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Sample records for chest radiographic findings

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

    SciTech Connect

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

    1983-04-01

    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 postoperative complications following thoracomoty and open-heart surgery.

  2. Severe adenovirus community-acquired pneumonia in immunocompetent adults: chest radiographic and CT findings

    PubMed Central

    Tan, Dingyu; Fu, Yangyang; Wang, Zhiwei; Cao, Jian; Walline, Joseph; Zhu, Huadong

    2016-01-01

    Background Severe adenovirus pneumonia and its associated imaging features are well-described in immunocompromised patients but are rare and poorly understood in immunocompetent adults. We sought to describe the radiographic and CT findings of severe adenovirus community-acquired pneumonia (CAP) in eight immunocompetent adults. Methods We reviewed systematically chest imaging manifestations of laboratory-confirmed severe adenovirus pneumonia in eight immunocompetent adults from April 2012 to April 2014. Results All patients showed abnormal results on initial chest radiograph and CT, with the exception of one normal initial chest radiograph. The abnormalities of the initial chest radiographs were unilateral (n=4) or bilateral (n=3), including consolidation (n=4), dense patchy opacity (n=3), ground glass opacity (GGO) (n=1), and pleural effusion (n=1). The initial CT findings consisted of unilateral (n=5) and bilateral (n=3) abnormalities, including consolidation (n=8), GGO (n=2), pleural effusion (n=3) and small nodules (n=1). Focal consolidation was the predominant finding in six patients whose initial CT scans were examined within one week after illness onset. Follow-up radiologic findings showed rapid development of bilateral consolidation within ten days after illness onset, usually accompanied by adjacent ground-glass opacity and pleural effusion. The parenchymal abnormalities began to absorb around two weeks after illness onset, with no appearances of fibrosis. Conclusions Severe adenovirus CAP in immunocompetent adults mainly appears as focal consolidation followed by rapid progression to bilateral consolidation, usually accompanied by adjacent GGO and pleural effusion, which may resemble bacterial pneumonia. Adenovirus should be considered in severe pneumonia cases with negative cultures and failure to respond to antibiotics. PMID:27162658

  3. Approach to Pediatric Chest Radiograph.

    PubMed

    Jana, Manisha; Bhalla, Ashu Seith; Gupta, Arun Kumar

    2016-06-01

    Chest radiograph remains the first line imaging modality even today, especially in ICU settings. Hence proper interpretation of chest radiographs is crucial, which can be achieved by adopting a systematic approach and proper description and identification of abnormalities. In this review, the authors describe a short and comprehensive way of interpreting the pediatric chest radiograph. PMID:26983619

  4. Pulmonary scintigraphic findings in children with pectus excavatum by the comparison of chest radiograph indices.

    PubMed

    Kao, C H; Liao, S Q; Wang, S J; Yeh, S H

    1992-11-01

    Pulmonary scintigraphy, including Xe-133 ventilation combined with Tc-99m MAA perfusion scans, was performed in 23 children (3 girls, 20 boys, ages: 2-9 years) with pectus excavatum, and the indices from lateral chest radiography were used for comparison. The findings of pulmonary scintigraphy were analyzed as 1) ventilation fractions (VF), and 2) perfusion fractions (PF) between bilateral lungs; and 3) ventilation-perfusion ratios (V/Q ratio) of both lungs. The results showed that 6 of 23 cases had impaired VF, 11 of 23 cases had impaired PF, and 7 of 23 cases had an impaired V/Q ratio in the right and left lung, respectively. The severity of sternal depression in pectus excavatum was shown as certain indices that were obtained on routine lateral chest radiographs. However, no significant correlations existed between the differences in the fractions and the indices. Our results suggest that pulmonary scintigraphy is not necessary for children with pectus excavatum to predict the severity of sternal depression and pulmonary function, because 1) pulmonary scintigraphy is very difficult to perform in children; 2) unnecessary radiation exposure should be avoided; and 3) it is not well correlated with the severity of the depressed sternum. PMID:1424376

  5. Common errors in evaluating chest radiographs.

    PubMed

    Mann, H

    1990-01-01

    Chest radiographs that are correctly obtained and interpreted provide valuable diagnostic information. However, some radiographs are not taken at total lung capacity, and the appearance of the lungs on film may mimic certain lung disorders. Most common interpretive pitfalls in chest radiography can be avoided by physicians who are familiar with the film appearance of varying degrees of lung inflation, technical limitations of portable radiography, and common chest abnormalities. When further definition is necessary, additional projections should be obtained. Chest fluoroscopy and computed tomography can offer further clarification, if needed. PMID:2296566

  6. Enhancement of chest radiographs using eigenimage processing

    NASA Astrophysics Data System (ADS)

    Bones, Philip J.; Butler, Anthony P. H.; Hurrell, Michael

    2006-08-01

    Frontal chest radiographs ("chest X-rays") are routinely used by medical personnel to assess patients for a wide range of suspected disorders. Often large numbers of images need to be analyzed. Furthermore, at times the images need to analyzed ("reported") when no radiological expert is available. A system which enhances the images in such a way that abnormalities are more obvious is likely to reduce the chance that an abnormality goes unnoticed. The authors previously reported the use of principal components analysis to derive a basis set of eigenimages from a training set made up of images from normal subjects. The work is here extended to investigate how best to emphasize the abnormalities in chest radiographs. Results are also reported for various forms of image normalizing transformations used in performing the eigenimage processing.

  7. 42 CFR 37.3 - Chest radiographs required for miners.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Chest radiographs required for miners. 37.3 Section... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic Examinations § 37.3 Chest radiographs required for miners. (a) Voluntary examinations. Every operator must provide to...

  8. Unsupervised segmentation of lungs from chest radiographs

    NASA Astrophysics Data System (ADS)

    Ghosh, Payel; Antani, Sameer K.; Long, L. Rodney; Thoma, George R.

    2012-03-01

    This paper describes our preliminary investigations for deriving and characterizing coarse-level textural regions present in the lung field on chest radiographs using unsupervised grow-cut (UGC), a cellular automaton based unsupervised segmentation technique. The segmentation has been performed on a publicly available data set of chest radiographs. The algorithm is useful for this application because it automatically converges to a natural segmentation of the image from random seed points using low-level image features such as pixel intensity values and texture features. Our goal is to develop a portable screening system for early detection of lung diseases for use in remote areas in developing countries. This involves developing automated algorithms for screening x-rays as normal/abnormal with a high degree of sensitivity, and identifying lung disease patterns on chest x-rays. Automatically deriving and quantitatively characterizing abnormal regions present in the lung field is the first step toward this goal. Therefore, region-based features such as geometrical and pixel-value measurements were derived from the segmented lung fields. In the future, feature selection and classification will be performed to identify pathological conditions such as pulmonary tuberculosis on chest radiographs. Shape-based features will also be incorporated to account for occlusions of the lung field and by other anatomical structures such as the heart and diaphragm.

  9. Bone suppression technique for chest radiographs

    NASA Astrophysics Data System (ADS)

    Huo, Zhimin; Xu, Fan; Zhang, Jane; Zhao, Hui; Hobbs, Susan K.; Wandtke, John C.; Sykes, Anne-Marie; Paul, Narinder; Foos, David

    2014-03-01

    High-contrast bone structures are a major noise contributor in chest radiographic images. A signal of interest in a chest radiograph could be either partially or completely obscured or "overshadowed" by the highly contrasted bone structures in its surrounding. Thus, removing the bone structures, especially the posterior rib and clavicle structures, is highly desirable to increase the visibility of soft tissue density. We developed an innovative technology that offers a solution to suppress bone structures, including posterior ribs and clavicles, on conventional and portable chest X-ray images. The bone-suppression image processing technology includes five major steps: 1) lung segmentation, 2) rib and clavicle structure detection, 3) rib and clavicle edge detection, 4) rib and clavicle profile estimation, and 5) suppression based on the estimated profiles. The bone-suppression software outputs an image with both the rib and clavicle structures suppressed. The rib suppression performance was evaluated on 491 images. On average, 83.06% (±6.59%) of the rib structures on a standard chest image were suppressed based on the comparison of computer-identified rib areas against hand-drawn rib areas, which is equivalent to about an average of one rib that is still visible on a rib-suppressed image based on a visual assessment. Reader studies were performed to evaluate reader performance in detecting lung nodules and pneumothoraces with and without a bone-suppression companion view. Results from reader studies indicated that the bone-suppression technology significantly improved radiologists' performance in the detection of CT-confirmed possible nodules and pneumothoraces on chest radiographs. The results also showed that radiologists were more confident in making diagnoses regarding the presence or absence of an abnormality after rib-suppressed companion views were presented

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

    PubMed Central

    Schluchter, Mark; Wood, Beverly P.; Berdon, Walter E.; Boechat, M. Ines; Easley, Kirk A.; Meziane, Moulay; Mellins, Robert B.; Norton, Karen I.; Singleton, Edward; Trautwein, Lynn

    2015-01-01

    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. PMID:9361051

  11. 42 CFR 37.3 - Chest radiographs required for miners.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Chest radiographs required for miners. 37.3 Section... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations § 37.3 Chest radiographs required for miners. (a) Voluntary examinations. Every operator...

  12. Segmentation of ribs in digital chest radiographs

    NASA Astrophysics Data System (ADS)

    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.

  13. 42 CFR 37.54 - Notification of abnormal radiographic findings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... section 203 of the Act (see 30 CFR part 90). Positive findings with regard to pneumoconiosis will be... CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic Examinations Specifications for Interpretation, Classification, and Submission of Chest Radiographs §...

  14. Image analysis of chest radiographs. Final report

    SciTech Connect

    Hankinson, J.L.

    1982-06-01

    The report demonstrates the feasibility of using a computer for automated interpretation of chest radiographs for pneumoconiosis. The primary goal of this project was to continue testing and evaluating the prototype system with a larger set of films. After review of the final contract report and a review of the current literature, it was clear that several modifications to the prototype system were needed before the project could continue. These modifications can be divided into two general areas. The first area was in improving the stability of the system and compensating for the diversity of film quality which exists in films obtained in a surveillance program. Since the system was to be tested with a large number of films, it was impractical to be extremely selective of film quality. The second area is in terms of processing time. With a large set of films, total processing time becomes much more significant. An image display was added to the system so that the computer determined lung boundaries could be verified for each film. A film handling system was also added, enabling the system to scan films continuously without attendance.

  15. Computer Analysis Of ILO Standard Chest Radiographs Of Pneumoconiosis

    NASA Astrophysics Data System (ADS)

    Li, C. C.; Shu, David B. C.; Tai, H. T.; Hou, W.; Kunkle, G. A.; Wang, Y.; Hoy, R. J.

    1982-11-01

    This paper presents study of computer analysis of the 1980 ILO standard chest radiographs of pneumoconiosis. Algorithms developed for detection of individual small rounded and irregular opacities have been experimented and evaluated on these standard radiographs. The density, shape, and size distribution of the detected objects in the lung field, in spite of false positives, can be used as indicators for the beginning of pneumoconiosis. This approach is potentially useful in computer-assisted screening and early detection process where the annual chest radiograph of each worker is compared with his (her) own normal radiograph obtained previously.

  16. Radiographic findings in liveborn triploidy.

    PubMed

    Silverthorn, K G; Houston, C S; Newman, D E; Wood, B J

    1989-01-01

    The detailed radiographic features of triploidy, a fatal congenital disorder with 69 chromosomes, have not previously been reported. Radiographs of ten liveborn infants with chromosomally confirmed triploidy showed six findings highly suggestive of this diagnosis: harlequin orbits, small anterior fontanelle, gracile ribs, diaphyseal overtubulation of long bones, upswept clavicles and antimongoloid pelvis. Sixteen other less specific findings showed many similarities to those found in trisomy 18. PMID:2748230

  17. 42 CFR 37.60 - Submitting required chest radiograph classification and miner identification documents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Submitting required chest radiograph classification... OF COAL MINERS Chest Radiographic Examinations Specifications for Interpretation, Classification, and Submission of Chest Radiographs § 37.60 Submitting required chest radiograph classification and...

  18. Radiographic findings of Proteus Syndrome

    PubMed Central

    Gandhi, Nishant Mukesh; Davalos, Eric A.; Varma, Rajeev K.

    2015-01-01

    The extremely rare Proteus Syndrome is a hamartomatous congenital syndrome with substantial variability between clinical patient presentations. The diagnostic criteria consist of a multitude of clinical findings including hemihypertrophy, macrodactyly, epidermal nevi, subcutaneous hamartomatous tumors, and bony abnormalities. These clinical findings correlate with striking radiographic findings. PMID:27186241

  19. Usefulness of chest radiographs in first asthma attacks

    SciTech Connect

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

    1983-08-11

    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.

  20. Enhancement and compression of digital chest radiographs.

    PubMed

    Cohn, M; Trefler, M; Young, T Y

    1990-01-01

    The application of digital technologies to chest radiography holds the promise of routine application of image processing techniques to effect image enhancement. Because of their inherent spatial resolution, however, digital chest images impose severe constraints on data storage devices. Compression of these images will relax such constraints and facilitate image transmission on a digital network. We evaluated an algorithm for enhancing digital chest images that has allowed significant data compression while improving the diagnostic quality of the image. This algorithm is based on the photographic technique of unsharp masking. Image quality was measured with respect to the task of tumor detection and compression ratios as high as 2:1 were achieved. This compression can be supplemented by irreversible methods. PMID:2299708

  1. Eliminating rib shadows in chest radiographic images providing diagnostic assistance.

    PubMed

    Oğul, Hasan; Oğul, B Buket; Ağıldere, A Muhteşem; Bayrak, Tuncay; Sümer, Emre

    2016-04-01

    A major difficulty with chest radiographic analysis is the invisibility of abnormalities caused by the superimposition of normal anatomical structures, such as ribs, over the main tissue to be examined. Suppressing the ribs with no information loss about the original tissue would therefore be helpful during manual identification or computer-aided detection of nodules on a chest radiographic image. In this study, we introduce a two-step algorithm for eliminating rib shadows in chest radiographic images. The algorithm first delineates the ribs using a novel hybrid self-template approach and then suppresses these delineated ribs using an unsupervised regression model that takes into account the change in proximal thickness (depth) of bone in the vertical axis. The performance of the system is evaluated using a benchmark set of real chest radiographic images. The experimental results determine that proposed method for rib delineation can provide higher accuracy than existing methods. The knowledge of rib delineation can remarkably improve the nodule detection performance of a current computer-aided diagnosis (CAD) system. It is also shown that the rib suppression algorithm can increase the nodule visibility by eliminating rib shadows while mostly preserving the nodule intensity. PMID:26775736

  2. 42 CFR 37.4 - Chest radiographic examinations conducted by the Secretary.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Chest radiographic examinations conducted by the... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic Examinations § 37.4 Chest radiographic examinations conducted by the Secretary. (a) The Secretary will...

  3. 42 CFR 37.50 - Interpreting and classifying chest radiographs-film.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Interpreting and classifying chest radiographs-film. 37.50 Section 37.50 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Radiographs § 37.50 Interpreting and classifying chest radiographs—film. (a) Chest radiographs must...

  4. Adult Hirschprung disease: radiographic findings.

    PubMed

    Mindelzun, R E; Hicks, S M

    1986-09-01

    Hirschprung disease is usually diagnosed in infancy. Occasionally patients reach adulthood without diagnosis or treatment. Four cases of adult Hirschprung disease are described. The principal radiographic findings are a markedly dilated, feces-filled colon above the zone of transition; a narrowed rectum; a cone- or funnel-shaped zone of transition; and a mosaic colonic pattern caused by collapsed redundant mucosa after colonic cleansing. In an adult, identification on a barium enema examination of an abrupt, smooth transition zone in the rectum with proximal colonic dilatation, in conjunction with an appropriate clinical history, should suggest the diagnosis of adult Hirschprung disease. PMID:3737900

  5. Reassessing the standard chest radiograph for intraparenchymal activity

    SciTech Connect

    Putman, C.E.; Hoeck, B.

    1986-01-01

    The results concerning the activity or inactivity of the alveolitis determined with our proposed scoring system were comparable to those determined with gallium scanning in 68.2% of the patients with biopsy-proven sarcoidosis in our study. Certainly, further evaluation of a larger series of patients over a longer period of time will be required to more adequately evaluate this classification method. We also believe this methodology is reproducible and can be utilized by experienced interpreters of chest radiographs. If we closely reevaluate the 32% of the cases in which the radiographic results disagreed with the gallium assessment of activity, two points worthy of mention become evident. In one group the gallium indices were borderline for activity whereas in the other group the radiographic criteria were most likely indicative of irreversible parenchymal changes. When the radiographs for the latter group were reevaluated for signs of fibrosis such as volume loss, cystic changes, and alteration in vascular patterns, it was possible to delineate a significant false-positive group of patients. We will be reporting the long-term results of our observations over the next several years as well as adding more groups of patients to our initial study analysis. At that time, correlation with all other measurable parameters in determining high-intensity alveolitis versus low-intensity alveolitis will be compared to these new chest radiographic profiles.

  6. Use of chest radiographs in epidemiological investigations of pneumoconioses.

    PubMed Central

    Mulloy, K B; Coultas, D B; Samet, J M

    1993-01-01

    The International Labour Organisation (ILO) classification of radiographs of pneumoconioses was developed to limit variation in classification of parenchymal abnormalities. In this study the manner in which chest radiographs were interpreted in 134 investigations reported in four peer reviewed journals during the five year period 1985-90 was examined. The approach for applying the ILO system was poorly described in most studies. For example, of 86 investigations using more than one reader, 66.3% described the method of reconciliation, but methods were not consistent among investigations. Our results indicate a number of potential problems in application of the ILO system, and gaps in existing recommendations that should be considered. PMID:8457495

  7. Automatic segmentation of lung fields on chest radiographic images.

    PubMed

    Carreira, M J; Cabello, D; Mosquera, A

    1999-06-01

    In this work we have implemented a system for the automatic segmentation of lung fields in chest radiographic images. The image analysis process is carried out in three levels. In the first one we perform operations on the image that are independent from domain knowledge. This knowledge is implicitly and not very elaborately used in the intermediate level and used in an explicit manner in the high level block, globally corresponding to the idea of progressive segmentation. The representation of knowledge in the high level block is in the form of production rules. The control structure is in general bottom-up but there are certain hybrid control stages, in which the control is driven by the region model (main organs) we are seeking. We have applied the global system to a set of 45 posteroanterior (PA) chest radiographs, obtaining a mean degree of overlap with contours drawn by radiologists of 87%. PMID:10356306

  8. A Computer-Aided Detection System for Digital Chest Radiographs.

    PubMed

    Carrillo-de-Gea, Juan Manuel; García-Mateos, Ginés; Fernández-Alemán, José Luis; Hernández-Hernández, José Luis

    2016-01-01

    Computer-aided detection systems aim at the automatic detection of diseases using different medical imaging modalities. In this paper, a novel approach to detecting normality/pathology in digital chest radiographs is proposed. The problem tackled is complicated since it is not focused on particular diseases but anything that differs from what is considered as normality. First, the areas of interest of the chest are found using template matching on the images. Then, a texture descriptor called local binary patterns (LBP) is computed for those areas. After that, LBP histograms are applied in a classifier algorithm, which produces the final normality/pathology decision. Our experimental results show the feasibility of the proposal, with success rates above 87% in the best cases. Moreover, our technique is able to locate the possible areas of pathology in nonnormal radiographs. Strengths and limitations of the proposed approach are described in the Conclusions. PMID:27372536

  9. 42 CFR 37.50 - Interpreting and classifying chest radiographs-film.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Interpreting and classifying chest radiographs-film. 37.50 Section 37.50 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Interpreting and classifying chest radiographs—film. (a) Chest radiographs must be interpreted and...

  10. Optimum radiographic examination for consideration of compensation awards: I. General methodology and application to chest examination.

    PubMed

    Eisenberg, R L; Hedgcock, M W; Williams, E A; Lyden, B J; Akin, J R; Gooding, G A; Ovenfors, C O

    1980-11-01

    A major goal of the radiologist is to devise methods to decrease health care costs and radiation exposure without sacrificing diagnostic accuracy. In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for chest disease or injury claimed to be service-related. Three separate readings of every chest radiographic assessment could have been made from a single posteroanterior view. In eight cases, granulomas or mild hyperexpansion of the lungs were only appreciated using the lateral projection, but these findings were not clinically significant and did not affect decisions as to whether compensation sould be awarded. The only potentially serious lesion missed (a possible pulmonary nodule) using the posteroanterior view alone was also missed using the lateral and only suggested by the oblique views. Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examination of the chest to a single posteroanterior view would eliminate 150,000 radiographs in the evaluation of 190,000 applicants and yield an annual savings of almost $900,000. PMID:6778148

  11. Spatial resolution and chest nodule detection: an interesting incidental finding

    NASA Astrophysics Data System (ADS)

    Toomey, R. J.; McEntee, M. F.; Ryan, J. T.; Evanoff, M. G.; Hayes, A.; Brennan, P. C.

    2010-02-01

    This study reports an incidental finding from a larger work. It examines the relationship between spatial resolution and nodule detection for chest radiographs. Twelve examining radiologists with the American Board of Radiology read thirty chest radiographs in two conditions - full (1500 × 1500 pixel) resolution, and 300 × 300 pixel resolution linearly interpolated to 1500 × 1500 pixels. All images were surrounded by a 10-pixel sharp grey border to aid in focussing the observer's eye when viewing the comparatively unsharp interpolated images. Fifteen of the images contained a single simulated pulmonary nodule. Observers were asked to rate their confidence that a nodule was present on each radiograph on a scale of 1 (least confidence, certain no lesion is present) to 6 (most confidence, certain a lesion was present). All other abnormalities were to be ignored. No windowing, levelling or magnification of the images was permitted and viewing distance was constrained to approximately 70cm. Images were displayed on a 3 megapixel greyscale monitor. Receiver operating characteristic (ROC) analysis was applied to the results of the readings using the Dorfman-Berbaum-Metz multiplereader, multiple-case method. No statistically significant differences were found with either readers and cases treated as random or with cases treated as fixed. Low spatial frequency information appears to be sufficient for the detection of chest lesion of the type used in this study.

  12. Paratracheal lymphadenopathy: radiographic findings and correlation with CT

    SciTech Connect

    Mueler, N.L.; Webb, W.R.; Gamsu, G.

    1985-09-01

    Possible signs of paratracheal lymphadenopathy on the posteroanterior (PA) chest radiograph were assessed in 98 patients and correlated with computed tomography (CT). The nodes were normal is size in 62 patients and enlarged in 36. While the lateral contour of the superior vena cava (SVC) was convex in 46 patients (47%), 81 (83%) had an increased density in the region of the SVC. When all four parameters were combined, lymphadenopathy could be detected on the PA view in 87 patients (89%). CT demonstrated that the enlarged nodes were anterolateral rather than directly lateral to the trachea and also immediately posterior to the SVC, explaining the findings on the PA radiograph.

  13. Digital replication of chest radiographs without altering diagnostic observer performance

    NASA Astrophysics Data System (ADS)

    Flynn, Michael J.; Davies, Eric; Spizarny, David; Beute, Gordon H.; Peterson, Edward; Eyler, William R.; Gross, Barry; Chen, Ji

    1991-05-01

    A study to test the ability of a high-fidelity system to digitize chest radiographs, store the data in a computer, and reprint the film without altering diagnostic observer performance is reported. Two hundred and fifty-two (252) chest films with subtle image features indicative of interstitial disease, pulmonary nodule, or pneumothorax, along with 36 normal chest films were used in the study. Films were selected from a key word search on a computerized report archive and were graded by two experienced radiologists. Each film was digitized with 86 micron pixels and stored in 4000 X 5000 arrays using a research instrument. Replicates were printed using a commercial laser film printer (Eastman Kodak Company) having 80 micron pixels. Originals and replicates were observed separately by two different experienced radiologists. Each indicated a graded response for the three possible pathologies. The agreement of observers between responses for replicates and originals was described by the kappa statistic and compared to the agreement when rereading the original film. The final result of this study supports a hypothesis that the replicate is indistinguishable from the original.

  14. Organizing pneumonia: chest HRCT findings*

    PubMed Central

    Faria, Igor Murad; Zanetti, Gláucia; Barreto, Miriam Menna; Rodrigues, Rosana Souza; Araujo-Neto, Cesar Augusto; Silva, Jorge Luiz Pereira e; Escuissato, Dante Luiz; Souza, Arthur Soares; Irion, Klaus Loureiro; Mançano, Alexandre Dias; Nobre, Luiz Felipe; Hochhegger, Bruno; Marchiori, Edson

    2015-01-01

    OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parenchyma of patients with organizing pneumonia. METHODS: This was a retrospective review of the HRCT scans of 36 adult patients (26 females and 10 males) with biopsy-proven organizing pneumonia. The patients were between 19 and 82 years of age (mean age, 56.2 years). The HRCT images were evaluated by two independent observers, discordant interpretations being resolved by consensus. RESULTS: The most common HRCT finding was that of ground-glass opacities, which were seen in 88.9% of the cases. The second most common finding was consolidation (in 83.3% of cases), followed by peribronchovascular opacities (in 52.8%), reticulation (in 38.9%), bronchiectasis (in 33.3%), interstitial nodules (in 27.8%), interlobular septal thickening (in 27.8%), perilobular pattern (in 22.2%), the reversed halo sign (in 16.7%), airspace nodules (in 11.1%), and the halo sign (in 8.3%). The lesions were predominantly bilateral, the middle and lower lung fields being the areas most commonly affected. CONCLUSIONS: Ground-glass opacities and consolidation were the most common findings, with a predominantly random distribution, although they were more common in the middle and lower thirds of the lungs. PMID:26176521

  15. 42 CFR 37.51 - Interpreting and classifying chest radiographs-digital radiography systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Interpreting and classifying chest radiographs-digital radiography systems. 37.51 Section 37.51 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic...

  16. Radiographic findings in congenital lead poisoning

    SciTech Connect

    Pearl, M.; Boxt, L.M.

    1980-07-01

    Because lead crosses the placenta throughout pregnancy, the fetus is at risk for lead poisoning. A full term, asymptomatic child was born with congenital lead poisoning secondary to maternal pica. Radiographic findings of a dense cranial vault, lead lines, and delayed skeletal and deciduous dental development were noted at birth. After chelation therapy, when the patient was seven months old, radiographs revealed normal skeletal maturation. Tooth eruption did not occur until 15 months of age. Newborn infants with these radiographic findings should be screened for subclinical, congenital lead poisoning.

  17. Semi-automated location identification of catheters in digital chest radiographs

    NASA Astrophysics Data System (ADS)

    Keller, Brad M.; Reeves, Anthony P.; Cham, Matthew D.; Henschke, Claudia I.; Yankelevitz, David F.

    2007-03-01

    Localization of catheter tips is the most common task in intensive care unit imaging. In this work, catheters appearing in digital chest radiographs acquired by portable chest x-rays were tracked using a semi-automatic method. Due to the fact that catheters are synthetic objects, its profile does not vary drastically over its length. Therefore, we use forward looking registration with normalized cross-correlation in order to take advantage of a priori information of the catheter profile. The registration is accomplished with a two-dimensional template representative of the catheter to be tracked generated using two seed points given by the user. To validate catheter tracking with this method, we look at two metrics: accuracy and precision. The algorithms results are compared to a ground truth established by catheter midlines marked by expert radiologists. Using 12 objects of interest comprised of naso-gastric, endo-tracheal tubes, and chest tubes, and PICC and central venous catheters, we find that our algorithm can fully track 75% of the objects of interest, with a average tracking accuracy and precision of 85.0%, 93.6% respectively using the above metrics. Such a technique would be useful for physicians wishing to verify the positioning of catheter tips using chest radiographs.

  18. Fully automated scoring of chest radiographs in cystic fibrosis.

    PubMed

    Lee, Min-Zhao; Cai, Weidong; Song, Yang; Selvadurai, Hiran; Feng, David Dagan

    2013-01-01

    We present a prototype of a fully automated scoring system for chest radiographs (CXRs) in cystic fibrosis. The system was used to analyze real, clinical CXR data, to estimate the Shwachman-Kulczycki score for the image. Images were resampled and normalized to a standard size and intensity level, then segmented with a patch-based nearest-neighbor mapping algorithm. Texture features were calculated regionally and globally, using Tamura features, local binary patterns (LBP), gray-level co-occurrence matrix and Gabor filtering. Feature selection was guided by current understanding of the disease process, in particular the reorganization and thickening of airways. Combinations of these features were used as inputs for support vector machine (SVM) learning to classify each CXR, and evaluated using two-fold cross-validation for agreement with clinician scoring. The final computed score for each image was compared with the score assigned by a physician. Using this prototype system, we analyzed 139 CXRs from an Australian pediatric cystic fibrosis registry, for which texture directionality showed greatest discriminating power. Computed scores agreed with clinician scores in 75% of cases, and up to 90% of cases in discriminating severe disease from mild disease, similar to the level of human interobserver agreement for this dataset. PMID:24110600

  19. System for pathology categorization and retrieval in chest radiographs

    NASA Astrophysics Data System (ADS)

    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.

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

    NASA Astrophysics Data System (ADS)

    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).

  1. On your toes: Detecting mediastinal air on the chest radiograph in ecstasy abusers.

    PubMed

    Naidoo, Mergan; Govind, Mayuri

    2016-01-01

    Abnormal mediastinal air may be caused by inhalational illicit drug use subsequent to barotrauma resulting from coughing after deep inhalation and breath holding. It may also arise from oesophageal rupture due to retching after ingestion of the illicit drug. The history can alert the practitioner to this cause of chest pain. As chest radiographs are widely accessible and mediastinal air is easily recognisable, the chest radiograph should be included and carefully scrutinised in the diagnostic workup of chest pain in the recreational drug abuser. It is prudent to exclude oesophageal rupture, particularly in the setting of retching, before deciding on conservative and expectant management. PMID:27138662

  2. [Chest radiograph of atypical pneumonia: comparison among Chlamydia pneumoniae. Pneumonia, ornithosis, and Mycoplasma pneumoniae pneumonia].

    PubMed

    Itoh, I; Ishida, T; Hashimoto, T; Arita, M; Osawa, M; Tachibana, H; Nishiyama, H; Takakura, S; Bando, K; Nishizawa, Y; Amitani, R; Onishi, H; Taguchi, Y

    2000-11-01

    No report has been found comparing Chlamydia pneumoniae (C. pneumoniae) pneumonia radiographically with other atypical pneumonias, Chlamydia psittaci (C. psittaci) pneumonia and Mycoplasma pneumoniae (M. pneumoniae) pneumonia. We described the chest radiographs of three kinds of pneumonia cases: 46 cases of C. pneumoniae pneumonia, 39 cases of C. psittaci pneumonia, and 131 cases of M. pneumoniae pneumonia. Radiographic shadows were categorized into main shadows and sub-shadows. The main shadows are classified from the viewpoint of the characteristics; air space consolidation(AS), ground-glass opacity(GG), reticular shadow(RS), bronchopneumonia(BP), and small nodular shadows (SN). The size, the site, and the number of the main shadows were also analyzed. In comparison among the three pneumonias, BP was the most frequent in M. pneumoniae pneumonia (0.40/case). AS predominated in C. pneumoniae pneumonia (0.67/case), and GG in C. psittaci pneumonia (0.62/case). The number of main shadows was equal, about 1.4/case in three pneumonias. Large shadows were less frequent in M. pneumoniae pneumonia than C. pneumoniae pneumonia (p = 0.02) and C. psittaci pneumonia (p = 0.01). Main shadows were more frequent in the outer zone in M. pneumoniae pneumonia than C. psittaci pneumonia (p = 0.01), and in the middle zone in C. psittaci pneumonia than in M. pneumoniae pneumonia (p = 0.02). Cases with bilateral main shadows were less common in M. pneumoniae pneumonia (9%) than C. pneumoniae pneumonia(33%, p = 0.001) and C. psittaci pneumonia(30%, p = 0.005). Thickening of bronchovascular bundles as a sub-shadow was most frequently noted in M. pneumoniae pneumonia. Some differences among the three atypical pneumonias were seen in the chest radiograph. However, no specific findings of C. pneumoniae pneumonia were shown radiographically in this study. PMID:11140079

  3. Chest Radiographic Patterns and the Transmission of Tuberculosis: Implications for Automated Systems

    PubMed Central

    Lau, Angela; Barrie, James; Winter, Christopher; Elamy, Abdel-Halim; Tyrrell, Gregory; Long, Richard

    2016-01-01

    Background Computer-aided detection to identify and diagnose pulmonary tuberculosis is being explored. While both cavitation on chest radiograph and smear-positivity on microscopy are independent risk factors for the infectiousness of pulmonary tuberculosis it is unknown which radiographic pattern, were it detectable, would provide the greatest public health benefit; i.e. reduced transmission. Herein we provide that evidence. Objectives 1) to determine whether pulmonary tuberculosis in a high income, low incidence country is more likely to present with “typical” adult-type pulmonary tuberculosis radiographic features and 2) to determine whether those with “typical” radiographic features are more likely than those without such features to transmit the organism and/or cause secondary cases. Methods Over a three-year period beginning January 1, 2006 consecutive adults with smear-positive pulmonary tuberculosis in the Province of Alberta, Canada, were identified and their pre-treatment radiographs scored by three independent readers as “typical” (having an upper lung zone predominant infiltrate, with or without cavitation but no discernable adenopathy) or “atypical” (all others). Each patient’s pre-treatment bacillary burden was carefully documented and, during a 30-month transmission window, each patient’s transmission events were recorded. Mycobacteriology, radiology and transmission were compared in those with “typical” versus “atypical” radiographs. Findings A total of 97 smear-positive pulmonary tuberculosis cases were identified, 69 (71.1%) with and 28 (28.9%) without “typical” chest radiographs. “Typical” cases were more likely to have high bacillary burdens and cavitation (Odds Ratios and 95% Confidence Intervals: 2.75 [1.04–7.31] and 9.10 [2.51–32.94], respectively). Typical cases were also responsible for most transmission events—78% of tuberculin skin test conversions (p<0.002) and 95% of secondary cases in reported

  4. Paratracheal lymphadenopathy: radiographic findings and correlation with CT.

    PubMed

    Müller, N L; Webb, W R; Gamsu, G

    1985-09-01

    Possible signs of paratracheal lymphadenopathy on the posteroanterior (PA) chest radiograph were assessed in 98 patients and correlated with computed tomography (CT). The nodes were normal in size in 62 patients and enlarged (greater than 15 mm) in 36. Among the latter group, widening of the right paratracheal stripe was seen in 11 (31%) and enlargement of the azygos node in 15 (42%). While the lateral contour of the superior vena cava (SVC) was convex in 46 patients (47%), 81 (83%) had an increased density in the region of the SVC. When all four parameters were combined, lymphadenopathy could be detected on the PA view in 87 patients (89%). CT demonstrated that the enlarged nodes were anterolateral rather than directly lateral to the trachea and also immediately posterior to the SVC, explaining the findings on the PA radiograph. PMID:4023240

  5. 42 CFR 37.51 - Interpreting and classifying chest radiographs-digital radiography systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... standard digital chest radiographic images provided for use with the Guidelines for the Use of the ILO... NIOSH-approved standard digital images may be used for classifying digital chest images for pneumoconiosis. Modification of the appearance of the standard images using software tools is not permitted....

  6. Automated localization of costophrenic recesses and costophrenic angle measurement on frontal chest radiographs

    NASA Astrophysics Data System (ADS)

    Maduskar, Pragnya; Hogeweg, Laurens; Philipsen, Rick; van Ginneken, Bram

    2013-03-01

    Computer aided detection (CAD) of tuberculosis (TB) on chest radiographs (CXR) is difficult because the disease has varied manifestations, like opacification, hilar elevation, and pleural effusions. We have developed a CAD research prototype for TB (CAD4TB v1.08, Diagnostic Image Analysis Group, Nijmegen, The Netherlands) which is trained to detect textural abnormalities inside unobscured lung fields. If the only abnormality visible on a CXR would be a blunt costophrenic angle, caused by pleural fluid in the costophrenic recess, this is likely to be missed by texture analysis in the lung fields. The goal of this work is therefore to detect the presence of blunt costophrenic (CP) angles caused by pleural effusion on chest radiographs. The CP angle is the angle formed by the hemidiaphragm and the chest wall. We define the intersection point of both as the CP angle point. We first detect the CP angle point automatically from a lung field segmentation by finding the foreground pixel of each lung with maximum y location. Patches are extracted around the CP angle point and boundary tracing is performed to detect 10 consecutive pixels along the hemidiaphragm and the chest wall and derive the CP angle from these. We evaluate the method on a data set of 250 normal CXRs, 200 CXRs with only one or two blunt CP angles and 200 CXRs with one or two blunt CP angles but also other abnormalities. For these three groups, the CP angle location and angle measurements were accurate in 91%, 88%, and 92% of all the cases, respectively. The average CP angles for the three groups are indeed different with 71.6° +/- 22.9, 87.5° +/- 25.7, and 87.7° +/- 25.3, respectively.

  7. Simulating nodules in chest radiographs with real nodules from multi-slice CT images

    NASA Astrophysics Data System (ADS)

    Schilham, Arnold; van Ginneken, Bram

    2006-03-01

    To improve the detection of nodules in chest radiographs, large databases of chest radiographs with annotated, proven nodules are needed for training of both radiologists and computer-aided detection systems. The construction of such databases is a laborious and time-consuming task. This study presents a novel technique to produce large amounts of chest x-rays with annotated, simulated nodules. Realistic nodules in radiographs are generated using real nodules segmented from CT images. Results from an observer study indicate that the simulated nodules can not be distinguished from real nodules. This method has great potential to aid the development of automated detection systems and to generate teaching files for human observers.

