects in the PLATINO study.

    Science.gov (United States)

    Luize, Ana P; Menezes, Ana Maria B; Perez-Padilla, Rogelio; Muiño, Adriana; López, Maria Victorina; Valdivia, Gonzalo; Lisboa, Carmem; Montes de Oca, Maria; Tálamo, Carlos; Celli, Bartolomé; Nascimento, Oliver A; Gazzotti, Mariana R; Jardim, José R

    2014-10-30

    Spirometry is the gold standard for diagnosing chronic obstructive pulmonary disease (COPD). Although there are a number of different guideline criteria for deciding who should be selected for spirometric screening, to date it is not known which criteria are the best based on sensitivity and specificity. Firstly, to evaluate the proportion of subjects in the PLATINO Study that would be recommended for spirometry testing according to Global initiative for Obstructive Lung Disease (GOLD)-modified, American College of Chest Physicians (ACCP), National Lung Health Education Program (NLHEP), GOLD and American Thoracic Society/European Respiratory Society (ATS/ERS) criteria. Secondly, we aimed to compare the sensitivity, specificity, and positive predictive and negative predictive values, of these five different criteria. Data from the PLATINO study included information on respiratory symptoms, smoking and previous spirometry testing. The GOLD-modified spirometry indication criteria are based on three positive answers out of five questions: the presence of cough, phlegm in the morning, dyspnoea, age over 40 years and smoking status. Data from 5,315 subjects were reviewed. Fewer people had an indication for spirometry (41.3%) according to the GOLD-modified criteria, and more people had an indication for spirometry (80.4%) by the GOLD and ATS/ERS criteria. A low percentage had previously had spirometry performed: GOLD-modified (14.5%); ACCP (13.2%); NLHEP (12.6%); and GOLD and ATS/ERS (12.3%). The GOLD-modified criteria showed the least sensitivity (54.9) and the highest specificity (61.0) for detecting COPD, whereas GOLD and ATS/ERS criteria showed the highest sensitivity (87.9) and the least specificity (20.8). There is a considerable difference in the indication for spirometry according to the five different guideline criteria. The GOLD-modified criteria recruit less people with the greatest sum of sensitivity and specificity.

  11. Chest pain

    International Nuclear Information System (INIS)

    Martinez A, Juan Carlos; Saenz M, Oscar; Martinez M, Camilo; Gonzales A Francisco; Nicolas R, Jose; Vergara V, Erika P; Pereira G, Alberto M

    2010-01-01

    In emergency departments, chest pain is one of the leading motives of consultation. We thus consider it important to review aspects such as its classification, causes, and clinical profiles. Initial assessment should include a full clinical history comprising thorough anamnesis and physical examination. Adequate interpretation of auxiliary tests, ordered in accordance with suspected clinical conditions, should lead to accurate diagnosis. We highlight certain symptoms and clinical signs, ECG and X-ray findings, cardiac bio markers, arterial blood gases, and CT-scanning. Scores of severity and prognosis such as TIMI are assessed. Optimal treatment of the clinical conditions leading to chest pain depends on adequate initial approach and assessment.

  12. Chest pain related to crack cocaine smoking

    International Nuclear Information System (INIS)

    Eurman, D.W.; Potash, H.I.; Eyler, W.R.; Beute, G.H.; Paganussi, P.

    1988-01-01

    The chest radiographs of 80 patients coming to emergency room because of chest pain and/or shortness of breath following the smoking of highly potent crack cocaine were retrospectively reviewed. Four showed intrathoracic free air (pneumomediastinum in two, hemopneumothorax in one, and pneumothorax in one). Four other patients showed subsegmental atelectasis or parenchymal infiltrate. Radiographic detection of these abnormalities was of importance in the clinical management of the patients. This spectrum of findings is presented with a discussion of the pathophysiologic mechanisms and other potential complications of this form of drug abuse

  13. Radiographic positioning

    International Nuclear Information System (INIS)

    Eisenberg, R.L.; Dennis, C.A.; May, C.

    1989-01-01

    This book concentrates on the routine radiographic examinations commonly performed. It details the wide variety of examinations possible and their place in initial learning and in the radiology department as references for those occasions when an unusual examination is requested. This book provides information ranging from basic terminology to skeletal positioning to special procedures. Positions are discussed and supplemented with a picture of a patient, the resulting radiograph, and a labeled diagram. Immobilization and proper shielding of the patient are also shown

  14. Radiographic Test

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H.J; Yang, S.H. [Korea Electric Power Research Institute, Taejon (Korea)

    2002-07-01

    This report contains theory, procedure technique and interpretation of radiographic examination and written for whom preparing radiographic test Level II. To determine this baseline of technical competence in the examination, the individual must demonstrate a knowledge of radiography physics, radiation safety, technique development, radiation detection and measurement, facility design, and the characteristics of radiation-producing devices and their principles of operation. (author) 98 figs., 23 tabs.

  15. Spirometry in elderly laryngectomized patients: A feasibility study.

    Science.gov (United States)

    Izzo, Alessandro; Perrotta, Fabio; Cennamo, Antonio; Cerqua, Francesco Saverio; Rinaldi, Luca; Mazzella, Antonio; Grella, Edoardo; Tranfa, Carmelindo; Bianco, Andrea; Stefanelli, Francesco; Mazzarella, Gennaro

    2016-09-01

    Laryngeal cancer is the second most common respiratory neoplasm after lung cancer. Laryngectomy is a well established treatment for larynx cancers which involve relevant anatomic alterations. Spirometry is an essential investigation tool for diagnosis and severity of respiratory diseases, difficult to perform in laryngectomees. 43 consecutive laryngectomized patients were enrolled from July 2014 to March 2015. Patients fulfilling inclusion criteria underwent spirometry at baseline assessment and after two days. During the examination, the spirometer was placed directly on the stoma of the patient, through mouthpiece "Spirometry Filter 74". At baseline, 26 eligible laryngectomees correctly performed the spirometry test with mouthpiece adhering to the stoma; 4 patients refused to perform the second spirometry after 2 days. The feasibility of spirometry examination in these patients was 100% despite difficulties in the execution of the test. The Pearson coefficient of reproducibility for FEV1, FVC and Tiffeneau Index was, respectively, 0.98, 0.94 and 0.77. Spirometry in laryngectomee patients is a feasible procedure for assessment of respiratory function; despite technical difficulties in the execution of the test, our results underline the reproducibility and repeatability of the spirometry. In conclusion, when performed within dedicated respiratory pathophysiology unit, spirometry is a reliable tool in the assessment and follow up of laryngectomees. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  16. The use of spirometry in a primary care setting

    OpenAIRE

    Blain, Elizabeth A; Craig, Timothy J

    2009-01-01

    Elizabeth A Blain, Timothy J CraigPenn State Hershey Medical Center, Hershey, PA, USAObjective: To determine the use of spirometry in family practice, internal medicine, and pediatric outpatient settings.Methods: Data were collected from 45 outpatient offices in the central Pennsylvania area via phone survey that asked a set of four questions: 1) Do you have spirometry in your office? 2) Do you use spirometry for asthma patients? 3) In what situation do you use spirometry for? 4) Do you use s...

  17. Intrathoracic tuberculous lymphadenopathy in children: a guide to chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    George, Anthony; Andronikou, Savvas [Bristol Royal Hospital for Children and the University of Bristol, Department of Paediatric Radiology, Bristol (United Kingdom); Pillay, Tanyia; Zar, Heather J. [University of Cape Town and Medical Research Council Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, Red Cross War Memorial Children' s Hospital, Cape Town (South Africa); Goussard, Pierre [Tygerberg Hospital and the University of Stellenbosch, Department of Paediatrics and Child Health, Cape Town (South Africa)

    2017-09-15

    Making the diagnosis of pulmonary tuberculosis in children can be difficult because microbiological confirmation is not often achieved. Diagnosis is therefore often based on clinical features in combination with chest radiograph findings. Chest radiographs can demonstrate lymphadenopathy of the hilar and para-tracheal regions on the anteroposterior view, and subcarinal lymphadenopathy on the lateral view. However poor interobserver agreement has been reported for radiologist and clinician assessment of lymphadenopathy. This might reflect the lack of standardised imaging criteria for diagnosis as well as radiologists' objectives for achieving sensitivity rather than specificity. In this paper the authors provide a pictorial aid of chest radiographs in children with culture-confirmed tuberculosis to help clinicians identify lymph node enlargement in primary pulmonary tuberculosis. This collection of images comprises chest radiographs accompanied by schematics and either CT or MRI scan confirmation of pathological lymph node enlargement at the positions commonly affected in tuberculosis. (orig.)

  18. Spirometry, Static Lung Volumes, and Diffusing Capacity.

    Science.gov (United States)

    Vaz Fragoso, Carlos A; Cain, Hilary C; Casaburi, Richard; Lee, Patty J; Iannone, Lynne; Leo-Summers, Linda S; Van Ness, Peter H

    2017-09-01

    Spirometric Z-scores from the Global Lung Initiative (GLI) rigorously account for age-related changes in lung function and are thus age-appropriate when establishing spirometric impairments, including a restrictive pattern and air-flow obstruction. However, GLI-defined spirometric impairments have not yet been evaluated regarding associations with static lung volumes (total lung capacity [TLC], functional residual capacity [FRC], and residual volume [RV]) and gas exchange (diffusing capacity). We performed a retrospective review of pulmonary function tests in subjects ≥40 y old (mean age 64.6 y), including pre-bronchodilator measures for: spirometry ( n = 2,586), static lung volumes by helium dilution with inspiratory capacity maneuver ( n = 2,586), and hemoglobin-adjusted single-breath diffusing capacity ( n = 2,508). Using multivariable linear regression, adjusted least-squares means (adj LS Means) were calculated for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity. The adj LS Means were expressed with and without height-cubed standardization and stratified by GLI-defined spirometry, including normal ( n = 1,251), restrictive pattern ( n = 663), and air-flow obstruction (mild, [ n = 128]; moderate, [ n = 150]; and severe, [ n = 394]). Relative to normal spirometry, restrictive-pattern had lower adj LS Means for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity ( P ≤ .001). Conversely, relative to normal spirometry, mild, moderate, and severe air-flow obstruction had higher adj LS Means for FRC and RV ( P < .001). However, only mild and moderate air-flow obstruction had higher adj LS Means for TLC ( P < .001), while only moderate and severe air-flow obstruction had higher adj LS Means for RV/TLC ( P < .001) and lower adj LS Means for hemoglobin-adjusted single-breath diffusing capacity ( P < .001). Notably, TLC (calculated as FRC + inspiratory capacity) was not increased in severe air-flow obstruction ( P ≥ .11

  19. Correlation and Agreement of Handheld Spirometry with Laboratory Spirometry in Allogeneic Hematopoietic Cell Transplant Recipients.

    Science.gov (United States)

    Cheng, Guang-Shing; Campbell, Angela P; Xie, Hu; Stednick, Zach; Callais, Cheryl; Leisenring, Wendy M; Englund, Janet A; Chien, Jason W; Boeckh, Michael

    2016-05-01

    Early detection of subclinical lung function decline may help identify allogeneic hematopoietic cell transplant (HCT) recipients who are at increased risk for late noninfectious pulmonary complications, including bronchiolitis obliterans syndrome. We evaluated the use of handheld spirometry in this population. Allogeneic HCT recipients enrolled in a single-center observational trial performed weekly spirometry with a handheld spirometer for 1 year after transplantation. Participants performed pulmonary function tests in an outpatient laboratory setting at 3 time points: before transplantation, at day 80 after transplantation, and at 1 year after transplantation. Correlation between the 2 methods was assessed by Pearson and Spearman correlations; agreement was assessed using Bland-Altman plots. A total of 437 subjects had evaluable pulmonary function tests. Correlation for forced expiratory volume in 1 second (FEV1) was r = .954 (P spirometry correlated well with laboratory spirometry after allogeneic HCT and may be useful for self-monitoring of patients for early identification of airflow obstruction. Copyright © 2016 American Society for Blood and Marrow Transplantation. All rights reserved.

  20. Pseudoprominent aorta: Radiographic findings and CT correlation

    International Nuclear Information System (INIS)

    Brown, K.T.; Shepard, J.A.O.; Stewart, W.J.

    1985-01-01

    The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented

  1. Pseudoprominent aorta: Radiographic findings and CT correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.T.; Shepard, J.A.O.; Stewart, W.J.

    1985-05-01

    The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented.

  2. Chest X-Ray

    Medline Plus

    Full Text Available ... talk with you about chest radiography also known as chest x-rays. Chest x-rays are the ... treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray ...

  3. Factors associated with abnormal spirometry among HIV-infected individuals.

    Science.gov (United States)

    Drummond, M Bradley; Huang, Laurence; Diaz, Philip T; Kirk, Gregory D; Kleerup, Eric C; Morris, Alison; Rom, William; Weiden, Michael D; Zhao, Enxu; Thompson, Bruce; Crothers, Kristina

    2015-08-24

    HIV-infected individuals are susceptible to development of chronic lung diseases, but little is known regarding the prevalence and risk factors associated with different spirometric abnormalities in this population. We sought to determine the prevalence, risk factors and performance characteristics of risk factors for spirometric abnormalities among HIV-infected individuals. Cross-sectional cohort study. We analyzed cross-sectional US data from the NHLBI-funded Lung-HIV consortium - a multicenter observational study of heterogeneous groups of HIV-infected participants in diverse geographic sites. Logistic regression analysis was performed to determine factors statistically significantly associated with spirometry patterns. A total of 908 HIV-infected individuals were included. The median age of the cohort was 50 years, 78% were men and 68% current smokers. An abnormal spirometry pattern was present in 37% of the cohort: 27% had obstructed and 10% had restricted spirometry patterns. Overall, age, smoking status and intensity, history of Pneumocystis infection, asthma diagnosis and presence of respiratory symptoms were independently associated with an abnormal spirometry pattern. Regardless of the presence of respiratory symptoms, five HIV-infected participants would need to be screened with spirometry to diagnose two individuals with any abnormal spirometry pattern. Nearly 40% of a diverse US cohort of HIV-infected individuals had an abnormal spirometry pattern. Specific characteristics including age, smoking status, respiratory infection history and respiratory symptoms can identify those at risk for abnormal spirometry. The high prevalence of abnormal spirometry and the poor predictive capability of respiratory symptoms to identify abnormal spirometry should prompt clinicians to consider screening spirometry in HIV-infected populations.

  4. Spirometry of healthy adult South African men

    African Journals Online (AJOL)

    1996-07-07

    Jul 7, 1996 ... radiographic screening process was used to identify a healthy population ... significantly lower values than the Autolink for FVC measurements despite .... t Medical Instrumentation. ATS '" American ... Quality control. Biological ...

  5. Diagnosing pulmonary edema: lung ultrasound versus chest radiography.

    Science.gov (United States)

    Martindale, Jennifer L; Noble, Vicki E; Liteplo, Andrew

    2013-10-01

    Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. To evaluate the ability of residents to recognize pulmonary edema on lung ultrasound using chest radiographs as a comparison standard. This is a prospective, blinded, observational study of a convenience sample of resident physicians in the Departments of Emergency Medicine (EM), Internal Medicine (IM), and Radiology. Residents were given a tutorial on interpreting pulmonary edema on both chest radiograph and lung ultrasound. They were then shown both ultrasounds and chest radiographs from 20 patients who had presented to the emergency department with dyspnea, 10 with a primary diagnosis of pulmonary edema, and 10 with alternative diagnoses. Cohen's κ values were calculated to describe the strength of the correlation between resident and gold standard interpretations. Participants included 20 EM, 20 IM, and 20 Radiology residents. The overall agreement with gold standard interpretation of pulmonary edema on lung ultrasound (74%, κ = 0.51, 95% confidence interval 0.46-0.55) was superior to chest radiographs (58%, κ = 0.25, 95% confidence interval 0.20-0.30) (P Radiology residents interpreted chest radiographs more accurately than did EM and IM residents. Residents were able to more accurately identify pulmonary edema with lung ultrasound than with chest radiograph. Physicians with minimal exposure to lung ultrasound may be able to correctly recognize pulmonary edema on lung ultrasound.

  6. Chest tomosynthesis: technical and clinical perspectives.

    Science.gov (United States)

    Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

    2014-02-01

    The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. The standard of spirometry in the RSA | Basson | South African ...

    African Journals Online (AJOL)

    Standards for high-quality lung function testing have not yet been formally adopted in the RSA, despite the increase in the performance of spirometry. A study was undertaken to determine the standard of spirometry in clinical practice in this country. Forty-five spirometer users agreed to participate. Responses to a ...

  8. Quality of routine spirometry tests in Dutch general practices.

    NARCIS (Netherlands)

    Schermer, T.R.J.; Crockett, A.J.; Poels, P.J.P.; Dijke, J.J. van; Akkermans, R.P.; Vlek, H.F.; Pieters, W.R.

    2009-01-01

    BACKGROUND: Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. AIM: To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. DESIGN OF STUDY: Analysis

  9. The Yield from Routine Chest X-Rays in Stage 3 Breast Cancer ...

    African Journals Online (AJOL)

    Context: Cancer of the breast is a common malignancy in Nigerian women and various imaging examinations, including the chest radiograph are routinely requested in all patients with this disease. Objective: The objective of this study was to determine the positive yield from routine chest radiographs in Nigerian patients ...

  10. Cash's textbook of chest, heart and vascular disorders for physiotherapists

    International Nuclear Information System (INIS)

    Downie, P.A.; Innocenti, D.M.; Jackson, S.E.

    1987-01-01

    A very high proportion of the patients treated by physiotherapy will have had a chest radiograph (x-ray) either because their primary disease is pulmonary or there is some long standing heart or lung illness which should be taken into account during the management of an acute problem. This chapter outlines the principles involved in reading the radiograph

  11. Animal radiographs

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    This chapter presents historical x rays of a wide variety of animals taken within 5 years of the discovery of x radiation. Such photos were used as tests or as illustrations for radiographic publications. Numerous historical photographs are included. 10 refs

  12. A Reduction in Radiographic Exposure and Image Quality in Film ...

    African Journals Online (AJOL)

    Purpose: To develop a protocol for the optimization of diagnostic chest radiography examination, the effect of radiographic exposure reduction on image quality is investigated. Procedure: Fourty-eight adult patients presenting for posterior-anterior (PA) chest radiography in a tertiary health care centre were categorized into 3 ...

  13. Chest radiography after minor chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Rossen, B.; Laursen, N.O.; Just, S.

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.

  14. Pulmonary edema: radiographic differential diagnosis

    International Nuclear Information System (INIS)

    Yoo, Dong Soo; Choi, Young Hi; Kim, Seung Cheol; An, Ji Hyun; Lee, Jee Young; Park, Hee Hong

    1997-01-01

    To evaluate the feasibility of using chest radiography to differentiate between three different etiologies of pulmonary edema. Plain chest radiographs of 77 patients, who were clinically confirmed as having pulmonary edema, were retrospectively reviewed. The patients were classified into three groups : group 1 (cardiogenic edema : n = 35), group 2 (renal pulmonary edema : n = 16) and group 3 (permeability edema : n = 26). We analyzed the radiologic findings of air bronchogram, heart size, peribronchial cuffing, septal line, pleural effusion, vascular pedicle width, pulmonary blood flow distribution and distribution of pulmonary edema. In a search for radiologic findings which would help in the differentiation of these three etiologies, each finding was assessed. Cardiogenic and renal pulmonary edema showed overlapping radiologic findings, except for pulmonary blood flow distribution. In cardiogenic pulmonary edema (n=35), cardiomegaly (n=29), peribronchial cuffing (n=29), inverted pulmonary blood flow distribution (n=21) and basal distribution of edema (n=20) were common. In renal pulmonary edema (n=16), cardiomegaly (n=15), balanced blood flow distribution (n=12), and central (n=9) or basal distribution of edema (n=7) were common. Permeability edema (n=26) showed different findings. Air bronchogram (n=25), normal blood flow distribution (n=14) and peripheral distribution of edema (n=21) were frequent findings, while cardiomegaly (n=7), peribronchial cuffing (n=7) and septal line (n=5) were observed in only a few cases. On plain chest radiograph, permeability edema can be differentiated from cardiogenic or renal pulmonary edema. The radiographic findings which most reliably differentiated these two etiologies were air bronchogram, distribution of pulmonary edema, peribronchial cuffing and heart size. Only blood flow distribution was useful for radiographic differentiation of cardiogenic and renal edema

  15. Dental radiographic units - radiation safety and patient doses

    International Nuclear Information System (INIS)

    Nagpal, J.S.; Varadharajan, Geetha

    2001-01-01

    Three models of dental radiographic machines have been examined for radiation safety. Using TL dosemeters, doses received by the patients at chest level and the gonads have been estimated. Care should be taken to shield gonads during dental radiographic examinations. (author)

  16. Adult sail sign: radiographic and computed tomographic features.

    Science.gov (United States)

    Lee, Yu-Jin; Han, Daehee; Koh, Young Hwan; Zo, Joo Hee; Kim, Sang-Hyun; Kim, Deog Kyeom; Lee, Jeong Sang; Moon, Hyeon Jong; Kim, Jong Seung; Chun, Eun Ju; Youn, Byung Jae; Lee, Chang Hyun; Kim, Sam Soo

    2008-02-01

    The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. To investigate the sail sign appearing in adult chest radiography. Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging.

  17. A study of reduction of patient's radiation exposure by using the new ortho screen film systems (4). A study of the possibility of higher developing temperature by observation of chest phantom radiographs

    International Nuclear Information System (INIS)

    Yagi, Hirofumi; Fukui, Toshihito; Yasutomo, Motokatsu; Takashima, Koosuke; Kuroda, Tokue; Nishitani, Hiromu.

    1995-01-01

    Recently, some new ortho screen-film systems (Konica EX system, Fuji AD system and Kodak IEF system) are being developed. The granulalities of these systems have been greatly improved and gross fogs are lower than those of traditional ortho screen-film systems. Even if the radiographs with the new ortho screen-film are processed at higher temperature than with the old ortho system such as Lanex Medium/TMC-RA (Eastman Kodak), the deterioration in the image quality is negligible. Furthermore, the speed of the screen-film systems increases as the developing temperature rises. Therefore, there may be the potential to reduce patients' radiation exposure without greatly decreasing the image quality. At that time, the problem arises how to determine the appropriate developing temperature. The limit of developing temperature for the new ortho system was determined as the temperature for getting the same gross fog in old ortho-system. In this report, phantom radiographs were made at various developing temperatures and the comments about the higher limit of the developing temperature were solicited from medical doctors who evaluated them. Consequently, it has been confirmed there are sufficient image quality in the radiographs which were developed at the higher developing temperature than at the temperature used in many faculties now. (author)

  18. Spirometry in primary care for children with asthma.

    Science.gov (United States)

    Banasiak, Nancy Cantey

    2014-01-01

    Spirometry is an essential part of diagnosing a child with asthma. The National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA) expert panels recommend spirometry to be performed on children five years of age and older as an objective assessment of lung function, to diagnosis asthma, and for ongoing yearly management of asthma (GINA, 2012; NAEPP, 2007). According to the NAEPP expert panel, history and physical examination alone are not reliable to accurately diagnose asthma, exclude alternative diagnosis, or determine lung impairment (NAEPP, 2007 Dombkowski, Hassan, Wasilevich, and Clark (2010) found 52% of physicians who provide primary care to children used spirometry, but only 21% used spirometry according to the national guidelines, and only 35% of physicians surveyed were comfortable interpreting the test results. Zanconato, Meneghelli, Braga, Zacchello, and Baraldi (2005) found that 21% of spirometry readings were interpreted incorrectly, concluding that proper training and quality control were important to provide if spirometry in the primary care office setting is to be used. The purpose of this article is to review the appropriate use of spirometry in pediatric primary care.

  19. Correlation Of Radiographic Patterns Of Pulmonary Tuberculosis ...

    African Journals Online (AJOL)

    Patients with higher CD4+ counts often present in \\"classic\\" fashion (upper zone infiltrates cavities) whereas those with low CD4+ counts are more likely to present atypically. The chest radiographic appearances of HIV-seropositive patients presenting with pulmonary tuberculosis (PTB) are diverse, creating difficulty in ...

  20. Cash's textbook of chest, heart and vascular disorders for physiotherapists

    Energy Technology Data Exchange (ETDEWEB)

    Downie, P.A.; Innocenti, D.M.; Jackson, S.E.

    1987-01-01

    This book includes a chapter on chest radiographs. A very high proportion of the patients treated by physiotherapy will have had a chest radiograph (x-ray) either because their primary disease is pulmonary or there is some long standing heart or lung illness which should be taken into account during the management of an acute problem. The chapter outlines the principles involved in reading the radiograph.

  1. Spirometry reference values in Indigenous Australians: a systematic review.

    Science.gov (United States)

    Blake, Tamara L; Chang, Anne B; Petsky, Helen L; Rodwell, Leanne T; Brown, Michael G; Hill, Debra C; Thompson, Bruce; McElrea, Margaret S

    2016-07-04

    To evaluate published spirometry data for Australian Aboriginal and Torres Strait Islander (Indigenous) peoples to determine (i) whether their ethnicity influenced spirometry results; and (ii) if any reliable spirometry reference values exist for Indigenous Australians. Systematic review of published and grey literature. PubMed and Cochrane Library databases, references of included articles and appropriate grey literature. Last searches were conducted in April 2016. We included any study that performed spirometry on healthy Indigenous Australians and compared their results with those from people of European ancestry. Two authors independently screened titles and abstracts and then reviewed potentially relevant full-text articles for possible inclusion. We used PRISMA systematic review reporting methods to collate data. Of a possible 125 studies, 18 full-text articles were reviewed, but only nine fulfilled the inclusion criteria. None specified Torres Strait Islander inclusion. All studies reported lower spirometry values (as much as 30% lower) for Aboriginal people compared with non-Indigenous people. Five studies developed spirometry reference values for Indigenous Australians; however, none adhered to all participant inclusion and exclusion criteria outlined by the American Thoracic Society and European Respiratory Society. Hence, reported results and subsequent reference values may not be a true representation of spirometry values in healthy Indigenous people. The lower spirometry values reported for Indigenous Australians may be due to study limitations. Furthermore, there are currently no reliable spirometry reference values for Indigenous Australians that adhere to current guidelines. Developing a set of Indigenous Australian reference values will improve the accuracy of test interpretation and aid in the diagnosis of respiratory disease in this population.