  8. The futility of universal pre-employment chest radiographs.

    PubMed Central

    Lohiya, Ghan-Shyam; Tan-Figueroa, Lilia; Lohiya, Piyush; Bui, De

    2006-01-01

    In a developmental center, a preemployment chest x-ray was required for all job applicants. We scrutinized the pros and cons of this practice through a review of the medical literature and our experience, and discussion with our colleagues. We concluded that such chest x-ray caused unwarranted radiation exposure, did not produce compliance with the tuberculosis laws, gave a false sense of security regarding workers' compensation risk management, was contrary to established occupational medicine practice guidelines, and was unnecessary and wasteful. We discontinued such chest x-rays. The purpose of the pre-employment examination should remain narrowly job related. Even long-established procedures require periodic utilization review. PMID:17225852

  9. Histiocytic disorders of the chest: imaging findings.

    PubMed

    Ahuja, Jitesh; Kanne, Jeffrey P; Meyer, Cristopher A; Pipavath, Sudhakar N J; Schmidt, Rodney A; Swanson, Jonathan O; Godwin, J David

    2015-01-01

    Histiocytic disorders of the chest comprise a broad spectrum of diseases. The lungs may be involved in isolation or as part of systemic disease. Some of these disorders are primary and have unknown etiology, and others result from a histiocytic response to a known cause. Among primary histiocytic disorders, pulmonary Langerhans cell histiocytosis (PLCH) is the most common; others include Erdheim-Chester disease and Rosai-Dorfman disease. Adult PLCH occurs almost exclusively in adults aged 20-40 years who smoke. Pediatric PLCH is extremely rare and typically occurs as part of multisystemic disease. Erdheim-Chester disease affects middle-aged and older adults; thoracic involvement usually occurs as part of systemic disease. Rosai-Dorfman disease affects children and young adults and manifests as painless cervical lymphadenopathy. Examples of secondary histiocytic disorders are storage diseases such as Gaucher disease, Niemann-Pick disease, and Fabry disease; pneumoconiosis such as silicosis and coal workers' pneumoconiosis; and infections such as Whipple disease and malakoplakia. These disorders are characterized at histopathologic examination on the basis of infiltration of alveoli or the pulmonary interstitium by histiocytes, which are a group of cells that includes macrophages and dendritic cells. Dendritic cells are a heterogeneous group of nonphagocytic antigen-presenting immune cells. Immunohistochemical markers help to distinguish among various primary histiocytic disorders. Characteristic radiologic findings in the appropriate clinical context may obviate biopsy to establish a correct diagnosis. However, in the absence of these findings, integration of clinical, pathologic, and radiologic features is required to establish a diagnosis. PMID:25763722

  10. Effect of morphing between unenhanced and multiscale enhanced chest radiographs on pulmonary nodule detection

    NASA Astrophysics Data System (ADS)

    Pietrzyk, Mariusz W.; Zöhrer, Fabian; Harz, Markus T.; McEntee, Mark; Hahn, Horst K.; Haygood, Tamara; Evanoff, Michael G.; Brennan, Patrick C.

    2012-02-01

    Aim: This study aims to determine the effectiveness of a novel image-processing algorithm for multi-scale enhancement of chest radiographs to improve detection and localization of real pulmonary nodules. Background: Our wavelet-based enhancement method interactively adjusts the contrast of medical images extracting the spatial frequency components at different scales, followed by a weighting procedure. This study aims to explore the usefulness of this novel procedure for chest image reporting. Method: Sixteen radiologists viewed 50 PA chest radiographs in order to localize pulmonary nodules. The databank contains 25 normal and 25 abnormal images, with multi-nodule cases. Subjects were allowed to mark unlimited number of locations followed by ranking confidence of nodule presence according to a 5-level scale. Subjects viewed all cases at least in two out of three conditions: unprocessed, enhanced and with morphing between these two. MCMR ROC and JAFROC analyses were conducted. Results: No significant differences were found in ROC AUC values across modalities and specialities. Only localization performance with morphing tool is significantly higher (F(1,8)=13.303, p=0.007) for chest expert (JAFROC FOM=0.6355) from non-chest (JAFROC FOM=0.4675) radiologists. Conclusion: Radiologists specialized in chest image interpretation performed consistently well in localizing pulmonary nodules, whereas non-chest radiologists were suffer from distracting effect of morphing tool.

  11. Enhancement of chest radiographs obtained in the intensive care unit through bone suppression and consistent processing

    NASA Astrophysics Data System (ADS)

    Chen, Sheng; Zhong, Sikai; Yao, Liping; Shang, Yanfeng; Suzuki, Kenji

    2016-03-01

    Portable chest radiographs (CXRs) are commonly used in the intensive care unit (ICU) to detect subtle pathological changes. However, exposure settings or patient and apparatus positioning deteriorate image quality in the ICU. Chest x-rays of patients in the ICU are often hazy and show low contrast and increased noise. To aid clinicians in detecting subtle pathological changes, we proposed a consistent processing and bone structure suppression method to decrease variations in image appearance and improve the diagnostic quality of images. We applied a region of interest-based look-up table to process original ICU CXRs such that they appeared consistent with each other and the standard CXRs. Then, an artificial neural network was trained by standard CXRs and the corresponding dual-energy bone images for the generation of a bone image. Once the neural network was trained, the real dual-energy image was no longer necessary, and the trained neural network was applied to the consistent processed ICU CXR to output the bone image. Finally, a gray level-based morphological method was applied to enhance the bone image by smoothing other structures on this image. This enhanced image was subtracted from the consistent, processed ICU CXR to produce a soft tissue image. This method was tested for 20 patients with a total of 87 CXRs. The findings indicated that our method suppressed bone structures on ICU CXRs and standard CXRs, simultaneously maintaining subtle pathological changes.

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

    NASA Astrophysics Data System (ADS)

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

    2012-03-01

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... of Workers' Compensation Programs 20 CFR Parts 718 and 725 RIN 1240-AA07 Black Lung Benefits Act: Standards for Chest Radiographs AGENCY: Office of Workers' Compensation Programs, Labor. ACTION: Direct final rule; withdrawal. SUMMARY: The Office of Workers' Compensation Programs (OWCP) published a...

  14. Computerized method for detection of vertebral fractures on lateral chest radiographs based on morphometric data

    NASA Astrophysics Data System (ADS)

    Kasai, Satoshi; Li, Feng; Shiraishi, Junji; Li, Qiang; Straus, Christopher; Vokes, Tamara; MacMahon, Heber; Doi, Kunio

    2007-03-01

    Vertebral fractures are the most common osteoporosis-related fractures. It is important to detect vertebral fractures, because they are associated with increased risk of subsequent fractures, and because pharmacologic therapy can reduce the risk of subsequent fractures. Although vertebral fractures are often not clinically recognized, they can be visualized on lateral chest radiographs taken for other purposes. However, only 15-60% of vertebral fractures found on lateral chest radiographs are mentioned in radiology reports. The purpose of this study was to develop a computerized method for detection of vertebral fractures on lateral chest radiographs in order to assist radiologists' image interpretation. Our computerized method is based on the automated identification of upper and lower vertebral edges. In order to develop the scheme, radiologists provided morphometric data for each identifiable vertebra, which consisted of six points for each vertebra, for 25 normals and 20 cases with severe fractures. Anatomical information was obtained from morphometric data of normal cases in terms of vertebral heights, heights of vertebral disk spaces, and vertebral centerline. Computerized detection of vertebral fractures was based on the reduction in the heights of fractured vertebrae compared to adjacent vertebrae and normal reference data. Vertebral heights from morphometric data on normal cases were used as reference. On 138 chest radiographs (20 with fractures) the sensitivity of our method for detection of fracture cases was 95% (19/20) with 0.93 (110/118) false-positives per image. In conclusion, the computerized method would be useful for detection of potentially overlooked vertebral fractures on lateral chest radiographs.

  15. Multi-scale Morphological Image Enhancement of Chest Radiographs by a Hybrid Scheme.

    PubMed

    Alavijeh, Fatemeh Shahsavari; Mahdavi-Nasab, Homayoun

    2015-01-01

    Chest radiography is a common diagnostic imaging test, which contains an enormous amount of information about a patient. However, its interpretation is highly challenging. The accuracy of the diagnostic process is greatly influenced by image processing algorithms; hence enhancement of the images is indispensable in order to improve visibility of the details. This paper aims at improving radiograph parameters such as contrast, sharpness, noise level, and brightness to enhance chest radiographs, making use of a triangulation method. Here, contrast limited adaptive histogram equalization technique and noise suppression are simultaneously performed in wavelet domain in a new scheme, followed by morphological top-hat and bottom-hat filtering. A unique implementation of morphological filters allows for adjustment of the image brightness and significant enhancement of the contrast. The proposed method is tested on chest radiographs from Japanese Society of Radiological Technology database. The results are compared with conventional enhancement techniques such as histogram equalization, contrast limited adaptive histogram equalization, Retinex, and some recently proposed methods to show its strengths. The experimental results reveal that the proposed method can remarkably improve the image contrast while keeping the sensitive chest tissue information so that radiologists might have a more precise interpretation. PMID:25709942

  16. Multi-scale Morphological Image Enhancement of Chest Radiographs by a Hybrid Scheme

    PubMed Central

    Alavijeh, Fatemeh Shahsavari; Mahdavi-Nasab, Homayoun

    2015-01-01

    Chest radiography is a common diagnostic imaging test, which contains an enormous amount of information about a patient. However, its interpretation is highly challenging. The accuracy of the diagnostic process is greatly influenced by image processing algorithms; hence enhancement of the images is indispensable in order to improve visibility of the details. This paper aims at improving radiograph parameters such as contrast, sharpness, noise level, and brightness to enhance chest radiographs, making use of a triangulation method. Here, contrast limited adaptive histogram equalization technique and noise suppression are simultaneously performed in wavelet domain in a new scheme, followed by morphological top-hat and bottom-hat filtering. A unique implementation of morphological filters allows for adjustment of the image brightness and significant enhancement of the contrast. The proposed method is tested on chest radiographs from Japanese Society of Radiological Technology database. The results are compared with conventional enhancement techniques such as histogram equalization, contrast limited adaptive histogram equalization, Retinex, and some recently proposed methods to show its strengths. The experimental results reveal that the proposed method can remarkably improve the image contrast while keeping the sensitive chest tissue information so that radiologists might have a more precise interpretation. PMID:25709942

  17. Development of computerized method for detection of vertebral fractures on lateral chest radiographs

    NASA Astrophysics Data System (ADS)

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

    2006-03-01

    Osteoporosis is one of the major public health concerns in the world. Several clinical trials indicated clearly that pharmacologic therapy for osteoporosis is effective for persons with vertebral fractures for preventing subsequent fractures. It is, therefore, important to diagnose vertebral fractures early. Although most vertebral fractures are asymptomatic, they can often be detected on lateral chest radiographs which may be obtained for other purposes. However, investigators have reported that vertebral fractures which were visible on lateral chest radiographs were underdiagnosed or underreported. Therefore, our purpose in this study was to develop a computerized method for detection of vertebral fractures on lateral chest radiographs and to assist radiologists' image interpretation. Our computerized scheme is based on the detection of upper and lower edges of vertebrae on lateral chest images. A curved rectangular area which included a number of visible vertebrae was identified. This area was then straightened such that the upper and lower edges of the vertebrae were oriented horizontally. For detection of vertebral edges, line components were enhanced, and a multiple thresholding technique followed by image feature analysis was applied to the line enhanced image. Finally, vertebral heights determined from the detected vertebral edges were used for characterizing the shape of the vertebrae and for distinguishing fractured from normal vertebrae. Our preliminary results indicated that all of the severely fractured vertebrae in a small database were detected correctly by our computerized method.

  18. Zone-based analysis for automated detection of abnormalities in chest radiographs

    SciTech Connect

    Kao, E-Fong; Kuo, Yu-Ting; Hsu, Jui-Sheng; Chou, Ming-Chung; Liu, Gin-Chung

    2011-07-15

    Purpose: The aim of this study was to develop an automated method for detection of local texture-based and density-based abnormalities in chest radiographs. Methods: The method was based on profile analysis to detect abnormalities in chest radiographs. In the method, one density-based feature, Density Symmetry Index, and two texture-based features, Roughness Maximum Index and Roughness Symmetry Index, were used to detect abnormalities in the lung fields. In each chest radiograph, the lung fields were divided into four zones initially and then the method was applied to each zone separately. For each zone, Density Symmetry Index was obtained from the projection profile of each zone, and Roughness Maximum Index and Roughness Symmetry Index were obtained by measuring the roughness of the horizontal profiles via moving average technique. Linear discriminant analysis was used to classify normal and abnormal cases based on the three indices. The discriminant performance of the method was evaluated using ROC analysis. Results: The method was evaluated on a database of 250 normal and 250 abnormal chest images. In the optimized conditions, the zone-based performance Az of the method for zones 1, 2, 3, and 4 were 0.917, 0.897, 0.892, and 0.814, respectively, and the case-based performance Az of the method was 0.842. Our previous method for detection of gross abnormalities was also evaluated on the same database. The case-based performance of our previous method was 0.689. Conclusions: In comparing the previous method and the new method proposed in this study, there was a great improvement by the new method for detection of local texture-based and density-based abnormalities. The new method combined with the previous one has potential for screening abnormalities in chest radiographs.

  19. Hierarchical Markov random-field modeling for texture classification in chest radiographs

    NASA Astrophysics Data System (ADS)

    Vargas-Voracek, Rene; Floyd, Carey E., Jr.; Nolte, Loren W.; McAdams, Page

    1996-04-01

    A hierarchical Markov random field (MRF) modeling approach is presented for the classification of textures in selected regions of interest (ROIs) of chest radiographs. The procedure integrates possible texture classes and their spatial definition with other components present in an image such as noise and background trend. Classification is performed as a maximum a-posteriori (MAP) estimation of texture class and involves an iterative Gibbs- sampling technique. Two cases are studied: classification of lung parenchyma versus bone and classification of normal lung parenchyma versus miliary tuberculosis (MTB). Accurate classification was obtained for all examined cases showing the potential of the proposed modeling approach for texture analysis of radiographic images.

  20. Follow-up chest radiographs in Vietnam veterans: are they useful?

    PubMed

    Pollei, S; Mettler, F A; Kelsey, C A; Walters, M R; White, R E

    1986-10-01

    Agent Orange exposure and its long-term health consequences on Vietnam veterans have been widely discussed in the past few years. Myriad physical and mental disabilities have been studied with regard to exposure to various herbicides. The number of persons potentially exposed is large, since 2.4-2.8 million U.S. military personnel served in Vietnam. A case-control study was undertaken to determine if persons who served in the U.S. military in Vietnam have either cardiovascular or pulmonary effects that can be demonstrated on long-term follow-up chest radiographs. Information regarding military service in Vietnam was obtained from interviews and, in some cases, review of military records. Vietnam veterans did not have an increased prevalence of abnormalities on follow-up chest radiographs. A subset of Vietnam veterans who had greater estimated opportunities for Agent Orange exposure also did not appear to be at greater risk than the control population. PMID:3763850

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

    PubMed Central

    Castro, Denise A; Naqvi, Asad A; Manson, David; Flavin, Michael P; VanDenKerkhof, Elizabeth; Soboleski, Donald

    2015-01-01

    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 to improve

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

    PubMed Central

    Lanzman, Rotem S.; Winter, Joachim; Blondin, Dirk; Fürst, Günter; Scherer, Axel; Miese, Falk R; 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. PMID:21927563

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

    SciTech Connect

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

    2013-07-15

    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{sub 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.

  4. The usefulness of computed tomography in detecting asbestos-related pleural abnormalities in people who had indeterminate chest radiographs: the Libby, MT, experience.

    PubMed

    Muravov, Oleg I; Kaye, Wendy E; Lewin, Michael; Berkowitz, Zahava; Lybarger, Jeffrey A; Campolucci, Sharon S; Parker, John E

    2005-01-01

    This epidemiological study was conducted to determine whether high-resolution computed tomography (HRCT) is useful to screen for pulmonary abnormalities in people exposed to vermiculite containing asbestos. During June-September 2001, we evaluated HRCT of 353 people in Libby, MT, who had been exposed to asbestiform minerals associated with vermiculite. Of these, 334 participants of the summer 2000 medical testing program underwent HRCT of the chest at St. John's Lutheran Hospital and 19 eligible people who recently had undergone an HRCT scan at the same facility and under the same testing protocol allowed the study reviewers to use that scan. All 353 study participants were former vermiculite mine/mill workers (n = 55), their household contacts (n = 99), and people exposed to vermiculite through recreational or other activities (n = 199). Participants' 2000 medical testing results indicated only one of the three B-reader chest radiograph reviewers had reported a pleural abnormality (indeterminate chest radiograph). Three expert computer tomography (CT) scan evaluators reviewed the HRCT scans and identified pleural abnormalities in 98 (27.8%) of the 353 participants whose previous chest radiographs were classified indeterminate. Of these 98 people, 69 (70.4%) were either former vermiculite mine/mill workers or household contacts, and 40 (40.8%) showed pleural calcification on HRCT. Thirty out of the 40 people with pleural calcification reported having no occupational exposure to either Libby vermiculite or asbestos. Our findings indicate that low-dose HRCT can be considered for screening certain former vermiculite mine/mill workers and their household contacts who have indeterminate chest radiographs and may be useful for diagnosing a suspicious finding on a chest radiograph, particularly in a high-risk person. PMID:15881982

  5. Postprocedural chest radiograph: Impact on the management in critical care unit.

    PubMed

    Gupta, Prashant K; Gupta, Kumkum; Jain, Manish; Garg, Tanuj

    2014-01-01

    Postprocedural chest radiograph is done to illustrate the position of endotracheal tubes (ETTs), nasogastric and drainage tubes, indwelling catheters, and intravascular lines or any other lifesaving devices to confirm their position. These devices are intended to save life, but may be life-threatening if in the wrong place. The incidence of malposition and complications ranges from 3% to 14%, respectively. The portable chest radiograph is of tremendous value, inexpensive and can be obtained quickly at the patient's bedside in any location of the hospital. A systemic literature search was performed in PubMed and the Cochranre library by setting up the search using either single text word or combinations. Those studies were also included where the chest radiograph was compared with other imaging modalities. Its clinical efficacy, cost-effectiveness and practicality allow anesthesiologist to evaluate the post-procedural position and complications of ETT, indwelling catheters, and multi lumen intravascular lines. Knowledge of the radiological features of commonly used devices is of utmost importance. PMID:25886216

  6. Interobserver variation in the chest radiograph component of the lung injury score.

    PubMed

    Beards, S C; Jackson, A; Hunt, L; Wood, A; Frerk, C M; Brear, G; Edwards, J D; Nightingale, P

    1995-11-01

    The lung injury score is a semi-quantitative system used in the definition and grading of the acute respiratory distress syndrome. It is composed of two, three or four equally weighted components. One component is derived from the chest radiograph, which may contribute up to 50% of the total score. A score of 1 is awarded for each quadrant on the chest radiograph which contains alveolar consolidation. We examined the interobserver variation between two anaesthetists, two radiologists and two critical care physicians who scored blindly 100 chest radiographs from patients with adult respiratory distress syndrome. There was very good agreement between the two radiologists in the total scores (kappa 0.97) and in individual scores in each of the 4 quadrants (kappa 0.97-1.0). The agreement between anaesthetists and radiologists was only fair for the total score (kappa 0.37-0.42), but moderate to good for individual quadrant scores (kappa 0.43-0.73). The agreement between the two anaesthetists was moderate for individual quadrant scores (kappa 0.44-0.60), but only fair for total score (kappa 0.34). There was poor agreement between the two critical care physicians for total score (kappa 0.05) and for individual quadrant scores (kappa 0.04-0.20). Agreement between the physicians and other observers was poor to fair for the total score (kappa 0.12-0.32) and poor to moderate for the individual quadrant scores (kappa 0.15-0.63). Both anaesthetists and physician 2 underestimated the overall chest scores (median scores 2, 3 and 1 respectively) in comparison to the radiologists (median scores 3.5). Physician 1 significantly overscored (median score 4). The chest radiograph component of the lung injury score can be consistently assessed by radiologists, but significant variations may be introduced when assessed by other clinicians. This has significant implications for the use of the lung injury score in studies of adult respiratory distress syndrome and other studies which

  7. Nationwide surveys of chest, abdomen, lumbosacral spine radiography, and upper gastrointestinal fluoroscopy: a summary of findings.

    PubMed

    Spelic, David C; Kaczmarek, Richard V; Hilohi, Mike C; Moyal, Albert E

    2010-03-01

    This paper reports findings from Nationwide Evaluation of X-ray Trends surveys conducted in 2001, 2002, and 2003 of clinical facilities that perform routine radiographic examinations of the adult chest, abdomen, lumbosacral spine, and upper gastrointestinal fluoroscopic examinations. Randomly identified clinical facilities were surveyed in approximately 40 participating states. For the surveyed radiographic exams, additional facilities that use computed radiography or digital radiography were surveyed to ensure adequate sample sizes for determining comparative statistics. State radiation control personnel performed site visits and collected data on patient exposure, radiographic/fluoroscopic technique factors, image quality, and quality-control and quality-assurance practices. Results of the NEXT surveys are compared with those of previous surveys conducted in 1964 and 1970 by the U.S. Public Health Service and the Food and Drug Administration. An estimated 155 million routine adult chest exams were performed in 2001. Average patient entrance skin air kerma from chest radiography at facilities using digital-based imaging modalities was found to be significantly higher (p < 0.001), but not so for routine abdomen or lumbosacral spine radiography. Digital-based imaging showed a substantial reduction in patient exposure for the radiographic portion of the routine upper gastrointestinal fluoroscopy exam. Long-term trends in surveyed diagnostic examinations show that average patient exposures are at their lowest levels. Of concern is the observation that a substantial fraction of surveyed non-hospital sites indicated they do not regularly have a medical physics survey conducted on their radiographic equipment. These facilities are likely unaware of the radiation doses they administer to their patients. PMID:20147791

  8. An image-based technique to assess the perceptual quality of clinical chest radiographs

    SciTech Connect

    Lin Yuan; Luo Hui; Dobbins, James T. III; Page McAdams, H.; Wang, Xiaohui; Sehnert, William J.; Barski, Lori; Foos, David H.; Samei, Ehsan

    2012-11-15

    Purpose: Current clinical image quality assessment techniques mainly analyze image quality for the imaging system in terms of factors such as the capture system modulation transfer function, noise power spectrum, detective quantum efficiency, and the exposure technique. While these elements form the basic underlying components of image quality, when assessing a clinical image, radiologists seldom refer to these factors, but rather examine several specific regions of the displayed patient images, further impacted by a particular image processing method applied, to see whether the image is suitable for diagnosis. In this paper, the authors developed a novel strategy to simulate radiologists' perceptual evaluation process on actual clinical chest images. Methods: Ten regional based perceptual attributes of chest radiographs were determined through an observer study. Those included lung grey level, lung detail, lung noise, rib-lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm-lung contrast, and subdiaphragm area. Each attribute was characterized in terms of a physical quantity measured from the image algorithmically using an automated process. A pilot observer study was performed on 333 digital chest radiographs, which included 179 PA images with 10:1 ratio grids (set 1) and 154 AP images without grids (set 2), to ascertain the correlation between image perceptual attributes and physical quantitative measurements. To determine the acceptable range of each perceptual attribute, a preliminary quality consistency range was defined based on the preferred 80% of images in set 1. Mean value difference ({mu}{sub 1}-{mu}{sub 2}) and variance ratio ({sigma}{sub 1}{sup 2}/{sigma}{sub 2}{sup 2}) were investigated to further quantify the differences between the selected two image sets. Results: The pilot observer study demonstrated that our regional based physical quantity metrics of chest radiographs correlated very well with

  9. A patient image-based technique to assess the image quality of clinical chest radiographs

    NASA Astrophysics Data System (ADS)

    Lin, Yuan; Samei, Ehsan; Luo, Hui; Dobbins, James T., III; McAdams, H. Page; Wang, Xiaohui; Sehnert, William J.; Barski, Lori; Foos, David H.

    2011-03-01

    Current clinical image quality assessment techniques mainly analyze image quality for the imaging system in terms of factors such as the capture system DQE and MTF, the exposure technique, and the particular image processing method and processing parameters. However, when assessing a clinical image, radiologists seldom refer to these factors, but rather examine several specific regions of the image to see whether the image is suitable for diagnosis. In this work, we developed a new strategy to learn and simulate radiologists' evaluation process on actual clinical chest images. Based on this strategy, a preliminary study was conducted on 254 digital chest radiographs (38 AP without grids, 35 AP with 6:1 ratio grids and 151 PA with 10:1 ratio grids). First, ten regional based perceptual qualities were summarized through an observer study. Each quality was characterized in terms of a physical quantity measured from the image, and as a first step, the three physical quantities in lung region were then implemented algorithmically. A pilot observer study was performed to verify the correlation between image perceptual qualities and physical quantitative qualities. The results demonstrated that our regional based metrics have promising performance for grading perceptual properties of chest radiographs.

  10. Chest radiograph--a poor method for determining the size of a pneumothorax.

    PubMed

    Engdahl, O; Toft, T; Boe, J

    1993-01-01

    The ability of chest radiographs to determine the size of a pneumothorax was tested in 16 patients using computed tomographic (CT) scan as a reference method. To determine if CT with a slice thickness of 12 mm could be used, its accuracy was assessed in a lung model experiment. The lung model consisted of a water-filled plastic bag (lung) fitted into a plastic chamber (hemithorax), both of approximately the same size and shape as in man. Water was drawn off in incremental steps and a CT was done after each step. The area of the pneumothorax was calculated by computer and when multiplied by slice thickness and number of slices, the total volume of the pneumothorax could be compared with the extracted amount of water. A good correlation (r = 0.99), with the line of regression close to the line of identity, was found between the CT investigation and the artificial pneumothorax. In the patients, the size of the pneumothorax, judged by radiograph using two different methods of calculation, was correlated to the size obtained by CT. The correlation was poor (r = 0.71) irrespective of method of calculation. The size of the pneumothorax estimated by CT showed a good correlation (r = 0.99) to the initial aspirated air volumes in 12 of the 16 patients treated with drainage. A cautious attitude toward the use of chest radiographs for calculations of the degree of lung collapse in patients with pneumothorax is recommended. PMID:8417891

  11. 42 CFR 37.54 - Notification of abnormal radiographic findings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... in accordance with section 203 of the Act (see 30 CFR part 90). Positive findings with regard to... CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations Specifications for Interpretation, Classification, and Submission of...

  12. Chest CT findings of influenza virus‐associated pneumonia in 12 adult patients

    PubMed Central

    Fujita, Jiro; Bandoh, Shuji; Yamaguchi, Masahiro; Higa, Futoshi; Tateyama, Masao

    2008-01-01

    Objective  In this study, we describe the chest computed tomography findings of influenza virus‐associated pneumonia in adult patients. Methods  Our retrospective study included 12 adult patients who had proven influenza virus ‐ associated pneumonia. Results  Out of 12 patients, six were diagnosed as having pure influenza virus pneumonia, five as having bronchopneumonia caused by bacteria associated with influenza A infection, and one as having a cryptogenic organizing pneumonia associated with influenza A infection. Conclusion  Radiographic findings of influenza virus pneumonia in adult patients consist of ground‐glass attenuation. Localized patchy consolidations were observed in cases of bronchopneumonia. PMID:19453425

  13. Radiographic findings in recurrent parathyroid carcinoma

    SciTech Connect

    Krudy, A.G.; Doppman, J.L.; Marx, S.J.; Brennan, M.F.; Spiegel, A.; Aurback, G.D.

    1982-03-01

    Seven cases of recurrent parathyroid carcinoma were reviewed. Subperiosteal resorption was seen in 6, pulmonary nodules in 4, renal calculi in 5, brown tumors in 5, and pancreatic calcifications in 1. Angiography was performed in 5 patients, showing 1 definite and 2 probable cervical recurrences, 1 mediastinal lesion, and 1 case of possible bone metastases. Venous sampling for parathyroid hormone was carried out in 4 patients and suggested residual disease in 2; in addition, there were 1 false and 1 true negative. CT was performed in 4 patients and was useful in delineating metastatic pulmonary nodules, cervical recurrence, and hepatic metastases. The radiographic approach to recurrent parathryoid carcinoma and the use of CT and angiography are discussed.

  14. Improved texture analysis for automatic detection of tuberculosis (TB) on chest radiographs with bone suppression images

    NASA Astrophysics Data System (ADS)

    Maduskar, Pragnya; Hogeweg, Laurens; Philipsen, Rick; Schalekamp, Steven; van Ginneken, Bram

    2013-03-01

    Computer aided detection (CAD) of tuberculosis (TB) on chest radiographs (CXR) is challenging due to over-lapping structures. Suppression of normal structures can reduce overprojection effects and can enhance the appearance of diffuse parenchymal abnormalities. In this work, we compare two CAD systems to detect textural abnormalities in chest radiographs of TB suspects. One CAD system was trained and tested on the original CXR and the other CAD system was trained and tested on bone suppression images (BSI). BSI were created using a commercially available software (ClearRead 2.4, Riverain Medical). The CAD system is trained with 431 normal and 434 abnormal images with manually outlined abnormal regions. Subtlety rating (1-3) is assigned to each abnormal region, where 3 refers to obvious and 1 refers to subtle abnormalities. Performance is evaluated on normal and abnormal regions from an independent dataset of 900 images. These contain in total 454 normal and 1127 abnormal regions, which are divided into 3 subtlety categories containing 280, 527 and 320 abnormal regions, respectively. For normal regions, original/BSI CAD has an average abnormality score of 0.094+/-0.027/0.085+/-0.032 (p - 5.6×10-19). For abnormal regions, subtlety 1, 2, 3 categories have average abnormality scores for original/BSI of 0.155+/-0.073/0.156+/-0.089 (p = 0.73), 0.194+/-0.086/0.207+/-0.101 (p = 5.7×10-7), 0.225+/-0.119/0.247+/-0.117 (p = 4.4×10-7), respectively. Thus for normal regions, CAD scores slightly decrease when using BSI instead of the original images, and for abnormal regions, the scores increase slightly. We therefore conclude that the use of bone suppression results in slightly but significantly improved automated detection of textural abnormalities in chest radiographs.

  15. Quantification and visualization of relative local ventilation on dynamic chest radiographs

    NASA Astrophysics Data System (ADS)

    Tanaka, Rie; Sanada, Shigeru; Okazaki, Nobuo; Kobayashi, Takeshi; Nakayama, Kazuya; Matsui, Takeshi; Hayashi, Norio; Matsui, Osamu

    2006-03-01

    Recently-developed dynamic flat-panel detector (FPD) with a large field of view is possible to obtain breathing chest radiographs, which provide respiratory kinetics information. This study was performed to investigate the ability of dynamic chest radiography using FPD to quantify relative ventilation according to respiratory physiology. We also reported the results of primary clinical study and described the possibility of clinical use of our method. Dynamic chest radiographs of 12 subjects involving abnormal subjects during respiration were obtained using a modified FPD system (30 frames in 10 seconds). Imaging was performed in three different positions (standing, and right and left decubitus positions) to change the distribution of local ventilation by changing the lung's own gravity in each area. The distance from the lung apex to the diaphragm (abbr. DLD) was measured by the edge detection technique for use as an index of respiratory phase. We measured pixel values in each lung area and calculated correlation coefficients with DLD. Differences in the pixel values between the maximum inspiratory and expiratory frame were calculated, and the trend of distribution was evaluated by two-way analysis of variance. Pixel value in each lung area was strongly associated with respiratory phase and its time variation and distribution were consistent with known properties in respiratory physiology. Dynamic chest radiography using FPD combined with our computerized methods was capable of quantifying relative amount of ventilation during respiration, and of detecting regional differences in ventilation. In the subjects with emphysema, areas with decreased respiratory changes in pixel value are consisted with the areas with air trapping. This method is expected to be a useful novel diagnostic imaging method for supporting diagnosis and follow-up of pulmonary disease, which presents with abnormalities in local ventilation.

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

    SciTech Connect

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

    2012-03-15

    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.

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

    PubMed

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

    2014-06-01

    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. PMID:24705198

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

    NASA Astrophysics Data System (ADS)

    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. Chest Computed Tomography Findings in HIV-Infected Individuals in the Era of Antiretroviral Therapy

    PubMed Central

    Clausen, Emily; Wittman, Catherine; Gingo, Matthew; Fernainy, Khaled; Fuhrman, Carl; Kessinger, Cathy; Weinman, Renee; McMahon, Deborah; Leader, Joseph; Morris, Alison

    2014-01-01

    Background Chest radiographic abnormalities were common in HIV-infected individuals in the pre-combination antiretroviral therapy era, but findings may differ now due to a changing spectrum of pulmonary complications. Methods Cross-sectional study of radiographic abnormalities in an HIV-infected outpatient population during the antiretroviral therapy era. Demographics, chest computed tomography, and pulmonary function tests were obtained in HIV-infected volunteers without acute respiratory illness from the University of Pittsburgh HIV/AIDS clinic. Overall prevalence of radiographic abnormalities and potential risk factors for having any abnormality, nodules, or emphysema were evaluated using univariate and multivariable analyses. Results A majority of the 121 participants (55.4%) had a radiographic abnormality with the most common being emphysema (26.4%), nodules (17.4%), and bronchiectasis (10.7%). In multivariate models, age (odds ratio [OR] per year  = 1.07, 95% confidence interval [CI] 1.04–1.14, p<0.001), pneumonia history (OR  = 3.60, 95% CI  = 1.27–10.20, p = 0.016), and having ever smoked (OR  = 3.66, p = 0.013, 95% CI  = 1.31–10.12) were significant predictors of having any radiographic abnormality. Use of antiretroviral therapy, CD4 cell count, and HIV viral load were not associated with presence of abnormalities. Individuals with radiographic emphysema were more likely to have airway obstruction on pulmonary function tests. Only 85.8% participants with nodules had follow-up imaging resulting in 52.4% having stable nodules, 23.8% resolution of their nodules, 4.8% development of a new nodule, and 4.8% primary lung cancer. Conclusions Radiographic abnormalities remain common in HIV-infected individuals with emphysema, nodules, and bronchiectasis being the most common. Age, smoking, and pneumonia were associated with radiographic abnormalities, but HIV-associated factors did not seem to predict risk. PMID:25409510

  20. Use of effective detective quantum efficiency to optimise radiographic exposures for chest imaging with computed radiography

    NASA Astrophysics Data System (ADS)

    Ertan, Ferihan; Mackenzie, Alistair; Urbanczyk, Hannah J.; Ranger, Nicole T.; Samei, Ehsan

    2009-02-01

    The purpose of the work was to test if effective detective quantum efficiency (eDQE) could be useful for optimisation of radiographic factors for computed radiography (CR) for adult chest examinations. The eDQE was therefore measured across a range of kilovoltage, with and without an anti-scatter grid. The modulation transfer function, noise power spectra, transmission factor and scatter fraction were measured with a phantom made of sheets of Aluminum and Acrylic. The entrance air kerma was selected to give an effective dose of 4.9 μSv. The effective noise equivalent quanta (eNEQ) is introduced in this work. eNEQ can be considered equal to the number of X-ray quanta equivalent in the image corrected for the amount of scatter and the blurring processes. The eNEQ was then normalised to account for slight differences in the effective dose (eNEQED). The peak eNEQED was largest at 80 kV and 100 kV with no grid and with grid respectively. At each kilovoltage, the eNEQED and eDQE were between 10% and 70% larger when the grid was not used. The results show that 80 kV without grid is the most suitable exposure conditions for CR in chest. This is consistent with clinical practice in the UK and previous publications recommending a low kV technique for CR for average sized adult chest imaging.

  1. Bone Suppression Increases the Visibility of Invasive Pulmonary Aspergillosis in Chest Radiographs

    PubMed Central

    Schalekamp, Steven; van Ginneken, Bram; van den Berk, Inge A. H.; Hartmann, Ieneke J. C.; Snoeren, Miranda M.; Odink, Arlette E.; van Lankeren, Winnifred; Pegge, Sjoert A. H.; Schijf, Laura J.; Karssemeijer, Nico; Schaefer-Prokop, Cornelia M.

    2014-01-01

    Objective 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. Methods 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. Results 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%. Conclusion 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. PMID:25279774

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

    PubMed

    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. PMID:26530048

  3. Evaluation of the usefulness of modified biological fingerprints in chest radiographs for patient recognition and identification.

    PubMed

    Shimizu, Yoichiro; Matsunobu, Yusuke; Morishita, Junji

    2016-07-01

    We have been developing an image-searching method to identify misfiled images in a PACS server. Developing new biological fingerprints (BFs) that would reduce the influence of differences in positioning and breathing phases to improve the performance of recognition is desirable. In our previous studies, the whole lung field (WLF) that included the shadows of the body and lungs was affected by differences in positioning and/or breathing phases. In this study, we showed the usefulness of a circumscribed lung with a rectangular region of interest and the upper half of a chest radiograph as modified BFs. We used 200 images as hypothetically misfiled images. The cross-correlation identifies the resemblance between the BFs in the misfiled images and the corresponding BFs in the database images. The modified BFs indicated better results than did WLF in a receiver operating characteristic analysis; therefore, they could be used as identifiers for patient recognition and identification. PMID:27132238

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

    SciTech Connect

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

    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

  5. Computer-aided detection of malpositioned endotracheal tubes in portable chest radiographs

    NASA Astrophysics Data System (ADS)

    Huo, Zhimin; Mao, Hongda; Zhang, Jane; Sykes, Anne-Marie; Munn, Samson; Wandtke, John

    2014-03-01

    Portable chest radiographic images play a critical role in examining and monitoring the condition and progress of critically ill patients in intensive care units (ICUs). For example, portable chest images are acquired to ensure that tubes inserted into the patients are properly positioned for effective treatment. In this paper, we present a system that automatically detects the position of an endotracheal tube (ETT), which is inserted into the trachea to assist patients who have difficulty breathing. The computer detection includes the detections of the lung field, spine line, and aortic arch. These detections lead to the identification of regions of interest (ROIs) used for the subsequent detection of the ETT and carina. The detection of the ETT and carina is performed within the ROIs. Our ETT and carina detection methods were trained and tested on a large number of images. The locations of the ETT and carina were confirmed by an experienced radiologist for the purpose of performance evaluation. Our ETT detection achieved an average sensitivity of 85% at less than 0.1 false-positive detections per image. The carina approach correctly identified the carina location within a 10 mm distance from the truth location for 81% of the 217 testing images. We expect our system will assist ICU clinicians to detect malpositioned ETTs and reposition malpositioned ETTs more effectively and efficiently.