  2. Chest X-Ray

    Medline Plus

    Full Text Available ... about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed x-ray exams and use a very small dose of ... of the inside of the chest. A chest x-ray is used to evaluate the lungs, heart and ...

  3. Optical compensation device for chest film radiography

    Science.gov (United States)

    Gould, Robert G.; Hasegawa, Bruce H.; DeForest, Sherman E.; Schmidt, Gregory W.; Hier, Richard G.

    1990-07-01

    Although chest radiography is the most commonly performed radiographic examination and one of the most valuable and cost-effective studies in medicine it suffers from relatively high error rates in both missing pathology and false positive interpretations. Detectability of lung nodules and other structures in underpenetrated regions of the chest film can be improved by both exposure and optical compensation but current compensation systems require major capital cost or a significant change in normal clinical practice. A new optical compensation system called the " Intelligent X-Ray Illuminator" (IXI) automatically and virtually instantaneously generates a patient-specific optical unsharp mask that is projected directly on a radiograph. When a radiograph is placed on the IXI which looks much like a conventional viewbox it acquires a low-resolution electronic image of this film from which the film transmission is derived. The transmission information is inverted and blurred in an image processor to form an unsharp mask which is fed into a spatial light modulator (SLM) placed between a light source and the radiograph. The SLM tailors the viewbox luminance by decreasing illumination to underexposed (i. e. transmissive) areas of the radiograph presenting the observer with an optically unsharp-masked image. The IXI uses the original radiograph and will allow it to be viewed on demand with conventional (uniform illumination. Potentially the IXI could introduce the known beneficial aspects of optical unsharp masking into radiology at low capital

  4. Quality assurance of spirometry in a population-based study -predictors of good outcome in spirometry testing.

    Science.gov (United States)

    Tan, Wan C; Bourbeau, Jean; O'Donnell, Denis; Aaron, Shawn; Maltais, Francois; Marciniuk, Darcy; Hernandez, Paul; Cowie, Robert; Chapman, Kenneth; Sonia Buist, A; Sin, Don; Mark Fitzgerald, J

    2014-04-01

    The assurance of high-quality spirometry testing remains a challenge. Spirometry training consisted of standardized coaching followed by certification for 35 spirometry-naïve and 9 spirometry-experienced research assistants. Spirometry was performed before and after bronchodilator (BD) in random population samples of 5176 people aged 40 years and older from 9 sites in Canada. using the hand-held EasyOne spirometer (ndd Medical Technologies Inc., Andover, MA, USA). Pulmonary function quality assurance with over reading was conducted centrally in Vancouver: spirograms were reviewed and graded according to ATS/ERS standards with prompt feedback to the technician at each site. Descriptive statistics were calculated for manoeuvre acceptability and repeatability variables. A logistic regression model was constructed for the predictors of spirometry quality success. 95% of test sessions achieved pre-determined quality standards for back extrapolated volume (BEV), time to peak flow (PEFT) and end of test volume (EOTV). The mean forced expiratory time (FET) was 11.2 seconds. Then, 90% and 95% of all manoeuvres had FEV1 and FVC that were repeatable within 150 ml and 200 ml respectively. Test quality was slightly better for post-BD test sessions compared with pre-BD for both groups of research assistants. Independent predictors of acceptable test quality included participant characteristics: female sex, younger age, greater BD responsiveness; but not study site or prior experience in completing spirometry by the technologist. Good quality spirometry tests are attainable in large multicenter epidemiological studies by trained research assistants, irrespective of their prior experience in spirometry.

  5. Digital luminescence radiography of the chest

    International Nuclear Information System (INIS)

    Kehler, M.

    1991-10-01

    The aim of the present study was to evaluate the efficacy of a digital system in chest radiology compared to the conventional film-screen system. The first studies (1-3) were purely clinical, had two parts, one clinical and one using phantoms, and the 5:th used solely phantoms. Except for the first - pilot - study, the studies were performed as receiver operating characteristic (ROC) analysis. From one exposure, two digital radiographs were obtained, one simulating the film-screen radiograph and one enhanced, using an unsharp mask. The conventional radiograph was compared to this double-image, but in addition to this, even to the simulated normal and enhanced separately (1-3). To evaluate the value of inverted (positive) radiographs, the original digital (negative) radiographs were inverted, and then compared to the originals (4). As digitzation means easy storing and transfer of data and possibility of electronic display, the diagnostic performance of an interactive workstation was assessed (5). In the clinical studies, a variety of chest affections were used: atelectasis, tumor, pneumothorax, fibrosis, mediastinal and bony changes, tuberculosis, incompensations and enlargement of the heart (1), pneumothorax (2), fibrosis (3), and tumor (4). In the phantom studies, test objects simulating tumors (4) and pneumothorax (5) were used. In no study was statistical significant difference seen between the digital and conventional system (p>0.05). Neither in the clinical nor the phantom study did inversion of the radiographs improve diagnostic performance. The workstation performed almost equally well as the radiographs even with a resolution of 1.25 1p/mm compared to the digital radiographs 2.5 and film-screen radiographs 5 1p/mm. (au) (50 refs.)

  6. Imaging of chest wall infections

    International Nuclear Information System (INIS)

    Chelli Bouaziz, Mouna; Jelassi, Helmi; Chaabane, Skander; Ladeb, Mohamed Fethi; Ben Miled-Mrad, Khaoula

    2009-01-01

    A wide variety of infections can affect the chest wall including pyogenic, tuberculous, fungal, and some other unusual infections. These potentially life-threatening disorders are frequent especially among immunocompromised patients but often misdiagnosed by physical examination and radiographs. The purpose of this article is to describe the clinical and imaging features of these different chest wall infections according to the different imaging modalities with emphasis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The outcome of chest wall infection depends on early diagnosis, severity of the immunosuppression, offending organism, and extent of infection. Because clinical findings and laboratory tests may be not contributive in immunocompromised patients, imaging plays an important role in the early detection and precise assessment of the disease. US, CT, and MRI are all useful: bone destruction is more accurately detected with CT whereas soft tissue involvement are better visualized with US and MRI. CT and US are also used to guide percutaneous biopsy and drainage procedures. MR images are helpful in pre-operative planning of extensive chest wall infections. (orig.)

  7. MRI of the Chest

    Medline Plus

    Full Text Available ... gives detailed pictures of structures within the chest cavity, including the mediastinum , chest wall, pleura, heart and ... helpful to assess the vessels of the chest cavity (arteries and veins). MRA can also demonstrate an ...

  8. MRI of the Chest

    Medline Plus

    Full Text Available ... to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI ... of the chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and chest wall soft ...

  9. Face mask spirometry and respiratory pressures in normal subjects.

    NARCIS (Netherlands)

    Wohlgemuth, M.; Kooi, E.L. van der; Hendriks, J.C.M.; Padberg, G.W.A.M.; Folgering, H.T.M.

    2003-01-01

    Spirometry and maximal respiratory pressures are pulmonary function parameters commonly used to evaluate respiratory function. Prediction values are available for conventional lung function devices using a standard tube or flanged type of mouthpiece connection. This equipment is not suitable for

  10. Spirometry in a population of coal miners in Paipa, Colombia

    Directory of Open Access Journals (Sweden)

    Nubia González

    2017-12-01

    Conclusions: Spirometry is a useful test for detecting the presence of respiratory disorders in the population of coal miners. The time of exposure was significantly associated with the respiratory disease exhibited by these miners.

  11. Pharmacists performing quality spirometry testing: an evidence based review.

    Science.gov (United States)

    Cawley, Michael J; Warning, William J

    2015-10-01

    The scope of pharmacist services for patients with pulmonary disease has primarily focused on drug related outcomes; however pharmacists have the ability to broaden the scope of clinical services by performing diagnostic testing including quality spirometry testing. Studies have demonstrated that pharmacists can perform quality spirometry testing based upon international guidelines. The primary aim of this review was to assess the published evidence of pharmacists performing quality spirometry testing based upon American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines. In order to accomplish this, the description of evidence and type of outcome from these services were reviewed. A literature search was conducted using five databases [PubMed (1946-January 2015), International Pharmaceutical Abstracts (1970 to January 2015), Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews] with search terms including pharmacy, spirometry, pulmonary function, asthma or COPD was conducted. Searches were limited to publications in English and reported in humans. In addition, Uniform Resource Locators and Google Scholar searches were implemented to include any additional supplemental information. Eight studies (six prospective multi-center trials, two retrospective single center studies) were included. Pharmacists in all studies received specialized training in performing spirometry testing. Of the eight studies meeting inclusion and exclusion criteria, 8 (100%) demonstrated acceptable repeatability of spirometry testing based upon standards set by the ATS/ERS guidelines. Acceptable repeatability of seven studies ranged from 70 to 99% consistent with published data. Available evidence suggests that quality spirometry testing can be performed by pharmacists. More prospective studies are needed to add to the current evidence of quality spirometry testing performed by

  12. Reference values for spirometry in preschool children.

    Science.gov (United States)

    Burity, Edjane F; Pereira, Carlos A C; Rizzo, José A; Brito, Murilo C A; Sarinho, Emanuel S C

    2013-01-01

    Reference values for lung function tests differ in samples from different countries, including values for preschoolers. The main objective of this study was to derive reference values in this population. A prospective study was conducted through a questionnaire applied to 425 preschool children aged 3 to 6 years, from schools and day-care centers in a metropolitan city in Brazil. Children were selected by simple random sampling from the aforementioned schools. Peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volumes (FEV1, FEV0.50), forced expiratory flow (FEF25-75) and FEV1/FVC, FEV0.5/FVC and FEF25-75/FVC ratios were evaluated. Of the 425 children enrolled, 321 (75.6%) underwent the tests. Of these, 135 (42.0%) showed acceptable results with full expiratory curves and thus were included in the regression analysis to define the reference values. Height and gender significantly influenced FVC values through linear and logarithmic regression analysis. In males, R(2) increased with the logarithmic model for FVC and FEV1, but the linear model was retained for its simplicity. The lower limits were calculated by measuring the fifth percentile residues. Full expiratory curves are more difficult to obtain in preschoolers. In addition to height, gender also influences the measures of FVC and FEV1. Reference values were defined for spirometry in preschool children in this population, which are applicable to similar populations. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. A smart spirometry device for asthma diagnosis.

    Science.gov (United States)

    Kassem, A; Hamad, M; El Moucary, C

    2015-08-01

    In this paper an innovative prototype for smart asthma spirometry device to be used by doctors and asthma patients is presented. The novelty in this prototype relies in the fact that it is destined to subtend not only adults but offers an efficient and attractive manner to accommodate children patients as well thus, making it efficient for doctors, patients and parents to detect and monitor such intricate cases at stages as early as six years old. Moreover, the apparatus used enables us to integrate a vital parameter representing the Forced Expiratory Volume to the final diagnosis. Besides, the presented device will automatically diagnose those patients, assess their asthma condition, and schedule their medication process without excessive visits to medical centers whilst providing doctors with accurate and pertinent and comprehensive medical data in a chronological fashion. Zooming into under the hood of the device, a fully reliable hardware digital system lies along with a flowmeter detector and a Bluetooth emitter to interface with a user-friendly GUI-based application installed on smartphones which incorporates appealing animated graphics to encourage children to take the test. Furthermore, the device offers the capability of storing chronological data and a relevant resourceful display for accurate tracking of patients' medical record, the evolvement of their asthma condition, and the administered medication. Finally, the entire device is aligned with the medical requirements as per doctors' and telemedicine specialists' recommendations; the experiments carried out demonstrated the effectiveness and sustainable use of such device.

  14. Quantitative computed tomography versus spirometry in predicting air leak duration after major lung resection for cancer.

    Science.gov (United States)

    Ueda, Kazuhiro; Kaneda, Yoshikazu; Sudo, Manabu; Mitsutaka, Jinbo; Li, Tao-Sheng; Suga, Kazuyoshi; Tanaka, Nobuyuki; Hamano, Kimikazu

    2005-11-01

    Emphysema is a well-known risk factor for developing air leak or persistent air leak after pulmonary resection. Although quantitative computed tomography (CT) and spirometry are used to diagnose emphysema, it remains controversial whether these tests are predictive of the duration of postoperative air leak. Sixty-two consecutive patients who were scheduled to undergo major lung resection for cancer were enrolled in this prospective study to define the best predictor of postoperative air leak duration. Preoperative factors analyzed included spirometric variables and area of emphysema (proportion of the low-attenuation area) that was quantified in a three-dimensional CT lung model. Chest tubes were removed the day after disappearance of the air leak, regardless of pleural drainage. Univariate and multivariate proportional hazards analyses were used to determine the influence of preoperative factors on chest tube time (air leak duration). By univariate analysis, site of resection (upper, lower), forced expiratory volume in 1 second, predicted postoperative forced expiratory volume in 1 second, and area of emphysema ( 10%) were significant predictors of air leak duration. By multivariate analysis, site of resection and area of emphysema were the best independent determinants of air leak duration. The results were similar for patients with a smoking history (n = 40), but neither forced expiratory volume in 1 second nor predicted postoperative forced expiratory volume in 1 second were predictive of air leak duration. Quantitative CT is superior to spirometry in predicting air leak duration after major lung resection for cancer. Quantitative CT may aid in the identification of patients, particularly among those with a smoking history, requiring additional preventive procedures against air leak.