  6. Eye-position study of the effects of a verbal prompt and pictorial backgrounds on the search for lung nodules in chest radiographs

    NASA Astrophysics Data System (ADS)

    Kundel, Harold L.; Nodine, Calvin F.; Toto, Lawrence C.

    1999-05-01

    Peripherally inconspicuous nodules on chest radiographs are frequently missed by competent readers. In order to find a peripherally inconspicuous nodule the reader must inspect the nodule site with the central vision and decide if the features at the site are sufficiently characteristic to report a nodule. The experiment reported here was carried out to examine the effect of a nodule prompt and distraction by unrelated native abnormalities on the location and recognition of inconspicuous lung nodules on chest x-ray images. On two occasions separated by 3 years, 4 radiologists had their eye- position recorded while viewing 24 chest radiographs, 12 with prominent native abnormalities and 12 with no abnormalities. An inconspicuous nodule was simulated in the lungs of half of the radiographs on the first viewing and in the other half on the second viewing. For the first viewing, the readers were instructed to report any abnormalities. For the second viewing the readers were told to report any abnormalities including nodules. A nodule prompt triggers a scanning strategy that sends the central vision to high probability nodule sites early in search and at the same time relaxes the criteria used to evaluate nodule features resulting in more true positives and false positives without a change in absolute detectability. Prominent native abnormalities, unrelated to nodules, do not affect the search strategy but competitively inhibit the nodule feature recognition mechanism.

  7. A method to produce and validate a digitally reconstructed radiograph-based computer simulation for optimisation of chest radiographs acquired with a computed radiography imaging system

    PubMed Central

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

    2011-01-01

    Objectives The purpose of this study was to develop and validate a computer model to produce realistic simulated computed radiography (CR) chest images using CT data sets of real patients. Methods Anatomical noise, which is the limiting factor in determining pathology in chest radiography, is realistically simulated by the CT data, and frequency-dependent noise has been added post-digitally reconstructed radiograph (DRR) generation to simulate exposure reduction. Realistic scatter and scatter fractions were measured in images of a chest phantom acquired on the CR system simulated by the computer model and added post-DRR calculation. Results The model has been validated with a phantom and patients and shown to provide predictions of signal-to-noise ratios (SNRs), tissue-to-rib ratios (TRRs: a measure of soft tissue pixel value to that of rib) and pixel value histograms that lie within the range of values measured with patients and the phantom. The maximum difference in measured SNR to that calculated was 10%. TRR values differed by a maximum of 1.3%. Conclusion Experienced image evaluators have responded positively to the DRR images, are satisfied they contain adequate anatomical features and have deemed them clinically acceptable. Therefore, the computer model can be used by image evaluators to grade chest images presented at different tube potentials and doses in order to optimise image quality and patient dose for clinical CR chest radiographs without the need for repeat patient exposures. PMID:21933979

  8. Subtle radiographic findings of acute, isolated distal radioulnar joint dislocation.

    PubMed

    Duryea, Dennis M; Payatakes, Alexander H; Mosher, Timothy J

    2016-09-01

    Distal radioulnar dislocations typically occur in association with fractures of the distal radius and/or ulna. Rare isolated dislocations or subluxations are more difficult to diagnose and are initially missed in up to 50 % of cases. We present two cases of missed isolated volar rotatory dislocation of the distal radioulnar joint. Subtle, overlooked radiographic findings of abnormal radioulnar alignment and ulnar styloid projection are highlighted. The supplemental role of cross-sectional imaging is reviewed. Adequate clinical information, appropriate radiographic technique, and high index of suspicion are necessary for the accurate and timely diagnosis of this rare injury pattern. PMID:27229875

  9. Unusual thoracic radiographic findings in children treated for Hodgkin's disease

    SciTech Connect

    Jochelson, M.S.; Tarbell, N.J.; Weinstein, H.J.

    1986-06-01

    Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

  10. Acute, proximal aortic dissection with negative D-Dimer assay and normal portable chest radiograph: a case report.

    PubMed

    Thota, Darshan; Zanoni, Steve; Mells, Cary; Auten, Jonathan D

    2015-01-01

    Acute aortic dissection is one of the most devastating and time-sensitive diagnosis to consider in young adults with chest pain. Military medicine is represented by a larger proportion of 18- to 50-year-old individuals than is seen in the general medical population. Although uncommon in frequency, younger patients are more likely to suffer from proximal, aortic dissections. Chest radiographs and D-Dimer assays are used frequently as risk stratification tools, but have significant limitations in these more proximal dissections. Because of the frequency and lethality of nonspecific presentations, there exists a need for a sensitive screening tool. This case report presents a 43-year-old male with a concerning history and physical examination for aortic dissection, but a normal portable chest radiograph and a normal D-Dimer assay. It highlights the importance of clinical acumen in developing and maintaining a high clinical index of suspicion based on a Bayesian pretest probability model. PMID:25562879

  11. Correlations of Radiographic Findings in Patients with Low Back Pain

    PubMed Central

    Igbinedion, B. O. E; Akhigbe, A.

    2011-01-01

    Background: Low back pain can cause severe debilitating pain that may lead to loss of productivity. The pain is usually non-specific and imaging request protocols varies. However, physicians may order lumbo-sacral x-ray in the initial radiologic assessment of the patient. This study aims to determine the frequency of occurrence of radiographic findings in patients reporting low back pain including the presence of osteophytes, spondylolisthesis and degenerative disc diseases and determine the relationship with patients’ features including age, sex, marital status, level of education, body mass index and other radiographic findings. Method: Patients who presented at our department for radiographic assessment of the lumbo-sacral spine were voluntarily recruited. Their radiographs were reviewed and questionnaire administered. Height and weight were measured. The radiographic findings were documented and data analysis using Chi square with significant level set at p < 0.05. Result: Lumbo-sacral x-rays of 337 patients were reviewed with more females than males, ratio 1:1.4. Osteophytes were demonstrable in 73.6%; spondylolisthesis, 13.4%; and disc degeneration, 28.2%. Disc degeneration correlated with age, educational status, osteophytosis, osteopenia and spondylolisthesis. Osteophytosis correlated with age, BMI and educational level. While spondylolisthesis correlated with educational level and sex. Conclusion: Osteophytosis was the commonest finding in patients presenting with LBP. Disc degeneration shows a strong association with osteophytosis and spondylolisthesis and it is reported to herald these changes. Radiography still shows some correlations between the findings in LBP and patients’ characteristics. PMID:21969104

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

    SciTech Connect

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

    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

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

    SciTech Connect

    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.

  14. Morphometric comparison of clavicle outlines from 3D bone scans and 2D chest radiographs: a shortlisting tool to assist radiographic identification of human skeletons.

    PubMed

    Stephan, Carl N; Amidan, Brett; Trease, Harold; Guyomarc'h, Pierre; Pulsipher, Trenton; Byrd, John E

    2014-03-01

    This paper describes a computerized clavicle identification system primarily designed to resolve the identities of unaccounted-for U.S. 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 photofluorographs. 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. PMID:24313347

  15. Use of a digitally reconstructed radiograph-based computer simulation for the optimisation of chest radiographic techniques for computed radiography imaging systems

    PubMed Central

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

    2012-01-01

    Objectives The purpose of this study was to derive an optimum radiographic technique for computed radiography (CR) chest imaging using a digitally reconstructed radiograph computer simulator. The simulator is capable of producing CR chest radiographs of adults with various tube potentials, receptor doses and scatter rejection. Methods Four experienced image evaluators graded images of average and obese adult patients at different potentials (average-sized, n=50; obese, n=20), receptor doses (n=10) and scatter rejection techniques (average-sized, n=20; obese, n=20). The quality of the images was evaluated using visually graded analysis. The influence of rib contrast was also assessed. Results For average-sized patients, image quality improved when tube potential was reduced compared with the reference (102 kVp). No scatter rejection was indicated. For obese patients, it has been shown that an antiscatter grid is indicated, and should be used in conjunction with as low a tube potential as possible (while allowing exposure times <20 ms). It is also possible to reduce receptor air kerma by 50% without adversely influencing image quality. Rib contrast did not interfere at any tube potential. Conclusions A virtual clinical trial has been performed with simulated chest CR images. Results indicate that low tube potentials (<102 kVp) are optimal for average and obese adults, the former acquired without scatter rejection, the latter with an anti-scatter grid. Lower receptor (and therefore patient doses) than those used clinically are possible while maintaining adequate image quality. PMID:22253349

  16. Are daily routine chest radiographs necessary after pulmonary surgery in adult patients?

    PubMed Central

    Reeb, Jeremie; Falcoz, Pierre-Emmanuel; Olland, Anne; Massard, Gilbert

    2013-01-01

    A best evidence topic was constructed according to a structured protocol. The question addressed was whether daily routine (DR) chest radiographs (CXRs) are necessary after pulmonary surgery in adult patients. Of the 66 papers found using a report search, seven presented the best evidence to answer the clinical question. Four of these seven studies specifically addressed post-cardiothoracic adult patients. Three of these seven studies addressed intensive care unit (ICU) patients and included post-cardiothoracic adult patients in well-designed studies. Six of these seven studies compared the DR CXRs strategy to the clinically indicated, on-demand (OD) CXRs strategy. Another study analysed the clinical impact of ceasing to perform the DR, postoperative, post-chest tubes removal CXRs. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. We conclude that, on the whole, the seven studies are unanimously in favour of forgoing DR CXRs after lung resection and advocate OD CXRs. One study suggested that hypoxic patients could benefit from a DR CXRs strategy, while other studies failed to identify any subgroup for whom performing DR CXRs was beneficial. Indeed, DR CXRs, commonly taken after thoracic surgery, have poor diagnostic and therapeutic value. Eliminating them for adult patients having undergone thoracic surgery significantly decreases the number of CXRs per patient without increasing mortality rates, length of hospital stays (LOSs), readmission rates and adverse events. Hence, current evidence shows that DR CXRs could be forgone after lung resection because OD CXRs, recommended by clinical monitoring, have a better impact on management and have not been proved to negatively affect patient outcomes. Moreover, an OD CXRs strategy lowers the cost of care. Nevertheless, an OD CXRs strategy requires close clinical monitoring by experienced surgeons and dedicated intensivists. However

  17. The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease

    PubMed Central

    Carrera, Guillermo; Baynes, Keith; Mautz, Alan; DuBois, Melissa; Cerniglia, Ross; Ryan, Lawrence M.

    2016-01-01

    Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p<0.0002). Four hundred eighty-nine patients had knee films. Six of these patients had AC joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p=0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p=0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition. PMID:23609408

  18. Application of phase congruency for discriminating some lung diseases using chest radiograph.

    PubMed

    Rijal, Omar Mohd; Ebrahimian, Hossein; Noor, Norliza Mohd; Hussin, Amran; Yunus, Ashari; Mahayiddin, Aziah Ahmad

    2015-01-01

    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. PMID:25918551

  19. Pattern-histogram-based temporal change detection using personal chest radiographs

    NASA Astrophysics Data System (ADS)

    Ugurlu, Yucel; Obi, Takashi; Hasegawa, Akira; Yamaguchi, Masahiro; Ohyama, Nagaaki

    1999-05-01

    An accurate and reliable detection of temporal changes from a pair of images has considerable interest in the medical science. Traditional registration and subtraction techniques can be applied to extract temporal differences when,the object is rigid or corresponding points are obvious. However, in radiological imaging, loss of the depth information, the elasticity of object, the absence of clearly defined landmarks and three-dimensional positioning differences constraint the performance of conventional registration techniques. In this paper, we propose a new method in order to detect interval changes accurately without using an image registration technique. The method is based on construction of so-called pattern histogram and comparison procedure. The pattern histogram is a graphic representation of the frequency counts of all allowable patterns in the multi-dimensional pattern vector space. K-means algorithm is employed to partition pattern vector space successively. Any differences in the pattern histograms imply that different patterns are involved in the scenes. In our experiment, a pair of chest radiographs of pneumoconiosis is employed and the changing histogram bins are visualized on both of the images. We found that the method can be used as an alternative way of temporal change detection, particularly when the precise image registration is not available.

  20. Incidental radiographic finding of the concealed art of susuk.

    PubMed

    Devang Divakar, Darshan; Mavinapalla, Seema; Al Kheraif, Abdulaziz Abdullah; Ramakrishnaiah, Ravikumar; Abd Rahim, Muhammad Furqon Bin; Khan, Aftab Ahmed

    2016-07-01

    Susuk, or charm needles, are small, metallic needles inserted under the skin, considered to enhance beauty, health and luck. This hidden secret of inserting susuk is a traditional superstitious ritual, widely practiced among women of Southeast Asia. Here, we present an interesting case of incidental radiographic finding of the concealed art of susuk, which was exposed on a panoramic radiograph taken on a routine basis as a part of diagnostic work up at our centre. An orthopantomogram revealed bilateral metallic foreign bodies in the maxillo-facial region. Anamnestic data affirmed the practice of the body art of susuk. The charm needles were present in the orofacial region without the patient experiencing any pathological signs or symptoms. PMID:26271077

  1. The value of radiographic findings for the progression of pandemic 2009 influenza A/H1N1 virus infection

    PubMed Central

    2013-01-01

    Background Most illnesses caused by pandemic influenza A (H1N1) pdm09 virus (A/H1N1) infection are acute and self-limiting among children. However, in some children, disease progression is rapid and may require hospitalization and transfer to a pediatric intensive care unit (PICU). We investigated factors associated with rapid disease progression among children admitted to hospital for A/H1N1 infection, particularly findings on initial chest radiographs. Methods In this retrospective study, we investigated the records of children who had received a laboratory or clinical diagnosis of A/H1N1 infection and were admitted to the largest children’s hospital in Japan between May 2009 and March 2010. The medical records were reviewed for age, underlying diseases, vital signs on admission, initial chest radiographic findings, and clinical outcomes. According to chest radiographic findings, patients were classified into 4 groups, as follows: [1] normal (n = 46), [2] hilar and/or peribronchial markings alone (n = 64), [3] consolidation (n = 64), and [4] other findings (n = 29). Factors associated with clinical outcomes were analyzed using logistic regression. Results Two hundreds and three patients (median 6.8 years) were enrolled in this study. Fifteen percent (31/203) of patients were admitted to PICU. Among 31 patients, 39% (12/31) of patients required mechanical ventilation (MV). When the initial chest radiographic findings were compared between patients with consolidation (n = 64) and those without consolidation (n = 139), a higher percentage of patients with consolidation were admitted to PICU (29.7% vs.8.6%, P < 0.001) and required MV (17.2% vs. 0.7%, P < 0.001). These findings remain significant when the data were analyzed with the logistic regression (P < 0.001, P < 0.001, respectively). Conclusions Consolidation on initial chest radiographs was the most significant factor to predict clinical course of hospitalized children with the 2009 A/H1N1 infection. PMID

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

    PubMed

    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 microGy and 43 +/- 19 microGy, 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 microSv, regardless of sex, and an imparted energy of 18.5 +/- 6.7 microJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 +/- 7.6 microSv (males)/17.2 +/- 7.6 microSv (females) and 29.7 +/- 13.2 microJ. 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. PMID:16985285

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed Central

    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 for intensive care unit (ICU) patients. Method This was a prospective observational study conducted in a 28-bed, mixed medical–surgical ICU of a university hospital. Results 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. Conclusion 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. PMID:16420655

  5. Elimination of routine chest radiographs following off-pump coronary artery bypass surgery: A randomized controlled trial study

    PubMed Central

    Forouzannia, Seyed Khalil; Sarvi, Ali; Sarebanhassanabadi, Mohammadtaghi; Nafisi-Moghadam, Reza

    2015-01-01

    Background: Post cardiac surgery routine chest radiographs (CXRs), ordered without any clinical and laboratory indications, is a standard obligatory practice in many cardiothoracic centers. Routine CXRs incur cost, manpower, and radiation. The objective of this study is to assess early outcome in off-pump coronary artery bypass (OPCAB) patients with postoperative routine versus clinically indicated CXR protocols. Materials and Methods: This study is a randomized clinical trial conducted on 231 OPCAB candidates in Afshar Cardiac Center, Yazd, Iran. Patients were categorized into two groups. All 118 patients in group A had routine postoperative CXRs. The 113 patients in group B were selectively exposed to CXR only on clinical indications. All patients were postoperatively followed up for 30 days. Data gathered from both groups were statistically analyzed. Results: Routine postoperative CXRs obtained in 118 OPCAB group A candidates showed abnormal findings in 20 patients that did not require new intervention. One month follow-up of these patients showed no complications. In 113 OPCAB candidates of group B, 7 on-demand CXRs were obtained on clinical evaluation that required added intervention. In a 1-month follow-up of this group, five patients presented with symptomatic complaints. On re-examination, none needed readmission, intervention, or paraclinical evaluation. No complications were observed due to CXR elimination. Conclusion: The study suggests that postoperative CXR selected on clinical grounds in place of routine CXR does not change early postoperative outcome of OPCAB procedure. PMID:26682202

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

    SciTech Connect

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

    2006-12-15

    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

  7. [Radiographic and pathological findings in 4 patients with pulmonary cryptococcosis].

    PubMed

    Hidaka, T; Ichinose, I; Tamura, K

    1997-01-01

    We reviewed the records of 4 patients with pathologically diagnosed pulmonary cryptococcosis to determine whether there was any relationship between radiographic and pathological findings. The underlying disease were diabetes mellitus (patient 1), rheumatoid arthritis treated with glucocorticoids (patient 2), and adultonset T cell leukemia (patients 3 and 4). All radiographs showed multiple nodules, and patchy and localized infiltrates, which progressed to diffuse interstitial infiltration. According to Mark's classification, the pathological findings in patients 1 and 2 showed granulomatous pneumonia, those in patient 3 showed histiocytic pneumonia, and patient 4 had intercapillary cryptococci with no inflammatory response. The granuloma appeared larger in patient 1 than in patient 2. This concurred with the clinical findings, i.e. large granulomas formed in immunocompetent patients, and diffuse pulmonary infiltrates developed in those whose immune systems had been compromised. When a granuloma formed, roentgenograms showed a well defined nodular shadow, with some nodules developing in the cavity. When granuloma formation became unclear, roentgenograms tended to show localized-to-diffuse infiltration, or interstitial shadows. PMID:9071170

  8. Vascular Pedicle Width on Chest Radiograph as a Measure of Volume Overload: Meta-Analysis

    PubMed Central

    Wang, Hao; Shi, Runhua; Mahler, Simon; Gaspard, Joseph; Gorchynski, Julie; D'Etienne, James; Arnold, Thomas

    2011-01-01

    Introduction Vascular pedicle width (VPW), a measurement obtained from a chest radiograph (CR), is thought to be an indicator of circulating blood volume. To date there are only a handful of studies that demonstrate a correlation between high VPW and volume overload, each utilizing different VPW values and CR techniques. Our objective was to determine a mean VPW measurement from erect and supine CRs and to determine whether VPW correlates with volume overload. Methods MEDLINE database, Web of Science, and the Cochrane Central Register of Controlled Trials were searched electronically for relevant articles. References from the original and review publications selected electronically were manually searched for additional relevant articles. Two investigators independently reviewed relevant articles for inclusion criteria and data extraction. Mean VPW measurements from both supine and erect CRs and their correlation with volume overload were calculated. Results Data from 8 studies with a total of 363 subjects were included, resulting in mean VPW measurements of 71 mm (95% confidence interval [CI] 64.9–77.3) and 62 mm (95% CI 49.3–75.1) for supine and erect CRs, respectively. The correlation coefficients for volume overload and VPW were 0.81 (95% CI 0.74–0.86) for both CR techniques and 0.81 (95% CI 0.72–0.87) for supine CR and 0.80 (95% CI 0.69–0.87) for erect CR, respectively. Conclusion There is a clinical and statistical correlation between VPW and volume overload. VPW may be used to evaluate the volume status of a patient regardless of the CR technique used. PMID:22224132

  9. Rib suppression in chest radiographs to improve classification of textural abnormalities

    NASA Astrophysics Data System (ADS)

    Hogeweg, Laurens E.; Mol, Christian; de Jong, Pim A.; van Ginneken, Bram

    2010-03-01

    The computer aided diagnosis (CAD) of abnormalities on chest radiographs is difficult due to the presence of overlapping normal anatomy. Suppression of the normal anatomy is expected to improve performance of a CAD system, but such a method has not yet been applied to the computer detection of interstitial abnormalities such as occur in tuberculosis (TB). The aim of this research is to evaluate the effect of rib suppression on a CAD system for TB. Profiles of pixel intensities sampled perpendicular to segmented ribs were used to create a local PCA-based shape model of the rib. The model was normalized to the local background intensity and corrected for gradients perpendicular to the rib. Subsequently rib suppressed images were created by subtracting the models for each rib from the original image. The effect of rib suppression was evaluated using a CAD system for TB detection. Small square image patches were sampled randomly from 15 normal and 35 TB-affected images containing textural abnormalities. Abnormalities were outlined by a radiologist and were given a subtlety rating from 1 to 5. Features based on moments of intensity distributions of Gaussian derivative filtered images were extracted. A supervised learning approach was used to discriminate between normal and diseased image patches. The use of rib suppressed images increased the overall performance of the system, as measured by the area under the receiver operator characteristic (ROC) curve, from 0.75 to 0.78. For the more subtly rated patches (rated 1-3) the performance increased from 0.62 to 0.70.

  10. Dentomaxillofacial manifestations of Gaucher's disease: preliminary clinical and radiographic findings

    PubMed Central

    Nobre, RM; Ribeiro, ALR; Alves-Junior, SM; Tuji, FM; Rodrigues Pinheiro, M das G; Pinheiro, LR; Pinheiro, JJV

    2012-01-01

    Objectives A wide variety of manifestations is presented in patients with Gaucher's disease (GD), including bone, haematology and visceral disturbances. This study was conducted to ascertain the main maxillofacial abnormalities by means of clinical survey, panoramic and cone beam CT (CBCT); to compare the patient's group with an age–sex matched control group; and to correlate clinical and radiological data. Methods Ten patients previously diagnosed with GD were submitted to clinical and radiological surveys (CBCT and panoramic radiographs). The examination consisted of anamnesis, extra- and intraoral examinations and analyses of each patient's records. Imaging data were collected from the point of view of 3 observers, and the results compared with a healthy group (20 individuals) by means of statistical analysis (Fisher's exact test). Results Gaucher patients had significantly more manifestations than otherwise healthy carriers. The most prevalent findings were enlarged marrow spaces, generalized osteopenia and effacement of jaw structures (mandibular canal, lamina dura and mental foramen). Here we describe a case in which thickening of the maxillary sinus mucosa was observed on CBCT rather than opacification of the sinus as seen on panoramic radiographs. Pathological fractures, root resorption and delay on tooth eruption were not observed. Conclusions A poor relationship could be observed between clinical and radiological data. Patients showed important bone manifestations, which require careful diagnostic and surgical planning whenever necessary. Although panoramic radiographs have shown significant differences, CBCT is more effective in pointing out differences between patients and a control group, thus showing it as an important tool for evaluation of Gaucher patients. PMID:22988312

  11. [A study on chest radiographs in medical check-ups for over-staying foreigners].

    PubMed

    Yamamura, J

    2001-01-01

    During the past nine years from 1991 to 1999, Minatomachi Medical Center and other organizations have provided free medical check-ups for foreigners in Kanagawa, Tokyo and Chiba. Eighty-five percent of the total of the 2370 examined were over-staying foreigners who were not covered by national health insurance system. The ratio of male to female was two to one and the most of them were in the twenties and thirties. As for their ethnic origins from forty-three countries, the Filipinos were the largest numbers, followed by Koreans, Iranians, Bangladeshi, and Chinese/Taiwanese. As a result of chest radiographs, 82% were normal, 8.3% mostly normal, 9.6% tuberculosis shadow (TBS) including active, non active and previous, 0.09% suspected pneumonia, 0.05% suspected cardiac disease, and 0.05% suspected sarcoidosis. The TBS and active tuberculosis (ATB) rates of all examined were 9.6% and 0.69% respectively. There was no significant difference in each TBS and ATB rate between the two sexes. Seen from the age group, it was found that the more aged they were, the higher the TBS and the ATB rates were. The TBS and the ATB rates were 24.6% and 2.73% in the Koreans, 10.7% and 0% in the Chinese/Taiwanese, 10.2% and 0.65% in the Filipinos, 11.3% and 1.44% in the South-East Asians, 6.3% and 0.25% in the South Asians, 2.3% and 0% in the Iranians, 3.7% and 0% in the sub-Saharan Africans, 8.5% and 0.61% in the Latin Americans, and 0% and 0% in the Europeans/North Americans. Based on a presumed ATB rate of 0.75%, approximately two thousand cases with ATB could be calculated to exist among the estimated 270,000 over-staying foreigners. It is, therefore, important to give them more frequent medical check-ups for early detection of latent cases with ATB. PMID:11211779

  12. Validation of an image-based technique to assess the perceptual quality of clinical chest radiographs with an observer study

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

    We previously proposed a novel image-based quality assessment technique1 to assess the perceptual quality of clinical chest radiographs. In this paper, an observer study was designed and conducted to systematically validate this technique. Ten metrics were involved in the observer study, i.e., lung grey level, lung detail, lung noise, riblung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm-lung contrast, and subdiaphragm area. For each metric, three tasks were successively presented to the observers. In each task, six ROI images were randomly presented in a row and observers were asked to rank the images only based on a designated quality and disregard the other qualities. A range slider on the top of the images was used for observers to indicate the acceptable range based on the corresponding perceptual attribute. Five boardcertificated radiologists from Duke participated in this observer study on a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions. The observer data were analyzed in terms of the correlations between the observer ranking orders and the algorithmic ranking orders. Based on the collected acceptable ranges, quality consistency ranges were statistically derived. The observer study showed that, for each metric, the averaged ranking orders of the participated observers were strongly correlated with the algorithmic orders. For the lung grey level, the observer ranking orders completely accorded with the algorithmic ranking orders. The quality consistency ranges derived from this observer study were close to these derived from our previous study. The observer study indicates that the proposed image-based quality assessment technique provides a robust reflection of the perceptual image quality of the clinical chest radiographs. The derived quality consistency ranges can be used to automatically predict the acceptability of a clinical chest radiograph.

  13. The Effect Of Pixel Size On The Detection Rate Of Early Pulmonary Sarcoidosis In Digital Chest Radiographic Systems

    NASA Astrophysics Data System (ADS)

    MacMahon, Heber; Vyborny, Carl; Powell, Gregory; Doi, Kunio; Metz, Charles E.

    1984-08-01

    In digital radiography the pixel size used determines the potential spatial resolution of the system. The need for spatial resolution varies depending on the subject matter imaged. In many areas, including the chest, the minimum spatial resolution requirements have not been determined. Sarcoidosis is a disease which frequently causes subtle interstitial infiltrates in the lungs. As the initial step in an investigation designed to determine the minimum pixel size required in digital chest radiographic systems, we have studied 1 mm pixel digitized images on patients with early pulmonary sarcoidosis. The results of this preliminary study suggest that neither mild interstitial pulmonary infiltrates nor other abnormalities such as pneumothoraces may be detected reliably with 1 mm pixel digital images.

  14. Pseudolesion of the chest. A conglomerate shadow on the lateral radiograph.

    PubMed

    Stark, P; Lester, R G; Greene, R E

    1985-04-01

    A pseudolesion encountered in the lateral chest roentgenogram of normal patients is described. This concatenation of shadows can produce an opacity which projects over the distal aortic arch and can simulate a mass or pneumonia. This pseudolesion can be found in 4 to 5 percent of normal lateral chest films and is formed by superimposition of normal upper lobe vascular structures. PMID:3979146

  15. Computer-aided detection of interstitial abnormalities in chest radiographs using a reference standard based on computed tomography

    SciTech Connect

    Arzhaeva, Yulia; Prokop, Mathias; Tax, David M. J.; De Jong, Pim A.; Schaefer-Prokop, Cornelia M.; Ginneken, Bram van

    2007-12-15

    A computer-aided detection (CAD) system is presented for the localization of interstitial lesions in chest radiographs. The system analyzes the complete lung fields using a two-class supervised pattern classification approach to distinguish between normal texture and texture affected by interstitial lung disease. Analysis is done pixel-wise and produces a probability map for an image where each pixel in the lung fields is assigned a probability of being abnormal. Interstitial lesions are often subtle and ill defined on x-rays and hence difficult to detect, even for expert radiologists. Therefore a new, semiautomatic method is proposed for setting a reference standard for training and evaluating the CAD system. The proposed method employs the fact that interstitial lesions are more distinct on a computed tomography (CT) scan than on a radiograph. Lesion outlines, manually drawn on coronal slices of a CT scan of the same patient, are automatically transformed to corresponding outlines on the chest x-ray, using manually indicated correspondences for a small set of anatomical landmarks. For the texture analysis, local structures are described by means of the multiscale Gaussian filter bank. The system performance is evaluated with ROC analysis on a database of digital chest radiographs containing 44 abnormal and 8 normal cases. The best performance is achieved for the linear discriminant and support vector machine classifiers, with an area under the ROC curve (A{sub z}) of 0.78. Separate ROC curves are built for classification of abnormalities of different degrees of subtlety versus normal class. Here the best performance in terms of A{sub z} is 0.90 for differentiation between obviously abnormal and normal pixels. The system is compared with two human observers, an expert chest radiologist and a chest radiologist in training, on evaluation of regions. Each lung field is divided in four regions, and the reference standard and the probability maps are converted into

  16. Synchronization of radiograph film exposure with the inspiratory pause. Effect on the appearance of bedside chest radiographs in mechanically ventilated patients.

    PubMed

    Langevin, P B; Hellein, V; Harms, S M; Tharp, W K; Cheung-Seekit, C; Lampotang, S

    1999-12-01

    The appearance of portable chest radiographs (CXRs) may be affected by changes in ventilation, particularly when patients are mechanically ventilated. Synchronization of the CXR with the ventilatory cycle should limit the influence of respiratory variation on the appearance of the CXR. This study evaluates the effect of synchronizing the CXR film exposure with ventilation on the appearance of the radiograph. Twenty-five patients who remained intubated postoperatively, were mechanically ventilated, and required a CXR were enrolled in this triple-blind, randomized prospective study. Each patient received one radiograph using conventional techniques and another using the interface. The sequence of the two films was randomized, and the two films were taken on the same patient within a few minutes of each other. Hence, each patient served as his own control and the position of the patient, source-film distance, intensity (Kvp), and duration of the exposure (mAs) were identical for the two films. Five board-certified radiologists were then asked to compare paired films for clarity of lines and tubes, definition of the pulmonary vasculature, visibility of the mediastinum, definition of the diaphragm, and degree of lung inflation. Radiologists were also asked to choose which films they preferred. A majority of board certified radiologists preferred CXRs taken with the interface in 21 of 25 patients (p < 0.0001). Furthermore, four of the five criteria evaluated were improved (p < 0.05) on synchronized CXRs. Synchronization of the bedside CXR with the end of inspiration ensures that they are always obtained at maximal inflation, which improves the appearance of a majority of radiographs by at least one of five criteria. PMID:10588630

  17. Integration of temporal subtraction and nodule detection system for digital chest radiographs into picture archiving and communication system (PACS): four-year experience.

    PubMed

    Sakai, Shuji; Yabuuchi, Hidetake; Matsuo, Yoshio; Okafuji, Takashi; Kamitani, Takeshi; Honda, Hiroshi; Yamamoto, Keiji; Fujiwara, Keiichi; Sugiyama, Naoki; Doi, Kunio

    2008-03-01

    Since May 2002, temporal subtraction and nodule detection systems for digital chest radiographs have been integrated into our hospital's picture archiving and communication systems (PACS). Image data of digital chest radiographs were stored in PACS with the digital image and communication in medicine (DICOM) protocol. Temporal subtraction and nodule detection images were produced automatically in an exclusive server and delivered with current and previous images to the work stations. The problems that we faced and the solutions that we arrived at were analyzed. We encountered four major problems. The first problem, as a result of the storage of the original images' data with the upside-down, reverse, or lying-down positioning on portable chest radiographs, was solved by postponing the original data storage for 30 min. The second problem, the variable matrix sizes of chest radiographs obtained with flat-panel detectors (FPDs), was solved by improving the computer algorithm to produce consistent temporal subtraction images. The third problem, the production of temporal subtraction images of low quality, could not be solved fundamentally when the original images were obtained with different modalities. The fourth problem, an excessive false-positive rate on the nodule detection system, was solved by adjusting this system to chest radiographs obtained in our hospital. Integration of the temporal subtraction and nodule detection system into our hospital's PACS was customized successfully; this experience may be helpful to other hospitals. PMID:17333415

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

    PubMed

    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. PMID:6444573

  19. Using Standardized Interpretation of Chest Radiographs to Identify Adults with Bacterial Pneumonia—Guatemala, 2007–2012

    PubMed Central

    Wortham, Jonathan M.; Gray, Jennifer; Verani, Jennifer; Contreras, Carmen Lucia; Bernart, Chris; Moscoso, Fabiola; Moir, Juan Carlos; Reyes Marroquin, Emma Lissette; Castellan, Rigoberto; Arvelo, Wences; Lindblade, Kim; McCracken, John P.

    2015-01-01

    Background Bacterial pneumonia is a leading cause of illness and death worldwide, but quantifying its burden is difficult due to insensitive diagnostics. Although World Health Organization (WHO) protocol standardizes pediatric chest radiograph (CXR) interpretation for epidemiologic studies of bacterial pneumonia, its validity in adults is unknown. Methods Patients (age ≥15 years) admitted with respiratory infections to two Guatemalan hospitals between November 2007 and March 2012 had urine and nasopharyngeal/oropharyngeal (NP/OP) swabs collected; blood cultures and CXR were also performed at physician clinical discretion. ‘Any bacterial infection’ was defined as a positive urine pneumococcal antigen test, isolation of a bacterial pneumonia pathogen from blood culture, or detection of an atypical bacterial pathogen by polymerase chain reaction (PCR) of nasopharyngeal/oropharyngeal (NP/OP) specimens. ‘Viral infection’ was defined as detection of viral pathogens by PCR of NP/OP specimens. CXRs were interpreted according to the WHO protocol as having ‘endpoint consolidation’, ‘other infiltrate’, or ‘normal’ findings. We examined associations between bacterial and viral infections and endpoint consolidation. Findings Urine antigen and/or blood culture results were available for 721 patients with CXR interpretations; of these, 385 (53%) had endpoint consolidation and 253 (35%) had other infiltrate. Any bacterial infection was detected in 119 (17%) patients, including 106 (89%) pneumococcal infections. Any bacterial infection (Diagnostic Odds Ratio [DOR] = 2.9; 95% confidence Interval (CI): 1.3–7.9) and pneumococcal infection (DOR = 3.4; 95% CI: 1.5–10.0) were associated with ‘endpoint consolidation’, but not ‘other infiltrate’ (DOR = 1.7; 95% CI: 0.7–4.9, and 1.7; 95% CI: 0.7–4.9 respectively). Viral infection was not significantly associated with ‘endpoint consolidation’, ‘other infiltrate,’ or ‘normal’ findings

  20. Radiographer.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document, which is designed for use in developing a tech prep competency profile for the occupation of radiographer, lists technical competencies and competency builders for 18 units pertinent to the health technologies cluster in general as well as those specific to the occupation of radiographer. The following skill areas are covered in the…

  1. Radiographic evaluation of the patient with chest pain of suspected myocardial origin

    SciTech Connect

    Green, C.E.; Satler, L.F.; Elliott, L.P.

    1984-11-01

    The evaluation of the patient with suspected angina pectoris is discussed and an approach presented which makes use of radiologic tests in conjunction with exercise testing to quickly and efficiently determine the likelihood and severity of coronary artery disease. The relative merits and limitations of chest radiography, cardiac fluoroscopy, nuclear medicine, and coronary arteriography are discussed.

  2. Artifacts in chest radiographs with a third-generation computed radiography system.

    PubMed

    Volpe, J P; Storto, M L; Andriole, K P; Gamsu, G

    1996-03-01

    Photostimulable phosphor computed radiography (CR) is a developing and increasingly widespread technology. The purpose of this pictorial essay is to familiarize readers with the appearance and cause of image artifacts that can occur in a third-generation computed radiographic system. Artifacts are described that relate to imaging plates, image readers, image processing, and film processing. PMID:8623644

  3. 42 CFR 37.42 - Chest radiograph specifications-digital radiography systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... one, the facility must provide a clean gown. Facilities must be heated to a comfortable temperature... resolution, modulation transfer function (MTF), image signal-to-noise and detective quantum efficiency must... aligned to the grid; (10) Radiographs must not be made when the environmental temperatures and humidity...

  4. Assessment of congestive heart failure in chest radiographs. Observer performance with two common film-screen systems.

    PubMed

    Henriksson, L; Sundin, A; Smedby, O; Albrektsson, P

    1990-09-01

    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. PMID:2261292

  5. New finding in the radiographic diagnosis of Achilles tendon rupture

    SciTech Connect

    Newmark, H.; Mellon, W.S. Jr.; Malhotra, A.K.; Olken, S.M.; Halls, J.

    1982-06-01

    The authors describe a new radiographic sign of rupture of the Achilles tendon system. It is a fracture, with separation through an osteophyte at the insertion of this tendon. Previously reported signs are also discussed as well as the present case report.