  15. Radiographic element

    International Nuclear Information System (INIS)

    Abbott, T.I.; Jones, C.G.

    1984-01-01

    Radiographic elements are disclosed comprised of first and second silver halide emulsion layers separated by an interposed support capable of transmitting radiation to which the second image portion is responsive. At least the first imaging portion contains a silver halide emulsion in which thin tubular silver halide grains of intermediate aspect ratios (from 5:1 to 8:1) are present. Spectral sensitizing dye is adsorbed to the surface of the tubular grains. Increased photographic speeds can be realized at comparable levels of crossover. (author)

  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. Algorithm for optimisation of paediatric chest radiography

    International Nuclear Information System (INIS)

    Kostova-Lefterova, D.

    2016-01-01

    The purpose of this work is to assess the current practice and patient doses in paediatric chest radiography in a large university hospital. The X-ray unit is used in the paediatric department for respiratory diseases. Another purpose was to recommend and apply optimized protocols to reduce patient dose while maintaining diagnostic image quality for the x-ray images. The practice of two different radiographers was studied. The results were compared with the existing practice in paediatric chest radiography and the opportunities for optimization were identified in order to reduce patient doses. A methodology was developed for optimization of the x-ray examinations by grouping children in age groups or according to other appropriate indication and creating an algorithm for proper selection of the exposure parameters for each group. The algorithm for the optimisation of paediatric chest radiography reduced patient doses (PKA, organ dose, effective dose) between 1.5 and 6 times for the different age groups, the average glandular dose up to 10 times and the dose for the lung between 2 and 5 times. The resulting X-ray images were of good diagnostic quality. The subjectivity in the choice of exposure parameters was reduced and standardization has been achieved in the work of the radiographers. The role of the radiologist, the medical physicist and radiographer in the process of optimization was shown. It was proven the effect of teamwork in reducing patient doses at keeping adequate image quality. Key words: Chest Radiography. Paediatric Radiography. Optimization. Radiation Exposure. Radiation Protection

  18. A study on the difference in the accuracy between radiographs and CT in detecting pulmonary lesions of tuberculosis

    International Nuclear Information System (INIS)

    Noumi, Fumiko; Kaneko, Takeshi; Inoue, Masako

    2010-01-01

    Classification of pulmonary tuberculosis designated by the Japanese Society for Tuberculosis is a classification of pulmonary tuberculosis on radiographs findings. We analyzed both radiographs and CT in 150 patients with lung tuberculosis at the diagnosis based on the society classification. In 52 patients, the classification by radiographs was not consistent with that by CT. Generally, radiographs missed small and faint opacities in the lung. There were cases which showed tuberculous opacities in CT, diagnosed as normal by Radiographs. It is concluded that the diagnosis of the pulmonary tuberculosis by chest radiographs may lead to underdiagnosis and underestimation of its severity. Hence, chest CT is very useful for making an accurate diagnosis. (author)

  19. Prevalence of Respiratory Diseases According to Spirometry Findings Among Patients Attending the Spirometry Department of Dhulikhel Hospital.

    Science.gov (United States)

    Prajapati, B K; Pradhan, S

    2016-01-01

    Background Spirometry is a standard test for screening and evaluation of patients with symptoms of cough and shortness of breath. Despite its easy availability, low cost and ease of performance it has not been widely used in clinical practice in Nepal. Objective To assess the prevalence of respiratory diseases in a regional referral centre in patients referred for spirometry. Method This is a descriptive cross-sectional study including patients referred for spirometry to the spirometry unit of Dhulikhel Hospital, Kathmandu University Hospital from 2014 July to 2015 October. The spirometry findings of the patients fulfilling the criteria of American Thoracic Society/European Respitatory Society (ATS/ERS) guidelines were analyzed and categorized as normal, having obstructive lung diseases including chronic obstructive pulmonary disease (COPD) and bronchial asthma or restrictive lung disease. Data were analyzed using SPSS 20.0 software. Result Out of 821 patients, 755 patients (92%) fulfilled ATS/ERS criteria for satisfactory spirometry. The prevalence of COPD was 31.4%, bronchial asthma 24.2% and restrictive lung disease 8.1%. The mean age of patients diagnosed with COPD was 57.8±10.8 years; bronchial asthma 44.3±16.2 years; and restrictive lung disease 44.6±21.5 years. Both COPD and bronchial asthma were common in females. About twenty two percent of the COPD patients were non-smokers and 86.3% of these were females. The most common symptoms for referral was cough and shortness of breath: these symptoms were more likely to be associated with abnormal spirometry findings. Conclusion Spirometry is a crucial preliminary test for evaluation of patients with respiratory symptoms. It should be used more frequently to help stratify patients for appropriate treatment.

  20. Chest X-ray findings in children with influenza A (H1N1) virus infection

    International Nuclear Information System (INIS)

    Zhou Min; Guo Wanliang; Wang Jian

    2011-01-01

    Objective: To assess the chest X-ray radiographic findings in children with influenza A (H1N1) virus infection. Methods: The chest X-ray radiographs in 67 children with influenza A (H1N1) virus infection were reviewed in this study. The chest radiographs were obtained 3-8 days after the onset of symptoms and for the follow-up. Results: The abnormalities were bilateral in 53 patients and unilateral in 7 patients. The predominant radiographic findings were bilateral patchy consolidation (n=42) with rapid confluence in 10 patients, lobular consolidation (n=7) with interstitial hyperplasia in 1 patient 3 month later, diffuse consolidation (n=11) with interstitial hyperplasia in all patients after 3 month. Conclusion: The predominant chest X-ray radiographic findings are bilateral patchy consolidation and diffuse consolidation with interstitial hyperplasia afterward. (authors)

  1. Chest radiography after minor chest trauma

    International Nuclear Information System (INIS)

    Rossen, B.; Laursen, N.O.; Just, S.

    1987-01-01

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma. (orig.)

  2. The chest X-ray in antiglomerular basement membrane antibody disease (Goodpasture's syndrome)

    International Nuclear Information System (INIS)

    Bowley, N.B.; Steiner, R.E.; Chin, W.S.

    1979-01-01

    The chest radiographs of 25 patients with proven antiglomerular basement membrane antibody disease (Goodpasture's syndrome) were analysed. All except two of the patients had pulmonary haemorrhage at some stage of their disease. Altogether there were 39 episodes of pulmonary haemorrhage, 25 being relapses. During seven episodes the chest radiograph was normal. Relapses of pulmonary haemorrhage never occurred in isolation but were usually associated with infection (not necessarily a chest infection) or occasionally fluid overload. Conversely fluid overload or infection were always associated with pulmonary haemorrhage provided there were high or rising titres of circulating antibodies at the time. Therefore in a patient with antiglomerular basement membrane antibody disease, the presence of shadowing in the lung fields on the chest radiograph almost invariably means the patient has pulmonary haemorrhage whether or not pulmonary oedema or a chest infection are present. Limitation of shadowing by a fissure, loss of major portions of the diaphragmatic or cardiac silhouette, involvement of the lung apex or costophrenic angles suggest an underlying chest infection. Septal lines suggest fluid overload. Pleural effusions are seen with chest infections and fluid overload. The carbon monoxide uptake (KCO) was invariably high in the presence of pulmonary haemorrhage even if the chest radiograph was normal. A combined use of KCO and chest radiographs is the best method of monitoring lung disease in these patients. (author)

  3. [Imaging of pleural diseases: evaluation of imaging methods based on chest radiography].

    Science.gov (United States)

    Poyraz, Necdet; Kalkan, Havva; Ödev, Kemal; Ceran, Sami

    2017-03-01

    The most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest- X-Ray findings are the presence of pleural effusion and thickening. Small pleural effusions are not readily identified on posteroanterior chest radiograph. However, lateral decubitus chest radiograph and chest ultrasonography may show small pleural effusions. These are more efficient methods than posteroanterior chest radiograph in the erect position for demonstrating small amounts of free pleural effusions. Chest ultrasonograph may be able to help in distinguishing the pleural pathologies from parenchymal lesions. On chest radiograph pleural effusions or pleural thickening may obscure the visibility of the underlying disease or parenchymal abnormality. Thus, computed tomography (CT) may provide additional information of determining the extent and severity of pleural disease and may help to differentiate malign pleural lesions from the benign ones. Moreover, CT may provide the differentiation of parenchmal abnormalities from pleural pathologies. CT (coronal and sagittal reformatted images) that also show invasion of chest wall, mediastinum and diaphragm, as well as enlarged hilar or mediastinal lymph nodes. Standart non-invasive imaging techniques may be supplemented with magnetic resonans imaging (MRI).

  4. Quality of intensive care chest imaging

    International Nuclear Information System (INIS)

    Adam, G.; Wein, B.; Keulers, P.; Stargardt, A.; Guenther, R.W.

    1989-01-01

    The authors have evaluated the image quality of a stimulable phosphorous plate system in intensive care chest radiography. Four radiologists examined 308 chest radiographs (200 conventional, 108 digital) according to the following criteria: visibility of catheters, tubes (artificial objects), bronchi, central and peripheral vessels, diaphragm, trachea, and retrocardial lung parenchyma. Detectability of these structures was classified as good, poor, or impossible to see. In addition, optical density was measured in the region of liver, heart, and lung. Results were evaluated by Student and υ test

  5. Chest X-Ray

    Medline Plus

    Full Text Available ... I’d like to talk with you about chest radiography also known as chest x-rays. Chest x-rays are the most ... far outweighs any risk. For more information about chest x-rays, visit Radiology Info dot org. Thank you for your time! ...

  6. Chest Pain: First Aid

    Science.gov (United States)

    First aid Chest pain: First aid Chest pain: First aid By Mayo Clinic Staff Causes of chest pain can vary from minor problems, such as indigestion ... 26, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-chest-pain/basics/ART-20056705 . Mayo ...

  7. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... d like to talk with you about chest radiography also known as chest x-rays. Chest x- ...

  8. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... you about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed ...

  9. Reference values of inspiratory spirometry for Finnish adults.

    Science.gov (United States)

    Kainu, Annette; Timonen, Kirsi L; Vanninen, Esko; Sovijärvi, Anssi R

    2018-03-07

    Inspiratory spirometry is used in evaluation of upper airway disorders e.g. fixed or variable obstruction. There are, however, very few published data on normal values for inspiratory spirometry. The main aim of this study was to produce reference values for inspiratory spirometry for healthy Finnish adults. Inspiratory spirometry was preplanned to a sample of the Finnish spirometry reference values sample. Data was successfully retrieved from 368 healthy nonsmoking adults (132 males) between 19 and 83 years of age. Reference equations were produced for forced inspiratory vital capacity (FIVC), forced inspiratory volume in one second (FIV1), FIV1/FIVC, peak inspiratory flow (PIF) and the ratios of FIV1/forced expiratory volume in one second and PIF/peak expiratory flow. The present values were compared to PIF values from previously used Finnish study of Viljanen et al. (1982) reference values and Norwegian values for FIV1, FIVC and FIV1/FIVC presented by Gulsvik et al. (2001). The predicted values from the Gulsvik et al. (2001), provided a good fit for FIVC, but smaller values for FIV1 with mean 108.3 and 109.1% of predicted values for males and females, respectively. PIF values were 87.4 and 91.2% of Viljanen et al. (1982) predicted values in males and females, respectively. Differences in measurement methods and selection of results may contribute to the observed differences. Inspiratory spirometry is technically more demanding and needs repeatability criteria to improve validity. New reference values are suggested to clinical use in Finland when assessing inspiratory spirometry. Utility of inspiratory to expiratory values indices in assessment of airway collapse need further study.

  10. Errors in chest x-ray interpretation

    International Nuclear Information System (INIS)

    Woznitza, N.; Piper, K.

    2015-01-01

    Full text: Reporting of adult chest x-rays by appropriately trained radiographers is frequently used in the United Kingdom as one method to maintain a patient focused radiology service in times of increasing workload. With models of advanced practice being developed in Australia, New Zealand and Canada, the spotlight is on the evidence base which underpins radiographer reporting. It is essential that any radiographer who extends their scope of practice to incorporate definitive clinical reporting perform at a level comparable to a consultant radiologist. In any analysis of performance it is important to quantify levels of sensitivity and specificity and to evaluate areas of error and variation. A critical review of the errors made by reporting radiographers in the interpretation of adult chest x-rays will be performed, examining performance in structured clinical examinations, clinical audit and a diagnostic accuracy study from research undertaken by the authors, and including studies which have compared the performance of reporting radiographers and consultant radiologists. overall performance will be examined and common errors discussed using a case based approach. Methods of error reduction, including multidisciplinary team meetings and ongoing learning will be considered

  11. Radiographic apparatus

    International Nuclear Information System (INIS)

    Lapidus, S.N.

    1979-01-01

    Raytheon Company, U.S.A. have patented an on-line electronic system of normalising the responses from the photomultiplier tubes used in conjunction with a scintillator in an X-ray radiographic camera. A problem with present cameras is that the individual photomultipliers have different intensity responses which also change in time with respect to each other. The individual responses of each photomultiplier tube are measured with a uniform sheet of radioactive material in front of the camera. The associated electronic equipment then calculates scaling factors which give all photomultiplier tubes an identical response and then places these factors in an addressable store. The store is then addressed in an on-line mode to produce a visual display of the transmitted X-rays. (U.K.)