  6. Evaluation of dental panoramic radiographic findings in edentulous jaws: A retrospective study of 743 patients "Radiographic features in edentulous jaws"

    PubMed Central

    Kose, Taha Emre; Cakir Karabas, Hulya; Ozcan, Ilknur

    2015-01-01

    PURPOSE The aim of this study was to determine the frequency of significant panoramic radiographic findings and eventual treatment requirements before conventional or implant supported prosthetic treatment in asymptomatic edentulous patients. MATERIALS AND METHODS A total of 743 asymptomatic edentulous patients were retrospectively evaluated using a digital panoramic system. We analyzed the radiographic findings, including impacted teeth, retained root fragments, foreign bodies, severe atrophy of the posterior maxillary alveolar bone, mucous retention cysts, soft tissue calcifications and radiopaque-radiolucent conditions. RESULTS Four-hundred-eighty-seven (65.6%) patients had no radiographic finding. A total of 331 radiographic findings were detected in 256 (34%) patients. In 52.9% (n=175) of these conditions, surgical treatment was required before application of implant-supported fixed prosthesis. However, before application of conventional removable prosthesis surgical treatment was required for 6% (n=20) of these conditions. CONCLUSION The edentulous patients who will have implant placement for implant-supported fixed prosthesis can frequently require additional surgical procedures to eliminate pathological conditions. PMID:26576254

  7. Detection of radiographic findings in lung fibrosis using storage phosphor plates.

    PubMed

    Müller, R D; Herting, D; Hirche, H; John, V; Buddenbrock, B; Gocke, P; Wiebringhaus, R; Konietzko, N; Langer, R

    1997-01-01

    The aim of this work was to examine the influence of the filter kernel size on the detectability of differing radiological findings in interstitial lung disease. In 97 patients with confirmed pulmonary fibrosis chest radiographs were obtained with a filmscreen system of speed class 200 and with correspondingly exposed storage phosphorous plates. The size of the filter kernel used for the image postprocessing varied between sigma 5 and sigma 70. The detectability of interstitial lung changes was evaluated independently by eight readers on the basis of a defined rating system. The results were analysed using multifactorial analysis of variance with Scheffé test at a significance level of p = 0.05. Small kernel sizes (S 5, S 10) combined with high edge enhancement were only of benefit in the imaging of septal lines, but reduced the detectability of nodular and reticular structures. Good detail detectability of both micronodules and septal lines was obtained with a medium kernel size of sigma 40. Storage phosphor radiography utilizing the appropriate choice of postprocessing parameters provides equivalent image quality for evaluating interstitial lung changes compared with a modern filmscreen technique. PMID:9204345

  8. Acute non-traumatic gastrothorax: presentation of a case with chest pain and atypical radiologic findings.

    PubMed

    Singh, Deepwant; Mackeith, Pieter; Gopal, Dipesh Pravin

    2016-01-01

    A previously well 71-year-old woman presented to the Emergency Department with acute-onset left-sided chest pain. She was haemodynamically stable with unremarkable systemic examination. Her electrocardiogram and troponin were within normal limits and her chest radiograph showed a raised left hemi-diaphragm. Two hours after admission, this woman became acutely breathless, and suffered a pulseless electrical activity cardiac arrest. After cardiopulmonary resuscitation, there was a return of spontaneous circulation and regained consciousness. A repeat clinical assessment revealed a new left-sided dullness to percussion with contralateral percussive resonance on respiratory examination. CXR revealed a left pan-hemi-thoracic opacity whilst better definition using CT-pulmonary angiography (CTPA) indicated an acute tension gastrothorax secondary to a large left-sided diaphragmatic hernia. Nasogastric (NG) tube insertion was used to decompress the stomach and the patient underwent uncomplicated emergency laparoscopic hernia reduction. She remained well at 1-year follow-up. PMID:27027934

  9. Cardiac findings on non-gated chest computed tomography: A clinical and pictorial review.

    PubMed

    Kanza, Rene Epunza; Allard, Christian; Berube, Michel

    2016-02-01

    The use of chest computed tomography (CT) as an imaging test for the evaluation of thoracic pathology has significantly increased during the last four decades. Although cardiopulmonary diseases often overlap in their clinical manifestation, radiologists tend to overlook the heart while interpreting routine chest CT. Recent advances in CT technology have led to significant reduction of heart motion artefacts and now allow for the identification of several cardiac findings on chest CT even without electrocardiogram (ECG) gating. These observations range from simple curiosity to both benign and malignant discoveries, to life-threatening discoveries. We here present a clinical and radiologic review of common and less common cardiac findings discovered on non-gated chest CT in order to draw the attention of radiologists and referring physicians to these possibilities. PMID:26781150

  10. Computer-assisted instruction and diagnosis of radiographic findings.

    PubMed

    Harper, D; Butler, C; Hodder, R; Allman, R; Woods, J; Riordan, D

    1984-04-01

    Recent advances in computer technology, including high bit-density storage, digital imaging, and the ability to interface microprocessors with videodisk, create enormous opportunities in the field of medical education. This program, utilizing a personal computer, videodisk, BASIC language, a linked textfile system, and a triangulation approach to the interpretation of radiographs developed by Dr. W. L. Thompson, can enable the user to engage in a user-friendly, dynamic teaching program in radiology, applicable to various levels of expertise. Advantages include a relatively more compact and inexpensive system with rapid access and ease of revision which requires little instruction to the user. PMID:6376675

  11. Incidental Finding of a Foreign Object on a Panoramic Radiograph.

    PubMed

    Schafer, Tara; Riggs, Bruce; Murakaru, June; Kalathingal, Sajitha

    2015-01-01

    This study's purpose was to describe a case involving the discovery of a foreign body in the ear canal of an eight-year-old boy, revealed during a recall evaluation to a dental clinic. A panoramic radiograph revealed a radiopaque object in the area of the external auditory meatus. The patient's mother reported one incidence of reported ear pain that resolved spontaneously, but the patient denied placing any object into his ear both in our clinic and at the time he reported ear pain to his mother. The patient was referred to an otolaryngologist, and the object was removed. PMID:26531089

  12. A comparative study for chest radiograph image retrieval using binary texture and deep learning classification.

    PubMed

    Anavi, Yaron; Kogan, Ilya; Gelbart, Elad; Geva, Ofer; Greenspan, Hayit

    2015-08-01

    In this work various approaches are investigated for X-ray image retrieval and specifically chest pathology retrieval. Given a query image taken from a data set of 443 images, the objective is to rank images according to similarity. Different features, including binary features, texture features, and deep learning (CNN) features are examined. In addition, two approaches are investigated for the retrieval task. One approach is based on the distance of image descriptors using the above features (hereon termed the "descriptor"-based approach); the second approach ("classification"-based approach) is based on a probability descriptor, generated by a pair-wise classification of each two classes (pathologies) and their decision values using an SVM classifier. Best results are achieved using deep learning features in a classification scheme. PMID:26736908

  13. Comparison of two methods for evaluating image quality of chest radiographs

    NASA Astrophysics Data System (ADS)

    Herrmann, C.; Sund, P.; Tingberg, A.; Keddache, S.; Mansson, L. G.; Almen, A.; Mattsson, S.

    2000-04-01

    The Imix radiography system (Oy Imix Ab, Finland) consists of an intensifying screen, optics, and a CCD camera. An upgrade of this system (Imix 2000) with a red-emitting screen and new optics has recently been released. The image quality of Imix (original version), Imix 2000, and two storage-phosphor systems, Fuji FCR 9501 and Agfa ADC70 was evaluated in physical terms (DQE) and with visual grading of the visibility of anatomical structures in clinical images (141 kV). PA chest images of 50 healthy volunteers were evaluated by experienced radiologists. All images were evaluated on Siemens Simomed monitors, using the European Quality Criteria. The maximum DQE values for Imix, Imix 2000 Agfa and Fuji were 11%, 14%, 17% and 19%, respectively (141 kV, 5 (mu) Gy). Using the visual grading, the observers rated the systems in the following descending order: Fuji, Imix 2000, Agfa, and Imix. Thus, the upgrade to Imix 2000 resulted in higher DQE values and a significant improvement in clinical image quality. The visual grading agrees reasonably well with the DQE results; however, Imix 2000 received a better score than what could be expected from the DQE measurements.

  14. Lung segmentation in chest radiographs using anatomical atlases with nonrigid registration.

    PubMed

    Candemir, Sema; Jaeger, Stefan; Palaniappan, Kannappan; Musco, Jonathan P; Singh, Rahul K; Zhiyun Xue; Karargyris, Alexandros; Antani, Sameer; Thoma, George; McDonald, Clement J

    2014-02-01

    The National Library of Medicine (NLM) is developing a digital chest X-ray (CXR) screening system for deployment in resource constrained communities and developing countries worldwide with a focus on early detection of tuberculosis. A critical component in the computer-aided diagnosis of digital CXRs is the automatic detection of the lung regions. In this paper, we present a nonrigid registration-driven robust lung segmentation method using image retrieval-based patient specific adaptive lung models that detects lung boundaries, surpassing state-of-the-art performance. The method consists of three main stages: 1) a content-based image retrieval approach for identifying training images (with masks) most similar to the patient CXR using a partial Radon transform and Bhattacharyya shape similarity measure, 2) creating the initial patient-specific anatomical model of lung shape using SIFT-flow for deformable registration of training masks to the patient CXR, and 3) extracting refined lung boundaries using a graph cuts optimization approach with a customized energy function. Our average accuracy of 95.4% on the public JSRT database is the highest among published results. A similar degree of accuracy of 94.1% and 91.7% on two new CXR datasets from Montgomery County, MD, USA, and India, respectively, demonstrates the robustness of our lung segmentation approach. PMID:24239990

  15. Radiographic and ultrasonographic findings of uterine neoplasms in nine dogs.

    PubMed

    Patsikas, Michail; Papazoglou, Lysimachos G; Jakovljevic, Samuel; Papaioannou, Nikolaos G; Papadopoulou, Paraskevi L; Soultani, Christina B; Chryssogonidis, Ioannis A; Kouskouras, Konstantinos A; Tziris, Nikolaos E; Charitanti, Afroditi A

    2014-01-01

    The records of nine female intact dogs with histologically confirmed uterine tumors were reviewed retrospectively, and the related radiographic and ultrasonographic signs of the lesions detected were recorded. Radiography revealed a soft-tissue opacity between the urinary bladder and colon in six of seven dogs with uterine body and/or cervical tumors, and a soft-tissue opacity in the midventral abdomen in two dogs with uterine horn tumors. Ultrasonography revealed masses in all dogs with uterine body/cervical tumors and could delineate the origin of the mass in one of two dogs with uterine horn tumors. The mass was characterized ultrasonographically as solid in three dogs (all leiomyomas), solid with cystic component in four dogs (two adenocarcinomas, one leiomyoma, and one fibroleiomyoma), and cystic in two (both leiomyomas). Hyperechoic foci in the mass were observed in three dogs. Ultrasonography was a useful method for demonstrating uterine body and/or cervical tumors. However, it was not possible to ascertain sonographically that a mass originated in a uterine horn unless there was associated evidence of uterine horn to which the mass could be traced. The ultrasonographic appearance of uterine tumors was variable, and the type of neoplasm could only be determined by taking biopsies of the mass. PMID:25028432

  16. Chest radiographic image quality: comparison of asymmetric screen-film, digital storage phosphor, and digital selenium drum systems--preliminary study.

    PubMed

    Beute, G H; Flynn, M J; Eyler, W R; Samei, E; Spizarny, D L; Zylak, C J

    1998-01-01

    Conventional screen-film radiography does not display all regions of the thorax satisfactorily. Three chest radiographic techniques display both the lung and the mediastinum with good contrast. These techniques are asymmetric screen-film (ASF), digital storage phosphor (DSP), and digital selenium drum (DSD) imaging. ASF systems use two asymmetric screen-film combinations to produce a wide-latitude image of the thorax with good contrast in the lungs. In DSP systems, image data are acquired digitally with a wide dynamic range by using the optical output of a photostimulable phosphor plate; in DSD systems, the wide-range digital image data are acquired by using the electronic charge generated on a drum coated with a thin layer of amorphous selenium. The appearance of a DSP or DSD radiograph is then determined by user-selected image processing operations: tone scaling, spatial frequency processing, and dynamic range compensation. Digital chest radiographs processed with strong regional equalization provide both excellent contrast in the lungs and effective display of the mediastinum and chest wall. At visual comparison, the high lung contrast and good mediastinal, retrocardiac, and subdiaphragmatic detail provided by the DSD method distinguish it from the other two methods. PMID:9599395

  17. Ossification of the Medial Clavicular Epiphysis on Chest Radiographs: Utility and Diagnostic Accuracy in Identifying Korean Adolescents and Young Adults under the Age of Majority.

    PubMed

    Yoon, Soon Ho; Yoo, Hye Jin; Yoo, Roh Eul; Lim, Hyun Ju; Yoon, Jeong Hwa; Park, Chang Min; Lee, Sang Seob; Yoo, Seong Ho

    2016-10-01

    The aim of our study was to evaluate the utility and diagnostic accuracy of the ossification grade of medial clavicular epiphysis on chest radiographs for identifying Korean adolescents and young adults under the age of majority. Overall, 1,151 patients (age, 16-30) without any systemic disease and who underwent chest radiography were included for ossification grading. Two radiologists independently classified the ossification of the medial clavicular epiphysis from chest radiographs into five grades. The age distribution and inter-observer agreement on the ossification grade were assessed. The diagnostic accuracy of the averaged ossification grades for determining whether the patient is under the age of majority was analyzed by using receiver operating characteristic (ROC) curves. Two separate inexperienced radiologists assessed the ossification grade in a subgroup of the patients after reviewing the detailed descriptions and image atlases developed for ossification grading. The median value of the ossification grades increased with increasing age (from 16 to 30 years), and the trend was best fitted by a quadratic function (R-square, 0.978). The inter-observer agreements on the ossification grade were 0.420 (right) and 0.404 (left). The area under the ROC curve (AUC) was 0.922 (95% CI, 0.902-0.942). The averaged ossification scores of 2.62 and 4.37 provided 95% specificity for a person < 19 years of age and a person ≥ 19 years of age, respectively. A preliminary assessment by inexperienced radiologists resulted in an AUC of 0.860 (95% CI, 0.740-0.981). The age of majority in Korean adolescents and young adults can be estimated using chest radiographs. PMID:27550480

  18. Wassel's Type V Polydactyly with Plain Radiographic and CT Findings

    PubMed Central

    Mete, Berna Dirim; Altay, Canan; Gursoy, Merve; Oyar, Orhan

    2015-01-01

    Duplication of the thumb is the most common polydactyly of the hand. Wassel's classification is frequently used to classify the polydactyly of the hand. His classification was based on the level of duplication and the number of bones in the thumb, and has seven groups (Types I–VII) according to the level of the bifurcation, except for his Type VII. The most common type is the bifurcation at the metacarpophalangeal joint (Type IV). In this paper, we report a very rare case of Type V thumb polydactyly in a 42-year-old man, who presented with swan neck deformity of the radial thumb and discuss the plain radiography and computed tomography (CT) findings. Kumar recently reported plain radiography findings in a case of bifid first metacarpal in a 13-year-old girl, who presented with swan neck deformity of the left thumb. To our knowledge, our case is the second presented case that has a swan neck deformity with bifid metacarpal. PMID:25861550

  19. [Manifestations of lobar atelectasis on chest x-rays and correlation with computed tomography findings].

    PubMed

    Cortés Campos, A; Martínez Rodríguez, M

    2014-01-01

    Atelectasis is an important indicator of potentially severe underlying disease that must be diagnosed as early as possible. One of the most common mechanisms is the reabsorption of air distal to respiratory tract obstruction. The chest x-ray is an excellent tool to diagnose atelectasis, and it is especially useful for ruling out central bronchial obstructions (e.g., from endobronchial tumors). If the signs of volume loss are not recognized correctly, the diagnosis and treatment can be delayed. This article describes the main findings of lobar atelectasis on chest x-rays and their correlations with CT findings, including the classic signs described in the literature and other, less known and sometimes subtle signs. PMID:24252304

  20. Elimination of daily routine chest radiographs in a mixed medical–surgical intensive care unit

    PubMed Central

    Graat, Marleen E.; Kröner, Anke; Spronk, Peter E.; Korevaar, Johanna C.; Stoker, Jaap; Vroom, Margreeth B.

    2007-01-01

    Objective To determine the impact of elimination of daily routine chest radiographs (CXRs) in a mixed medical–surgical intensive care unit (ICU) on utility of on demand CXRs, length of stay (LOS) in ICU, readmission rate, and mortality rate. Design and setting Prospective, nonrandomized, controlled study in a 28-bed ICU. Analysis included data of all admitted ICU patients during 5 months before and after elimination of daily routine CXRs. Results Before elimination, 2457 daily routine CXRs and 1437 on demand CXRs were obtained from 754 patients. After elimination, 1267 CXRs were obtained from 622 patients. The ratio of CXRs/patient day decreased from 1.1 ± 0.3 to 0.6 ± 0.4 (p < 0.05). Elimination did not result in a change in utility and timing of on demand CXRs. The absolute diagnostic and therapeutic value of on demand CXRs increased with elimination of daily routine CXRs: before intervention, 147 unexpected predefined abnormalities were found (10.2% of all on demand CXRs in 15.9% of all patients), of which 57 (3.9%) in 6.4% of all patients led to a change in therapy. After intervention, 156 unexpected predefined abnormalities were found (11.6%; p < 0.05), of which 61 (4.8%) in 9.5% of all patients (p < 0.05) led to a change in therapy. The LOS in ICU, readmission rate and ICU, and hospital mortality rate were not influenced by the change in strategy. Conclusions Elimination of daily routine CXRs reduced the number of CXRs in a mixed medical–surgical ICU, while not affecting readmission rate and ICU and hospital mortality rates. Electronic supplementary material The online version of this article (doi:10.1007/s00134-007-0542-1) contains supplementary material, which is available to authorized users PMID:17333118

  1. Radiographic Findings in Revision Anterior Cruciate Ligament Reconstructions from the MARS Cohort

    PubMed Central

    2013-01-01

    The Multicenter ACL (anterior cruciate ligament) Revision Study (MARS) group was developed to investigate revision ACL reconstruction outcomes. An important part of this is obtaining and reviewing radiographic studies. The goal for this radiographic analysis is to establish radiographic findings for a large revision ACL cohort to allow comparison with future studies. The study was designed as a cohort study. Various established radiographic parameters were measured by three readers. These included sagittal and coronal femoral and tibial tunnel position, joint space narrowing, and leg alignment. Inter- and intraobserver comparisons were performed. Femoral sagittal position demonstrated 42% were more than 40% anterior to the posterior cortex. On the sagittal tibia tunnel position, 49% demonstrated some impingement on full-extension lateral radiographs. Limb alignment averaged 43% medial to the medial edge of the tibial plateau. On the Rosenberg view (45-degree flexion view), the minimum joint space in the medial compartment averaged 106% of the opposite knee, but it ranged down to a minimum of 4.6%. Lateral compartment narrowing at its minimum on the Rosenberg view averaged 91.2% of the opposite knee, but it ranged down to a minimum of 0.0%. On the coronal view, verticality as measured by the angle from the center of the tibial tunnel aperture to the center of the femoral tunnel aperture measured 15.8 degree ± 6.9% from vertical. This study represents the radiographic findings in the largest revision ACL reconstruction series ever assembled. Findings were generally consistent with those previously demonstrated in the literature. PMID:23404491

  2. Radiographic findings in revision anterior cruciate ligament reconstructions from the Mars cohort.

    PubMed

    2013-08-01

    The Multicenter ACL (anterior cruciate ligament) Revision Study (MARS) group was developed to investigate revision ACL reconstruction outcomes. An important part of this is obtaining and reviewing radiographic studies. The goal for this radiographic analysis is to establish radiographic findings for a large revision ACL cohort to allow comparison with future studies. The study was designed as a cohort study. Various established radiographic parameters were measured by three readers. These included sagittal and coronal femoral and tibial tunnel position, joint space narrowing, and leg alignment. Inter- and intraobserver comparisons were performed. Femoral sagittal position demonstrated 42% were more than 40% anterior to the posterior cortex. On the sagittal tibia tunnel position, 49% demonstrated some impingement on full-extension lateral radiographs. Limb alignment averaged 43% medial to the medial edge of the tibial plateau. On the Rosenberg view (45-degree flexion view), the minimum joint space in the medial compartment averaged 106% of the opposite knee, but it ranged down to a minimum of 4.6%. Lateral compartment narrowing at its minimum on the Rosenberg view averaged 91.2% of the opposite knee, but it ranged down to a minimum of 0.0%. On the coronal view, verticality as measured by the angle from the center of the tibial tunnel aperture to the center of the femoral tunnel aperture measured 15.8 degree ± 6.9% from vertical. This study represents the radiographic findings in the largest revision ACL reconstruction series ever assembled. Findings were generally consistent with those previously demonstrated in the literature. PMID:23404491

  3. Pleural-based changes on chest x-ray after irradiation for primary breast cancer: correlation with findings on computerized tomography

    SciTech Connect

    Srinivasan, G.; Kurtz, D.W.; Lichter, A.S.

    1983-10-01

    In treating breast cancer with excisional biopsy and irradiation, a volume of lung underlying the breast and chest wall receives significant doses of irradiation. This irradiation can produce pleural and pulmonary changes that can be seen on routine chest radiographs. In five such cases, we have examined pre and post-treatment computerized tomograms of the chest and show that these radiographic changes are pleural-based and lie within the high dose radiation volume. Failure to correct radiation treatment plans for the influence of lung density results in an increased dose to lung and pleura that could, in theory, exacerbate pulmonary and pleural radiation effects.

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

    PubMed

    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. PMID:27322975

  5. Coal worker's pneumoconiosis: CT assessment in exposed workers and correlation with radiographic findings.

    PubMed

    Remy-Jardin, M; Degreef, J M; Beuscart, R; Voisin, C; Remy, J

    1990-11-01

    To study the signs of coal worker's pneumoconiosis (CWP) at computed tomography (CT), the authors obtained thoracic CT scans in 170 coal-dust-exposed workers who were concomitantly evaluated with conventional posteroanterior and lateral radiography. The profusion and extent of disease was assessed by means of CT in two groups of miners: group 1 (n = 86), miners with worker's compensation and radiographic evidence of CWP, and group 2(n = 84), miners who had applied for compensation without radiographic evidence of CWP. The CT signs of CWP consisted of micronodules, nodules, and progressive massive fibrosis. The comparative analysis demonstrates the superiority of an optimal CT technique over chest radiography in the evaluation of simple silicosis, with improved sensitivity in the detection of small parenchymal opacities. CT provides additional information on the stage of the disease but also clarifies some ambiguities of the ILO classification of small opacities. CT was equivalent to radiography for complicated silicosis, except in the identification of necrosis. CT evaluations are complementary to plain radiography in the assessment of CWP, and the addition of high-resolution CT is useful in achieving a more accurate evaluation of the small parenchymal opacities. PMID:2217770

  6. Genetic correlations between performance traits and radiographic findings in the limbs of German Warmblood riding horses.

    PubMed

    Stock, K F; Distl, O

    2007-01-01

    Results of mare performance tests in the field (MPT-F) of 10,949 mares, mare performance tests at station (MPT-S) of 1,712 mares, and inspections of horses intended for sale at riding horse auctions (AU) of 4,772 horses were used to investigate genetic correlations between corresponding performance traits. Mare performance tests were held in 1995 to 2004 and auction inspections in 1999 to 2004. Scores on a scale from 0 to 10 were given for gaits under rider (walk, trot, canter), rideability (evaluated by judging commission and test rider), free-jumping (ability, style, total), and character. Radiography results of 5,102 Hanoverian Warmblood horses were used to investigate genetic correlations between performance traits and particular radiographic findings. The radiographic findings included osseous fragments in fetlock and hock joints, deforming arthropathy in hock joints, and distinct radiographic findings in the navicular bones, which were analyzed as binary traits, and radiographic appearance of the navicular bones, which was analyzed as a quasi-linear trait. Genetic parameters were estimated multivariately in linear animal models with REML using information on the horses radiographed and their contemporaries (n = 18,609). Heritability of performance traits ranged between 0.14 and 0.61, and heritability of radiographic findings between 0.14 and 0.33. Additive genetic correlations between corresponding performance traits were close to unity for MPT-F and MPT-S, ranged from 0.81 to 0.90 for MPT-F and AU, and were 0.75 to 0.92 for MPT-S and AU. Genetic correlations between performance and radiography results were mostly close to zero. Indications of negative additive genetic correlations were observed for deforming arthropathy in hock joints and canter, rideability evaluated by test rider, jumping traits and character, and osseous fragments in hock joints and character. Selection of horses for radiological health of their limbs will assist further genetic

  7. Evaluation of the image quality of ink-jet printed paper copies of digital chest radiographs as compared with film: a receiver operating characteristic study.

    PubMed

    Lyttkens, K; Kirkhorn, T; Kehler, M; Andersson, B; Ebbesen, A; Hochbergs, P; Jarlman, O; Lindberg, C G; Holmer, N G

    1994-05-01

    Paper copies of digital radiographs printed with the continuous ink-jet technique have proved to be of a high enough quality for demonstration purposes. We present a study on the image quality of ink-jet printed paper copies of digital chest radiographs, based on receiver operating characteristic (ROC) analysis. Eighty-three digital radiographs of a chest phantom with simulated tumors in the mediastinum and right lung, derived from a computed radiography (CR) system were presented in two series of hard copies as ink-jet printed paper copies and as laser recorded film. The images, with a matrix of 1,760 x 2,140 pixels, were printed with a spatial resolution of 10 pixels/mm in the CR film recorder as well as in the ink-jet printer. On film, every image was recorded in two versions, one optimized for the mediastinum and one for the lungs. On paper, only one image was printed; this constituted an effort to optimize both the mediastinum and the lungs. The ink-jet printed images, printed on a matt coated paper, were viewed as on-sight images with reflected light. The examinations were reviewed by six radiologists, and ROC curves were constructed. No significant difference was found between the performance of film and that of ink-jet paper prints. Because the cost for a paper copy is only a tenth of that of film, remarkable cost reductions can be achieved by using the ink jet technique instead. Our results show that further quality studies of ink-jet printed images are worthwhile. PMID:8075185

  8. Pneumothorax in the Supine Patient: Subtle Radiographic Signs.

    PubMed

    Rierson, Davis; Bueno, Juliana

    2016-07-01

    Routine posteroanterior chest radiographs and computed tomography scans are more sensitive for detecting pneumothoraces than anteroposterior chest radiographs. However, supine chest radiographs are commonly performed as part of the initial and routine assessment of trauma and critically ill patients. Rates of occult pneumothorax can be as high as 50% and have a significant impact in the mortality of these patients; thus, a prompt diagnosis of this entity is important. This pictorial essay will illustrate the pleural anatomy, explain the distribution of air within the pleural space in the supine position, and review the radiologic findings that characterize this entity. PMID:27105051

  9. Radiographic findings on 3rd molars removed in 20-year-old men.

    PubMed

    Rajasuo, Ari; Peltola, Jaakko; Ventä, Irja; Murtomaa, Heikki

    2003-10-01

    In this study we assess radiographic findings characteristic of mandibular 3rd molars that had required either routine or surgical extraction. X-ray findings relating to acute pericoronitis were also examined. The material was collected by investigating patient records and rotational panoramic radiographs of 20-year-old Finnish male conscripts (n = 738) treated during military service because of 3rd-molar-related problems. The follicle around the crown of mandibular 3rd molars with acute pericoronitis was enlarged in 19% of cases and in 13% of chronic symptom-free pericoronitis cases (not statistically significant difference). Mandibular 3rd molars extracted surgically were more often mesially inclined than those extracted routinely (61% vs. 23%; P < 0.001), partially or totally intrabony impacted (92% vs. 66%; P < 0.001) and deep situated (on average 4.2 mm vs. 2.5 mm under the occlusal plane). Surgical extraction was also associated with the roots completely developed [92% vs. 84% of the teeth routinely extracted, odds ratio (OR) 2.6, 95% confidence interval (CI) 1.2-5.5] and with the absence of radiographic pericoronitis [around 27% vs. 39% of the teeth routinely extracted (OR 0.5, 95% CI 0.3-0.8)]. In 86% of cases the space between 2nd molar and ramus of the mandible was narrower than the 3rd molar extracted surgically, whereas this was 62% in routine extraction cases (P < 0.001). We conclude that there are some typical 3rd-molar findings in rotational panoramic radiographs that show a need for surgical extraction. PMID:14763776

  10. Genetic correlations between conformation traits and radiographic findings in the limbs of German Warmblood riding horses.

    PubMed

    Stock, Kathrin Friederike; Distl, Ottmar

    2006-01-01

    Studbook inspection (SBI) data of 20 768 German Warmblood mares and radiography results (RR) data of 5102 Hanoverian Warmblood horses were used for genetic correlation analyses. The scores on a scale from 0 to 10 were given for conformation and basic quality of gaits, resulting in 14 SBI traits which were used for the correlation analyses. The radiographic findings considered included osseous fragments in fetlock (OFF) and hock joints (OFH), deforming arthropathy in hock joints (DAH) and distinct radiographic findings in the navicular bones (DNB) which were analyzed as binary traits, and radiographic appearance of the navicular bones (RNB) which was analyzed as a quasi-linear trait. Genetic parameters were estimated multivariately in linear animal models with REML using information on 24 448 horses with SBI and/or RR records. The ranges of heritability estimates were h2 = 0.14-0.34 for the RR traits and h2 = 0.09-0.50 for the SBI traits. Negative additive genetic correlations of r(g) = -0.19 to -0.56 were estimated between OFF and conformation of front and hind limbs and walk at hand, and between DNB and hind limb conformation. There were indications of negative additive genetic correlations between DAH and all SBI traits, but because of low prevalence and low heritability of DAH, these results require further scrutiny. Positive additive genetic correlations of r(g) = 0.37-0.52 were estimated between OFF and withers height and between OFH and withers height, indicating that selection for taller horses will increase disposition to develop OFF and OFH. Selection of broodmares with regards to functional conformation will assist, but cannot replace possible selection against radiographic findings in the limbs of young Warmblood riding horses, particularly with regards to OFF. PMID:17129565

  11. Retention of uranium in the chest: implications of findings in vivo and postmortem

    SciTech Connect

    Keane, A.T.; Polednak, A.P.

    1981-01-01

    An unusually protracted retention of uranium in the chests of certain workers at a uranium-processing plant has been reported in the literature. This finding has implications for the protection of current uranium workers and for health-effects studies of early workers. It is shown that the limited data obtained postmortem that have been reported do not reveal a significant unusually protracted retention of uranium in the pulmonary region or in the tracheobronchial lymph nodes. Probable explanations of the disparate findings are discussed. Data are presented on mortality from cancers of lymphatic tissues among males who worked in the period from 1943 to 1947 at the Y-12 Plant, Tennessee-Eastman Corp., Oak Ridge. No increased mortality from these cancers was evident.

  12. Retention of uranium in the chest: implications of findings in vivo and postmortem.

    PubMed

    Keane, A T; Polednak, A P

    1983-01-01

    An unusually protracted retention of uranium in the chests of certain workers at a uranium processing plant has been reported in the literature. This finding has implications for the protection of current uranium workers and for health-effects studies of early workers. It is shown that the limited data obtained postmortem that have been reported do not reveal a significant unusually protracted retention of uranium in the pulmonary region or in the tracheobronchial lymph nodes. Probable explanations of the disparate findings are discussed. Data are presented on mortality from cancers of lymphatic tissues among males who worked in the period from 1943 to 1947 at the Y-12 Plant, Tennessee-Eastman Corp., Oak Ridge. No significantly increased mortality from these cancers was evident. PMID:6862916

  13. Histological evaluation of pulp tissue from second primary molars correlated with clinical and radiographic caries findings

    PubMed Central

    Gopinath, Vellore Kannan; Anwar, Khurshid

    2014-01-01

    Background: Managing dental caries in young children is demanding due to the elusions present on the right diagnostic criteria for treatment. The present study evaluated the histological status of pulp tissues extracted from primary second molar with caries involvement. Histological findings are correlated with clinical and radiographic assessment. Materials and Methods: Simple experimental study was conducted on upper or lower second primary molars with occlusal (22 teeth) or proximal (22 teeth) dental caries. Selected children were below 6 years of age. Percentage of caries involvement, residual dentin thickness (RDT), radiographic assessment of interradicular and periapical areas, clinical caries depth and signs and symptoms are the parameters considered for comparing with the histological findings. The specimens were grouped based on the nature of the inflammatory process as acute or chronic. The data were analyzed by Student t-test to compare histological types of inflammation with clinical parameters. P value < 0.05 was considered as significant. Results: Four cases revealed severe acute inflammation in coronal and relatively mild acute inflammation in radicular pulp. In the rest of the specimen coronal and radicular pulp had similar acute or chronic inflammatory changes. Histological evidence of pulpitis correlated with dental caries depth of ≥80%, RDT of ≤1 mm, radiographic rarefactions in the interradicular regions and symptoms of pain. Conclusion: Primary second molars with more than two-third caries involvement with symptoms of pain histologically showed inflammation of both coronal and radicular pulp tissues in all cases. PMID:24932190

  14. An 81-year-old man with an abnormal right-sided heart shadow on chest radiograph.

    PubMed

    Shah, Rahman; Khan, M Rehan; Fan, Tai-Hwang M; Ruff, Genina; Ramanathan, Kodangudi B

    2015-02-01

    An 81-year-old man presented with a 1-week history of dry cough. He also complained of mild dyspnea, wheezing, and low-grade fever. He denied hemoptysis, fever, rashes, or chest pain. The patient's medical history included coronary artery bypass surgery, hypertension, gastroesophageal reflux disease, and COPD. The patient was a retired welder and an ex-smoker. PMID:25644917

  15. The x-ray light valve: A potentially low-cost, digital radiographic imaging system--a liquid crystal cell design for chest radiography

    SciTech Connect

    Szeto, Timothy C.; Webster, Christie Ann; Koprinarov, Ivaylo; Rowlands, J. A.

    2008-03-15

    Digital x-ray radiographic systems are desirable as they offer high quality images which can be processed, transferred, and stored without secondary steps. However, current clinical systems are extraordinarily expensive in comparison to film-based systems. Thus, there is a need for an economical digital imaging system for general radiology. The x-ray light valve (XLV) is a novel digital x-ray detector concept with the potential for high image quality and low cost. The XLV is comprised of a photoconductive detector layer and liquid crystal (LC) cell physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected at the surface of the photoconductor, causing a change in the reflective properties of the LC cell. The visible image so formed can subsequently be digitized with an optical scanner. By choosing the properties of the LC cell in combination with the appropriate photoconductor thickness and bias potentials, the XLV can be optimized for various diagnostic imaging tasks. Specifically for chest radiography, we identified three potentially practical reflective cell designs by selecting from those commonly used in LC display technology. The relationship between reflectance and x-ray exposure (i.e., the characteristic curve) was determined for all three cells using a theoretical model. The results indicate that the reflective electrically controlled birefringence (r-ECB) cell is the preferred choice for chest radiography, provided that the characteristic curve can be shifted towards lower exposures. The feasibility of the shift of the characteristic curve is shown experimentally. The experimental results thus demonstrate that an XLV based on the r-ECB cell design exhibits a characteristic curve suitable for chest radiography.

  16. Computer aided detection of lung cancer in the absence of the cancer on chest radiographs: effect of the computer-aided detection on radiologists' performance on cancer-free cases

    NASA Astrophysics Data System (ADS)

    Osicka, Teresa; Freedman, Matthew T.; Lo, Shih-Chung B.; Lure, Fleming; Xu, Xin-Wei; Lin, Jesse; Zhang, Ron; Zhao, Hui

    2005-04-01

    Using data from a clinical trial of a commercial CAD system for lung cancer detection we separately analyzed the location, if any, selected on each film by 15 radiologists as they interpreted chest radiographs, 160 of which did not contain cancers. On the cancer-free cases, the radiologists showed statistically significant difference in decisions while using the CAD (p-value 0.002). Average specificity without computer assistance was 78%, and with computer assistance 73%. In a clinical trial with CAD for lung cancer detection there are multiple machine false positives. On chest radiographs of older current or former smokers, there are many scars that can appear like cancer to the interpreting radiologists. We are reporting on the radiologists' false positives and on the effect of machine false positive detections on observer performance on cancer-free cases. The only difference between radiologists occurred when they changed their initial true negative decision to false positive (p-value less than 0.0001), average confidence level increased, on the scale from 0.0 to 100.0, from 16.9 (high confidence of non-cancer) to 53.5 (moderate confidence cancer was present). We are reporting on the consistency of misinterpretation by multiple radiologists when they interpret cancer-free radiographs of smokers in the absence of CAD prompts. When multiple radiologists selected the same false positive location, there was usually a definite abnormality that triggered this response. The CAD identifies areas that are of sufficient concern for cancer that the radiologists will switch from a correct decision of no cancer to mark a false positive, previously overlooked, but suspicious appearing cancer-free area; one that has often been marked by another radiologist without the use of the CAD prompt. This work has implications on what should be accepted as ground truth in ROC studies: One might ask, "What a false positive response means?" when the finding, clinically, looks like cancer

  17. Male Pectoral Implants: Radiographic Appearance of Complications.

    PubMed

    Kuzmiak, Cherie M; Damitz, Lynn; Burke, Rachael; Hwang, Michael

    2016-03-01

    There has been a significant surge in aesthetic chest surgery for men in the last several years. Male chest enhancement is performed with surgical placement of a solid silicone pectoral implant. In the past, male chest correction and implantation were limited to the treatment of men who had congenital absence or atrophy of the pectoralis muscle and pectus excavatum deformity. But today, the popularization of increased chest and pectoral size fostered by body builders has more men desiring chest correction with implantation for non-medical reasons. We present a case of a 44-year-old, male with a displaced left pectoral implant with near extrusion and with an associated peri-implant soft tissue mass and fluid collection. While the imaging of these patients is uncommon, our case study presents the radiographic findings of male chest enhancement with associated complications. PMID:27200162

  18. Effect of Picture Archiving and Communication System Image Manipulation on the Agreement of Chest Radiograph Interpretation in the Neonatal Intensive Care Unit

    PubMed Central

    Castro, Denise A.; Naqvi, Asad Ahmed; Vandenkerkhof, Elizabeth; Flavin, Michael P.; Manson, David; Soboleski, Donald

    2016-01-01

    Objective: Variability in image interpretation has been attributed to differences in the interpreters’ knowledge base, experience level, and access to the clinical scenario. Picture archiving and communication system (PACS) has allowed the user to manipulate the images while developing their impression of the radiograph. The aim of this study was to determine the agreement of chest radiograph (CXR) impressions among radiologists and neonatologists and help determine the effect of image manipulation with PACS on report impression. Materials and Methods: Prospective cohort study included 60 patients from the Neonatal Intensive Care Unit undergoing CXRs. Three radiologists and three neonatologists reviewed two consecutive frontal CXRs of each patient. Each physician was allowed manipulation of images as needed to provide a decision of “improved,” “unchanged,” or “disease progression” lung disease for each patient. Each physician repeated the process once more; this time, they were not allowed to individually manipulate the images, but an independent radiologist presets the image brightness and contrast to best optimize the CXR appearance. Percent agreement and opposing reporting views were calculated between all six physicians for each of the two methods (allowing and not allowing image manipulation). Results: One hundred percent agreement in image impression between all six observers was only seen in 5% of cases when allowing image manipulation; 100% agreement was seen in 13% of the cases when there was no manipulation of the images. Conclusion: Agreement in CXR interpretation is poor; the ability to manipulate the images on PACS results in a decrease in agreement in the interpretation of these studies. New methods to standardize image appearance and allow improved comparison with previous studies should be sought to improve clinician agreement in interpretation consistency and advance patient care. PMID:27274414

  19. Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases.

    PubMed

    Helenius, L M J; Tervahartiala, P; Helenius, I; Al-Sukhun, J; Kivisaari, L; Suuronen, R; Kautiainen, H; Hallikainen, D; Lindqvist, C; Leirisalo-Repo, M

    2006-11-01

    The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and 18 with spondyloarthropathy (SPA). They were clinically examined, and panoramic tomography, lateral panoramic radiography and MRI of the TMJ were performed. MRI showed reduced articular cartilage in 25% (4/16) of RA, 0% (0/15) of MCTD, 17% (3/18) of AS and 17% (3/18) of SPA patients. Condylar changes included erosion, osteophytes and abnormal shape. Disc alterations included perforation, abnormal anterior position and decreased movement. These abnormalities were most frequent in RA patients, and least frequent in MCTD and SPA patients. Crepitation and reduced maximum opening of the mouth correlated with abnormalities of the disc and articular cartilage as shown by MRI. Severe condylar erosion in panoramic tomograms significantly correlated with MRI findings of condylar erosion (P<0.01), diminished thickness of condylar cartilage, abnormal condylar shape, and abnormal shape of the temporal surface of the TMJ (P< or =0.001). The presence of crepitation, limited mandibular movement and/or pain on movement of the jaw often indicated structural damage to the TMJ. Panoramic radiographs provide an alternative method to MRI but, to obtain a more detailed anatomic picture, MRI is recommended for patients with acute unexplained pain or as part of preoperative work up. A panoramic recording is not indicated when MRI is planned. PMID:17052893

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

    NASA Astrophysics Data System (ADS)

    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.

  1. Chest pain due to Pinch-off syndrome: radiological findings and endovascular rescue.

    PubMed

    Viviani, E; Giribono, A M; Ferrara, D; Santagata, A; Narese, D; Midiri, F; Albano, D; Porcellini, M

    2016-01-01

    Port-a-cath is widely used as a route for administration of drugs in hematology and oncology patients and, recently, has been adapted also for hemodialysis patients. Major complications include infection, thrombosis, arrhythmia, and embolization. The Pinch-off-syndrome (POS) means the clavicle and the first rib compress the long-term central venous catheter. The reported incidence rate ranges from 1.4% to 4.1%. This syndrome can be recognized on chest radiography by observing a thinning of the catheter lumen through the passage between the clavicle and the first rib. Catheter fracture is a rare but potentially life-threatening complication that must be recognized and treated promptly. Management of dislodged ports includes percutaneous transcatheter retrieval, open thoracotomy retrieval and oral anticoagulant therapy. Among these techniques, percutaneous transcatheter retrieval is an easy, safe and efficient method. We report the successful percutaneous endovascular retrieval of dislodged intracardiac catheter, separated from its port, in a 58 year-old male patient who presented with chest pain. PMID:26980633

  2. Phantom tumour of the lung in a patient with renal failure misdiagnosed as chest infection

    PubMed Central

    Althomali, Sarah Ali; Almalki, Mazen Mohammed; Mohiuddin, Syed Atif

    2014-01-01

    Phantom or vanishing tumour of the lung is a rare finding on chest radiographs that has been reported secondary to heart failure or chronic kidney disease. It has been described as an interlobular effusion of the transverse or oblique fissure of the right lung. Although it is uncommon, it should always be considered as a differential diagnosis for a radiographic opacity of the right-middle lung zone because it can be easily mistaken for a lung mass or infiltration. We herein present a case involving a patient with chronic kidney disease and a radiographic opacity of the right-middle lung that was diagnosed as a chest infection. The patient did not respond to various antibiotics and showed a poor response to diuretics, the standard treatment for phantom tumour. However, the patient markedly improved after dialysis, and the radiographic chest opacity disappeared. PMID:24943144

  3. Phantom tumour of the lung in a patient with renal failure misdiagnosed as chest infection.

    PubMed

    Althomali, Sarah Ali; Almalki, Mazen Mohammed; Mohiuddin, Syed Atif

    2014-01-01

    Phantom or vanishing tumour of the lung is a rare finding on chest radiographs that has been reported secondary to heart failure or chronic kidney disease. It has been described as an interlobular effusion of the transverse or oblique fissure of the right lung. Although it is uncommon, it should always be considered as a differential diagnosis for a radiographic opacity of the right-middle lung zone because it can be easily mistaken for a lung mass or infiltration. We herein present a case involving a patient with chronic kidney disease and a radiographic opacity of the right-middle lung that was diagnosed as a chest infection. The patient did not respond to various antibiotics and showed a poor response to diuretics, the standard treatment for phantom tumour. However, the patient markedly improved after dialysis, and the radiographic chest opacity disappeared. PMID:24943144

  4. Can chest high-resolution computed tomography findings diagnose pulmonary alveolar microlithiasis?*

    PubMed Central

    Francisco, Flávia Angélica Ferreira; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Escuissato, Dante Luiz; Araujo Neto, Cesar Augusto; Silva, Jorge Luiz Pereira e; Silva, Claudio S.; Hochhegger, Bruno; Souza Jr., Arthur Soares; Zanetti, Gláucia; Marchiori, Edson

    2015-01-01

    Objective The present study was aimed at retrospectively reviewing high-resolution computed tomography (HRCT) findings in patients with pulmonary alveolar microlithiasis in order to evaluate the frequency of tomographic findings and their distribution in the lung parenchyma. Materials and Methods Thirteen patients (9 females and 4 males; age, 9 to 59 years; mean age, 34.5 years) were included in the present study. The HRCT images were independently evaluated by two observers whose decisions were made by consensus. The inclusion criterion was the presence of abnormalities typical of pulmonary alveolar microlithiasis at HRCT, which precludes lung biopsy. However, in 6 cases lung biopsy was performed. Results Ground-glass opacities and small parenchymal nodules were the predominant tomographic findings, present in 100% of cases, followed by small subpleural nodules (92.3%), subpleural cysts (84.6%), subpleural linear calcifications (69.2%), crazy-paving pattern (69.2%), fissure nodularity (53.8%), calcification along interlobular septa (46.2%) and dense consolidation (46.2%). Conclusion As regards distribution of the lesions, there was preferential involvement of the lower third of the lungs. No predominance of distribution in axial and anteroposterior directions was observed. PMID:26379317

  5. [Estimation of population genetic parameters for radiographical findings of elbow dsyplasia in the Labrador Retriever].

    PubMed

    Engler, Jennifer; Hamann, Henning; Distl, Ottmar

    2009-01-01

    specific genetic effects from a body side or sex-specific genetic effects could be observed for the expression of ED. Dogs showing radiographic signs of ED or dogs having been submitted for a surgery due to clinical signs of ED have to be precluded from breeding. The veterinary practitioner can help to reduce the frequency of dogs exhibiting a genetic disposition to ED when the radiographs of the elbow joints of many as possible purebred dogs are submitted to the respective dog breeding associations. PMID:19863010

  6. Morbidity and mortality of vermiculite miners and millers exposed to tremolite-actinolite: Part III. Radiographic findings

    SciTech Connect

    Amandus, H.E.; Althouse, R.; Morgan, W.K.; Sargent, E.N.; Jones, R.

    1987-01-01

    A study was conducted to estimate the exposure-response relationship for tremolite-actinolite fiber exposure and radiographic findings among 184 men employed at a Montana vermiculite mine and mill. Workers were included if they had been employed during 1975-1982 and had achieved at least 5 years tenure at the Montana site. Past fiber exposure was associated with an increased prevalence of parenchymal and pleural radiographic abnormalities. Smoking was not significantly related to the prevalence of small opacities. However, the number of workers who had never smoked was small, and this prevented measurement of the smoking effect. Under control for smoking and age, the prevalence of small opacities was significantly greater for vermiculite workers with greater than 100 fiber/cc-years exposure than for comparison groups (cement workers, blue collar workers, and coal miners) who had no known occupational fiber exposure. A logistic model predicted an increase of 1.3% in the odds ratio for small opacities at an additional exposure of 5 fiber-years.

  7. Learning from others: effects of viewing another person's eye movements while searching for chest nodules

    NASA Astrophysics Data System (ADS)

    Litchfield, Damien; Ball, Linden J.; Donovan, Tim; Manning, David J.; Crawford, Trevor

    2008-03-01

    We report a study that investigated whether experienced and inexperienced radiographers benefit from knowing where another person looked during pulmonary nodule detection. Twenty-four undergraduate radiographers (1 year of experience) and 24 postgraduate radiographers (5+ years of experience) searched 42 chest x-rays for nodules and rated how confident they were in their decisions. Eye movements were also recorded. Performance was compared across three within-participant conditions: (1) free search - where radiographers could identify nodules as normal; (2) image preview - where radiographers were first shown each chest x-ray for 20 seconds before they could then proceed to mark the location of any nodules; and (3) eye movement preview - which was identical to image preview except that the 20 second viewing period displayed an overlay of the real-time eye movements of another radiographer's scanpath for that image. For this preview condition half of each group were shown where a novice radiographer looked, and the other half were shown where an experienced radiologist looked. This was not made known to the participants until after the experiment. Performance was assessed using JAFROC analysis. Both groups of radiographers performed better in the eye movement preview condition compared with the image preview or free search conditions, with inexperienced radiographers improving the most. We discuss our findings in terms of the task-specific information interpreted from eye movement previews, task difficulty across images, and whether it matters if radiographers are previewing the eye movements of an expert or a novice.

  8. Chest imaging features of patients afflicted with Influenza A (H1N1) in a Malaysian tertiary referral centre

    PubMed Central

    Bux, SI; Mohd. Ramli, N; Ahmad Sarji, S; Kamarulzaman, A

    2010-01-01

    This is a retrospective descriptive study of the chest imaging findings of 118 patients with confirmed A(H1N1) in a tertiary referral centre. About 42% of the patients had positive initial chest radiographic (CXR) findings. The common findings were bi-basal air-space opacities and perihilar reticular and alveolar infiltrates. In select cases, high-resolution computed tomography (CT) imaging showed ground-glass change with some widespread reticular changes and atelectasis. PMID:21611071

  9. Sarcoidosis: a diagnostic challenge in atypical radiologic findings of unilateral lymphadenopathy

    PubMed Central

    Meillier, Andrew; Commodore, Marius

    2015-01-01

    Sarcoidosis is a chronic systemic disease with a wide array of clinical findings. Given that the clinical symptoms are not pathognomonic, chest radiographs have become essential to the initial diagnosis and choice of treatment modality. Diagnosis hinges on ruling out alternative diagnoses; sometimes, advanced radiologic techniques and histopathology are required. On this occasion, we present a case of a patient with generalized symptoms, no significant chest radiograph findings and lymphadenopathy where advanced imaging and pathology assisted in the diagnosis. PMID:26719811

  10. Frequency and number of ultrasound lung rockets (B-lines) using a regionally based lung ultrasound examination named vet BLUE (veterinary bedside lung ultrasound exam) in dogs with radiographically normal lung findings.

    PubMed

    Lisciandro, Gregory R; Fosgate, Geoffrey T; Fulton, Robert M

    2014-01-01

    Lung ultrasound is superior to lung auscultation and supine chest radiography for many respiratory conditions in human patients. Ultrasound diagnoses are based on easily learned patterns of sonographic findings and artifacts in standardized images. By applying the wet lung (ultrasound lung rockets or B-lines, representing interstitial edema) versus dry lung (A-lines with a glide sign) concept many respiratory conditions can be diagnosed or excluded. The ultrasound probe can be used as a visual stethoscope for the evaluation of human lungs because dry artifacts (A-lines with a glide sign) predominate over wet artifacts (ultrasound lung rockets or B-lines). However, the frequency and number of wet lung ultrasound artifacts in dogs with radiographically normal lungs is unknown. Thus, the primary objective was to determine the baseline frequency and number of ultrasound lung rockets in dogs without clinical signs of respiratory disease and with radiographically normal lung findings using an 8-view novel regionally based lung ultrasound examination called Vet BLUE. Frequency of ultrasound lung rockets were statistically compared based on signalment, body condition score, investigator, and reasons for radiography. Ten left-sided heart failure dogs were similarly enrolled. Overall frequency of ultrasound lung rockets was 11% (95% confidence interval, 6-19%) in dogs without respiratory disease versus 100% (95% confidence interval, 74-100%) in those with left-sided heart failure. The low frequency and number of ultrasound lung rockets observed in dogs without respiratory disease and with radiographically normal lungs suggests that Vet BLUE will be clinically useful for the identification of canine respiratory conditions. PMID:24382172

  11. Experimental Actinobacillus pleuropneumoniae challenge in swine: Comparison of computed tomographic and radiographic findings during disease

    PubMed Central

    2012-01-01

    Background In pigs, diseases of the respiratory tract like pleuropneumonia due to Actinobacillus pleuropneumoniae (App) infection have led to high economic losses for decades. Further research on disease pathogenesis, pathogen-host-interactions and new prophylactic and therapeutic approaches are needed. In most studies, a large number of experimental animals are required to assess lung alterations at different stages of the disease. In order to reduce the required number of animals but nevertheless gather information on the nature and extent of lung alterations in living pigs, a computed tomographic scoring system for quantifying gross pathological findings was developed. In this study, five healthy pigs served as control animals while 24 pigs were infected with App, the causative agent of pleuropneumonia in pigs, in an established model for respiratory tract disease. Results Computed tomographic (CT) findings during the course of App challenge were verified by radiological imaging, clinical, serological, gross pathology and histological examinations. Findings from clinical examinations and both CT and radiological imaging, were recorded on day 7 and day 21 after challenge. Clinical signs after experimental App challenge were indicative of acute to chronic disease. Lung CT findings of infected pigs comprised ground-glass opacities and consolidation. On day 7 and 21 the clinical scores significantly correlated with the scores of both imaging techniques. At day 21, significant correlations were found between clinical scores, CT scores and lung lesion scores. In 19 out of 22 challenged pigs the determined disease grades (not affected, slightly affected, moderately affected, severely affected) from CT and gross pathological examination were in accordance. Disease classification by radiography and gross pathology agreed in 11 out of 24 pigs. Conclusions High-resolution, high-contrast CT examination with no overlapping of organs is superior to radiography in the

  12. Use of chest sonography in acute-care radiology☆

    PubMed Central

    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

  13. Pure neuritic leprosy presenting as ulnar nerve neuropathy: a case report of electrodiagnostic, radiographic, and histopathological findings.

    PubMed

    Payne, Russell; Baccon, Jennifer; Dossett, John; Scollard, David; Byler, Debra; Patel, Akshal; Harbaugh, Kimberly

    2015-11-01

    Hansen's disease, or leprosy, is a chronic infectious disease with many manifestations. Though still a major health concern and leading cause of peripheral neuropathy in the developing world, it is rare in the United States, with only about 150 cases reported each year. Nevertheless, it is imperative that neurosurgeons consider it in the differential diagnosis of neuropathy. The causative organism is Mycobacterium leprae, which infects and damages Schwann cells in the peripheral nervous system, leading first to sensory and then to motor deficits. A rare presentation of Hansen's disease is pure neuritic leprosy. It is characterized by nerve involvement without the characteristic cutaneous stigmata. The authors of this report describe a case of pure neuritic leprosy presenting as ulnar nerve neuropathy with corresponding radiographic, electrodiagnostic, and histopathological data. This 11-year-old, otherwise healthy male presented with progressive right-hand weakness and numbness with no cutaneous abnormalities. Physical examination and electrodiagnostic testing revealed findings consistent with a severe ulnar neuropathy at the elbow. Magnetic resonance imaging revealed diffuse thickening and enhancement of the ulnar nerve and narrowing at the cubital tunnel. The patient underwent ulnar nerve decompression with biopsy. Pathology revealed acid-fast organisms within the nerve, which was pathognomonic for Hansen's disease. He was started on antibiotic therapy, and on follow-up he had improved strength and sensation in the ulnar nerve distribution. Pure neuritic leprosy, though rare in the United States, should be considered in the differential diagnosis of those presenting with peripheral neuropathy and a history of travel to leprosy-endemic areas. The long incubation period of M. leprae, the ability of leprosy to mimic other conditions, and the low sensitivity of serological tests make clinical, electrodiagnostic, and radiographic evaluation necessary for diagnosis

  14. Image processing in digital chest radiography: effect on diagnostic efficacy.

    PubMed

    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 (512 x 512 image format) viewed on a 625 line monitor were processed in three different ways: (1) standard display; (2) digital edge enhancement for the standard display; and (3) inverse intensity display. The radiographs were interpreted independently by three radiologists. The 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 and 17 cases with pneumonia/atelectasis. Interstitial lung disease, pleural plaques, and pulmonary emphysema were found in 30, 18 and 19 cases, respectively. The sensitivity of conventional radiography when averaged overall findings was better than that of the digital techniques (P less than 0.001). The differences in diagnostic accuracy measured by sensitivity and specificity between the three digital display modes were small. Standard image display showed better sensitivity for pulmonary nodules (0.74 vs 0.66; P less than 0.05) but poorer specificity for pulmonary emphysema (0.85 vs. 0.93; P less than 0.05) compared with inverse intensity display. We conclude that when using 512 x 512 image format, the routine use of digital edge enhancement and tone reversal at digital chest radiographs is not warranted. PMID:1563421

  15. Use of Coronary Computed Tomographic Angiography Findings to Modify Statin and Aspirin Prescription in Patients With Acute Chest Pain.

    PubMed

    Pursnani, Amit; Celeng, Csilla; Schlett, Christopher L; Mayrhofer, Thomas; Zakroysky, Pearl; Lee, Hang; Ferencik, Maros; Fleg, Jerome L; Bamberg, Fabian; Wiviott, Stephen D; Truong, Quynh A; Udelson, James E; Nagurney, John T; Hoffmann, Udo

    2016-02-01

    Coronary CT angiography (CCTA) is used in patients with low-intermediate chest pain presenting to the emergency department for its reliability in excluding acute coronary syndrome (ACS). However, its influence on medication modification in this setting is unclear. We sought to determine whether knowledge of CCTA-based coronary artery disease (CAD) was associated with change in statin and aspirin prescription. We used the CCTA arm of the Rule Out Myocardial Infarction using Computed Angiographic Tomography II multicenter, randomized control trial (R-II) and comparison cohort from the observational Rule Out Myocardial Infarction using Computed Angiographic Tomography I cohort (R-I). In R-II, subjects were randomly assigned to CCTA to guide decision making, whereas in R-I patients underwent CCTA with results blinded to caregivers and managed according to standard care. Our final cohort consisted of 277 subjects from R-I and 370 from R-II. ACS rate was similar (6.9% vs 6.2% respectively, p = 0.75). For subjects with CCTA-detected obstructive CAD without ACS, initiation of statin was significantly greater after disclosure of CCTA results (0% in R-I vs 20% in R-II, p = 0.009). Conversely, for subjects without CCTA-detected CAD, aspirin prescription was lower with disclosure of CCTA results (16% in R-I vs 4.8% in R-II, p = 0.001). However, only 68% of subjects in R-II with obstructive CAD were discharged on statin and 65% on aspirin. In conclusion, physician knowledge of CCTA results leads to improved alignment of aspirin and statin with the presence and severity of CAD although still many patients with CCTA-detected CAD are not discharged on aspirin or statin. Our findings suggest opportunity for practice improvement when CCTA is performed in the emergency department. PMID:26762723

  16. Demographic and clinical factors associated with radiographic severity of first metatarsophalangeal joint osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot

    PubMed Central

    Menz, H.B.; Roddy, E.; Marshall, M.; Thomas, M.J.; Rathod, T.; Myers, H.; Thomas, E.; Peat, G.M.

    2015-01-01

    Summary Objective To explore demographic and clinical factors associated with radiographic severity of first metatarsophalangeal joint osteoarthritis (OA) (First MTPJ OA). Design Adults aged ≥50 years registered with four general practices were mailed a Health Survey. Responders reporting foot pain within the last 12 months were invited to undergo a clinical assessment and weight-bearing dorso-plantar and lateral radiographs of both feet. Radiographic first MTPJ OA in the most severely affected foot was graded into four categories using a validated atlas. Differences in selected demographic and clinical factors were explored across the four radiographic severity subgroups using analysis of variance (ANOVA) and ordinal regression. Results Clinical and radiographic data were available from 517 participants, categorised as having no (n = 105), mild (n = 228), moderate (n = 122) or severe (n = 62) first MTPJ OA. Increased radiographic severity was associated with older age and lower educational attainment. After adjusting for age, increased radiographic first MTPJ OA severity was significantly associated with an increased prevalence of dorsal hallux and first MTPJ pain, hallux valgus, first interphalangeal joint (IPJ) hyperextension, keratotic lesions on the dorsal aspect of the hallux and first MTPJ, decreased first MTPJ dorsiflexion, ankle/subtalar joint eversion and ankle joint dorsiflexion range of motion, and a trend towards a more pronated foot posture. Conclusions This cross-sectional study has identified several dose–response associations between radiographic severity of first MTPJ OA and a range of demographic and clinical factors. These findings highlight the progressive nature of first MTPJ OA and provide insights into the spectrum of presentation of the condition in clinical practice. PMID:25450852

  17. Hypoxia and hydrothoraces in a case of liver cirrhosis: correlation of physiological, radiographic, scintigraphic, and pathological findings

    PubMed Central

    Stanley, N. N.; Williams, A. J.; Dewar, C. A.; Blendis, L. M.; Reid, Lynne

    1977-01-01

    Stanley, N. N., Williams, A. J., Dewar, C. A., Blendis, L. M., and Reid, Lynne (1977).Thorax, 32, 457-471. Hypoxia and hydrothoraces in a case of liver cirrhosis: correlation of physiological, radiographic, scintigraphic, and pathological findings. A case is reported of liver cirrhosis complicated by cyanosis and recurrent right hydrothorax. A diagnostic pneumoperitoneum demonstrated that direct movement of ascites through a diaphragmatic defect was responsible for the hydrothoraces. Pulmonary function tests between episodes of hydrothorax showed severe arterial hypoxaemia, a 23% right-to-left shunt, and a reduction in the carbon monoxide transfer factor to less than half of the predicted value. Evidence of abnormal intrapulmonary arteriovenous communications was obtained by perfusion scanning. At necropsy the central tendon of the diaphragm showed numerous areas of thinning which were easily ruptured. Injection of the pulmonary arterial tree demonstrated precapillary arteriovenous anastomoses and pleural spider naevi. A morphometric analysis provided quantitative evidence of pulmonary vasodilatation limited to the intra-acinar arteries, consistent with the effect of a circulating vasodilator. The scintigraphic and pathological findings suggested that shunting had been greater in the right than the left lung. Examination of thin lung sections by light microscopy showed that the walls of small veins were thickened, and electron microscopy showed that this was due to a layer of collagen. The walls of capillaries were similarly thickened, which caused an approximately two-fold increase in the minimum blood-gas distance and contributed to the reduction in transfer factor. Images PMID:929488

  18. Technique for chest radiography for pneumoconiosis

    SciTech Connect

    Sargent, E.N.

    1982-01-01

    Routine radiographic chest examinations have been performed using a variety of techniques. Although chest radiography is one of the most commonly performed radiographic examinations, it is often difficult to obtain consistently good quality roentgenograms. This publication provides a simple guide and relatively easy solution to the many problems that radiologic technologists might encounter. The language is purposely relatively simple and care has been taken to avoid difficult mathematical and physical explanations. The intent is to provide an easily referrable text for those who may encounter difficulties in producing acceptable chest radiographs.

  19. Mucopolysaccharidosis type I (Hurler syndrome): oral and radiographic findings and ultrastructural/chemical features of enamel and dentin.

    PubMed

    Guven, Gunseli; Cehreli, Zafer C; Altun, Ceyhan; Sençimen, Metin; Ide, Semra; Bayari, Sevgi H; Karaçay, Seniz

    2008-01-01

    Mucopolysaccharidosis type I (Hurler syndrome, MPS I-H) is an autosomal recessive inborn error of metabolism due to deficient alpha-L-iduronidase enzyme activity and is characterized by accumulation of incompletely degraded glycosaminoglycans that generally lead to impairment of organ and body functions. This report presents oral, dental, and radiographic findings in a boy who presented with MPS I-H. Nine of the patient's primary teeth were extracted and investigated using scanning electron microscopy, x-ray diffraction analysis, and Fourier transform infrared spectroscopy. Compared with the teeth of otherwise healthy patients, MPS I-H-affected dentin was characterized by extremely narrow dentinal tubules, whose direction followed an irregular wave-like pattern. The enamel-dentin junction was defective, as evidenced by microgaps, and the enamel displayed irregular arrangement of prisms. The additional novel observation was made that the protein structure of enamel and dentin changed in MPS I-H-affected teeth. Also, an increase was observed in the relative mineral/matrix ratio of MPS I-H-affected dentin, indicating that its protein content had decreased in comparison with normal dentin. PMID:17604658

  20. Pediatric digital chest imaging

    SciTech Connect

    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.

  1. 42 CFR 37.43 - Approval of radiographic facilities that use film.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic... their ability to make high quality diagnostic chest radiographs by submitting to NIOSH six or more sample chest radiographs made and processed at the applicant facility and which are of acceptable...

  2. Boerhaave's syndrome - tension hydropneumothorax and rapidly developing hydropneumothorax: two radiographic clues in one case.

    PubMed

    Nguyen Ho, Lam; Tran Van, Ngoc; Le, Thuong Vu

    2016-07-01

    Boerhaave's syndrome is a rare and severe condition with high mortality partly because of its atypical presentation resulting in delayed diagnosis and management. Diagnostic clues play an important role in the approach to this syndrome. Here, we report a 48 year-old male patient hospitalized with fever and left chest pain radiating into the interscapular area. Two chest radiographs undertaken 22 h apart showed a rapidly developing tension hydropneumothorax. The amylase level in the pleural fluid was high. The fluid in the chest tube turned bluish after the patient drank methylene blue. The diagnosis of Boerhaave's syndrome was suspected based on the aforementioned clinical clues and confirmed at the operation. The patient recovered completely with the use of antibiotics and surgical treatment. In this case, we describe key findings on chest radiographs that are useful in diagnosing Boerhaave's syndrome. PMID:27512563

  3. Boerhaave's syndrome – tension hydropneumothorax and rapidly developing hydropneumothorax: two radiographic clues in one case

    PubMed Central

    Tran Van, Ngoc; Le, Thuong Vu

    2016-01-01

    Abstract Boerhaave's syndrome is a rare and severe condition with high mortality partly because of its atypical presentation resulting in delayed diagnosis and management. Diagnostic clues play an important role in the approach to this syndrome. Here, we report a 48 year‐old male patient hospitalized with fever and left chest pain radiating into the interscapular area. Two chest radiographs undertaken 22 h apart showed a rapidly developing tension hydropneumothorax. The amylase level in the pleural fluid was high. The fluid in the chest tube turned bluish after the patient drank methylene blue. The diagnosis of Boerhaave's syndrome was suspected based on the aforementioned clinical clues and confirmed at the operation. The patient recovered completely with the use of antibiotics and surgical treatment. In this case, we describe key findings on chest radiographs that are useful in diagnosing Boerhaave's syndrome. PMID:27512563

  4. New developed DR detector performs radiographs of hand, pelvic and premature chest anatomies at a lower radiation dose and/or a higher image quality.

    PubMed

    Precht, Helle; Tingberg, Anders; Waaler, Dag; Outzen, Claus Bjørn

    2014-02-01

    A newly developed Digital Radiography (DR) detector has smaller pixel size and higher fill factor than earlier detector models. These technical advantages should theoretically lead to higher sensitivity and higher spatial resolution, thus making dose reduction possible without scarifying image quality compared to previous DR detector versions. To examine whether the newly developed Canon CXDI-70C DR detector provides an improved image quality and/or allows for dose reductions in hand and pelvic bone examinations as well as premature chest examinations, compared to the previous (CXDI-55C) DR detector version. A total of 450 images of a technical Contrast-Detail phantom were imaged on a DR system employing various kVp and mAs settings, providing an objective image quality assessment. In addition, 450 images of anthropomorphic phantoms were taken and analyzed by three specialized radiologists using Visual Grading Analysis (VGA). The results from the technical phantom studies showed that the image quality expressed as IQFINV values was on average approximately 45 % higher with the CXDI-70C detector compared to the CXDI-55C detector. Consistently, the VGA results from the anatomical phantom studies indicated that by using the CXDI-70C detector, diagnostic image quality could be maintained at a dose reduction of in average 30 %, depending on anatomy and kVp level. This indicates that the CXDI-70C detector is significantly more sensitive than the previous model, and supports a better clinical image quality. By using the newly developed DR detector a significant dose reduction is possible while maintaining image quality. PMID:24221693

  5. 42 CFR 37.44 - Approval of radiographic facilities that use digital radiography systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (45 CFR Part 160 and Subparts A, C, and E of Part 164). ... quality digital chest radiographs by submitting to NIOSH digital radiographic image files of a test object... digital radiographic image files from six or more sample chest radiographs that are of acceptable...

  6. 42 CFR 37.44 - Approval of radiographic facilities that use digital radiography systems.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF... quality digital chest radiographs by submitting to NIOSH digital radiographic image files of a test object... digital radiographic image files from six or more sample chest radiographs that are of acceptable...

  7. Senile Calcification of the Trachea, Aortic Arch, and Mitral Annulus: An Incidental Finding on Chest X-Ray.

    PubMed

    Hosseinzadeh Maleki, Mahmood; Kazemi, Toba; Davoody, Navid

    2015-10-27

    A 94-year-old woman presented with dizziness and hypotension of 2 days' duration. She denied any syncope, presyncope, or angina. She had received a permanent pacemaker 12 years previously for the management of complete heart block (CHB), but she failed to program it. Twelve-lead electrocardiography revealed CHB with ventricular escape rhythm (40/min), so we inserted a temporary pacemaker. Anteroposterior chest X-ray showed trachea, aortic arch, and severe mitral valve calcification. Tracheal calcification is usually seen after 40 years old without clinical importance. However, it is seen in patients with renal failure, metastases, and prolonged use of warfarin as well as in pregnancy.(1) (-) (3). PMID:26985213

  8. Clinical predictors of radiographic abnormalities among infants with bronchiolitis in a paediatric emergency department

    PubMed Central

    2014-01-01

    Background Acute viral respiratory exacerbation is one of the most common conditions encountered in a paediatric emergency department (PED) during winter months. We aimed at defining clinical predictors of chest radiography prescription and radiographic abnormalities, among infants with bronchiolitis in a paediatric emergency department. Methods We conducted a prospective cohort study of children less than 2 years of age with clinical bronchiolitis, who presented for evaluation at the paediatric emergency department of an urban general hospital in France. Detailed information regarding historical features, examination findings, and management were collected. Clinical predictors of interest were explored in multivariate logistic regression models. Results Among 410 chest radiographs blindly interpreted by two experts, 40 (9.7%) were considered as abnormal. Clinical predictors of chest radiography achievement were age (under three months), feeding difficulties, fever over 38°C, hypoxia under than 95% of oxygen saturation, respiratory distress, crackles, and bronchitis rales. Clinical predictors of radiographic abnormalities were fever and close to significance hypoxia and conjunctivitis. Conclusion Our study provides arguments for reducing chest radiographs in infants with bronchiolitis. For infants with clinical factors such as age less than three months, feeding difficulties, respiratory distress without hypoxia, isolated crackles or bronchitis rales, careful clinical follow-up should be provided instead of chest radiography. PMID:24906343

  9. Sonography of the Pediatric Chest.

    PubMed

    Goh, Yonggeng; Kapur, Jeevesh

    2016-05-01

    Traditionally, pediatric chest diseases are evaluated with chest radiography. Due to advancements in technology, the use of sonography has broadened. It has now become an established radiation-free imaging tool that may supplement plain-film findings and, in certain cases, the first-line modality for evaluation of the pediatric chest. This pictorial essay will demonstrate the diagnostic potential of sonography, review a spectrum of pediatric chest conditions, and discuss their imaging features and clinical importance. PMID:27009313

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

    PubMed Central

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

    2015-01-01

    Aim Evidence supporting the recommendation to include chest radiography in the work-up of all cervical cancer patients is limited. We investigated the diagnostic value of routine chest radiography in cervical cancer staging. Methods All consecutive cervical cancer patients who presented at our tertiary referral center in the Netherlands (January 2006 – September 2013), and for whom ≥6 months follow-up was available, were included. As part of the staging procedure, patients underwent a routine two-directional digital chest radiograph. Findings were compared to a composite reference standard consisting of all imaging studies and histology obtained during the 6 months following radiography. Results Of the 402 women who presented with cervical cancer, 288 (71.6%) underwent chest radiography and had ≥6 months follow-up. Early clinical stage (I/II) cervical cancer was present in 244/288 (84.7%) women, while 44 (15.3%) presented with advanced disease (stage III/IV). The chest radiograph of 1 woman – with advanced pre-radiograph stage (IVA) disease – showed findings consistent with pulmonary metastases. Radiographs of 7 other women – 4 early, 3 advanced stage disease – were suspicious for pulmonary metastases which was confirmed by additional imaging in only 1 woman (with pre-radiograph advanced stage (IIIB) disease) and excluded in 6 cases, including all women with early stage disease. In none of the 288 women were thoracic skeletal metastases identified on imaging or during 6 months follow up. Radiography was unremarkable in 76.4% of the study population, and showed findings unrelated to the cervical carcinoma in 21.2%. Conclusion Routine chest radiography was of no value for any of the early stage cervical cancer patients presenting at our tertiary center over a period of 7.7 years. PMID:26135733

  11. Chest Pain

    MedlinePlus

    Having a pain in your chest can be scary. It does not always mean that you are having a heart attack. There can be many other causes, ... embolism Costochondritis - an inflammation of joints in your chest Some of these problems can be serious. Get ...

  12. [Chest pain].

    PubMed

    Horn, Benedikt

    2015-01-01

    Chest pain in ambulatory setting is predominantly not heart-associated. Most patients suffer from muskuloskeletal or functional (psychogenic) chest pain. Differential diagnosis covers aortic dissection, rib-fracture, shingles, GERD, Tietze-Syndrome, pulmonary embolism, pleuritis, pneumothorax, pleurodynia and metastatic disease. In most cases history, symptoms and signs allow a clinical diagnosis of high pretest-probability. PMID:25533261

  13. Chest tomosynthesis: technical and clinical perspectives.

    PubMed

    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. PMID:24481756

  14. Filters For Chest Radiography

    NASA Astrophysics Data System (ADS)

    Ramanathan, N.; Paron, J.

    1980-08-01

    The objective of low dose radiography is achieved by a judicious combination of proper kV selection, fast film-screen systems and beam filtration. A systematic study of filters was undertaken to evaluate the improvements that can be realized in terms of patient Entrance Skin Exposures (ESE) for chest radiographs. The Picker CD 135 Generator and the Automatic Chest Filmer with dynamic phototiming were used for the study. The kV dependence of ESE with various amounts of zinc and aluminum filtration is presented. The effect of filtration on image contrast is discussed. The variations of ESE with phantom thickness under different filtration conditions are also considered. It was found that the ESE can be reduced by as much as a factor of 1.8 ± .1 with no significant increase in tube loading.

  15. Psychogenic Dyspnea and Therapeutic Chest Radiograph

    ERIC Educational Resources Information Center

    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…

  16. Surgical Management of Minimally Invasive Anterior Lumbar Interbody Fusion with Stand-Alone Interbody Cage for L4-5 Degenerative Disorders: Clinical and Radiographic Findings

    PubMed Central

    Hironaka, Yasuo; Morimoto, Tetsuya; Motoyama, Yasushi; Park, Young-Su; Nakase, Hiroyuki

    2013-01-01

    Surgical treatment for degenerative spinal disorders is controversial, although lumbar fusion is considered an acceptable option for disabling lower back pain. Patients underwent instrumented minimally invasive anterior lumbar interbody fusion (mini-ALIF) using a retroperitoneal approach except for requiring multilevel fusions, severe spinal canal stenosis, high-grade spondylolisthesis, and a adjacent segments disorders. We retrospectively reviewed the clinical records and radiographs of 142 patients who received mini-ALIF for L4-5 degenerative lumbar disorders between 1998 and 2010. We compared preoperative and postoperative clinical data and radiographic measurements, including the modified Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score for back and leg pain, disc height (DH), whole lumbar lordosis (WL), and vertebral wedge angle (WA). The mean follow-up period was 76 months. The solid fusion rate was 90.1% (128/142 patients). The average length of hospital stay was 6.9 days (range, 3–21 days). The mean blood loss was 63.7 ml (range, 10–456 ml). The mean operation time was 155.5 min (range, 96–280 min). The postoperative JOA and VAS scores for back and leg pain were improved compared with the preoperative scores. Radiological analysis showed significant postoperative improvements in DH, WL, and WA, and the functional and radiographical outcomes improved significantly after 2 years. The 2.8% complication rate included cases of wound infection, liquorrhea, vertebral body fractures, and a misplaced cage that required revision. Mini-ALIF was found to be associated with improved clinical results and radiographic findings for L4-5 disorders. A retroperitoneal approach might therefore be a valuable treatment option. PMID:24140782

  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

    SciTech Connect

    Chen Sheng; Suzuki, Kenji; MacMahon, Heber

    2011-04-15

    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. [Effects of surgery on muscles on clinical and radiographic findings in the hip joint region in cerebral palsy patients].