  12. Radiographic apparatus

    International Nuclear Information System (INIS)

    Dalton, B.L.

    1984-01-01

    This patent application describes a radiographic apparatus including an array of radiation sensors, a source of radiation for projecting a beam through a body and means for moving one of said source and array relative to the body and for producing an electrical signal representative of the movement of the other of said source and array needed to bring the array into register with the beam. Drive means are arranged to move the other of said source and array in response to the electrical signal. In one embodiment, the source is rotated by an amount measured by a grating and associated electronics. The required movement of the array to maintain registration is calculated and transmitted to a driver. Alternatively, a laser may be mounted with the same and the array driven so that the laser beam continuously impinges on a photocell mounted with the array. (author)

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

    International Nuclear Information System (INIS)

    Jong, P.A. de; Achterberg, J.A.; Kessels, O.A.M.; Beek, F.J.; Ginneken, B. van; Hogeweg, L.; Terheggen-Lagro, S.W.J.

    2011-01-01

    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< R<-0.42, P < 0.05), but not for observer 3. Agreement with observer 3 improved after the consensus meeting. Reference images improved agreement for overinflation and mottled and large shadows and correlation with lung function, but agreement for the modified Chrispin-Norman score did not improve further. Consensus meetings and reference images improve among-observer agreement for the modified Chrispin-Norman score, but good agreement was not achieved among all observers for the modified Chrispin-Norman score and for bronchial line and ring shadows. (orig.)

  14. 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

  15. The objective evaluation of obstructive pulmonary diseases with spirometry

    Directory of Open Access Journals (Sweden)

    Özkaya S

    2016-08-01

    Full Text Available Sevket Ozkaya,1 Adem Dirican,2 Tibel Tuna3 1Department of Pulmonary Medicine, Faculty of Medicine, Bahçes¸ehir University, Istanbul, 2Department of Pulmonary Medicine, Samsun Medical Park Hospital, 3Department of Pulmonary Medicine, Samsun Chest Diseases and Thoracic Surgery Hospital, Samsun, Turkey Abstract: Airway obstruction is variable in asthma, while it is progressive and persistent in chronic bronchitis and emphysema. However, some of the patients presenting with symptoms of chronic airway diseases have clinical features of both asthma and COPD. The group with “Asthma–COPD Overlap Syndrome” (ACOS phenotype was characterized by definitely irreversible airway obstruction accompanied by symptoms and signs of reversibility. In this study, we aimed to classify obstructive airway diseases by clinical, radiological, and pulmonary function tests. Patients at Samsun Medical Park Hospital Chest Diseases outpatient clinic were evaluated between January 2013 and April 2016, and a total of 235 patients were included in this study. Mean age of the patients was 55.3±14.5 (15–88 years, and the male/female ratio was 45/190. The baseline pulmonary function test results of the patients were as follows: mean forced vital capacity (FVC values 2,825±1,108 (710–6,870 mL and 74.3±22.4 (24–155%, forced expiratory volume in 1 second (FEV1 values 1,789±774 (480–4,810 mL and 58.1±20.0 (20–130%, FEV1/FVC values 62.5±6.8 (39–70%. Reversibility criteria following bronchodilator treatment were present in 107 (45.5% patients. We specified five subgroups for patients according to their clinical, radiological, and pulmonary test findings, namely Group 1 (asthma, Group 2 (ACOS, Group 3 (chronic bronchitis, and Group 4 (emphysema. Additionally, a group of patients who had clinical and spirometric features of both asthma and chronic bronchitis in association with underlying emphysema (emphysema with chronic bronchitis and emphysema with asthma

  16. Radiographers and trainee radiologists reporting accident radiographs

    DEFF Research Database (Denmark)

    Buskov, L; Abild, A; Christensen, A

    2013-01-01

    To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital....

  17. Pathway to Best Practice in Spirometry in the Ambulatory Setting.

    Science.gov (United States)

    Peracchio, Carol

    2016-01-01

    Spirometry performed in the ambulatory setting is an invaluable tool for diagnosis, monitoring, and evaluation of respiratory health in patients with chronic lung disease. If spirometry is not performed according to American Thoracic Society (ATS) guidelines, unnecessary repeated testing, increased expenditure of time and money, and increased patient and family anxiety may result. Two respiratory therapists at Mission Health System in Asheville, NC, identified an increase in patients arriving at the pulmonary function testing (PFT) laboratories with abnormal spirometry results obtained in the ambulatory setting. These abnormal results were due to incorrect testing procedure, not chronic lung disease. Three training methods were developed to increase knowledge of correct spirometry testing procedure in the ambulatory setting. The therapists also created a plan to educate offices that do not perform spirometry on the importance and availability of PFT services at our hospital for the population of patients with chronic lung disease. Notable improvements in posttraining test results were demonstrated. The education process was evaluated by a leading respiratory expert, with improvements suggested and implemented. Next steps are listed.

  18. Automated Spirometry Quality Assurance: Supervised Learning From Multiple Experts.

    Science.gov (United States)

    Velickovski, Filip; Ceccaroni, Luigi; Marti, Robert; Burgos, Felip; Gistau, Concepcion; Alsina-Restoy, Xavier; Roca, Josep

    2018-01-01

    Forced spirometry testing is gradually becoming available across different healthcare tiers including primary care. It has been demonstrated in earlier work that commercially available spirometers are not fully able to assure the quality of individual spirometry manoeuvres. Thus, a need to expand the availability of high-quality spirometry assessment beyond specialist pulmonary centres has arisen. In this paper, we propose a method to select and optimise a classifier using supervised learning techniques by learning from previously classified forced spirometry tests from a group of experts. Such a method is able to take into account the shape of the curve as an expert would during visual inspection. We evaluated the final classifier on a dataset put aside for evaluation yielding an area under the receiver operating characteristic curve of 0.88 and specificities of 0.91 and 0.86 for sensitivities of 0.60 and 0.82. Furthermore, other specificities and sensitivities along the receiver operating characteristic curve were close to the level of the experts when compared against each-other, and better than an earlier rules-based method assessed on the same dataset. We foresee key benefits in raising diagnostic quality, saving time, reducing cost, and also improving remote care and monitoring services for patients with chronic respiratory diseases in the future if a clinical decision support system with the encapsulated classifier is to be integrated into the work-flow of forced spirometry testing.

  19. Radiographic tales

    DEFF Research Database (Denmark)

    Mussmann, Bo Redder

    Purpose Until now a large number of scientific studies have focused on technological aspects of radiography. This study is a step in another direction which examines the relationship between man and technology within radiography instead of considering man and technology as separate entities. Meth...... of their narrative alertness. Errors and failure to keep the time schedule can, however, lead the radiographers to a change of perspective that makes them displace man from the scene of radiography by playing on the premises of technology.......Purpose Until now a large number of scientific studies have focused on technological aspects of radiography. This study is a step in another direction which examines the relationship between man and technology within radiography instead of considering man and technology as separate entities...... a practice in which the relationship between man and technology is marked by a struggle of domination of one over the other. The struggle expresses itself through two competing plots: A diagnostic plot with a prevailing, but not merely chronological structure mostly composed of events tied to pathology...

  20. Chest and spine radiography abnormality in blunt chest trauma correlated with major vessel injury in an unselected patient population

    International Nuclear Information System (INIS)

    Fernandez, G.; Kadir, S.; Encarnacion, C.

    1989-01-01

    To assess the true incidence of major vessel injury, the authors retrospectively reviewed all arch aortograms obtained for blunt chest trauma (BCT) during a 24-month period beginning December 1986. Aortograms were correlated with preangiographic chest radiographic and operative findings. The goals of this review were to examine the usefulness of commonly employed screening criteria for aortography and determine whether thoracic spine fractures imply a decreased likelihood of aortic injury. One hundred twenty aortograms were obtained during this period. The incidence of aortic laceration was 6.7%, and 7.5% had brachiocerebral vascular injury. Only 51% of chest radiographs were suggestive of vascular injury. Two patients with subtle radiographic findings had aortic laceration. One patient with a burst fracture of T-4 had aortic laceration. The results of this review indicate the incidence of great vessel injury is as high as that of injury to the aorta itself and that the presence of spine fractures does not exclude vascular injury

  1. Interpretation of Spirometry: Selection of Predicted Values and Defining Abnormality.

    Science.gov (United States)

    Chhabra, S K

    2015-01-01

    Spirometry is the most frequently performed investigation to evaluate pulmonary function. It provides clinically useful information on the mechanical properties of the lung and the thoracic cage and aids in taking management-related decisions in a wide spectrum of diseases and disorders. Few measurements in medicine are so dependent on factors related to equipment, operator and the patient. Good spirometry requires quality assured measurements and a systematic approach to interpretation. Standard guidelines on the technical aspects of equipment and their calibration as well as the test procedure have been developed and revised from time-to-time. Strict compliance with standardisation guidelines ensures quality control. Interpretation of spirometry data is based only on two basic measurements--the forced vital capacity (FVC) and the forced expiratory volume in 1 second (FEV1) and their ratio, FEV1/FVC. A meaningful and clinically useful interpretation of the measured data requires a systematic approach and consideration of several important issues. Central to interpretation is the understanding of the development and application of prediction equations. Selection of prediction equations that are appropriate for the ethnic origin of the patient is vital to avoid erroneous interpretation. Defining abnormal values is a debatable but critical aspect of spirometry. A statistically valid definition of the lower limits of normal has been advocated as the better method over the more commonly used approach of defining abnormality as a fixed percentage of the predicted value. Spirometry rarely provides a specific diagnosis. Examination of the flow-volume curve and the measured data provides information to define patterns of ventilatory impairment. Spirometry must be interpreted in conjunction with clinical information including results of other investigations.

  2. Oscillometry complements spirometry in evaluation of subjects following toxic inhalation

    Directory of Open Access Journals (Sweden)

    Kenneth I. Berger

    2015-12-01

    Full Text Available The World Trade Center (WTC destruction released dust and fumes into the environment. Although many community members developed respiratory symptoms, screening spirometry was usually normal. We hypothesised that forced oscillation testing would identify functional abnormalities undetected by spirometry and that symptom severity would relate to magnitude of abnormalities measured by oscillometry. A symptomatic cohort (n=848 from the Bellevue Hospital WTC Environmental Health Center was evaluated and compared to an asymptomatic cohort (n=475 from the New York City Department of Health WTC Health Registry. Spirometry and oscillometry were performed. Oscillometry measurements included resistance (R5 and frequency dependence of resistance (R5−20. Spirometry was normal for the majority of subjects (73.2% symptomatic versus 87.6% asymptomatic, p<0.0001. In subjects with normal spirometry, R5 and R5−20 were higher in symptomatic versus asymptomatic subjects (median (interquartile range R5 0.436 (0.206 versus 0.314 (0.129 kPa·L−1·s−1, p<0.001; R5−20 0.075 (0.085 versus 0.004 (0.042 kPa·L−1·s−1, p<0.0001. In symptomatic subjects, R5 and R5−20 increased with increasing severity and frequency of wheeze (p<0.05. Measurement of R5–20 correlated with the presence and severity of symptoms even when spirometry was within normal limits. These findings are in accord with small airway abnormalities as a potential explanation of the respiratory symptoms.

  3. Oscillometry complements spirometry in evaluation of subjects following toxic inhalation

    Science.gov (United States)

    Berger, Kenneth I.; Turetz, Meredith; Liu, Mengling; Shao, Yongzhao; Kazeros, Angeliki; Parsia, Sam; Caplan-Shaw, Caralee; Friedman, Stephen M.; Maslow, Carey B.; Marmor, Michael; Goldring, Roberta M.