    PubMed

    Schejbalová, A; Havlas, V

    2008-10-01

    PURPOSE OF THE STUDY Isolated or combined surgical procedures on muscles around the hip joint are currently indicated by many authors. In cerebral palsy patients they are regarded as essential intervention. MATERIAL In the years 2005-2007, surgery in the hip joint region was essential for 150 children between 3 and 18 years of age. At the time of surgery, the patients' locomotion ranged from stage 1 to stage 7 of the Vojta system. METHODS The outcome was evaluated by clinical and radiographic examination at 2 and 6 months post-operatively and hip migration percentage and Wiberg's CE angle were measured. RESULTS The best clinical and radiographic outcomes were achieved in children younger than 6 years of age. On the other hand, isolated transfer of the distal rectus femoris muscle significantly affected pelvis anteflexion in adolescent patients. The most marked decrease in migration percentage was found after adductor tenotomy combined with surgery on the iliopsoas muscle (55.6 %) or when the two procedures were combined with distal rectus femoris transfer. DISCUSSION Combined surigical procedures, i.e., adductor tenotomy, surgery on the iliopsoas muscle or rectus femoris muscle and medial hamstrings, with fixation using an abduction modified Atlanta brace, are effective in patients with marked lateral hip migration who are younger that 6 years. Isolated adductor tenotomy and distal transfer of the rectus femoris muscle markedly improve standing position in walking patients. CONCLUSION An appropriate combination of surgical procedures on muscles in the hip region and on medial hamstrings can significantly improve the patient's locomotion and, if lateral migration is present, help to avoid surgery on bones. PMID:19026189

  19. Chest MRI

    MedlinePlus

    ... imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (thoracic area). ... no side effects from the magnetic fields and radio waves have been reported. The most common type of ...

  20. Chest MRI

    MedlinePlus

    ... Restrictive cardiomyopathy Superior vena cava (SVC) obstruction Thoracic aortic aneurysm Thymus tumor Tumors of the chest Consult your ... Restrictive cardiomyopathy SVC obstruction Swollen lymph nodes Thoracic aortic aneurysm Patient Instructions Abdominal aortic aneurysm repair - open - discharge ...

  1. Chest radiology

    SciTech Connect

    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.

  2. Chest drainage.

    PubMed

    Carter, Chris

    2014-07-15

    As an intensive care nurse with experience of caring for critically ill patients in the UK and on deployed operations overseas, I found the CPD article useful in reviewing the pathophysiology of a pneumothorax, use of intrapleural chest drains, observations that should be recorded, and nursing care and management of a patient with an intrapleural chest drain. Reflecting on the time out activities in the CPD article was valuable. PMID:25005418

  3. 42 CFR 37.43 - Approval of radiographic facilities that use film.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest... demonstrating their ability to make high quality diagnostic chest radiographs by submitting to NIOSH six or more sample chest radiographs made and processed at the applicant facility and which are of acceptable...

  4. [Chest trauma].

    PubMed

    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. PMID:21640287

  5. Chest x-ray

    MedlinePlus

    ... Images Aortic rupture, chest x-ray Lung cancer, frontal chest x-ray Adenocarcinoma - chest x-ray Coal ... cancer - chest x-ray Lung nodule, right middle lobe - chest x-ray Lung mass, right upper lung - ...

  6. Value of normal electrocardiographic findings in predicting resting left ventricular function in patients with chest pain and suspected coronary artery disease

    SciTech Connect

    O'Keefe, J.H. Jr.; Zinsmeister, A.R.; Gibbons, R.J.

    1989-06-01

    Characterization of left ventricular function is important in managing patients with coronary artery disease. Although many methods are available to assess left ventricular function, most are either expensive, invasive, or both. In this study, we examined the ability of normal or near-normal resting electrocardiographic findings to predict resting left ventricular ejection fraction, measured by resting radionuclide angiography, in 874 patients with chest pain and suspected coronary artery disease. A retrospective review was undertaken of 4,410 Mayo Clinic patients who underwent rest and exercise radionuclide ventriculography for the evaluation of chest pain and known or suspected coronary artery disease; of these, 874 patients met the inclusion criteria for the current study. A 15-lead electrocardiogram, which was interpreted by the cardiologist or cardiology trainee working in the laboratory, was obtained at the same evaluation as the radionuclide study. In 590 patients with no previous history of a myocardial infarction and entirely normal resting electrocardiographic results without nonspecific ST-T wave abnormalities, the mean left ventricular ejection fraction was 0.63 +/- 0.004, and 559 patients (95%) had a normal resting ejection fraction (defined as 0.50 or more). Both nonspecific ST-T wave abnormalities (p less than 0.001) and, to a lesser degree, a history of myocardial infarction (p = 0.06) were independent predictors of an abnormal resting ejection fraction. In 185 patients with nonspecific ST-T wave abnormalities and no history of myocardial infarction, the mean left ventricular ejection fraction was 0.61 +/- 0.009, and 85% had a normal resting ejection fraction.

  7. Morphological variations of the anterior thoracic skeleton and their forensic significance: radiographic findings in a Spanish autopsy sample.

    PubMed

    Macaluso, P James; Lucena, Joaquín

    2014-08-01

    The anterior thoracic skeleton may exhibit a number of morphological variations or anomalies, including accessory ossicles, atypical fusion or nonfusion of bony segments, and accessory foramina. Awareness of these minor skeletal variants is important in forensic medicine given that they may be mistakenly identified as pathological or traumatic lesions. The identification of subtle morphological anomalies may also aid in the process of individualization by serving as points of similarity if their occurrence was recorded antemortem. This study assessed the prevalence of anatomical variants of the sternum and ribs in a modern population from Spain, since the frequency of these skeletal anomalies differs between population groups. The occurrence of sternal clefts and foramina, bifurcated ribs, fusion of the manubriosternal and sternoxiphoidal junctions, and type of xiphoid process end was evaluated on posterior-anterior digital radiographs. None of the morphological variations were associated with sex or age, with the exception of two traits related to the xiphoid process. The xiphoid process was absent more often in younger individuals, particularly specimens below the age of 30 years, whereas, complete fusion of the sternoxiphoidal junction was more often observed in individuals above 50 years of age. However, these morphological variants are highly variable in the study sample and thus they have limited utility in forensic age estimation in the Spanish population. Nonetheless, the presence of various morphological anomalies such as sternal foramina, bifid ribs, and triple-ended xiphoid processes may provide information useful for establishing a personal identification. PMID:24933632

  8. 42 CFR 37.6 - Chest roentgenographic examinations conducted by the Secretary.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Chest roentgenographic examinations conducted by... Chest Roentgenographic Examinations § 37.6 Chest roentgenographic examinations conducted by the Secretary. (a) The Secretary will give chest radiographs or make arrangements with an appropriate...

  9. 42 CFR 37.60 - Submitting required chest roentgenograms and miner identification documents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Submitting required chest roentgenograms and miner... Chest Roentgenographic Examinations Specifications for Interpretation, Classification, and Submission of Chest Radiographs § 37.60 Submitting required chest roentgenograms and miner identification...

  10. Routine chest x-ray examinations in occupational medicine

    SciTech Connect

    Ashenburg, N.J.

    1982-01-01

    To collect some data on the yield of the chest x-ray examination in pre-employment health evaluations, a retrospective study was carried out. Pre-employment chest x-ray examination reports on 3,266 applicants were reviewed in Eastman Kodak Company's Medical Department in Rochester, N.Y. All radiographs were interpreted by Board-certified radiologists. For the purpose of this study, positive findings were restricted to the pulmonary and cardiovascular systems. The findings included items that would not be considered completely normal. However, many were of no clinical significance. An important point in regard to the findings is that 80% of the applicants were under the age of 35. The data are summarized in Table 1. Positive findings were noted in 52 (1.6%) radiographs. Of these, 25 (0.7%) had some radiologic finding that was relevant in terms of clinical follow-up, appropriate job placement or deferment of employment. Only two of the 3,266 applicants were not employed because of the x-ray examination findings. Results suggests that a selective program, based on clinical history and examination and on past and proposed job exposure, might be appropriate.

  11. The “dirty chest”—correlations between chest radiography, multislice CT and tobacco burden

    PubMed Central

    Kirchner, J; Goltz, J P; Lorenz, F; Obermann, A; Kirchner, E M; Kickuth, R

    2012-01-01

    Objectives Cigarette smoking-induced airway disease commonly results in an overall increase of non-specific lung markings on chest radiography. This has been described as “dirty chest”. As the morphological substrate of this condition is similar to the anthracosilicosis of coal workers, we hypothesised that it is possible to quantify the radiological changes using the International Labour Organization (ILO) classification of pneumoconiosis. The aims of this study were to evaluate whether there is a correlation between the extent of cigarette smoking and increased lung markings on chest radiography and to correlate the chest radiographic scores with findings on CT studies. Methods In a prospective analysis a cohort of 85 smokers was examined. The cigarette consumption was evaluated in pack years (defined as 20 cigarettes per day over 1 year). Film reading was performed by two board-certified radiologists. Chest radiographs were evaluated for the presence of thickening of bronchial walls, the presence of linear or nodular opacities, and emphysema. To correlate the smoking habits with the increase of overall lung markings in chest radiography, the ILO profusion score was converted to numbers ranging from zero to nine. Chest radiographs were rated according to the complete set of standard films of the revised ILO classification. Results 63/85 (74%) of the smokers showed an increase in overall lung markings on chest radiography; 32 (37%) had an ILO profusion score of <1/1, 29 (34%) had an ILO profusion score of <2/2 and 2 (2%) had an ILO score of ≥2/2. There was a significant positive linear correlation between the increase of overall lung markings on chest radiography and the cigarette consumption quantified as pack years (r=0.68). The majority of the heavy smokers (>40 pack years) showed emphysema; there was no significant difference between the prevalence of emphysema as diagnosed by CT (62%) or chest radiography (71%) (p<0.05).The most common findings in CT

  12. Cervical spine disc prosthesis: radiographic, biomechanical and morphological post mortal findings 12 weeks after implantation. A retrieval example.

    PubMed

    Pitzen, Tobias; Kettler, Annette; Drumm, Joerg; Nabhan, Abdullah; Steudel, Wolf Ingo; Claes, Lutz; Wilke, Hans Joachim

    2007-07-01

    There is a gap between in vitro and clinical studies concerning performance of spinal disc prosthesis. Retrieval studies may help to bridge this gap by providing more detailed information about motion characteristics, wear properties and osseous integration. Here, we report on the radiographic, mechanical, histological properties of a cervical spine segment treated with a cervical spine disc prosthesis (Prodisc C, Synthes Spine, Paoli, USA) for 3 months. A 48-year-old male received the device due to symptomatic degenerative disc disease within C5-C6. The patient recovered completely from his symptoms. Twelve weeks later, he died from a subarachnoid hemorrhage. During routine autopsy, C3-T1 was removed with all attached muscles and ligaments and subjected to plain X-rays and computed tomography, three dimensional flexibility tests, shear test as well as histological and electronic microscopic investigations. We detected radiolucencies mainly at the cranial interface between bone and implant. The flexibility of the segment under pure bending moments of +/-2.5 Nm applied in flexion/extension, axial rotation and lateral bending was preserved, with, however, reduced lateral bending and enlarged neutral zone compared to the adjacent segments C4-C5, and C6-C7. Stepwise increase of loading in flexion/extension up to +/-9.5 Nm did not result in segmental destruction. A postero-anterior force of 146 N was necessary to detach the lower half of the prosthesis from the vertebra. At the polyethylene (PE) core, signs of wear were observed compared to an unused core using electronic microscopy. Metal and PE debris without signs of severe inflammatory reaction was found within the surrounding soft tissue shell of the segment. A thin layer of soft connective tissue covered the major part of the implant endplate. Despite the limits of such a case report, the results show: that such implants are able to preserve at least a certain degree of segmental flexibility, that direct bone

  13. Impact of positive chest X-ray findings and blood cultures on adverse outcomes following hospitalized pneumococcal lower respiratory tract infection: a population-based cohort study

    PubMed Central

    2013-01-01

    Background Little is known about the clinical presentation and outcome of pneumococcal lower respiratory tract infection (LRTI) without positive chest X-ray findings and blood cultures. We investigated the prognostic impact of a pulmonary infiltrate and bacteraemia on the clinical course of hospitalized patients with confirmed pneumococcal LRTI. Methods We studied a population-based multi-centre cohort of 705 adults hospitalized with LRTI and Streptococcus pneumoniae in LRT specimens or blood: 193 without pulmonary infiltrate or bacteraemia, 250 with X-ray confirmed pneumonia, and 262 with bacteraemia. We compared adverse outcomes in the three groups and used multiple regression analyses to adjust for differences in age, sex, comorbidity, and lifestyle factors. Results Patients with no infiltrate and no bacteraemia were of similar age but had more comorbidity than the other groups (Charlson index score ≥1: no infiltrate and no bacteraemia 81% vs. infiltrate without bacteraemia 72% vs. bacteraemia 61%), smoked more tobacco, and had more respiratory symptoms. In contrast, patients with a pulmonary infiltrate or bacteraemia had more inflammation (median C-reactive protein: no infiltrate and no bacteraemia 82 mg/L vs. infiltrate without bacteraemia 163 mg/L vs. bacteraemia 316 mg/L) and higher acute disease severity scores. All adverse outcomes increased from patients with no infiltrate and no bacteraemia to those with an infiltrate and to those with bacteraemia: Length of hospital stay (5 vs. 6 vs. 8 days); intensive care admission (7% vs. 20% vs. 23%); pulmonary complications (1% vs. 5% vs. 14%); and 30-day mortality (5% vs. 11% vs. 21%). Compared with patients with no infiltrate and no bacteraemia, the adjusted 30-day mortality rate ratio was 1.9 (95% confidence interval (CI) 0.9-4.1) in patients with an infiltrate without bacteraemia and 4.1 (95% CI 2.0-8.5) in bacteraemia patients. Adjustment for acute disease severity and inflammatory markers weakened these

  14. What Is Chest MRI?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Chest MRI? Chest MRI (magnetic resonance imaging) is a safe, noninvasive ... creates detailed pictures of the structures in your chest, such as your chest wall, heart, and blood ...

  15. The early development of medial coronoid disease in growing Labrador retrievers: radiographic, computed tomographic, necropsy and micro-computed tomographic findings.

    PubMed

    Lau, S F; Wolschrijn, C F; Hazewinkel, H A W; Siebelt, M; Voorhout, G

    2013-09-01

    Medial coronoid disease (MCD) encompasses lesions of the entire medial coronoid process (MCP), both of the articular cartilage and the subchondral bone. To detect the earliest signs of MCD, radiography and computed tomography were used to monitor the development of MCD in 14 Labrador retrievers, from 6 to 7 weeks of age until euthanasia. The definitive diagnosis of MCD was based on necropsy and micro-computed tomography findings. The frequency of MCD in the dogs studied was 50%. Radiographic findings did not provide evidence of MCD, ulnar subtrochlear sclerosis or blunting of the cranial edge of the MCP. Computed tomography was more sensitive (30.8%) than radiography (0%) in detecting early MCD, with the earliest signs detectable at 14 weeks of age. A combination of the necropsy and micro-computed tomography findings of the MCP showed that MCD was manifested as a lesion of only the subchondral bone in dogs <18 weeks of age. In all dogs (affected and unaffected), there was close contact between the base of the MCP and the proximal radial head in the congruent joints. Computed tomography and micro-computed tomography findings indicated that the lesions of MCD probably originated at the base of the MCP. PMID:23702281

  16. Musculoskeletal chest wall pain

    PubMed Central

    Fam, Adel G.; Smythe, Hugh A.

    1985-01-01

    The musculoskeletal structures of the thoracic wall and the neck are a relatively common source of chest pain. Pain arising from these structures is often mistaken for angina pectoris, pleurisy or other serious disorders. In this article the clinical features, pathogenesis and management of the various musculoskeletal chest wall disorders are discussed. The more common causes are costochondritis, traumatic muscle pain, trauma to the chest wall, “fibrositis” syndrome, referred pain, psychogenic regional pain syndrome, and arthritis involving articulations of the sternum, ribs and thoracic spine. Careful analysis of the history, physical findings and results of investigation is essential for precise diagnosis and effective treatment. ImagesFig. 3Fig. 4Fig. 5 PMID:4027804

  17. Comparing Clinicopathologic and Radiographic Findings Between TT-UMP, Classical, and Non-Encapsulated Follicular Variants of Papillary Thyroid Carcinomas.

    PubMed

    Baser, Husniye; Topaloglu, Oya; Tam, Abbas Ali; Alkan, Afra; Kilicarslan, Aydan; Ersoy, Reyhan; Cakir, Bekir

    2016-09-01

    Thyroid tumors of uncertain malignant potential (TT-UMP) comprise an accepted subgroup of follicular-patterned thyroid tumors for which benignancy or malignancy cannot be precisely assessed. We aimed to evaluate the demographic characteristics, ultrasound (US) findings, and cytological results of patients with TT-UMP and compare these findings to a classical variant of papillary thyroid carcinoma (CV-PTC) and non-encapsulated follicular variant of PTC (NEFV-PTC) patients; we also evaluated the immunohistochemical characteristics of patients with TT-UMP. Twenty-four patients with TT-UMP, 672 with CV-PTC, and 132 with NEFV-PTC were included in the study. Mean longitudinal nodule size and median nodule volume were higher in the TT-UMP group than in the CV-PTC and NEFV-PTC groups (p < 0.001 and p < 0.001 for CV-PTC; p < 0.001 and p = 0.008 for NEFV-PTC). The presence of halo and peripheral vascularization was observed more frequently in the TT-UMP group than in the CV-PTC group (p = 0.002 and p = 0.024). Benign and follicular neoplasm/suspicious for follicular neoplasm cytological results were higher in the TT-UMP group than in the CV-PTC group (p = 0.030 and p = 0.001). US findings were similar between TT-UMP and NEFV-PTC groups (all, p > 0.05). However, none of the patients with TT-UMP were called malignant; 105 patients (31.2 %) of CV-PTC and 11 patients (9.5 %) of NEFV-PTC (infiltrative FV) were classified as malignant cytologically. Tumor size was higher in the TT-UMP group than in the CV-PTC and NEFV-PTC groups (p < 0.001 and p = 0.006). In the TT-UMP group, positive expression of HBME-1, CK-19, and Gal-3 was found in 50, 33.3, and 25 % of patients, respectively. This study demonstrated that none of the TT-UMP patients were evaluated as malignant in preoperative cytology. However, patients with TT-UMP had higher nodule and tumor sizes than CV-PTC and NEFV-PTC patients; US features were similar between NEFV-PTC and TT

  18. Hepatic Hydatid Disease: Radiographics Findings

    PubMed Central

    Polat, Pınar; Atamanalp, S. Selçuk

    2009-01-01

    Hydatid disease (HD) is a unique parasitic disease that primarily affects the liver and is endemic in many parts of the world. There are four types of hydatid cysts (HCs) with various levels of organ involvement. All four HC types can be seen in the liver, with the right lobe being the most common site of involvement. There are many potential intrahepatic and extrahepatic complications that affect the liver and other organs. Intrahepatic complications include vascular and biliary complications and infection. With rare portal vein compression and decreased vascular supply, the involved lobe may show atrophic changes while the other lobe becomes hypertrophic. Intrahepatic biliary dilatation results from large cysts compressing intrahepatic ducts or due to cyst rupture into the biliary ducts. Cyst infection may also occur via a similar mechanism. Extrahepatic complications result from exophytic growth and hematogeneous dissemination. Exophytic growth causes migration of cysts into the lungs, mediastinum, heart and peritoneum. Hematogeneous dissemination involves all other organs. PMID:25610064

  19. Chest radiography in acute aortic syndrome: pearls and pitfalls.

    PubMed

    Chawla, Ashish; Rajendran, Surendran; Yung, Wai Heng; Babu, Suresh Balasubramanian; Peh, Wilfred C

    2016-08-01

    Acute aortic syndrome is a group of life-threatening diseases of the thoracic aorta that usually present to the emergency department. It includes aortic dissection, aortic intramural hematoma, and penetrating aortic ulcer. Rare aortic pathologies of aorto-esophageal fistula and mycotic aneurysm may also be included in this list. All these conditions require urgent treatment with complex clinical care and management. Most patients who present with chest pain are evaluated with a chest radiograph in the emergency department. It is important that maximum diagnostic information is extracted from the chest radiograph as certain signs on the chest radiograph are extremely useful in pointing towards the diagnosis of acute aortic syndrome. PMID:27282377

  20. Chest tube insertion

    MedlinePlus

    Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... When your chest tube is inserted, you will lie on your side or sit partly upright, with one arm over your ...

  1. Chest tube insertion

    MedlinePlus

    ... leaks from inside the lung into the chest ( pneumothorax ) Fluid buildup in the chest (called a pleural ... on the reason a chest tube is inserted. Pneumothorax usually improves, but sometimes needs minimally invasive surgery. ...

  2. Chest imaging and lung function impairment after long-term occupational exposure to low concentrations of chrysotile.

    PubMed

    Spyratos, Dionisios; Chloros, Diamantis; Haidich, Bettina; Dagdilelis, Loukas; Markou, Stamatia; Sichletidis, Lazaros

    2012-01-01

    The aim of the present study was the investigation of radiographic findings in relation to lung function after occupational exposure to permissible levels of relatively pure chrysotile (0.5-3% amphiboles). We studied 266 out of the total 317 employees who have worked in an asbestos cement factory during the period 1968-2004 with chest x-ray, high-resolution computed tomography (HRCT) and lung function tests. Sensitivity of chest x-ray was 43% compared to HRCT. Abnormal HRCT findings were found in 75 subjects (67%) and were related to age, occupational exposure duration, and spirometric data. The presence of parenchymal or visceral pleural lesions (exclusively or as the predominant abnormality) was being accompanied by lower total lung capacity and diffusion capacity. HRCT was much more sensitive than chest x-ray for occupational chrysotile exposure. Lung function impairment was related with parenchymal but not with pleural HRCT abnormalities. PMID:22524648

  3. [Radiographic assessment of pulmonary hypertension: Methodical aspects].

    PubMed

    Korobkova, I Z; Lazutkina, V K; Nizovtsova, L A; Riden, T V

    2015-01-01

    Pulmonary hypertension is a menacing complication of a number of diseases, which is responsible for high mortality rates and considerably poorer quality of life in a patient. The timely detection for pulmonary hypertension allows timely initiation of treatment, thus improvement in prognosis in the patient. Chest X-ray is the most commonly used radiographic technique for various causes. Physicians' awareness about the radiographic manifestations of pulmonary hypertension may contribute to the earlier detection of this severe disease. Owing to the natural contrast of reflected structures, a chest X-ray film gives a unique opportunity to assess pulmonary circulation vessels, to reveal the signs of pulmonary hypertension, and to estimate trends in the course of the disease. The paper details a procedure for analysis and the normal radiographic anatomy of pulmonary circulation vessels, gives the present classification of pulmonary hypertension, and sets forth its X-ray semiotics. PMID:26552229

  4. Painful Chest Wall Swellings: Tietze Syndrome or Chest Wall Tumor?

    PubMed

    Kaplan, Tevfik; Gunal, Nesimi; Gulbahar, Gultekin; Kocer, Bulent; Han, Serdar; Eryazgan, Mehmet Ali; Ozsoy, Arzu; Naldoken, Seniha; Alhan, Aslıhan; Sakinci, Unal

    2016-04-01

    Background Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction. Primary chest wall tumors may mimic TS. In this article, we report our experience of approximately 121 patients initially diagnosed as TS and determined chest wall tumor in some cases at the follow-up. Methods This is a retrospective review of patients diagnosed as TS by clinical examination, chest X-ray, electrocardiogram, routine laboratory tests, and computed tomography (CT) of chest: all treated and followed up between March 2001 and July 2012. There were 121 cases (41 males and 80 females; mean age, 39.6 ± 3.2 years) of TS. Results In 27 patients with initial normal radiological findings, the size of swellings had doubled during the follow-up period (mean, 8.51 ± 2.15 months). These patients were reevaluated with chest CT and bone scintigraphy and then early diagnostic biopsy was performed. Pathologic examination revealed primary chest wall tumor in 13 patients (5 malignant, 8 benign). CT had a sensitivity of 92.3% and a specificity of 64.2% in detection of tumors (kappa: 0.56, p = 0.002), whereas the sensitivity and the specificity of bone scan were 84.6 and 35.7%, respectively (kappa: 0.199, p = 0.385). Conclusion Primary chest wall tumors could mimic TS. Bone scintigraphy or CT is not specific enough to determine malignant and other benign disorders of costochondral junction. Therefore, clinicians should follow TS patients more closely, and in case of increasing size of swelling, early diagnostic biopsy should be considered. PMID:25742551

  5. Work related respiratory symptoms in radiographers.

    PubMed Central

    Smedley, J; Inskip, H; Wield, G; Coggon, D

    1996-01-01

    OBJECTIVE--To determine the prevalence of work related symptoms among radiographers compared with a control group of physiotherapists. METHOD--A postal questionnaire was used to collect information from radiographers and physiotherapists who registered in the United Kingdom during 1985-9. RESULTS--Satisfactory questionnaires were returned by 2354 (65%) of the radiographers and 3048 (69%) of the physiotherapists. There was a clear excess of work related symptoms among the radiographers. In particular, they were more likely to complain of symptoms that were worse at work, mouth soreness, sore, itchy, or runny eyes, persistent blocked nose, persistent itchy nose or sneezing, sore throat, headache, and of lower respiratory tract symptoms, which were also worse on workdays. These symptoms were associated particularly with the use of automatic processing machines. 235 radiographers gave a history of wheeze or chest tightness that had been worse at work or on days when at work. CONCLUSIONS--Work related symptoms suggesting irritation of the eyes and upper airways were more common in radiographers than controls, and may be related to exposure to x ray film processing chemicals. Men and women who reported work related wheeze or chest tightness will be followed up in more detail to assess the prevalence of occupational asthma in the cohort. PMID:8704868

  6. [Imaging signs in chest diagnostics].

    PubMed

    Krombach, G A

    2016-08-01

    Signs in chest imaging are defined as typical findings which can be easily recognized on x‑ray photographs or computed tomography (CT) scans of the chest. They are caused by different typical pathophysiological processes. Due to the association of a certain pathophysiological cause with a given sign, knowledge and use of these signs can allow the possible differential diagnoses to be narrowed down. If other imaging findings and clinical data are additionally taken into account, the diagnosis can be made with a high degree of confidence in many cases. PMID:27369549

  7. Exercises in chest X-ray diagnosis

    SciTech Connect

    Elliott, J.A.; Cowan, M.D.

    1986-01-01

    In the fifty exercises which form the first part of the book, radiographs are combined with a group of questions designed to test the readers clinical and radiological knowledge. The exercises cover all the common and many of the rarer cardiothoracic disorders which are revealed on the chest x-ray. Increasingly, computed tomography is used in the differential diagnosis of thoracic problems, and several examples have been included.

  8. [Development of breathing chest radiography: study of exposure timing].

    PubMed

    Tanaka, Rie; Sanada, Shigeru; Kobayashi, Takeshi; Suzuki, Masayuki; Matsui, Takeshi; Inoue, Hitoshi

    2003-08-01

    The flat-panel detector (FPD) has been introduced into clinical practice. A modified FPD, which has the ability to obtain dynamic chest radiographs, was introduced into our hospital, and clinical testing is ongoing. Both the inspiratory and expiratory phases have to be included in dynamic chest radiographs. The purpose of this study was to investigate the most appropriate chest radiography signal for observation of the respiratory process. We prepared ten protocol patterns that differed in terms of respiratory phase at X-ray exposure, exposure duration, and signal multiplicity. We also performed preliminary experiments and administered several questionnaires to ten volunteers. The volunteers breathed according to vocal and visual signals, and their respiratory waves were recorded by spirometer. The most appropriate protocol was similar to the method used for conventional chest radiography. PMID:12960952

  9. Cleidocranial Dysplasia: A Clinico-radiographic Spectrum with Differential Diagnosis

    PubMed Central

    Patil, Purva Prakash; Barpande, Suresh Ramchandra; Bhavthankar, Jyoti Dilip; Humbe, Jayanti G.

    2015-01-01

    Introduction: Cleidocranial dysplasia (CCD) is characterized by aplasia or hypoplasia of the clavicles, characteristic craniofacial malformations, and the presence of numerous supernumerary and unerupted teeth. It affects bones derived from both intra-membranous and endochondral ossification. Incidence has been reported as 1 in 10,00,000. It is caused by mutation in the gene encoding transcription factor Core Binding Factor Subunit Alpha l (CBFAl) or Runt related transcription factor 2 (RUNX2). Case Report: This presentation discusses the clinical and radiographic features of a familial case of cleidocranial dysplasia occurring in a father and a child. All the clinical and radiographic features, except that of the chest x-ray, were more prominent in the child than the father. This supports the fact that CCD is transmitted by an autosomal-dominant mode of inheritance with high penetrance and variable expressivity. It is sporadic in about 40% of cases. Each child of an individual with CCD has a 50% chance of in heriting the mutation. Conclusion: Diagnosis is mostly made on the basis of clinical and radiographic features. Molecular genetic testing such as sequence analysis or deletion analysis can be used in cleidocranial dysplasia. Some cases are diagnosed through incidental findings by physicians, treating patients for unrelated conditions. Treatment of these patients requires a multidisciplinary approach which includes orthopaedic and dental corrections along with management of any complications of cleidocranial dysplasia. PMID:27299035

  10. Chest X-Ray

    MedlinePlus Videos and Cool Tools

    ... Prostate Ultrasound Video: IMRT Video: Chest CT Video:Thyroid Ultrasound Video: Pediatric MRI Radiology and You About ... Prostate Ultrasound Video: IMRT Video: Chest CT Video:Thyroid Ultrasound Video: Pediatric MRI Radiology and You About ...

  11. Validation of the International Labour Office Digitized Standard Images for Recognition and Classification of Radiographs of Pneumoconiosis

    PubMed Central

    Halldin, Cara N.; Petsonk, Edward L.; Laney, A. Scott

    2015-01-01

    Rationale and Objectives Chest radiographs are recommended for prevention and detection of pneumoconiosis. In 2011, the International Labour Office (ILO) released a revision of the International Classification of Radiographs of Pneumoconioses that included a digitized standard images set. The present study compared results of classifications of digital chest images performed using the new ILO 2011 digitized standard images to classification approaches used in the past. Materials and Methods Underground coal miners (N = 172) were examined using both digital and film-screen radiography (FSR) on the same day. Seven National Institute for Occupational Safety and Health-certified B Readers independently classified all 172 digital radiographs, once using the ILO 2011 digitized standard images (DRILO2011-D) and once using digitized standard images used in the previous research (DRRES). The same seven B Readers classified all the miners’ chest films using the ILO film-based standards. Results Agreement between classifications of FSR and digital radiography was identical, using a standard image set (either DRILO2011-D or DRRES). The overall weighted κ value was 0.58.Somespecific differences in the results were seen and noted. However, intrareader variability in this study was similar to the published values and did not appear to be affected by the use of the new ILO 2011 digitized standard images. Conclusions These findings validate the use of the ILO digitized standard images for classification of small pneumoconiotic opacities. When digital chest radiographs are obtained and displayed appropriately, results of pneumoconiosis classifications using the 2011 ILO digitized standards are comparable to film-based ILO classifications and to classifications using earlier research standards. PMID:24507420

  12. Comparison of Rates of Coronary Angiography and Combined Testing Procedures in Patients Seen in the Emergency Room With Chest Pain (But No Objective Acute Coronary Syndrome Findings) Having Coronary Computed Tomography Versus Exercise Stress Testing.

    PubMed

    Grunau, Brian; Leipsic, Jonathon; Purssell, Elizabeth; Kasteel, Naomi; Nguyen, Kimchi; Kazem, Mikameh; Naoum, Christopher; Raju, Rekha; Blanke, Philipp; Heilbron, Brett; Taylor, Carolyn; Scheuermeyer, Frank X

    2016-07-15

    Coronary computed tomography angiography (CCTA) appears comparable to standard care, including exercise stress testing (EST), in diagnosing acute coronary syndrome in emergency department (ED) patients with chest pain but may increase downstream testing. The objective of this study was to investigate rates of post-CCTA versus post-EST testing for (1) invasive angiography and (2) all combined cardiac testing. This was a retrospective cohort study performed at 2 urban Canadian EDs involving patients aged up to 65 years with chest pain but no objective ACS findings that were evaluated with CCTA or EST at the physician's discretion. The primary outcome was the proportion of patients who had 30-day invasive angiography in each group; secondary outcomes included all subsequent 30-day cardiac testing, including nuclear medicine scanning. From July 1, 2012, to June 30, 2014, we collected 1,700 patients: 521 CCTA and 1,179 EST. Demographics and risk factors were similar in both cohorts. In the following 30 days, 30 CCTA (5.8%) and 297 EST (25.2%) patients underwent any type of additional cardiac testing (difference 19.4%, 95% CI 16.0 to 22.6), whereas 12 CCTA (2.3%) and 20 EST patients (1.7%) underwent angiography (difference 0.6%, 95% CI -0.8% to 2.6%). No patients in either group died or had a myocardial infarction within 30 days. For ED patients with chest pain who underwent brief observation, CCTA and EST had similar 30-day angiography rates, but CCTA patients underwent significantly less overall cardiac investigations. PMID:27236251

  13. Chest pain in children.

    PubMed Central

    Leung, A. K.; Robson, W. L.; Cho, H.

    1996-01-01

    Chest pain is usually a benign symptom in children. The most common identifiable causes are musculoskeletal. Often, no cause can be identified. Cardiac disorders are uncommon causes of chest pain children. Most causes can be diagnosed from history and physical examination. Treatment should be directed at the underlying cause. For idiopathic chest pain, reassurance and regular follow-up examinations are important. PMID:8704491

  14. Chest x-ray

    MedlinePlus

    Chest radiography; Serial chest x-ray; X-ray - chest ... You stand in front of the x-ray machine. You will be told to hold your breath when the x-ray is taken. Two images are usually taken. You will ...

  15. Crush injuries of the chest

    PubMed Central

    Davidson, I. A.; Bargh, W.; Cruickshank, A. N.; Duthie, W. H.

    1969-01-01

    Fifty-four patients previously treated for a severe chest injury in an artificial ventilation unit have been followed up. An attempt has been made to determine their state of health and activity. Particular attention has been paid to their respiratory function. The significance of the findings has been discussed. Images PMID:4899979

  16. American College of Chest Physicians

    MedlinePlus

    ... of Certification (MOC) CHEST GAIN NSCLC CHEST SEEK Innovation, Simulation, and Training Center Professional Representative Education Program ( ... of Certification (MOC) CHEST GAIN NSCLC CHEST SEEK Innovation, Simulation, and Training Center Professional Representative Education Program ( ...

  17. Plain radiographic diagnosis of thrombosis of left atrial appendage in mitral valve disease

    SciTech Connect

    Matsuyama, S.; Watabe, T.; Kuribayashi, S.; Ootaki, M.; Suzuki, Y.; Sugihara, M.; Kawada, S.; Koide, S.; Shohtsu, A.; Tomoda, H.

    1983-01-01

    Conventional posteroanterior chest radiographs of 42 patients with mitral valve disease who had had surgery were analyzed, and particular attention was directed to the presence or absence of the convexity of the left lower midcardiac border (left artrial segment). The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in six (60%) of 10 patients who had left atrial thrombosis, and in three (9%) of 32 patients who did not have thrombosis (false positive diagnosis). Four of the 10 patients who had left atrial thrombosis did not show this finding on the radiographs (false negative diagnosis). One of these four had a thrombus only against the posterior wall of the body of the left atrium. Therefore, the accuracy in the diagnosis of thrombosis of the left atrial appendage was 66.7% (six of nine) for patients who had thrombosis of the appendage. Standard chest radiographs are important in the evaluation of the patient with thrombosis of the left atrial appendage.

  18. Java interface to a computer-aided diagnosis system for acute pulmonary embolism using PIOPED findings

    NASA Astrophysics Data System (ADS)

    Frederick, Erik D.; Tourassi, Georgia D.; Gauger, Matthew; Floyd, Carey E., Jr.

    1999-05-01

    An interface to a Computer Aided Diagnosis (CAD) system for diagnosis of Acute Pulmonary Embolism (PE) from PIOPED radiographic findings was developed. The interface is based on Internet technology which is user-friendly and available on a broad range of computing platforms. It was designed to be used as a research tool and as a data collection tool, allowing researchers to observe the behavior of a CAD system and to collect radiographic findings on ventilation-perfusion lung scans and chest radiographs. The interface collects findings from physicians in the PIOPED reporting format, processes those findings and presents them as inputs to an artificial neural network (ANN) previously trained on findings from 1,064 patients from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study. The likelihood of PE predicted by the ANN and by the physician using the system is then saved for later analysis.