    2015-01-01

    The World Trade Center (WTC) destruction released dust and fumes into the environment. Although many community members developed respiratory symptoms, screening spirometry was usually normal. We hypothesised that forced oscillation testing would identify functional abnormalities undetected by spirometry and that symptom severity would relate to magnitude of abnormalities measured by oscillometry. A symptomatic cohort (n=848) from the Bellevue Hospital WTC Environmental Health Center was evaluated and compared to an asymptomatic cohort (n=475) from the New York City Department of Health WTC Health Registry. Spirometry and oscillometry were performed. Oscillometry measurements included resistance (R5) and frequency dependence of resistance (R5−20). Spirometry was normal for the majority of subjects (73.2% symptomatic versus 87.6% asymptomatic, p<0.0001). In subjects with normal spirometry, R5 and R5−20 were higher in symptomatic versus asymptomatic subjects (median (interquartile range) R5 0.436 (0.206) versus 0.314 (0.129) kPa·L−1·s−1, p<0.001; R5−20 0.075 (0.085) versus 0.004 (0.042) kPa·L−1·s−1, p<0.0001). In symptomatic subjects, R5 and R5−20 increased with increasing severity and frequency of wheeze (p<0.05). Measurement of R5–20 correlated with the presence and severity of symptoms even when spirometry was within normal limits. These findings are in accord with small airway abnormalities as a potential explanation of the respiratory symptoms. PMID:27730155

  4. Phenotype of normal spirometry in an aging population.

    Science.gov (United States)

    Vaz Fragoso, Carlos A; McAvay, Gail; Van Ness, Peter H; Casaburi, Richard; Jensen, Robert L; MacIntyre, Neil; Gill, Thomas M; Yaggi, H Klar; Concato, John

    2015-10-01

    In aging populations, the commonly used Global Initiative for Chronic Obstructive Lung Disease (GOLD) may misclassify normal spirometry as respiratory impairment (airflow obstruction and restrictive pattern), including the presumption of respiratory disease (chronic obstructive pulmonary disease [COPD]). To evaluate the phenotype of normal spirometry as defined by a new approach from the Global Lung Initiative (GLI), overall and across GOLD spirometric categories. Using data from COPDGene (n = 10,131; ages 45-81; smoking history, ≥10 pack-years), we evaluated spirometry and multiple phenotypes, including dyspnea severity (Modified Medical Research Council grade 0-4), health-related quality of life (St. George's Respiratory Questionnaire total score), 6-minute-walk distance, bronchodilator reversibility (FEV1 % change), computed tomography-measured percentage of lung with emphysema (% emphysema) and gas trapping (% gas trapping), and small airway dimensions (square root of the wall area for a standardized airway with an internal perimeter of 10 mm). Among 5,100 participants with GLI-defined normal spirometry, GOLD identified respiratory impairment in 1,146 (22.5%), including a restrictive pattern in 464 (9.1%), mild COPD in 380 (7.5%), moderate COPD in 302 (5.9%), and severe COPD in none. Overall, the phenotype of GLI-defined normal spirometry included normal adjusted mean values for dyspnea grade (0.8), St. George's Respiratory Questionnaire (15.9), 6-minute-walk distance (1,424 ft [434 m]), bronchodilator reversibility (2.7%), % emphysema (0.9%), % gas trapping (10.7%), and square root of the wall area for a standardized airway with an internal perimeter of 10 mm (3.65 mm); corresponding 95% confidence intervals were similarly normal. These phenotypes remained normal for GLI-defined normal spirometry across GOLD spirometric categories. GLI-defined normal spirometry, even when classified as respiratory impairment by GOLD, included adjusted mean values in the

  5. The abnormal chest X-ray – when to refer to a specialis t

    African Journals Online (AJOL)

    2007-11-19

    Nov 19, 2007 ... Radiological changes on a chest X-ray are an indication of pul- monary pathology or ... NB: Refer all cases of collapse for further investigation. Radiographic signs of lobar .... with areas of confluence producing consolidation.

  6. Variation in spirometry utilization between trained general practitioners in practices equipped with a spirometer.

    NARCIS (Netherlands)

    Poels, P.J.E.; Schermer, T.R.J.; Jacobs, A.; Akkermans, R.P.; Hartman, J.; Bottema, B.J.A.M.; Weel, C. van

    2006-01-01

    OBJECTIVE: To explore spirometry utilization among general practitioners and identify practitioner and practice-related factors associated with spirometry utilization. DESIGN: Multivariate multilevel cross-sectional analysis of a questionnaire survey. SETTING: Some 61 general practices involved in a

  7. Chest X-Ray

    Medline Plus

    Full Text Available ... some concerns about chest x-rays. However, it’s important to consider the likelihood of benefit to your health. While a chest x-ray use a ... posted: How to Obtain and Share ...

  8. Chest X-Ray

    Medline Plus

    Full Text Available ... and chest wall and may be used to help evaluate shortness of breath, persistent cough, fever, chest ... or injury. It may also be useful to help diagnose and monitor treatment for a variety of ...

  9. MRI of the Chest

    Medline Plus

    Full Text Available ... are the limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging ( ... heart, valves, great vessels, etc.). top of page What are some common uses of the procedure? MR ...

  10. 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 ...

  11. 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 ...

  12. Chest tube insertion

    Science.gov (United States)

    Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Be careful there are no kinks in your tube. The drainage system should always sit upright and be placed ...

  13. Neonates do not need to be handled for radiographs

    International Nuclear Information System (INIS)

    Slade, Dawn; Alfaham, Mazin; Davis, Peter; Tuthill, David; Harrison, Sara; Morris, Susan; Guildea, Zoe

    2005-01-01

    The handling of sick neonates may have detrimental effects such as hypoxia or bradycardia. Such handling is inevitable due to the frequent need for practical procedures; however, minimising handling reduces these adverse events and may improve outcome. Radiography is one of the commonest procedures performed on neonates. Usually the infant is lifted and placed onto the radiographic cassette; however, modern incubators often incorporate a tray beneath the mattress in which the radiographic cassette can be placed without the need to disturb the infant. To compare the quality of chest radiographs taken using the standard direct contact method, with those taken using the under-tray technique. A series of chest radiographs taken over a 21-month period were analysed independently by two consultant paediatric radiologists unaware of the radiographic details. The position of the radiograph, i.e. direct contact or under-tray, was determined by the radiographer. Radiographic quality was scored on the following features: exposure, blurring, rotation, cut-off or coning, and side markers. A subjective score was also included. The results from each radiologist were analysed separately. Seventy chest radiographs were analysed - 25 standard method, 45 under-tray. A statistically significant advantage for the under-tray method was seen on two analyses - radiologist 1 for exposure, and radiologist 2 for cut-off. No other significant differences were noted. There were no differences in the infants' weights or radiation exposure. The under-tray method for taking radiographs may produce films of at least equivalent quality to the standard method. Since the standard method involves handling with potential desaturation and bradycardia, this technique should cease. (orig.)

  14. Radiographic findings in pulmonary hypertension from unresolved embolism

    Energy Technology Data Exchange (ETDEWEB)

    Woodruff, W.W. III; Hoeck, B.E.; Chitwood, W.R. Jr.; Lyerly, H.K.; Sabiston, D.C. Jr.; Chen, J.T.T.

    1985-04-01

    Pulmonary artery hypertension with chronic pulmonary embolism is an uncommon entity that is potentially treatable with pulmonary embolectomy. Although the classic radiographic features have been described, several recent investigators report a significant percentage of these patients with normal chest radiographs. In a series of 22 patients, no normal radiographs were seen. Findings included cardiomegaly (86.4%) with right-sided enlargement (68.4%), right descending pulmonary artery enlargement (54.5%), azygos vein enlargement (27.3%), mosaic oligemia (68.2%), chronic volume loss (27.3%), atelectasis and/or effusion (22.7%), and pleural thickening (13.6%). Good correlation with specific areas of diminished vascularity was seen on chest radiographs compared with pulmonary angiograms.

  15. Radiographic findings in pulmonary hypertension from unresolved embolism

    International Nuclear Information System (INIS)

    Woodruff, W.W. III; Hoeck, B.E.; Chitwood, W.R. Jr.; Lyerly, H.K.; Sabiston, D.C. Jr.; Chen, J.T.T.

    1985-01-01

    Pulmonary artery hypertension with chronic pulmonary embolism is an uncommon entity that is potentially treatable with pulmonary embolectomy. Although the classic radiographic features have been described, several recent investigators report a significant percentage of these patients with normal chest radiographs. In a series of 22 patients, no normal radiographs were seen. Findings included cardiomegaly (86.4%) with right-sided enlargement (68.4%), right descending pulmonary artery enlargement (54.5%), azygos vein enlargement (27.3%), mosaic oligemia (68.2%), chronic volume loss (27.3%), atelectasis and/or effusion (22.7%), and pleural thickening (13.6%). Good correlation with specific areas of diminished vascularity was seen on chest radiographs compared with pulmonary angiograms

  16. Chest computed tomography

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...

  17. Influence of the diving wetsuit on standard spirometry

    NARCIS (Netherlands)

    Schellart, Nico A. M.; Sterk, Wouter

    2016-01-01

    INTRODUCTION A well-fitting wetsuit exerts a pressure on the body that may influence spirometry. This pressure is expected to reduce the forced vital capacity (FVC) due to hampered inspiration. Since the shape of the spirometric flow curve should not be changed by the pressure effects of the

  18. Prediction Equations for Spirometry for Children from Northern India.

    Science.gov (United States)

    Chhabra, Sunil K; Kumar, Rajeev; Mittal, Vikas

    2016-09-08

    To develop prediction equations for spirometry for children from northern India using current international guidelines for standardization. Re-analysis of cross-sectional data from a single school. 670 normal children (age 6-17 y; 365 boys) of northern Indian parentage. After screening for normal health, we carried out spirometry with recommended quality assurance according to current guidelines. We developed linear and nonlinear prediction equations using multiple regression analysis. We selected the final models on the basis of the highest coefficient of multiple determination (R2) and statistical validity. Spirometry parameters: FVC, FEV1, PEFR, FEF50, FEF75 and FEF25-75. The equations for the main parameters were as follows: Boys, Ln FVC = -1.687+0.016*height +0.022*age; Ln FEV1 = -1.748+0.015*height+0.031*age. Girls, Ln FVC = -9.989 +(2.018*Ln(height)) + (0.324*Ln(age)); Ln FEV1 = -10.055 +(1.990*Ln(height))+(0.358*Ln(age)). Nonlinear regression yielded substantially greater R2 values compared to linear models except for FEF50 for girls. Height and age were found to be the significant explanatory variables for all parameters on multiple regression with weight making no significant contribution. We developed prediction equations for spirometry for children from northern India. Nonlinear equations were superior to linear equations.

  19. Spirometry: a predictor of lung cancer among asbestos workers.

    Science.gov (United States)

    Świątkowska, Beata; Szeszenia-Dąbrowska, Neonila

    2017-01-01

    The significance of lung function as an independent risk factor for lung cancer remains unclear. The objective of the study is to answer the question if spirometry can identify patients at risk for lung cancer among people occupationally exposed to asbestos dust in the past. In order to identify a group of individuals with the highest risk of lung cancer incidence based on lung function levels of FEV 1 % predicted value, we examined 6882 subjects enrolled in the health surveillance program for asbestos related diseases over the years 2000-2014. We found a total of 110 cases confirmed as primary lung cancer. Using Cox's proportional hazards model after adjustment for age, gender, number of cigarettes, duration of smoking and cumulative asbestos exposure, we estimated that compared with the subjects with FEV 1 ≥90% pred, the HR of lung cancer was 1.40 (95%CI: 0.94-2.08) for the subjects with FEV 1 less than 90% and 1.95 (HR = 1.86; 95%CI: 1.12-3.08) for those with FEV 1 less than 70%. In addition, probability of the occurrence of lung cancer for FEV 1 spirometry and cancer diagnosis was three years or less. The results strongly support the hypothesis that spirometry can identify patients at a risk of lung cancer development. Regular spirometry should be offered to all patients with a history of asbestos exposure, at least once every three years.

  20. A Rwandan spirometry and resting ventilation study | Gahutu ...

    African Journals Online (AJOL)

    To illustrate spirometric population variation and ventilatory adaptation to moderate altitude, we report the spirometric and resting ventilation values observed in a student population in Butare, Rwanda (altitude: 1 768 m; barometric pressure: 629 mm Hg). Spirometry was carried out with a Mijnhardt Volutest VT-3 ...

  1. A guide to spirometry as applied to occupational health | White ...

    African Journals Online (AJOL)

    In the context of occupational health, spirometric testing of respiratory function has a number of important applications. These applications can be expected to become more widespread in view of extensive changes to occupational health and compensation legislation in South Africa. Spirometry is an essential component of ...

  2. Accuracy and Quality of Spirometry in Primary Care Offices.

    Science.gov (United States)

    Hegewald, Matthew J; Gallo, Heather M; Wilson, Emily L

    2016-12-01

    Spirometry is necessary for the optimal management of patients with respiratory disease. The quality of spirometry performed in the primary care setting has been inconsistent. We aimed to evaluate spirometer accuracy, determine the clinical significance of inaccurate spirometers, and assess the quality of spirograms obtained in primary care offices. We tested 17 spirometers used in primary care offices with a waveform generator; accuracy and precision were assessed using American Thoracic Society criteria. The clinical significance of inaccurate instruments was determined by applying the FEV 1 /FVC error from an obstructed waveform to a clinical data set. Spirogram quality was determined by grading spirograms using acceptability and repeatability criteria. The relationship between the number of tests performed by a clinic and test quality was assessed. Only 1 of 17 spirometers met accuracy criteria, with mean errors for FVC, FEV 1 , and FEV 1 /FVC ranging from 1.7 to 3.1%. Applying the percentage error to a clinical data set resulted in 28% of tests being recategorized from obstructed to nonobstructed. Of the spirograms reviewed, 60% were considered acceptable for clinical use. There was no association between the number of tests performed by a clinic and spirometry quality. Most spirometers tested were not accurate. The magnitude of the errors resulted in significant changes in the categorization of patients with obstruction. Acceptable-quality tests were produced for only 60% of patients. Our results raise concerns regarding the utility of spirometry obtained in primary care offices without greater attention to quality assurance and training.

  3. 21 CFR 868.1860 - Peak-flow meter for spirometry.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Peak-flow meter for spirometry. 868.1860 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1860 Peak-flow meter for spirometry. (a) Identification. A peak-flow meter for spirometry is a device used to measure a patient's...