  19. Community-acquired pneumonia in primary care: clinical assessment and the usability of chest radiography

    PubMed Central

    Moberg, A.B.; Taléus, U.; Garvin, P.; Fransson, S.-G.; Falk, M.

    2016-01-01

    Objectives To investigate the diagnostic value of different clinical and laboratory findings in pneumonia and to explore the association between the doctor’s degree of suspicion and chest X-ray (CXR) result and to evaluate whether or not CXR should be used routinely in primary care, when available. Design A three-year prospective study was conducted between September 2011 and December 2014. Setting Two primary care settings in Linköping, Sweden. Subjects A total of 103 adult patients with suspected pneumonia in primary care. Main outcome measures The physicians recorded results of a standardized medical physical examination, including laboratory results, and rated their suspicion into three degrees. The outcome of the diagnostic variables and the degree of suspicion was compared with the result of CXR. Results Radiographic pneumonia was reported in 45% of patients. When the physicians were sure of the diagnosis radiographic pneumonia was found in 88% of cases (p < 0.001), when quite sure the frequency of positive CXR was 45%, and when not sure 28%. Elevated levels of C-reactive protein (CRP) ≥ 50mg/L were associated with the presence of radiographic pneumonia when the diagnosis was suspected (p < 0.001). Conclusion This study indicates that CXR can be useful if the physician is not sure of the diagnosis, but when sure one can rely on one’s judgement without ordering CXR. Key pointsThere are different guidelines but no consensus on how to manage community-acquired pneumonia in primary care.When the physician is sure of the diagnosis the judgement is reliable without chest X-ray and antibiotics can be safely prescribed.Chest X-ray can be useful in the assessment of pneumonia in primary care, when the physician is not sure of the diagnosis. PMID:26849394

  20. Findings

    MedlinePlus

    ... Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry ... Glycobiology, Synthesis, Natural Products, Chemical Reactions Computers in Biology Bioinformatics, Modeling, Systems Biology, Data Visualization Diseases Cancer, ...

  1. Colonic interposition: radiographic evaluation.

    PubMed

    Agha, F P; Orringer, M B

    1984-04-01

    This report reviews the clinical and radiographic features of 40 patients who underwent visceral esophageal substitution with colon for benign or malignant lesions of the esophagus. The incidence and radiographic identification of complications are discussed. All patients were routinely examined with barium esophagrams on postoperative day 10. If an anastomotic leak was suspected clinically before this time, studies were performed using water-soluble iodinated contrast material. Follow-up barium esophagrams were obtained 1-96 months after operation (average, 60 months) in 24 patients. Eight patients (21%) demonstrated asymptomatic "jejunization" of the colonic mucosa with no attributable clinical manifestations; this finding resolved in 1-3 months, without sequelae, and has not been reported before. The spectrum of ischemic changes in the colonic segment included mucosal edema, spasm, ulceration, loss of haustration, and frank necrosis. Radiographically detectable early postoperative complications included anastomotic leak in six (three pharyngocolic, three cervical esophagocolic) and aspiration of barium into the tracheobronchial tree due to incoordinated swallowing in eight. Late postoperative complications included anastomotic narrowing (12) malfunctioning of the colon due to impaired emptying (five), recurrent aspiration pneumonia (three), small bowel obstruction (three), transhiatal herniation of small bowel through the diaphragmatic hiatus (one), and reflux into the retained bypassed esophagus (one). PMID:6608225

  2. Radiological findings in nine AIDS patients with Rhodococcus equi pneumonia.

    PubMed

    Wicky, S; Cartei, F; Mayor, B; Frija, J; Gevenois, P A; Giron, J; Laurent, F; Perri, G; Schnyder, P

    1996-01-01

    Rhodococcus equi (R. equi) infections have been incidentally reported as a cause of pulmonary infection in severely immunocompromised hosts, including AIDS patients. Our purpose is to describe the radiological findings in nine AIDS patients with R. equi pneumonia assessed by bronchoalveolar lavage (BAL), biopsies, cultures of sputum, and hemocultures. All patients were examined by chest radiographs and contrast-medium-enhanced chest CT. Dense pulmonary consolidations with or without cavitations accounted for the most striking radiological patterns. Chest CT also revealed six mediastinal involvements, strongly mimicking a lymphoma. Two of them had multiple bilateral pulmonary nodular opacities. Pleural effusion was not identified. Although intensive therapies were administered, seven among nine patients died within few months. In an AIDS patient living in a rural area or exposed to horses and presenting these radiological patterns, the possibility of R. equi pneumonia should be considered in the differential diagnosis along with other infectious diseases or lymphomas. PMID:8972317

  3. Clinical efficacy, radiographic and safety findings through 5 years of subcutaneous golimumab treatment in patients with active psoriatic arthritis: results from a long-term extension of a randomised, placebo-controlled trial (the GO-REVEAL study)

    PubMed Central

    Kavanaugh, Arthur; McInnes, Iain B; Mease, Philip; Krueger, Gerald G; Gladman, Dafna; van der Heijde, Désirée; Zhou, Yiying; Lu, Jiandong; Leu, Jocelyn H; Goldstein, Neil; Beutler, Anna

    2014-01-01

    Objectives Assess golimumab's long-term efficacy/safety in psoriatic arthritis (PsA). Methods Adults with active PsA (≥3 swollen and tender joints, active psoriasis) were randomly assigned to subcutaneous placebo, golimumab 50 mg, or golimumab 100 mg every 4 weeks (q4wks) through wk20. All patients received golimumab 50 mg or 100 mg q4wks from wk24 forward. Methotrexate was allowed and taken by approximately half the patients. Findings through 5 years are reported herein. Efficacy assessments included ≥20% improvement in American College of Rheumatology (ACR20) response, C-reactive-protein-based, 28-joint-count Disease Activity Score (DAS28-CRP) response, ≥75% improvement in Psoriasis Area and Severity Index (PASI75) scores, and PsA-modified Sharp/van der Heijde scores (SHSs). Results 126/405 (31%) randomised patients discontinued treatment through wk252. Golimumab was effective in maintaining clinical improvement through year-5 (ACR20: 62.8–69.9%, DAS28-CRP: 75.2-84.9% for randomised patients; PASI75: 60.8–72.2% among randomised patients with ≥3% body surface area involvement) and inhibiting radiographic progression (mean changes in PsA-modified SHS: 0.1–0.3) among patients with radiographic data. While concomitant methotrexate did not affect ACR20/PASI75, it appeared to reduce radiographic progression. No new safety signals were identified. Antibodies-to-golimumab occurred in 1.8%/10.0% of patients with/without methotrexate). Conclusions Long-term golimumab safety/efficacy in PsA was demonstrated through 5 years. Trial registration number NCT00265096. PMID:24748630

  4. Impact of patient photos on visual search during radiograph interpretation

    NASA Astrophysics Data System (ADS)

    Krupinski, Elizabeth A.; Applegate, Kimberly; DeSimone, Ariadne; Chung, Alex; Tridandanpani, Srini

    2016-03-01

    To increase detection of mislabeled medical imaging studies evidence shows it may be useful to include patient photographs during interpretation. This study examined how inclusion of photos impacts visual search. Ten radiologists viewed 21 chest radiographs with and without a photo of the patient while search was recorded. Their task was to note tube/line placement. Eye-tracking data revealed that presence of the photo reduced the number of fixations and total dwell on the chest image as a result of periodically looking at the photo. Average preference for having photos was 6.10 on 0-10 scale and neck and chest were preferred areas.

  5. Eye-tracking AFROC study of the influence of experience and training on chest x-ray interpretation

    NASA Astrophysics Data System (ADS)

    Manning, David; Ethell, Susan C.; Crawford, Trevor

    2003-05-01

    Four observer groups with different levels of expertise were tested in an investigation into the comparative nature of expert performance. The radiological task was the detection and localization of significant pulmonary nodules in postero-anterior vies of the chest in adults. Three test banks of 40 images were used. The observer groups were 6 experienced radiographers prior to a six month training program in chest image interpretation, the same radiographers after their tr4aining program, and 6 fresher undergraduate radiography students. Eye tracking was carried out on all observers to demonstrate differences in visual activity and nodule detection performance was measured with an AFROC technique. Detection performances of the four groups showed the radiologists and radiographers after training were measurably superior at the task. The eye-tracking parameters saccadic length, number of fixations visual coverage and scrutiny timer per film were measured for all subjects and compared. The missed nodules fixated and not fixated were also determined for the radiologist group. Results have shown distinct stylistic differences in the visual scanning strategies between the experienced and inexperienced observers that we believe can be generalized into a description of characteristics of expert versus non-expert performance. The findings will be used in the educational program of image interpretation for non-radiology practitioners.

  6. Traumatic pulmonary pseudocysts: CT findings.

    PubMed

    Tsitouridis, Ioannis; Tsinoglou, Konstantinos; Tsandiridis, Christos; Papastergiou, Christos; Bintoudi, Antonia

    2007-08-01

    Traumatic pulmonary pseudocyst constitutes an uncommon, though well recognized, manifestation of closed chest trauma. It is usually encountered in young patients, whose compliant chest wall permits the transmission of great compressive forces to the lung parenchyma and the laceration of the latter. Traumatic pulmonary pseudocyst is usually detected during the imaging evaluation of multi-injured patients with the use of computed tomography, as it is often not apparent in the initial supine anteroposterior chest radiographs. We present 5 cases of trauma patients, in whom we detected the presence of multiple traumatic pulmonary pseudocysts during the imaging evaluation of blunt chest trauma with the use of computed tomography. PMID:17721334

  7. Value of routine preoperative chest x-rays: a meta-analysis.

    PubMed

    Archer, C; Levy, A R; McGregor, M

    1993-11-01

    The purpose of this study was to estimate the frequency with which routine postoperative chest x-rays lead to clinically relevant new information. All articles in English, French and Spanish relating to routine chest radiography in North American or European populations were reviewed, using the Medline database and references listed in reviews and periodicals published from 1966 to 1992, inclusive. Twenty-one reports which supplied sufficient information were included for meta-analysis. On average, abnormalities were found in 10% of routine preoperative chest films. In only 1.3% of films were the abnormalities unexpected, i.e., were not already known or would not otherwise have been detected (95% CI: 0 to 2.8%). These findings were of sufficient importance to cause modification of management in only 0.1% (95% CI: 0 to 0.6%). The frequency with which the new information influenced health could not be estimated. Assuming only the direct cost to the health care system of each radiograph ($23), each finding which influenced management in any way would cost $23,000. It is concluded that in North American or European populations when a reliable history and a clinical examination are carried out, the cost of this test is so high relation to the clinical information provided that it is no longer justifiable. PMID:8269561

  8. Gallium-67 scans of the chest in patients with acquired immunodeficiency syndrome

    SciTech Connect

    Kramer, E.L.; Sanger, J.J.; Garay, S.M.; Greene, J.B.; Tiu, S.; Banner, H.; McCauley, D.I.

    1987-07-01

    Eighty-six (/sup 67/Ga)citrate chest scans were performed in 71 adult patients with the acquired immunodeficiency syndrome. Forty-five of these patients also had Kaposi's sarcoma. Only 29 of 57 abnormal scans were correlated with abnormal chest radiographs. Chest radiographs were negative for 27 scans and unavailable for one. Several scan patterns were seen. Diffusely increased lung uptake was seen most commonly with Pneumocystis carinii pneumonia, but also other infections and noninfectious inflammatory conditions. Focal uptake corresponding to regional lymph node groups occurred most often with Mycobacterium avium-intracellulare but aslo with lymphoma. Localized intrapulmonary uptake was seen in bacterial pneumonias. Perihilar activity occurred in two cases. When chest radiographs were abnormal and /sup 67/Ga scans negative, the most common diagnosis was pulmonary Kaposi's sarcoma.

  9. Radiographic scale grid for supervoltage radiographs.

    PubMed

    Wong, J T

    1975-01-01

    This paper deals with the construction and practical application of a radiographic scale grid incorporated into high energy radiation therapy machines in making port radiographs. The gadet is designed especially for the numerous small radiation therapy departments in community hospitals and private practices that do not have the sophistication provided by a simulator. PMID:812144

  10. Detection and labeling ribs on expiration chest radiographs

    NASA Astrophysics Data System (ADS)

    Park, Mira; Jin, Jesse S.; Wilson, Laurence S.

    2003-06-01

    Typically, inspiration is preferred when xraying the lungs. The x-ray technologist will ask a patient to be still and to take a deep breath and to hold it. This not only reduces the possibility of a blurred image but also enhances the quality of the image since air-filled lungs are easier to see on x-ray film. However, inspiration causes low density in the inner part of lung field. That means that ribs in the inner part of lung field have lower density than the other parts nearer to the border of the lung field. That is why edge detection algorithms often fail to detect ribs. Therefore to make rib edges clear we try to produce an expiration lung field using a 'hemi-elliptical cavity.' Based on the expiration lung field, we extract the rib edges using canny edge detector and a new connectivity method, called '4 way with 10-neighbors connectivity' to detect clavicle and rib edge candidates. Once the edge candidates are formed, our system selects the best candidates using knowledge-based constraints such as a gradient, length and location. The edges can be paired and labeled as superior rib edge and inferior rib edge. Then the system uses the clavicle, which is obtained in a same method for the rib edge detection, as a landmark to label all detected ribs.

  11. 42 CFR 37.41 - Chest radiograph specifications-film.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... device must provide rectangular collimation and must be of the type described in 21 CFR 1020.31(d), (e... 60 Hz. (g) Capacitor discharge and field emission units may be used if the model of such units...

  12. 42 CFR 37.41 - Chest radiograph specifications-film.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... device must provide rectangular collimation and must be of the type described in 21 CFR 1020.31(d), (e... 60 Hz. (g) Capacitor discharge and field emission units may be used if the model of such units...

  13. Radiographic parenchymal opacity, matching perfusion defect, and normal ventilation: a sign of pulmonary embolism. Work in progress

    SciTech Connect

    Strauss, E.B.; Sostman, H.D.; Gottschalk, A.

    1987-05-01

    By conventional criteria, perfusion defects that correspond to radiographic parenchymal opacities of similar size have less diagnostic significance for pulmonary embolism (PE) than perfusion defects in areas that are radiographically clear, regardless of the findings on ventilation scan. It was proposed that the demonstration of normal ventilation in areas with matched radiographic opacity and perfusion defects does support the diagnosis of PE. To test this hypothesis, a retrospective review was done of selected cases from a consecutive series of 85 pulmonary angiography studies. Cases were reviewed if the following criteria were met: chest radiography, ventilation-perfusion scintigraphy, and angiography of the relevant regions had all been performed within 24 hours of one another, and there was a radiographic opacity corresponding to the perfusion defect. Sixteen cases fulfilled these criteria. Six patients had normal ventilation in the regions of the radiographic infiltrate and perfusion defect, and all had PE. No patient had an area of opacity and perfusion defect and normal ventilation without PE.

  14. [Optimal beam quality for chest digital radiography].

    PubMed

    Oda, Nobuhiro; Tabata, Yoshito; Nakano, Tsutomu

    2014-11-01

    To investigate the optimal beam quality for chest computed radiography (CR), we measured the radiographic contrast and evaluated the image quality of chest CR using various X-ray tube voltages. The contrast between lung and rib or heart increased on CR images obtained by lowering the tube voltage from 140 to 60 kV, but the degree of increase was less. Scattered radiation was reduced on CR images with a lower tube voltage. The Wiener spectrum of CR images with a low tube voltage showed a low value under identical conditions of amount of light stimulated emission. The quality of chest CR images obtained using a lower tube voltage (80 kV and 100 kV) was evaluated as being superior to those obtained with a higher tube voltage (120 kV and 140 kV). Considering the problem of tube loading and exposure in clinical applications, a tube voltage of 90 to 100 kV (0.1 mm copper filter backed by 0.5 mm aluminum) is recommended for chest CR. PMID:25410333

  15. 42 CFR 37.44 - Approval of radiographic facilities that use digital radiography systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL... facility approval. (1) Facilities seeking approval must demonstrate the ability to make high quality... radiographic image files from six or more sample chest radiographs that are of acceptable quality to one...

  16. 42 CFR 37.8 - Radiographic examination at miner's expense.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Radiographic examination at miner's expense. 37.8 Section 37.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest...

  17. 42 CFR 37.80 - Availability of records for radiographs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Availability of records for radiographs. 37.80 Section 37.80 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest...

  18. [A rare case of chest pain].

    PubMed

    Bodócsi, Beáta; Koncz, István; Hum, Zsigmond; Serfőző, Orsolya; Pap-Szekeres, József; Szabó, István

    2016-09-01

    Chest pain is a common symptom in patients who visit Emergency Departments. The main task is to exclude life-threatening diseases such as acute coronary syndrome, pulmonary embolization and dissection of thoracic aorta. The authors present the history of a patient, who had an intense chest pain for 7 hours. In accordance with the diagnostic algorithm of chest pain, ECG, blood collection, chest X-ray and chest computed tomography angiography were performed. Acute coronary syndrome, pulmonary embolization and dissection of the thoracic aorta were excluded, however, chest computed tomography CT revealed a huge hiatal hernia as an incidental finding. An emergency surgical repair was performed and the patient recovered without any complications. The authors emphasize that the diagnostic algorithms focus on the confirmation or rejection of possible life threatening diseases in case of chest pain. However, it should be kept in mind that rarer causes may occur, which may require involvement of the relevant disciplines and multidisciplinary thinking. Orv. Hetil., 2016, 157(36), 1445-1448. PMID:27596512

  19. Spontaneous pneumomediastinum: an important differential in acute chest pain.

    PubMed

    Hogan, Francesca; McCullough, Chris; Rahman, Asif

    2014-01-01

    A 38-year-old man presented with pleuritic chest pain that was present on waking and localised to the left costal margin with no radiation. He was otherwise asymptomatic and denied preceding trauma, heavy lifting, coughing or recent vomiting. Observations and examination were unremarkable; however, a chest radiograph showed a pneumomediastinum. Spontaneous pneumomediastinum (SPM) is a rare condition that tends to follow a benign clinical course. A CT of the chest is generally only indicated if the chest X-ray fails to show an SPM in patients for whom there is a high index of clinical suspicion. A contrast-enhanced swallow study is only indicated if there is suspicion of an oesophageal tear or rupture. Evidence suggests that patients with SPM can be managed conservatively and observed for 24 h. PMID:25432910

  20. Comparison of scanning equalization and conventional chest radiography.

    PubMed

    Wandtke, J C; Plewes, D B

    1989-09-01

    A clinical comparison study of scanning equalization radiography (SER) and conventional chest radiography was performed with the latest prototype SER system. Conventional chest radiography was performed at 120 kVp with Lanex regular screens (Eastman Kodak, Rochester, NY) and Kodak Ortho-G or Ortho-C film (Eastman Kodak). The 253 volunteer patients were examined with both techniques. The chest radiographs were interpreted by four radiologists. The study group was composed of 58 normal and 195 abnormal posteroanterior and lateral chest radiographs. In 31 cases there were two major radiologic diagnoses. The number of correct interpretations increased when the SER images were examined, compared with the conventional Ortho-G (chi 2 = 4.17, P less than .05) and conventional Ortho-C (chi 2 = 16.9, P less than .001) radiographs. The overall accuracy of disease detection improved for all radiologists with the SER system. There was no disease category in which the accuracy of interpretation decreased when the SER system was used. The SER system is a clinically reliable method of improving image quality and increasing diagnostic accuracy. PMID:2772170

  1. Low-dose digital computed radiography in pediatric chest imaging

    SciTech Connect

    Kogutt, M.S.; Jones, J.P.; Perkins, D.D.

    1988-10-01

    A prototype digital computed radiographic imaging system that uses laser-stimulated luminescence was evaluated for its ability to achieve reproducible, high-detail, low-dose pediatric chest radiographs. Using this system, we performed a total of 401 examinations in infants and children, and achieved an 85% reduction in radiation dose, as compared with that delivered when film-screen techniques were used. We also achieved satisfactory image resolution, and the images obtained were of acceptable diagnostic quality. A direct comparison of analog and digital radiographs showed that comparable quality and clinical acceptability could be readily maintained between the two techniques. This study shows that high-quality images can be produced by this system at radiation doses reduced by 85% when compared with doses from standard radiographic techniques.

  2. Non-resolving Findings in a Long-term Radiographic Follow-up of an Infant with Acute Paraffin Oil Aspiration.

    PubMed

    Stathis, George; Priftis, Konstantinos N; Moustaki, Maria; Alexopoulou, Efthymia

    2014-01-01

    Acute lipoid pneumonia (LP) in children is a rare disorder caused by the aspiration of oil-based substances and is difficult to diagnose due to non-specific clinical symptoms and radiological findings. We report the case of a 5-month-old male infant with acute LP caused by accidental aspiration of a large amount of mineral oil. We present the imaging findings in the computed tomography scans performed during his hospitalization and focus on the residual abnormalities seen on a scan performed 7-years after the incident. This, to the best of our knowledge, is the longest follow-up report of an acute exogenous LP patient and the only case that demonstrates non-resolving abnormalities in a pediatric patient after a single acute episode of mineral oil aspiration. PMID:24678434

  3. Non-resolving Findings in a Long-term Radiographic Follow-up of an Infant with Acute Paraffin Oil Aspiration

    PubMed Central

    Stathis, George; Priftis, Konstantinos N.; Moustaki, Maria; Alexopoulou, Efthymia

    2014-01-01

    Acute lipoid pneumonia (LP) in children is a rare disorder caused by the aspiration of oil-based substances and is difficult to diagnose due to non-specific clinical symptoms and radiological findings. We report the case of a 5-month-old male infant with acute LP caused by accidental aspiration of a large amount of mineral oil. We present the imaging findings in the computed tomography scans performed during his hospitalization and focus on the residual abnormalities seen on a scan performed 7-years after the incident. This, to the best of our knowledge, is the longest follow-up report of an acute exogenous LP patient and the only case that demonstrates non-resolving abnormalities in a pediatric patient after a single acute episode of mineral oil aspiration. PMID:24678434

  4. Chest CT Scan

    MedlinePlus

    ... pictures to create a very detailed, three-dimensional (3D) model of organs. Sometimes, a substance called contrast dye is injected into a vein in your arm for the CT scan. This substance highlights areas in your chest, which ...

  5. Chest Injuries and Disorders

    MedlinePlus

    ... your neck and your abdomen. It includes the ribs and breastbone. Inside your chest are several organs, ... and collapsed lung Pleural disorders Esophagus disorders Broken ribs Thoracic aortic aneurysms Disorders of the mediastinum, the ...

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

    PubMed

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

    2007-09-01

    A test methodology using an anthropomorphic-equivalent chest phantom is described for the optimization of the Agfa computed radiography "MUSICA" processing algorithm for chest radiography. The contrast-to-noise ratio (CNR) in the lung, heart and diaphragm regions of the phantom, and the "system modulation transfer function" (sMTF) in the lung region, were measured using test tools embedded in the phantom. Using these parameters the MUSICA processing algorithm was optimized with respect to low-contrast detectability and spatial resolution. Two optimum "MUSICA parameter sets" were derived respectively for maximizing the CNR and sMTF in each region of the phantom. Further work is required to find the relative importance of low-contrast detectability and spatial resolution in chest images, from which the definitive optimum MUSICA parameter set can then be derived. Prior to this further work, a compromised optimum MUSICA parameter set was applied to a range of clinical images. A group of experienced image evaluators scored these images alongside images produced from the same radiographs using the MUSICA parameter set in clinical use at the time. The compromised optimum MUSICA parameter set was shown to produce measurably better images. PMID:17709364

  7. Shadows bordering the lung on radiographs of normal and obese persons

    PubMed Central

    Gluck, M. C.; Twigg, H. L.; Ball, M. F.; Rhodes, P. G.

    1972-01-01

    The thickness of the shadows that accompany ribs or border the lungs on the chest postero-anterior radiographs of 22 obese patients and 22 normal-weight subjects was measured, when present, at several rib levels. A similar measurement was made of accompanying rib shadows on chest postero-anterior radiographs of eight obese patients after weight reduction. Statistical analysis showed that there were significantly thicker soft tissue shadows adjacent to the ribs of obese subjects compared to normal-weight persons and of obese subjects before as compared to after weight reduction. Such shadows are more frequent and are seen at more rib levels of the obese. In addition, the following pertinent features are discussed: the mechanism by which soft tissue projects a radiographic shadow, the factors affecting its appearance, and the significance of such shadows as a variant of the normal chest radiograph and not as a manifestation of pathology. Images PMID:5034601

  8. Clinical findings among hard metal workers.

    PubMed Central

    Fischbein, A; Luo, J C; Solomon, S J; Horowitz, S; Hailoo, W; Miller, A

    1992-01-01

    In 1940, the first report appeared describing a pulmonary disorder associated with occupational exposures in the cemented tungsten carbide industry. The disease, known as "hard metal disease," has subsequently been characterised in detail and comprises a wide range of clinical signs and symptoms. In this report, clinical findings in a group of 41 hard metal workers employed until recently are described. A high prevalence of respiratory symptoms was found. Thirteen workers (31%) had abnormal chest radiographs indicative of interstitial lung disease. Fifty per cent of these had been employed in hard metal manufacturing for less than 10 years. Abnormalities of pulmonary function were also frequent and included a restrictive pattern of impairment and decrease in diffusing capacity (27%). Associations were found between diffusing capacity, chest radiographic abnormalities and right ventricular ejection fraction at exercise indicating cardiopulmonary effects. The findings show the continuous need to control excessive occupational exposures to prevent hard metal disease, the history of which now enters its sixth decade. PMID:1733452

  9. Mastitis, a Radiographic, Clinical, and Histopathologic Review.

    PubMed

    Cheng, Lin; Reddy, Vijaya; Solmos, Gene; Watkins, Latanja; Cimbaluk, David; Bitterman, Pincas; Ghai, Ritu; Gattuso, Paolo

    2015-01-01

    Mastitis is a benign inflammatory process of the breast with heterogeneous histopathological findings, which clinically and radiographically may mimic a mammary carcinoma. We undertook a retrospective study on 37 cases of mastitis in our institution to correlate the radiographic imaging features and the clinical presentation with the histopathological findings. Histologically, there were 21 granulomatous, 7 fibrous, 3 plasma cell, 3 lupus, 2 lymphocytic, and 1 case of acute mastitis. Radiographically, 16/25 (64%) patients with ultrasound studies showed irregular hypoechoic masses suspicious for malignancy. Clinically, 38% of patients had an associated systemic disease. PMID:25940456

  10. Visual simulation of radiographs

    SciTech Connect

    Laguna, G.

    1985-01-18

    A method for computer simulation of radiographs has been added to the LLNL version of the solid modeler TIPS-1 (Technical Information Processing System-1). This new tool will enable an engineer to compare an actual radiograph of a solid to its computer-generated counterpart. The appearance of discrepancies between the two can be an indication of flaws in the solid object. Simulated radiographs can also be used to preview the placement of x-ray sources to focus on areas of concern before actual radiographs are made.

  11. Chest wall tumour following iodized talc pleurodesis

    PubMed Central

    Jackson, John W.; Bennett, M. H.

    1973-01-01

    Jackson, J. W., and Bennett, M. H. (1973).Thorax, 28, 788-793. Chest wall tumour following iodized talc pleurodesis. A man of 37 had an iodized talc pleurodesis carried out for recurrent spontaneous pneumothorax. There was no history of industrial exposure to asbestos. Two years later he presented with pain in the right chest and radiographs at that time showed some localized pleural thickening at the site of the thoracoscopy cannulation for introduction of talc. A provisional diagnosis of talc granuloma, chemical abscess or tumour was made and exploratory thoracotomy revealed a tumour involving the chest wall, lung, and pleura which, on histological examination, showed adenocarcinoma of varying degrees of differentiation and in some parts also presenting a more squamoid appearance. Numerous doubly refractile talc particles were intimately associated with the tumour and fibrous tissue. Shortly after excision the patient developed evidence of systemic dissemination of the disease and died four months later. The possibility of this tumour being induced by the talc is discussed. A brief review is made of the various forms of talc used in surgery over the past 40 years and attention is drawn to the significance of the proportion of asbestos mineral which is present in talc as mined in various parts of the world. We do not consider that this is a case of mesothelioma of the pleura. Images PMID:4787992

  12. Diagnostic radiology peer review: a method inclusive of all interpreters of radiographic examinations regardless of specialty.

    PubMed

    Hopper, K D; Rosetti, G F; Edmiston, R B; Madewell, J E; Beam, L M; Landis, J R; Miller, K L; Ricci, J A; McCauslin, M A

    1991-08-01

    A proposed method of assessing the quality of diagnostic radiographic examinations includes peer review designed to evaluate physicians, including nonradiologists, involved in the performance and interpretation of such examinations. A pilot project evaluated this system with randomly selected Pennsylvania Blue Shield data files of 10 providers billing for chest radiography interpretations during the second quarter of 1989. Of the 98 chest radiographs reviewed blindly, all inadequately marked radiographs and incomplete written reports were produced by nonradiologists. Technical quality of images obtained by radiologists did not significantly differ from that of images obtained by nonradiologists (P = .189). All five interpretive errors that could have seriously affected the patient's health care were produced by nonradiologists (P = .019). Four of these serious errors were made by providers billing for fewer than 25 radiographs. While administrative and time cost limitations are obvious, this method of peer review encompasses all physicians billing for a particular radiographic service, irrespective of specialty. PMID:2068327

  13. [Chest wall reconstruction after resection of malignant chest wall tumors].

    PubMed

    Ayabe, H; Oka, T; Akamine, S; Takahashi, T; Nagayasu, T

    1998-05-01

    Full-thickness chest wall resection is performed for complete removal of primary and secondary malignant chest wall tumors. Large defects of the chest wall after resection must be repaired to maintain adequate ventilation, to protect important intrathoracic structures, and to preserve cosmetic integrity. Various materials have been utilized over the years to replace the rigid chest wall. At present, Marlex mesh and a composite of Marlex mesh and methylmethacrylate are frequently used to reconstruct rigid chest wall defects. On the other hand, to replace the soft part of the chest wall and cover the rigid materials, pedicled muscle flaps, myocutaneous flaps, or omentum are used. Major pedicled flaps include the pectoralis major, rectus abdominis and latissimus dorsi muscular, and musculocutaneous flaps. Techniques are now available to repair any chest wall site, and to restore chest continuity in patients whose tumors are curatively resected. PMID:9656244

  14. Radiographic Findings Associated with Vascular Anomalies

    PubMed Central

    Masand, Prakash

    2014-01-01

    Imaging of patients with vascular tumors and malformations has been sufficiently refined to answer pertinent questions when making treatment decisions in this challenging subgroup of pediatric patients. The imaging modalities at hand include conventional radiography, Doppler ultrasound, and magnetic resonance imaging with time-resolved, contrast-material enhanced magnetic resonance angiography. This review article will focus on the characteristic imaging features of some focal and diffuse vascular lesions, which have been classified by their clinical history and physical exam, and further labeled as a vascular tumor or slow-flow versus high-flow vascular malformation based on the updated classification system proposed by the International Society for the Study of Vascular Anomalies. The recent advances in knowledge regarding the biology of these vascular anomalies have led to increased awareness of the current nomenclature. Moreover, with better understanding of the imaging features, the radiologist has become a key player in the multidisciplinary approach offered at various institutions where appropriate treatment algorithms and interventional strategies are put together. This is crucial in avoiding misdiagnosis and improper management. PMID:25045332

  15. RETOUCHING OF RADIOGRAPHS.

    PubMed

    IRVINE, R F

    1964-06-13

    Underexposed or underdeveloped radiographs which could have been used for teaching or publication were treated prior to photographing with a technique similar to that used for photographic negative retouching. This method enables these radiographs to be used for diagnostic demonstration, where before they would have been condemned as unsuitable for reproduction. The method is simple and requires very little experience or equipment. PMID:14156836

  16. Are dental radiographs safe?

    PubMed

    Abbott, P

    2000-09-01

    Dental patients are often aware that radiation has the potential to harm them but they do not usually understand how or why and what potential harmful effects may arise from dental radiographs. The potential for undesirable effects must be balanced against the benefits obtained from radiographs. Dentists should address the concerns of patients who question the need for radiographs and allow them to make an informed decision. Data are available that relate radiation exposure levels from medical and dental radiographs to normal background exposure levels and allow comparisons with everyday risks in life. Recognized radiation authorities publish guidelines to help dentists with their use of radiographs, although, due to the time lag associated with testing and the publication of results, some of the published data may not always be entirely relevant to currently used X-ray machines and techniques. Dentists also have professional obligations not only to limit the use of radiographs to potentially beneficial situations but also to take good quality diagnostic radiographs, to limit the doses used, to use good radiation safety measures and to use modern equipment to achieve the best possible films. Radiographs must then be properly developed and viewed under appropriate conditions to gain the maximum possible diagnostic information from each exposure. PMID:11062940

  17. Chest compressions in an infant with osteogenesis imperfecta type II: No new rib fractures.

    PubMed

    Sewell, R D; Steinberg, M A

    2000-11-01

    The case report of a newborn female with osteogenesis imperfecta type II who underwent cardiopulmonary resuscitation (CPR) with manual chest compressions for several minutes is presented. Chest radiographs taken before and after the chest compressions were administered were reviewed by several radiologists from 3 different hospitals and demonstrated no new radiographically visible rib fractures. Collagen analysis, the patient's clinical appearance, and clinical course, as well as a consultant's opinion aided in confirmation of the diagnosis of osteogenesis imperfecta type II. A review of 4 previous studies concerning rib fractures and CPR is included. This unique case supports previous articles that have concluded that rib fractures rarely, if ever, result from CPR in pediatrics, even in children with a lethal underlying bone disease, such as osteogenesis imperfecta type II. cardiopulmonary resuscitation, chest compressions, osteogenesis imperfecta, rib fractures, bone disease. PMID:11061808

  18. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    PubMed Central

    Matos, António P.; Mascarenhas, Vasco; Herédia, Vasco

    2014-01-01

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall. PMID:25295188

  19. Multidetector computer tomography: evaluation of blunt chest trauma in adults.

    PubMed

    Palas, João; Matos, António P; Mascarenhas, Vasco; Herédia, Vasco; Ramalho, Miguel

    2014-01-01

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall. PMID:25295188

  20. Chest Pain (Beyond the Basics)

    MedlinePlus

    ... coronary arteries. Heart attack — A heart attack, or myocardial infarction (MI), occurs when the surface covering of a ... chest pain Criteria for the diagnosis of acute myocardial infarction Outpatient evaluation of the adult with chest pain ...

  1. Use and effectiveness of chest radiography and low-back radiography in screening

    SciTech Connect

    Joseph, L.P.; Rachlin, J.A.

    1986-10-01

    One of the Food and Drug Administration's educational programs to optimize the use of medical radiation is the investigation of the efficacy of selected x-ray film examinations. The goal of this program is to provide clinical information needed to aid physicians in their judgment. The routine chest-radiograph screening examination has been studied, and recommendations for five applications of chest-radiograph screening have been published. These recommendations, plus results of FDA research on the efficacy of low-back radiography, are discussed.

  2. Atypical chest discomfort in a 36-year-old man.

    PubMed

    Alexander, Lisa Mustone; Robie, Stephen; Baute, Scott

    2016-07-01

    This article focuses on aortic aneurysms and the evaluation of patients with atypical chest pain. A complete and accurate family history is essential. Clinicians should pay close attention to persistence of symptoms and age in patients with atypical chest discomfort who do not have routine confirmatory cardiac findings. PMID:27351640

  3. Clinical and Radiographic Manifestations of Sputum Culture-Negative Pulmonary Tuberculosis

    PubMed Central

    Nguyen, Minh-Vu H.; Jenny-Avital, Elizabeth R.; Burger, Susanne; Leibert, Eric M.; Achkar, Jacqueline M.

    2015-01-01

    Intervention at the earliest possible stage of pulmonary tuberculosis (PTB) reduces morbidity for the individual and transmission for the community. We characterize the clinical and radiographic manifestations of sputum culture-negative (Cx-) PTB in order to facilitate awareness of this under recognized and likely early disease state. In this cross-sectional sub-study, we reviewed the medical records of HIV-uninfected PTB patients enrolled from 2006–2014 within the context of a TB biomarker study in New York City. Cx- PTB was defined as clinical and/or radiographic presentation consistent with PTB, three initial mycobacterial sputum cultures negative, and no evidence of other respiratory disease. Diagnosis was confirmed by clinical and radiographic improvement on antituberculous treatment and/or culture, nucleic acid, or histological confirmation from a specimen other than the initial three sputa. Cx+ PTB was defined as above but with M. tuberculosis growth in at least one of the first three sputum cultures. Demographics, symptoms, and radiographic findings on initial presentation were compared between the two groups. Of 99 subjects diagnosed with PTB, 21 met the criteria of Cx- PTB. Cx- compared to Cx+ subjects presented with a significantly lower frequency of cough (70% vs. 91%, P = 0.02), sputum production (30% vs. 64%, P < 0.01), weight loss (25% vs. 54%, P = 0.02), and frequency of cavitation on chest CT (12% vs. 68%, P < 0.01). Our findings should raise awareness that neither a positive culture nor the hallmark symptoms are invariably associated with early TB disease. PMID:26448182

  4. Cardiac Injuries: A Review of Multidetector Computed Tomography Findings

    PubMed Central

    Baxi, Ameya Jagdish; Restrepo, Carlos; Mumbower, Amy; McCarthy, Michael; Rashmi, Katre

    2015-01-01

    Trauma is the leading cause of death in United States in the younger population. Cardiac trauma is common following blunt chest injuries and is associated with high morbidity and mortality. This study discusses various multidetector computed tomography (MDCT) findings of cardiac trauma. Cardiac injuries are broadly categorized into the most commonly occurring blunt cardiac injury and the less commonly occurring penetrating injury. Signs and symptoms of cardiac injury can be masked by the associated injuries. Each imaging modality including chest radiographs, echocardiography, magnetic resonance imaging and MDCT has role in evaluating these patients. However, MDCT is noninvasive; universally available and has a high spatial, contrast, and temporal resolution. It is a one stop shop to diagnose and evaluate complications of cardiac injury. MDCT is an imaging modality of choice to evaluate patients with cardiac injuries especially the injuries capable of causing hemodynamic instability. PMID:26839855

  5. Coccidioidomycosis - chest x-ray (image)

    MedlinePlus

    This chest x-ray shows the affects of a fungal infection, coccidioidomycosis. In the middle of the left lung (seen on the ... defined borders. Other diseases that may explain these x-ray findings include lung abscesses, chronic pulmonary tuberculosis, chronic ...