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

    International Nuclear Information System (INIS)

    Graat, Marleen E; Hendrikse, Karin A; Spronk, Peter E; Korevaar, Johanna C; Stoker, Jaap; Schultz, Marcus J

    2006-01-01

    To ascertain current chest radiography practice in intensive care units (ICUs) in the Netherlands. 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. 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 (< 20 beds, 65%) (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%). 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

  5. Adult Sail Sign: Radiographic and Computed Tomographic Features

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yu-Jin; Han, Daehee; Koh, Young Hwan; Zo, Joo Hee; Kim, Sang-Hyun; Kim, Deog Kyeom; Lee, Jeong Sang; Moon, Hyeon Jong; Kim, Jong Seung; Chun, Eun Ju; Youn, Byung Jae; Lee, Chang Hyun; Kim, Sam Soo (Dept. of Radiology, Cheil General Hospital, Kwandong Univ. College of Medicine, Seoul (KR))

    2008-02-15

    Background: The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. Purpose: To investigate the sail sign appearing in adult chest radiography. Material and Methods: Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). Results: The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. Conclusion: The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging

  6. Adult Sail Sign: Radiographic and Computed Tomographic Features

    International Nuclear Information System (INIS)

    Lee, Yu-Jin; Han, Daehee; Koh, Young Hwan; Zo, Joo Hee; Kim, Sang-Hyun; Kim, Deog Kyeom; Lee, Jeong Sang; Moon, Hyeon Jong; Kim, Jong Seung; Chun, Eun Ju; Y oun, Byung Jae; Lee, Chang Hyun; Kim, Sam Soo

    2008-01-01

    Background: The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. Purpose: To investigate the sail sign appearing in adult chest radiography. Material and Methods: Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). Results: The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. Conclusion: The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging

  7. Spirometry filters can be used to detect exhaled respiratory viruses.

    Science.gov (United States)

    Mitchell, Alicia B; Mourad, Bassel; Tovey, Euan; Buddle, Lachlan; Peters, Matthew; Morgan, Lucy; Oliver, Brian G

    2016-09-26

    Respiratory viruses are very common in the community and contribute to the burden of illness for patients with chronic respiratory diseases, including acute exacerbations. Traditional sampling methods are invasive and problematic to repeat. Accordingly, we explored whether respiratory viruses could be isolated from disposable spirometry filters and whether detection of viruses in this context represented presence in the upper or lower respiratory tract. Discovery (n  =  53) and validation (n  =  49) cohorts were recruited from a hospital outpatient department during two different time periods. Spirometry mouthpiece filters were collected from all participants. Respiratory secretions were sampled from the upper and lower respiratory tract by nasal washing (NW), sputum, and bronchoalveolar lavage (BAL). All samples were examined using RT-PCR to identify a panel of respiratory viruses (rhinovirus, respiratory syncytial virus, influenza A, influenza B, parainfluenza virus 1, 2 & 3, and human metapneumovirus). Rhinovirus was quantified using qPCR. Paired filter-NW samples (n  =  29), filter-sputum samples (n  =  24), filter-BAL samples (n  =  39) and filter-NW-BAL samples (n  =  10) provided a range of comparisons. At least one virus was detected in any sample in 85% of participants in the discovery cohort versus 45% in the validation cohort. Overall, 72% of viruses identified in the paired comparator method matched those detected in spirometry filters. There was a high correlation between viruses identified in spirometry filters compared with viruses identified in both the upper and lower respiratory tract using traditional sampling methods. Our results suggest that examination of spirometry filters may be a novel and inexpensive sampling method for the presence of respiratory viruses in exhaled breath.

  8. Radiographic abnormalities in tricyclic acid overdose

    International Nuclear Information System (INIS)

    Varnell, R.M.; Richardson, M.L.; Vincent, J.M.; Godwin, J.D.

    1987-01-01

    Several case reports have described adult respiratory distress syndrome (ARDS) secondary to tricyclic acid (TCA) overdose. During a 1-year period 83 patients requiring intubation secondary to drug overdose were evaluated. Abnormalities on chest radiographs occurred in 26 (50%) of the 54 patients with TCA overdose, compared to six (21%) of the 29 patients overdosed with other drugs. In addition, five (9%) of the patients with TCA overdose subsequently had radiographic and clinical abnormalities meeting the criteria for ARDS. Only one (3%) of the patients with non-TCA overdose subsequently had change suggesting ARDS. TCAs should be added to the list of drugs associated with ARDS, and TCA overdose should be considered a major risk factor in the development of radiographically evident abnormalities

  9. American College of Chest Physicians

    Science.gov (United States)

    ... Foundation Participate in the e-Community Get Social Career Connection Publications CHEST Journal CHEST SEEK Guidelines & Consensus Statements CHEST Physician CHEST NewsBrief Coding for Chest Medicine Tobacco Dependence Toolkit (3rd Ed.) Mobile Websites and Apps CHEST Journal ...

  10. Comparison of extravascular lung water volume with radiographic findings in dogs with experimentally increased permeability pulmonary edema

    International Nuclear Information System (INIS)

    Takeda, A.; Okumura, S.; Miyamoto, T.; Hagio, M.; Fujinaga, T.

    1995-01-01

    The relationship between extravascular lung water volume (ELWV) and chest radiographical findings was studied in general-anesthetized beagles. The dogs were experimentally injected with oleic acid to increase pulmonary vascular permeability. When the ELWV value in the dogs increased more than approximately 37% from the control value, their chest radiographs began to show signs of pulmonary edema. At this time, the chest X-ray density increased to 10% above the control level. PaO2 decreased, and PaCO2 increased after the administration of oleic acid. This clearly showed that the pulmonary gas exchange function was reduced following increasing ELWV. This comparison showed that probably the thermal-sodium double indicator dilution measurement of ELWV can detect slight hyperpermeability pulmonary edema that does not show on chest radiographs. The chest radiograph was therefore not suitable for the detection of slight pulmonary edema, because it did not show any changes in the early stages in hyperpermeability pulmonary edema

  11. Satisfaction of Search in Chest Radiography 2015.

    Science.gov (United States)

    Berbaum, Kevin S; Krupinski, Elizabeth A; Schartz, Kevin M; Caldwell, Robert T; Madsen, Mark T; Hur, Seung; Laroia, Archana T; Thompson, Brad H; Mullan, Brian F; Franken, Edmund A

    2015-11-01

    Two decades have passed since the publication of laboratory studies of satisfaction of search (SOS) in chest radiography. Those studies were performed using film. The current investigation tests for SOS effects in computed radiography of the chest. Sixty-four chest computed radiographs half demonstrating various "test" abnormalities were read twice by 20 radiologists, once with and once without the addition of a simulated pulmonary nodule. Receiver-operating characteristic detection accuracy and decision thresholds were analyzed to study the effects of adding the nodule on detecting the test abnormalities. Results of previous studies were reanalyzed using similar modern techniques. In the present study, adding nodules did not influence detection accuracy for the other abnormalities (P = .93), but did induce a reluctance to report them (P chest radiography (P chest radiography has changed, but it is not clear why. SOS may be changing as a function of changes in radiology education and practice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  12. Pilot program on distance training in spirometry testing - the technology feasibility study.

    Science.gov (United States)

    Nowiński, Adam; Romański, Emil; Bieleń, Przemysław; Bednarek, Michał; Puścińska, Elżbieta; Goljan-Geremek, Anna; Pływaczewski, Robert; Śliwinski, Paweł

    2015-01-01

    Office spirometry has been widely used in recent years by general practitioners in primary care setting, thus the need for stricter monitoring of the quality of spirometry has been recognized. A spirometry counseling network of outpatients clinics was created in Poland using portable spirometer Spirotel. The spirometry data were transferred to counseling centre once a week. The tests sent to the counseling centre were analyzed by doctors experienced in the analysis of spirometric data. In justified cases they sent their remarks concerning performed tests to the centres via e-mail. We received 878 records of spirometry tests in total. Data transmission via the telephone was 100% effective. The quality of spirometry tests performed by outpatients clinics was variable. The use of spirometers with data transfer for training purposes seems to be advisable. There is a need to proper face-to-face training of spirometry operators before an implementation of any telemedicine technology.

  13. Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project

    Energy Technology Data Exchange (ETDEWEB)

    Mahomed, Nasreen [University of the Witwatersrand, Department of Radiology, Johannesburg (South Africa); University of the Witwatersrand, Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg (South Africa); Fancourt, Nicholas [Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); Murdoch Children' s Research Institute, Melbourne (Australia); De Campo, John; De Campo, Margaret [Murdoch Children' s Research Institute, Melbourne (Australia); Melbourne University, Melbourne (Australia); Akano, Aliu [Department of Radiology National Hospital, Abuja (Nigeria); Medical Research Council, Gambia (South Africa); Cherian, Thomas [World Health Organization, Geneva (Switzerland); Cohen, Olivia G. [Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); World Health Organization, Geneva (Switzerland); Greenberg, David [Soroka University Medical Center, Beer-Sheva (Israel); Lacey, Stephen [Murdoch Children' s Research Institute, Melbourne (Australia); Kohli, Neera [King George Medical University, Lucknow (India); Lederman, Henrique M. [Paulista School of Medicine, Hospital Sao Paulo, Sao Paulo (Brazil); Madhi, Shabir A. [University of the Witwatersrand, Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg (South Africa); University of the Witwatersrand, Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg (South Africa); Manduku, Veronica [Kenya Medical Research Institute (KEMRI), Nairobi (Kenya); McCollum, Eric D. [Johns Hopkins School of Medicine, Eudowood Division of Pediatric Respiratory Sciences, Baltimore (United States); Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); Park, Kate [Oxford University Hospitals NHS Foundation Trust, Oxford (United Kingdom); Ribo-Aristizabal, Jose Luis [Hospital Sant Joan de Deu, Barcelona (Spain); Bar-Zeev, Naor [University of Malawi, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre (Malawi); University of Liverpool, Centre for Global Vaccine Research, Liverpool (United Kingdom); O' Brien, Katherine L. [Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); Mulholland, Kim [Murdoch Children' s Research Institute, Melbourne (Australia); London School of Hygiene and Tropical Medicine, London (United Kingdom)

    2017-10-15

    Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs. (orig.)

  14. Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project.

    Science.gov (United States)

    Mahomed, Nasreen; Fancourt, Nicholas; de Campo, John; de Campo, Margaret; Akano, Aliu; Cherian, Thomas; Cohen, Olivia G; Greenberg, David; Lacey, Stephen; Kohli, Neera; Lederman, Henrique M; Madhi, Shabir A; Manduku, Veronica; McCollum, Eric D; Park, Kate; Ribo-Aristizabal, Jose Luis; Bar-Zeev, Naor; O'Brien, Katherine L; Mulholland, Kim

    2017-10-01

    Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs.

  15. How Often is Chest Radiography Ordered for Patients with Pediatric Asthma?

    Directory of Open Access Journals (Sweden)

    Serap Özmen

    2017-08-01

    Full Text Available Objective: Although many children with asthma can be diagnosed clinically, chest radiographs are routinely requested in asthma attacks. The aim of this study is to determine how often chest radiographs are requested and the factors affecting these requests in pediatric patients with asthma. Methods: This cross-sectional study was performed by studying the electronic radiographic records of pediatric patients with asthma who were referred to our Pediatric Allergy and Immunology Department over a six-month period. A questionnaire was designed to obtain further information from the parents of the patients. Results: The records of 100 children with bronchial asthma, aged 21 to 192 months, were evaluated. The average number of chest radiographs was 3.9±3.8 (between 1-30. Fifty-one percent of the children underwent three or more chest radiographs. There was a positive correlation between the number of chest X-rays before asthma diagnosis and the frequency of antibiotic usage (r=0.222, p=0.026. An inverse correlation was found between the number of chest radiographs and the patients’ ages and the age at which asthma was diagnosed (r=−0.335, p=0.001; r=−0.211, p=0.035, respectively. In contrast, there was a positive correlation between the number of chest X-rays and the number of hospital admissions (r=0.205, p=0.040. A positive correlation between the frequency of antibiotic usage and the annual number of hospital admissions was determined (r=0.428, p=0.000. Furthermore, a positive correlation between the frequency of antibiotic usage and the frequency of asthma attacks was observed (r=0.292, p=0.003. Conclusion: The results of our study show that the use of chest radiographs is high in cases of childhood asthma, especially in younger children.

  16. Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project

    International Nuclear Information System (INIS)

    Mahomed, Nasreen; Fancourt, Nicholas; De Campo, John; De Campo, Margaret; Akano, Aliu; Cherian, Thomas; Cohen, Olivia G.; Greenberg, David; Lacey, Stephen; Kohli, Neera; Lederman, Henrique M.; Madhi, Shabir A.; Manduku, Veronica; McCollum, Eric D.; Park, Kate; Ribo-Aristizabal, Jose Luis; Bar-Zeev, Naor; O'Brien, Katherine L.; Mulholland, Kim

    2017-01-01

    Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs. (orig.)

  17. Standardization of thorax, skull and pelvis radiographic images

    International Nuclear Information System (INIS)

    Pina, D.R.; Ghilardi Netto, T.; Trad, C.S.; Brochi, M.A. Corte; Duarte, S.B.; Pina, S.R.

    2001-01-01

    The radiographic techniques for production of chest, skull and pelvis exam were determined for the standard patient. These techniques produced the quality image with smaller dose, for a standard patient, at any conventional X-ray equipment. The radiographic contrast produced for these techniques was measured utilizing the realistic-analytic phantom and classified as an ideal radiographic contrast. This work has the aim to keep the standard of the quality image, for any thickness of patients usually found in clinic routine of the radiodiagnosis service, satisfying the relation risk-benefit for the patient and cost- benefit for the institution. (author)

  18. Radiographic differentiation of atypical tuberculosis from mycobacterium tuberculosis

    International Nuclear Information System (INIS)

    Tarver, R.D.; Pearcy, E.A.; Conces, D.J. Jr.; Mathur, P.N.

    1987-01-01

    The chest radiographs of 95 patients with the new diagnosis of atypical turberculosis were reviewed to determine if any significant differences between atypical tuberculosis and that caused by Mycobacterium tuberculosis could be discerned. Findings included upper lobe involvement in B4 of the 95 patients and cavities in 76, with nearly equal groups having no, moderate, or extensive surrounding alveolar disease. Nodules were common; in six patients a nodule was the sole manifestation of disease. Adenopathy was seen in 12 of the 95 patients, atlectasis in 45, pleural thickening in 90, and effusions in three. These radiographic findings did not allow the radiographic differentiation of atypical tuberculosis from Mycobacterium tuberculosis infection

  19. Radiographic imaging. 4 ed.

    International Nuclear Information System (INIS)

    Chesney, D.N.; Chesney, M.O.

    1981-01-01

    This is a revised edition of the textbook previously entitled 'Radiographic Photography' and accords with the current syllabus of training for the Diploma of the Royal College of Radiographers. The aim is a non-mathematical approach to provide a guide for the student to the knowledge and understanding of the theoretical concepts which affect the quality of radiographic image; materials and practices are also reviewed, particularly in relation to the characteristics of the radiographic image, and to processing equipment and processing areas. The subject is dealt with under the following headings: the photographic process, film materials in x-ray departments, sensitometry, storage of film materials and radiographs, intensifying screens and cassettes, film processing, developing, fixing, rinsing, washing, drying, the processing area and equipment, systems for daylight film handling, the radiographic image, management of the quality, presentation of the radiograph, light images and their recording, fluorography, some special imaging processes, e.g. xerography, copying radiographs. (U.K.)

  20. Criteria for inhalation exposure systems utilizing concurrent flow spirometry

    International Nuclear Information System (INIS)

    Raabe, O.G.; Yeh, H.C.

    1974-01-01

    Principles are given for the design and operation of a new class of inhalation exposure systems utilizing concurrent flow spirometry (CFS), a simple method for providing realtime measurement of respiratory volumes and rates during inhalation exposure by mouth or nose of individual experimental animals or man to aerosols or gases. This technique is especially useful for inhalation exposure of larger experimental animals, such as horses, where whole-body plethysmography is usually impractical. Difficulties encountered with conventional exposure systems in maintenance of uniform aerosol or gas concentrations and prevention of large pressure excursions in the exposure chamber during breathing are obviated by systems utilizing the principles of concurrent flow spirometry. For illustration, two exposure units with CFS are described, one for exposure of Beagle dogs and one for ponies. (U.S.)

  1. The Use of Home Spirometry in Pediatric Cystic Fibrosis Patients

    Directory of Open Access Journals (Sweden)

    Aarti Shakkottai MD

    2017-02-01

    Full Text Available Medication adherence is poor among pediatric cystic fibrosis (CF patients, with adolescents having one of the lowest adherence rates. We wanted to identify an adherence intervention that would be acceptable to CF adolescents and assess its feasibility. We surveyed 40 adolescents with CF and asked about barriers to and motivators for their own adherence and to generate ideas for potential adherence interventions. Since most of the respondents chose frequent spirometry at home and medication reminders for interventions, we selected 5 subjects, 10 to 14 years of age, with CF to test the feasibility of home spirometry and medication reminders in pediatric CF patients. This article summarizes the results of both the survey and the feasibility pilot study.

  2. Multiple-beam equalization radiography in chest radiology

    International Nuclear Information System (INIS)

    Axelsson, B.; Forsberg, H.; Hansson, B.; Haverling, M.

    1991-01-01

    The large difference in transmission between the mediastinum and the part of the chest mainly containing lungs causes major problems in chest radiography. A system for advanced multiple beam equalization radiography has been evaluated. Evaluation of image quality has been performed both using standard phantoms and from clinical radiographs. Measurements of radiation dose burden to the patient have been made both in clinical examinations and using an anthropomorphic phantom. The image quality, in areas with low transmission, is substantially increased using the equalization system. In parts of the chest mainly containing lung tissue, conventional systems show an equal or slightly better image quality. The radiation dose burden to the patient is increased by 25 percent using the equation system, as compared to a low-dose air-gap system. In our opinion, the slight increase in radiation dose burden is well motivated by the high quality of the radiographs produced. (orig.)

  3. Spirometry improvement after muscular exercise in elite swimmers.

    Science.gov (United States)

    Rubini, Alessandro; Rizzato, Alex; Fava, Simone; Olivato, Nicola; Mangar, Devanand; Camporesi, Enrico M; Bosco, Gerardo

    2017-12-01

    An increased sympathetic activity during muscular effort is a well established physiological response, whose intensity is known to increase with the muscular load. Spirometry was described to improve as an effect of swimming training in healthy and asthmatic subjects, suggesting a decrease in airway resistance The aim was to investigate the possible effect of muscular exercise (swimming) on spirometry, in particular searching for possible differences because of different swimming times. The measurements were performed on 9 highly trained male competitive swimmers (age: 41±12.79 years, height: 1.69±0.06 meters, weight: 66.14±14.28 kg, BMI: 22.8±3.61 kg/m2) during an official competition. The data were collected at the border of the swimming-pool before (control, C) and few minutes after the swimming sessions (exercise, E), which consisted either of 800 meter (7 subjects) or 1500 meter (5 subjects) free style. A general trend indicating a postexercise increase in spirometry was observed. We found post-exercise significant increments in FEV1 and in MEF75 for both the 800 and 1500 meter swimming sessions, and in FEF25-75 and in MEF25 for the shorter distance. We conclude that, as it may be expected, muscular exercise induces an improvement of spirometry both because of a smooth muscle relaxation-induced modulation of airway diameter and resistance to airflow, and because of an enhanced expiratory muscle contraction strength. Both of these mechanisms are related to an increased sympathetic activity which is well known to accompany muscular exercise.

  4. Blunt chest trauma.

    Science.gov (United States)

    Stewart, Daphne J

    2014-01-01

    Blunt chest trauma is associated with a wide range of injuries, many of which are life threatening. This article is a case study demonstrating a variety of traumatic chest injuries, including pathophysiology, diagnosis, and treatment. Literature on the diagnosis and treatment was reviewed, including both theoretical and research literature, from a variety of disciplines. The role of the advance practice nurse in trauma is also discussed as it relates to assessment, diagnosis, and treatment of patients with traumatic chest injuries.

  5. A radiographic method for measurement of leg length inequality.

    Science.gov (United States)

    Friberg, O; Koivisto, E; Wegelius, C

    1985-01-01

    An accurate and simple radiographic method for the measurement of weight-bearing leg length inequality with a minimum of radiated body area is described. The measurement can be made in a conventional chest X-ray unit without other extra equipment than a gonad shield described here.

  6. PIKO-6® vs. forced spirometry in asthmatic children.

    Science.gov (United States)

    Gochicoa-Rangel, Laura; Larios-Castañeda, Pablo José; Miguel-Reyes, José Luis; Briseño, David Martínez; Flores-Campos, Roberto; Sáenz-López, Juan Arturo; Torre-Bouscoulet, Luis

    2014-12-01

    The PIKO-6® is an electronic device that measures forced expiratory volume at seconds 1 (FEV1) and 6 (FEV6) of a forced vital capacity (FVC) maneuver. This device could aid in diagnosing obstructive respiratory diseases. To determine the concordance of FEV1, FEV6, and the FEV1/FEV6 quotient achieved with PIKO-6® versus spirometric values from asthmatic patients, and compare results with measures from healthy children. A cross-sectional study with asthmatic and healthy 6-to-14-year-old children, all of whom performed a forced spirometry as well as a PIKO-6® test. The study included 82 subjects (58 asthmatics, 24 healthy children). Except for the functional parameters, the basal characteristics of the two groups were similar. The concordance correlation coefficient (CCC) for FEV1 was 0.938 (P spirometry was lower in patients with partially controlled or uncontrolled asthma compared to controlled or healthy children. The broad limits of agreement show that the FEV1, FEV6, and FEV1/FEV6 obtained with the PIKO-6® are not interchangeable with spirometry results. Longitudinal evaluations of asthma patients are necessary to assess the utility of PIKO-6®. © 2014 Wiley Periodicals, Inc.

  7. Spirometry. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR).

    Science.gov (United States)

    García-Río, Francisco; Calle, Myriam; Burgos, Felip; Casan, Pere; Del Campo, Félix; Galdiz, Juan B; Giner, Jordi; González-Mangado, Nicolás; Ortega, Francisco; Puente Maestu, Luis

    2013-09-01

    Spirometry is the main pulmonary function test and is essential for the evaluation and monitoring of respiratory diseases. Its utility transcends the field of Respiratory Medicine, is becoming increasingly important in primary care and applications have even been described outside the field of respiratory diseases. This document is therefore intended to serve as support for all health professionals who use spirometry, providing recommendations based on the best scientific evidence available. An update of the indications and contraindications of the test is proposed. The document sets out recommendations on the requirements necessary for conventional spirometers and portable office equipment, as well as on spirometer hygiene and quality control measures. Spirometric parameters that must be considered, performance of manoeuvres, criteria for acceptability and repeatability of measurements and their quality control are defined. A proposal is also established for presentation of the results and an evaluation and interpretation is proposed according to information generated in recent years. Finally, lines of adaptation and integration of spirometry in the field of new technologies are considered. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  8. Distinctly visible right upper lobe bronchus on the lateral chest: A clue to adolescent cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Reinig, J.W.; Sanchez, F.W.; Thomason, D.M.; Gobien, R.P.

    1985-05-01

    Radiographic differentiation between cystic fibrosis and asthma presenting in teenagers and young adults can be difficult. Many patients with a late presentation of cystic fibrosis display minimal changes on a chest radiograph. However, a large majority (90%) of cystic fibrosis patients with an essentially normal PA chest radiograph will have a distinctly outlined orifice of right upper lobe bronchus on a lateral chest film as opposed to a small number of asthmatics (25%) or normal patients (18%). This observation correlates well with the pathologic finding that the initial pulmonary involvement in cystic fibrosis is typically in the right upper lobe in adolescents. Teenager or young adult patients presenting with a history of repeated respiratory infections, asthma-like symptoms and a distinctly visible right upper lobe bronchus on a lateral chest film should be sweat-tested to exclude cystic fibrosis.

  9. Spirometry use: detection of chronic obstructive pulmonary disease in the primary care setting

    Science.gov (United States)

    Barnes, Thomas A; Fromer, Len

    2011-01-01

    Objective: To describe a practical method for family practitioners to stage chronic obstructive pulmonary disease (COPD) by the use of office spirometry. Methods: This is a review of the lessons learned from evaluations of the use of office spirometry in the primary care setting to identify best practices using the most recent published evaluations of office spirometry and the analysis of preliminary data from a recent spirometry mass screening project. A mass screening study by the American Association for Respiratory Care and the COPD Foundation was used to identify the most effective way for general practitioners to implement office spirometry in order to stage COPD. Results: A simple three-step method is described to identify people with a high pre-test probability in an attempt to detect moderate to severe COPD: COPD questionnaire, measurement of peak expiratory flow, and office spirometry. Clinical practice guidelines exist for office spirometry basics for safety, use of electronic peak flow devices, and portable spirometers. Conclusion: Spirometry can be undertaken in primary care offices with acceptable levels of technical expertise. Using office spirometry, primary care physicians can diagnose the presence and severity of COPD. Spirometry can guide therapies for COPD and predict outcomes when used in general practice. PMID:21472091

  10. Use of chest sonography in acute-care radiology☆

    Science.gov (United States)

    De Luca, C.; Valentino, M.; Rimondi, M.R.; Branchini, M.; Baleni, M. Casadio; Barozzi, L.

    2008-01-01

    Diagnosis of acute lung disease is a daily challenge for radiologists working in acute-care areas. It is generally based on the results of chest radiography performed under technically unfavorable conditions. Computed tomography (CT) is undoubtedly more accurate in these cases, but it cannot always be performed on critically ill patients who need continuous care. The use of thoracic ultrasonography (US) has recently been proposed for the study of acute lung disease. It can be carried out rapidly at the bedside and does not require any particularly sophisticated equipment. This report analyzes our experience with chest sonography as a supplement to chest radiography in an Emergency Radiology Unit. We performed chest sonography – as an adjunct to chest radiography – on 168 patients with acute chest pathology. Static and dynamic US signs were analyzed in light of radiographic findings and, when possible, CT. The use of chest US improved the authors' ability to provide confident diagnoses of acute disease of the chest and lungs. PMID:23397048

  11. Quality of radiograph

    International Nuclear Information System (INIS)

    Abdul Nassir Ibrahim; Azali Muhammad; Ab. Razak Hamzah; Abd. Aziz Mohamed; Mohamad Pauzi Ismail

    2008-01-01

    This chapter discussed on how to get a good radiograph. There are several factors that can make good radiograph such as density of radiograph, the contrast of radiograph, definition of radiograph, the present of artifact and backscattering. All of this factor will discuss detailed on each unit of chapter with some figure, picture to make the reader understand more when read this book. And at the end, the reader will introduce with penetrameter, one of device to determine the level of quality of the radiograph. There are two type of penetrameter like wire type or holes type. This standard must be followed by all the