  6. Treatment of Morbidity with Atypical Chest Pain

    PubMed Central

    Cott, Arthur

    1987-01-01

    The appropriate management of atypical chest pain requires an integration of medical and behavioural treatments. Unnecessary medicalization can increase morbidity. A sensitivity to the behavioural factors contributing to symptoms and disability may reduce both. The purpose of this paper is to provide physicians with a cognitive-behavioural perspective of the nature of morbidity and disability associated with chronic chest discomfort; some strategies for detecting heretofore unsuspected disability associated with chronic chest pain and related discomfort in patients with organic findings (both cardiac and non-cardiac), as well those with no identifiable disease process or organic cause; and some simple behavioural and cognitive-behavioural therapeutic techniques for treating and preventing such problems. PMID:21263912

  7. Test of radiologist performance in interpreting bedside chest examinations on a workstation

    NASA Astrophysics Data System (ADS)

    Freedman, Matthew T.; Lo, Shih-Chung B.; Nelson, Martha C.; Reagan, Kathleen; Horii, Steven C.; Mun, Seong K.

    1992-05-01

    A book cassette containing both a conventional film-screen radiographic system (FR) and a phosphor storage radiographic plate (SR) was used to obtain simultaneous bedside chest images in 22 patients in the Post Operative Cardiac and Surgical Intensive Care Units (ICUs). Twenty-five potential findings of normal structures, lung and pleural disease, and life support devices were recorded for each image in a five point rating format. The FR images are all considered of good diagnostic quality. The original FR films, the laser digitized FR images (DF) displayed on a workstation (WS), and the SR images displayed on a WS were compared. The WS viewing was on a 1 K X 1.2 K, 8 bit monitor. Free adjustment of window level, window width, and black-white inversion was allowed. Magnification allowed access to the 2 K data set. ROC analysis supports the null hypothesis that there is no difference in the diagnostic yield of good quality bedside obtained FR, DF made from good quality FR viewed on a workstation, and SR viewed on a workstation. Analysis of the subset of interstitial and airspace edema indicated that readers gave higher scores for interstitial disease on the WS for both false positive and true positive findings.

  8. [Acute Chest Pain].

    PubMed

    Gmür, Christian

    2016-02-17

    Acute chest pain is a frequent consultation reason in general practice as well as in emergency departments. With the help of history, physical examination, ECG, laboratory and newly developed risk scores, potentially life-threatening diseases and high-risk patients may be detected and treated early, quickly and cost-effectively. New biomarkers and their combination with risk scores can increase the negative predictive value to exclude certain diseases. PMID:26886697

  9. Radiographic Assessment for Back Pain

    MedlinePlus

    Radiographic Assessment for Back Pain What are Radiographic Assessments? When Should I get an X-ray for Low Back Pain? Other Reasons for Having an X-ray What ... What are Radiographic Assessments? Radiographic assessments for low back pain involve the use of X-rays to determine ...

  10. Pitfalls in Radiographic Interpretation of Emphysema Patients.

    PubMed

    Baik, Jun Hyun; Ko, Jeong Min; Park, Hyun Jin

    2016-08-01

    Emphysema commonly accompanies various complications such as pneumonia. Sometimes, these comorbidities look so strange on images, because destroyed airspaces could change the usual disease progression. So, we demonstrated various cases of common comorbidities with unusual radiographic findings in emphysema patients. Awareness of various findings of emphysema with commonly coexistent diseases may aid in the proper diagnosis and management of emphysema patients. PMID:27147485

  11. Chest neoplasms with infectious etiologies

    PubMed Central

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

    2011-01-01

    A wide spectrum of thoracic tumors have known or suspected viral etiologies. Oncogenic viruses can be classified by the type of genomic material they contain. Neoplastic conditions found to have viral etiologies include post-transplant lymphoproliferative disease, lymphoid granulomatosis, Kaposi’s sarcoma, Castleman’s disease, recurrent respiratory papillomatosis, lung cancer, malignant mesothelioma, leukemia and lymphomas. Viruses involved in these conditions include Epstein-Barr virus, human herpes virus 8, human papillomavirus, Simian virus 40, human immunodeficiency virus, and Human T-lymphotropic virus. Imaging findings, epidemiology and mechanism of transmission for these diseases are reviewed in detail to gain a more thorough appreciation of disease pathophysiology for the chest radiologist. PMID:22224176

  12. The 'ABC' of examining foot radiographs.

    PubMed Central

    Pearse, Eyiyemi O.; Klass, Benjamin; Bendall, Stephen P.

    2005-01-01

    INTRODUCTION: We report a simple systematic method of assessing foot radiographs that improves diagnostic accuracy and can reduce the incidence of inappropriate management of serious forefoot and midfoot injuries, particularly the Lisfranc-type injury. STUDY GROUP AND METHODS: Five recently appointed senior house officers (SHOs), with no casualty or Orthopaedic experience prior to their appointment, were shown a set of 10 foot radiographs and told the history and examination findings recorded in the casualty notes of each patient within 6 weeks of taking up their posts. They were informed that the radiographs might or might not demonstrate an abnormality. They were asked to make a diagnosis and decide on a management plan. The test was repeated after they were taught the 'ABC' method of evaluating foot radiographs. RESULTS: Diagnostic accuracy improved after SHOs were taught a systematic method of assessing foot radiographs. The proportion of correct diagnoses increased from 0.64 to 0.78 and the probability of recognising Lisfranc injuries increased from 0 to 0.6. CONCLUSIONS: The use of this simple method of assessing foot radiographs can reduce the incidence of inappropriate management of serious foot injuries by casualty SHOs, in particular the Lisfranc type injury. PMID:16263015

  13. Establishing Standards for Side-by-Side Radiographic Comparisons.

    PubMed

    Ross, Ann H; Lanfear, Alicja K; Maxwell, Ashley B

    2016-06-01

    The objectives of this research were to evaluate the use of various anatomical features that are visible in standard radiographs and to develop a standard system of assessing concordant features for making positive identifications through radiographic comparison.The radiographs used in the study include craniofacial (n = 41), chest (n = 100), and proximal femur (n = 49), which were made available by the North Carolina Office of the Chief Medical Examiner. Radiographs were scored for number of concordant features and were analyzed using classification decision trees. The accuracy of the classification tree models was evaluated using a receiver operating characteristic.Two or more points of concordance are required in lateral cranial radiographs for a 97% probability of a positive identification. If more than 1 concordant feature exists on the cervical vertebrae, there is a 99% probability of correct identification. For thoracic and lumbar vertebrae, 4 or more concordant features are required for a 98% probability of correct identification. If there are 1 or more femoral head and neck concordant features, the probability of a correct identification is 94% and 97%, respectively. This study established the minimum number of concordant areas needed to confirm positive identifications in 3 standard radiographic views. PMID:26999427

  14. Weld radiograph enigmas

    NASA Technical Reports Server (NTRS)

    Jemian, Wartan A.

    1986-01-01

    Weld radiograph enigmas are features observed on X-ray radiographs of welds. Some of these features resemble indications of weld defects, although their origin is different. Since they are not understood, they are a source of concern. There is a need to identify their causes and especially to measure their effect on weld mechanical properties. A method is proposed whereby the enigmas can be evaluated and rated, in relation to the full spectrum of weld radiograph indications. Thie method involves a signature and a magnitude that can be used as a quantitive parameter. The signature is generated as the diference between the microdensitometer trace across the radiograph and the computed film intensity derived from a thickness scan along the corresponding region of the sample. The magnitude is the measured difference in intensity between the peak and base line values of the signature. The procedure is demonstated by comparing traces across radiographs of a weld sample before and after the introduction of a hole and by a system based on a MacIntosh mouse used for surface profiling.

  15. Viewing Another Person's Eye Movements Improves Identification of Pulmonary Nodules in Chest X-Ray Inspection

    ERIC Educational Resources Information Center

    Litchfield, Damien; Ball, Linden J.; Donovan, Tim; Manning, David J.; Crawford, Trevor

    2010-01-01

    Double reading of chest x-rays is often used to ensure that fewer abnormalities are missed, but very little is known about how the search behavior of others affects observer performance. A series of experiments investigated whether radiographers benefit from knowing where another person looked for pulmonary nodules, and whether the expertise of…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  17. [Optimization of the chest computed tomography scan by varying the position of the arms].

    PubMed

    Matsumoto, Yoriaki; Masuda, Takanori; Imada, Naoyuki; Maruyama, Naoya; Inada, Satoshi; Ishibashi, Tooru; Satou, Tomoyasu

    2012-01-01

    Computed tomography automatic exposure control (CT-AEC) technique is calculated from a localizer radiograph. When we perform neck and chest CT examination, at first, we acquire localizer radiograph and neck images by placing the arm in a lowered position. Next, the arm is raised for the chest scan. Therefore, the localizer radiograph and subject information are different in the chest scan. In this situation, the chest scan with the use of the CT-AEC causes radiation over-dose. The purpose of this study is to optimize the CT-AEC by controlling noise index (NI), and make a chest CT scan condition considering the position of the arms. We measured the image noise (SD) in the phantom by using CT-AEC. In addition, dose length product (DLP) was recorded. Moreover, we examined the correlation with the clinical images. The results of our experiments show that radiation dose can be reduced with the image quality kept by controlling NI. PMID:22821158

  18. Advanced radiographic imaging techniques.

    NASA Technical Reports Server (NTRS)

    Beal, J. B.; Brown, R. L.

    1973-01-01

    Examination of the nature and operational constraints of conventional X-radiographic and neutron imaging methods, providing a foundation for a discussion of advanced radiographic imaging systems. Two types of solid-state image amplifiers designed to image X rays are described. Operational theory, panel construction, and performance characteristics are discussed. A closed-circuit television system for imaging neutrons is then described and the system design, operational theory, and performance characteristics are outlined. Emphasis is placed on a description of the advantages of these imaging systems over conventional methods.

  19. Neutron radiographic viewing system

    NASA Technical Reports Server (NTRS)

    Leysath, W.; Brown, R. L.

    1972-01-01

    Neutron radiographic viewing system consisting of camera head and control processor is developed for use in nondestructive testing applications. Camera head consists of neutron-sensitive image intensifier system, power supply, and SEC vidicon camera head. Both systems, with their optics, are housed on test mount.

  20. Radiographic intensifying screen

    SciTech Connect

    Ochiai, T.

    1985-02-26

    A radiographic intensifying screen comprising a substrate and a fluorescent layer provided thereon and consisting essentially of a binder and a radioluminescent phosphor dispersed therein. The binder comprises linear polyester resin or linear polyester resin crosslinked with a crosslinking agent. The screen exhibits improved physical properties.

  1. Findings from an evaluation of PlanAlyzer's double cross-over trials of computer-based, self-paced, case-based programs in anemia and chest pain diagnosis.

    PubMed Central

    Lyon, H. C.; Healy, J. C.; Bell, J. R.; O'Donnell, J. F.; Shultz, E. K.; Wigton, R. S.; Hirai, F.; Beck, J. R.

    1991-01-01

    We report on three years of research trials of the PlanAlyzer I Project--a carefully controlled research study using a microcomputer-based, self-paced, case-based, event-driven system for medical education. PlanAlyzer presents cases, elicits and critiques a second year student's approach to the diagnosis of anemias and chest pain. PlanAlyzer uses text, hypertext, images and critiquing theory. Students were randomized, one half becoming the experimental group who received the interactive PlanAlyzer cases in anemia, the other half becoming the controls who received the exact same content material in a text format. Later in each year there was a crossover, the controls becoming the experimentals for a similar intervention with the cardiology PlanAlyzer cases. Results at the end of the first two years of trials show that the programs have achieved some significant efficiency and economy gains. 96 faculty hours of classroom time were saved by using PlanAlyzer in their place, with no loss in student achievement. In terms of student proficiency and efficiency, combining the anemia and cardiology trials, the 328 students in the two years of full scale trials were able to accomplish the project's instructional objectives. The experimentals accomplished this in 43% less time than the controls. On the average, for both the anemia and chest pain programs, this amounted to students spending 7.5 hours longer on the 30 text cases than on the same 30 computer cases to achieve the same level of mastery. There have been no significant proficiency differences (as measured by current post-tests) between the experimental and control groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1807738

  2. Investigation and management of patients with pleuritic chest pain presenting to the accident and emergency department.

    PubMed Central

    Jones, K; Raghuram, A

    1999-01-01

    The assessment of a patient with pleuritic chest pain calls for a high degree of clinical acumen and a high degree of suspicion that the diagnosis might be pulmonary embolism. This area is one of the most difficult in A&E medicine (and indeed chest medicine). One error is to "think the best" when considering the diagnosis in such patients but experience soon teaches to "think PE" and diagnose less serious conditions only when pulmonary embolism has been excluded. A key consideration is the presence of risk factors. Because the diagnosis is difficult, there should be no hesitation in requesting a senior opinion or referring to the inpatient medical team. We have produced an algorithm (fig 1) for the investigation and management of pleuritic chest pain as discussed in this article. Three questions relating to this article are: (1) Can pulmonary embolism be the diagnosis in a patient with pleuritic chest pain but a normal chest radiograph, ECG, and arterial blood gases? (2) What is the chest radiograph abnormality which is most likely to alert you to the possibility of pulmonary embolism? (3) What percentage of patients with a low clinical suspicion of pulmonary embolism but a high probability V/Q scan will have pulmonary embolism demonstrated on pulmonary angiography? The three key references are The PIOPED Investigators, Dalen, and Fennerty. PMID:9918289

  3. Consequences of modern anthropometric dimensions for radiographic techniques and patient radiation exposures

    PubMed Central

    Shah, Chintan; Jones, A. Kyle; Willis, Charles E.

    2008-01-01

    Radiographic techniques are devised on the basis of anatomic dimensions. Inaccurate dimensions can cause radiographs to be exposed inappropriately and patient radiation exposures to be calculated incorrectly. The source of anatomic dimensions in common usage dates back to 1948. The objective of this study was to compare traditional and modern anthropometric data, use modern dimensions to estimate potential errors in patient exposure, and suggest modified technique guidelines. Anthropometry software was used to derive modern anatomic dimensions. Data from routine annual testing were analyzed to develop an x-ray generator output curve. Published tabulated data were used to determine the relationship between tissue half-value layer and kilovoltage. These relationships were used to estimate entrance skin exposure and create a provisional technique guide. While most anatomic regions were actually larger than previously indicated, some were similar, and a few were smaller. Accordingly, exposure estimates were higher, similar, or lower, depending on the anatomic region. Exposure estimates using modern dimensions for clinically significant regions of the trunk were higher than those calculated with traditional dimensions. Exposures of the postero-anterior chest, lateral chest, antero-posterior (AP) abdomen, male AP pelvis, and female AP pelvis were larger by 48%, 31%, 54%, 52%, and 112%, respectively. The dimensions of bony regions of the anatomy, such as the joints and skull, were unchanged. These findings are consistent with the idea that anatomic areas where fat is deposited are larger in the modern U.S. population than they were in previous years. Exposure techniques for manual radiography and calculations of patient dose for automatic exposure control radiography should be adjusted according to the modern dimensions. Population radiation exposure estimates calculated in national surveys should also be modified appropriately. PMID:18777922

  4. A Monte Carlo estimation of effective dose in chest tomosynthesis

    SciTech Connect

    Sabol, John M.

    2009-12-15

    Purpose: The recent introduction of digital tomosynthesis imaging into routine clinical use has enabled the acquisition of volumetric patient data within a standard radiographic examination. Tomosynthesis requires the acquisition of multiple projection views, requiring additional dose compared to a standard projection examination. Knowledge of the effective dose is needed to make an appropriate decision between standard projection, tomosynthesis, and CT for thoracic x-ray examinations. In this article, the effective dose to the patient of chest tomosynthesis is calculated and compared to a standard radiographic examination and to values published for thoracic CT. Methods: Radiographic technique data for posterior-anterior (PA) and left lateral (LAT) radiographic chest examinations of medium-sized adults was obtained from clinical sites. From these data, the average incident air kerma for the standard views was determined. A commercially available tomosynthesis system was used to define the acquisition technique and geometry for each projection view. Using Monte Carlo techniques, the effective dose of the PA, LAT, and each tomosynthesis projection view was calculated. The effective dose for all projections of the tomosynthesis sweep was summed and compared to the calculated PA and LAT values and to the published values for thoracic CT. Results: The average incident air kerma for the PA and left lateral clinical radiographic examinations were found to be 0.10 and 0.40 mGy, respectively. The effective dose for the PA view of a patient of the size of an average adult male was determined to be 0.017 mSv (ICRP 60) [0.018 mSv (ICRP 103)]. For the left lateral view of the same sized patient, the effective dose was determined to be 0.039 mSv (ICRP 60) [0.050 mSv (ICRP 103)]. The cumulative mA s for a tomosynthesis examination is recommended to be ten times the mA s of the PA image. With this technique, the effective dose for an average tomosynthesis examination was

  5. Outpatient radiographic exposure in the first five years of life

    SciTech Connect

    Fosarelli, P.D.; DeAngelis, C.

    1987-06-01

    Young children receive a variety of diagnostic radiographs over time. In some cases the exposure to radiation may be unwarranted because the films may yield confusing results, or may also need to be repeated because of poor technical quality. Even when the results are clearly negative, the subsequent treatment may proceed as if the film had been positive because of the child's clinical condition. The cumulative effect of such low-dose radiation on infants and children over time is unknown. The number and types of outpatient radiographs received by a cohort of poor children from a hospital-based continuity clinic during their first 5 years of life were reviewed. Also noted were the reason for obtaining the film, whether it was positive for that reason or another, whether the child had a chronic condition that prompted the use of radiograph, and the child's sex, race, and age when the film was obtained. Of the 218 children, 132 (60.6%) received 349 sets of films in their first 5 years. There was no difference in the number of films by race or sex. Chest and posttrauma bone or joint films accounted for 315 sets of films or 90.3% of the total. Overall, 25.8% of the 267 chest films were positive; this varied by age. Only 15% of the chest films were positive in the first year compared with 29 to 49% in the second through fifth years (p less than 0.001). Cough was the respiratory symptom most reliably associated with a positive chest film, both for the cohort (p less than 0.0001) and for children in the first year of life (p less than 0.01).

  6. Epithelioid hemangioendothelioma originating from the chest wall with rib metastases.

    PubMed

    Shimamura, Junichi; Kiyoshima, Moriyuki; Suzuki, Hisashi; Kitahara, Miyuki; Asato, Yuji; Iijima, Tatsuo; Amemiya, Ryuta

    2015-11-01

    An asymptomatic 39-year-old woman was referred to us for an abnormal nodular opacity detected on the chest X-ray. Histopathological and further examinations revealed findings consistent with epithelioid hemangioendothelioma (EHE) originating from the chest wall with metastases to the ribs. Complete excision was performed; however, adjuvant chemotherapy was not administered because of the patient's mental disorder. There are very few reports of EHE arising from the chest wall; therefore, we present this case report with the clinicopathological features of EHE and discuss the therapeutic aspects. PMID:24399489

  7. A low cost method of digitizing radiographs using a photo light box.

    PubMed

    Baldisserotto, Matteo; de Godoy, Giltom Fontoura; Barbieri, Denis

    2013-04-23

    We evaluated a low cost device for digitizing X-ray films. It consisted of a locally-made wooden box and a readily-available digital camera. Two experienced paediatric radiologists interpreted the original X-ray films (the reference standard) and the corresponding images obtained in the photo light box. Ninety paediatric chest X-ray films were used (30 were normal chest radiographs, 30 showed pneumonic-consolidation and 30 had interstitial infiltrates). The presence or absence of the three signs most frequently found in acute respiratory pathologies were evaluated: normal pulmonary transparency, pneumonic consolidation and interstitial infiltration. There was very good agreement between the X-ray films and the digitized images, with kappa values from 0.86 to 0.98. There was good agreement between the two observers, with kappa values from 0.67 to 0.90. The low-cost photo light box represents an accessible and low-cost approach to transmitting X-ray images, allowing findings or a second opinion from a specialist radiologist to be obtained from a distance. PMID:23612518

  8. Algorithm of chest wall keloid treatment.

    PubMed

    Long, Xiao; Zhang, Mingzi; Wang, Yang; Zhao, Ru; Wang, Youbin; Wang, Xiaojun

    2016-08-01

    Keloids are common in the Asian population. Multiple or huge keloids can appear on the chest wall because of its tendency to develop acne, sebaceous cyst, etc. It is difficult to find an ideal treatment for keloids in this area due to the limit of local soft tissues and higher recurrence rate. This study aims at establishing an individualized protocol that could be easily applied according to the size and number of chest wall keloids.A total of 445 patients received various methods (4 protocols) of treatment in our department from September 2006 to September 2012 according to the size and number of their chest wall keloids. All of the patients received adjuvant radiotherapy in our hospital. Patient and Observer Scar Assessment Scale (POSAS) was used to assess the treatment effect by both doctors and patients. With mean follow-up time of 13 months (range: 6-18 months), 362 patients participated in the assessment of POSAS with doctors.Both the doctors and the patients themselves used POSAS to evaluate the treatment effect. The recurrence rate was 0.83%. There was an obvious significant difference (P < 0.001) between the before-surgery score and the after-surgery score from both doctors and patients, indicating that both doctors and patients were satisfied with the treatment effect.Our preliminary clinical result indicates that good clinical results could be achieved by choosing the proper method in this algorithm for Chinese patients with chest wall keloids. This algorithm could play a guiding role for surgeons when dealing with chest wall keloid treatment. PMID:27583896

  9. Algorithm of chest wall keloid treatment

    PubMed Central

    Long, Xiao; Zhang, Mingzi; Wang, Yang; Zhao, Ru; Wang, Youbin; Wang, Xiaojun

    2016-01-01

    Abstract Keloids are common in the Asian population. Multiple or huge keloids can appear on the chest wall because of its tendency to develop acne, sebaceous cyst, etc. It is difficult to find an ideal treatment for keloids in this area due to the limit of local soft tissues and higher recurrence rate. This study aims at establishing an individualized protocol that could be easily applied according to the size and number of chest wall keloids. A total of 445 patients received various methods (4 protocols) of treatment in our department from September 2006 to September 2012 according to the size and number of their chest wall keloids. All of the patients received adjuvant radiotherapy in our hospital. Patient and Observer Scar Assessment Scale (POSAS) was used to assess the treatment effect by both doctors and patients. With mean follow-up time of 13 months (range: 6–18 months), 362 patients participated in the assessment of POSAS with doctors. Both the doctors and the patients themselves used POSAS to evaluate the treatment effect. The recurrence rate was 0.83%. There was an obvious significant difference (P < 0.001) between the before-surgery score and the after-surgery score from both doctors and patients, indicating that both doctors and patients were satisfied with the treatment effect. Our preliminary clinical result indicates that good clinical results could be achieved by choosing the proper method in this algorithm for Chinese patients with chest wall keloids. This algorithm could play a guiding role for surgeons when dealing with chest wall keloid treatment. PMID:27583896

  10. CT observation of rib abnormalities: spectrum of findings.

    PubMed

    Edelstein, G; Levitt, R G; Slaker, D P; Murphy, W A

    1985-01-01

    The CT studies in 63 patients in which rib abnormality was identified or excluded were retrospectively analyzed. The CT features were detailed and correlated with other available radiographic findings as well as clinical data. Contiguous spread of tumor to rib or metastasis to rib characteristically showed subtle or complete segmental lytic rib destruction. An accompanying extrapleural soft tissue mass was frequently seen with metastatic disease and myeloma. In nine patients CT showed rib destruction that had been obscured on chest radiography by heart, diaphragm, mass, or pleural effusion. Other imaging studies prompted consideration of neoplasm in seven patients in whom CT clearly showed benign post-traumatic or developmental lesions. Six patients had a clinically suspected chest wall mass excluded, leading to the diagnosis of Tietze syndrome. The ribs should be carefully inspected on all CT studies of the thorax and upper abdomen. Computed tomography is helpful when other imaging techniques, such as rib films or isotopic bone scans, have not resolved the question of clinically or radiographically suspected rib abnormality. PMID:3968282

  11. Radiologists remember mountains better than radiographs, or do they?

    PubMed

    Evans, Karla K; Marom, Edith M; Godoy, Myrna C B; Palacio, Diana; Sagebiel, Tara; Cuellar, Sonia Betancourt; McEntee, Mark; Tian, Charles; Brennan, Patrick C; Haygood, Tamara Miner

    2016-01-01

    Expertise with encoding material has been shown to aid long-term memory for that material. It is not clear how relevant this expertise is for image memorability (e.g., radiologists' memory for radiographs), and how robust over time. In two studies, we tested scene memory using a standard long-term memory paradigm. One compared the performance of radiologists to naïve observers on two image sets, chest radiographs and everyday scenes, and the other radiologists' memory with immediate as opposed to delayed recognition tests using musculoskeletal radiographs and forest scenes. Radiologists' memory was better than novices for images of expertise but no different for everyday scenes. With the heterogeneity of image sets equated, radiologists' expertise with radiographs afforded them better memory for the musculoskeletal radiographs than forest scenes. Enhanced memory for images of expertise disappeared over time, resulting in chance level performance for both image sets after weeks of delay. Expertise with the material is important for visual memorability but not to the same extent as idiosyncratic detail and variability of the image set. Similar memory decline with time for images of expertise as for everyday scenes further suggests that extended familiarity with an image is not a robust factor for visual memorability. PMID:26870748

  12. Observer POD for radiographic testing

    NASA Astrophysics Data System (ADS)

    Kanzler, Daniel; Ewert, Uwe; Müller, Christina; Pitkänen, Jorma

    2015-03-01

    The radiographic testing (RT) is a non-destructive testing (NDT) method capable of finding volumetric and open planar defects depending on their orientation. The radiographic contrast is higher for larger penetrated length of the defect in a component. Even though, the detectability of defects does not only depend on the contrast, but also on the noise, the defect area and the geometry of the defect. The currently applied Probability of Detection (POD) approach uses a detection threshold that is only based on a constant noise level or on a constant contrast threshold. This does not reflect accurately the results of evaluations by human observers. A new approach is introduced, using the widely applied POD evaluation and additionally a detection threshold depending on the lateral area and shape of the indication. This work shows the process of calculating the POD curves with simulated data by the modeling software aRTist and with artificial reference data of different defect types, such as ASTM E 476 EPS plates, flat bottom holes and notches. Additional experiments with different operators confirm that the depth of a defect, the lateral area and shape of its indication contribute with different weight to the detectability of the defect if evaluated by human operators on monitors.

  13. Observer POD for radiographic testing

    SciTech Connect

    Kanzler, Daniel E-mail: uwe.ewert@bam.de Ewert, Uwe E-mail: uwe.ewert@bam.de Müller, Christina E-mail: uwe.ewert@bam.de; Pitkänen, Jorma

    2015-03-31

    The radiographic testing (RT) is a non-destructive testing (NDT) method capable of finding volumetric and open planar defects depending on their orientation. The radiographic contrast is higher for larger penetrated length of the defect in a component. Even though, the detectability of defects does not only depend on the contrast, but also on the noise, the defect area and the geometry of the defect. The currently applied Probability of Detection (POD) approach uses a detection threshold that is only based on a constant noise level or on a constant contrast threshold. This does not reflect accurately the results of evaluations by human observers. A new approach is introduced, using the widely applied POD evaluation and additionally a detection threshold depending on the lateral area and shape of the indication. This work shows the process of calculating the POD curves with simulated data by the modeling software aRTist and with artificial reference data of different defect types, such as ASTM E 476 EPS plates, flat bottom holes and notches. Additional experiments with different operators confirm that the depth of a defect, the lateral area and shape of its indication contribute with different weight to the detectability of the defect if evaluated by human operators on monitors.

  14. Incentive spirometry versus routine chest physiotherapy for prevention of pulmonary complications after abdominal surgery.

    PubMed

    Hall, J C; Tarala, R; Harris, J; Tapper, J; Christiansen, K

    1991-04-20

    We entered 876 patients into a clinical trial aimed at preventing pulmonary complications after abdominal surgery. Patients either received conventional chest physiotherapy or were encouraged to perform maximal inspiratory manoeuvres for 5 min during each hour while awake, using an incentive spirometer. The incidence of pulmonary complications did not differ significantly between the groups: incentive spirometry 68 of 431 (15.8%, 95% CI 14.0-17.6%), and chest physiotherapy 68 of 445 (15.3%, CI 13.6-17.0%). Nor was there a difference between the groups in the incidence of positive clinical signs, pyrexia, abnormal chest radiographs, pathogens in sputum, respiratory failure (PO2 less than 60 mm Hg), or length of stay in hospital. We conclude that prophylactic incentive spirometry and chest physiotherapy are of equivalent clinical efficacy in the general management of patients undergoing abdominal surgery. PMID:1678039

  15. Male chest enhancement: pectoral implants.

    PubMed

    Benito-Ruiz, J; Raigosa, J M; Manzano-Surroca, M; Salvador, L

    2008-01-01

    The authors present their experience with the pectoral muscle implant for male chest enhancement in 21 patients. The markings and technique are thoroughly described. The implants used were manufactured and custom made. The candidates for implants comprised three groups: group 1 (18 patients seeking chest enhancement), group 2 (1 patient with muscular atrophy), and group 3 (2 patients with muscular injuries). Because of the satisfying results obtained, including significant enhancement of the chest contour and no major complications, this technique is used for an increasing number of male cosmetic surgeries. PMID:17676376

  16. Large Format Radiographic Imaging

    SciTech Connect

    J. S. Rohrer; Lacey Stewart; M. D. Wilke; N. S. King; S. A Baker; Wilfred Lewis

    1999-08-01

    Radiographic imaging continues to be a key diagnostic in many areas at Los Alamos National Laboratory (LANL). Radiographic recording systems have taken on many form, from high repetition-rate, gated systems to film recording and storage phosphors. Some systems are designed for synchronization to an accelerator while others may be single shot or may record a frame sequence in a dynamic radiography experiment. While film recording remains a reliable standby in the radiographic community, there is growing interest in investigating electronic recording for many applications. The advantages of real time access to remote data acquisition are highly attractive. Cooled CCD camera systems are capable of providing greater sensitivity with improved signal-to-noise ratio. This paper begins with a review of performance characteristics of the Bechtel Nevada large format imaging system, a gated system capable of viewing scintillators up to 300 mm in diameter. We then examine configuration alternatives in lens coupled and fiber optically coupled electro-optical recording systems. Areas of investigation include tradeoffs between fiber optic and lens coupling, methods of image magnification, and spectral matching from scintillator to CCD camera. Key performance features discussed include field of view, resolution, sensitivity, dynamic range, and system noise characteristics.

  17. Radiographic quality control devices.

    PubMed

    2000-04-01

    In this study, we evaluate eight radiographic quality control (QC) devices, which noninvasively measure the output from a variety of diagnostic x-ray production systems. When used as part of a quality assurance (QA) program, radiographic QC devices help ensure that x-ray equipment is working within acceptable limits. This in turn helps ensure that high-quality images are achieved with appropriate radiation doses and that resources are used efficiently (for example, by minimizing the number of repeat exposures required). Our testing focused on the physical performance, ease of use, and service and maintenance characteristics that affect the use of these devices for periodic, routine measurements of x-ray system parameters. We found that all the evaluated models satisfactorily measure all the parameters normally needed for a QA program. However, we did identify a number of differences among the models--particularly in the range of exposure levels that can be effectively measured and the ease of use. Three models perform well for a variety of applications and are very easy to use; we rate them Preferred. Three additional models have minor limitations but otherwise perform well; we rate them Acceptable. We recommend against purchasing two models because, although each performs acceptably for most applications, neither model can measure low levels of radiation. This Evaluation covers devices designed to measure the output of x-ray tubes noninvasively. These devices, called radiographic quality control (QC) devices, or QC meters, are typically used by medical physicists, x-ray engineers, biomedical engineers, and suitably trained radiographic technologists to make QC measurements. We focus on the use of these devices as part of an overall quality assurance (QA) program. We have not evaluated their use for other applications, such as acceptance testing. To be included in this study, a device must be able to measure the exposure- and kVp-related characteristics of most x

  18. Chest drainage systems in use.

    PubMed

    Zisis, Charalambos; Tsirgogianni, Katerina; Lazaridis, George; Lampaki, Sofia; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Karapantzos, Ilias; Karapantzou, Chrysanthi; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos; Zarogoulidis, Paul

    2015-03-01

    A chest tube is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum. It is used to remove air in the case of pneumothorax or fluid such as in the case of pleural effusion, blood, chyle, or pus when empyema occurs from the intrathoracic space. It is also known as a Bülau drain or an intercostal catheter. Insertion of chest tubes is widely performed by radiologists, pulmonary physicians and thoracic surgeons. Large catheters or small catheters are used based on each situation that the medical doctor encounters. In the current review we will focus on the chest drain systems that are in use. PMID:25815304

  19. Chest drainage systems in use

    PubMed Central

    Zisis, Charalambos; Tsirgogianni, Katerina; Lazaridis, George; Lampaki, Sofia; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Karapantzos, Ilias; Karapantzou, Chrysanthi; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos

    2015-01-01

    A chest tube is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum. It is used to remove air in the case of pneumothorax or fluid such as in the case of pleural effusion, blood, chyle, or pus when empyema occurs from the intrathoracic space. It is also known as a Bülau drain or an intercostal catheter. Insertion of chest tubes is widely performed by radiologists, pulmonary physicians and thoracic surgeons. Large catheters or small catheters are used based on each situation that the medical doctor encounters. In the current review we will focus on the chest drain systems that are in use. PMID:25815304

  20. Sarcoidosis: radiographic manifestations in the nails and distal phalanges.

    PubMed

    Albers, Brittany K; Sluzevich, Jason C; Garner, Hillary W

    2016-05-01

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. PMID:26768259

  1. Diagnostic implications of Ga-67 chest-scan patterns in human immunodeficiency virus-seropositive patients

    SciTech Connect

    Kramer, E.L.; Sanger, J.H.; Garay, S.M.; Grossman, R.J.; Tiu, S.; Banner, H.

    1989-03-01

    Consecutive gallium-67 scans (n = 237) of 180 human immunodeficiency virus-seropositive patients with suspected pulmonary infections were evaluated for intensity and pattern of gallium distribution. Scan findings were correlated with the history, chest radiographic findings, and clinicopathologic diagnoses. Pneumocystis carinii pneumonia (PCP) occurred significantly more often with heterogeneous diffuse uptake than with homogeneous diffuse uptake. Heterogeneous diffuse uptake had an 87% positive predictive value for PCP, which was higher than that of other patterns. Localized pulmonary uptake was most commonly due to bacterial pneumonia or PCP; ill-defined, perihilar uptake, to cytomegalovirus or PCP; and focal (lymph node) uptake, to tuberculosis or lymphoma. The positive predictive value of any pulmonary uptake for lung pathology was 93%, and the negative predictive value of a negative scan was 96%. These findings confirm the utility of gallium scanning in the detection of lung pathology related to acquired immunodeficiency syndrome, particularly PCP. Furthermore, identification of a diffuse pattern may permit the use of a less invasive test more specifically directed at the confirmation of a diagnosis of PCP.

  2. Prevalence of radiographic asbestosis in crocidolite miners and millers at Wittenoom, Western Australia.

    PubMed Central

    Cookson, W O; De Klerk, N H; Musk, A W; Armstrong, B K; Glancy, J J; Hobbs, M S

    1986-01-01

    An estimate has been made of the prevalence of unrecognised pneumoconiosis in former crocidolite workers from Wittenoom, Western Australia. All plain chest radiographs relating to a one in six random sample (1025 men) of all former Wittenoom workers who had never entered a compensation claim to the Pneumoconiosis Medical Board of Western Australia were sought from Perth teaching hospitals and from the Perth Chest Clinic where compulsory examination of all workers in the mining industry takes place. Radiographs were recovered for 83% of the men and read independently by two observers. By means of logistic regression analysis a current prevalence of parenchymal abnormality (defined as a radiographic profusion of small opacities of category 1/0 or greater on the ILO classification) of nearly 20% was calculated after adjustment for age, time since first exposure, and cumulative exposure level. One hundred men randomly selected from those known to be alive in the sample were invited to attend for a new radiographic examination. Seventy four men attended and the predicted prevalence was confirmed. It is estimated from these data that there were between 450 and 900 former Wittenoom workers in Australia at the end of 1980 who had radiographic abnormality consistent with pneumoconiosis but had not claimed compensation or had asbestosis diagnosed. The data are consistent with there being no threshold dose of crocidolite exposure for the development of radiographic abnormality in this group. PMID:3013280

  3. Radiographic solution contamination.

    PubMed

    Hardman, P K; Tilmon, M F; Taylor, T S

    1987-06-01

    Contamination of processor solutions adversely affects the image quality of radiographic films. The purpose of this study was to determine the amount of developer or fixer contaminant that was necessary to produce a significant densitometric change in the base plus fog, speed, or contrast optical density readings for panoramic film. Significant differences in base plus fog (after 16 mL of fixer contaminant was added to developer), speed index (after 4 mL), and contrast index (after 8 mL) were observed in comparison with control values. PMID:3473399

  4. Progressive dyspnea associated with a crazy-paving appearance on a chest computed tomography scan.

    PubMed

    Maimon, Nimrod; Paul, Narinder; Downey, Gregory P

    2006-01-01

    A 'crazy-paving' appearance of the lungs on computed tomography scanning of the chest was first described nearly 20 years ago in patients with pulmonary alveolar proteinosis, and was thought to be characteristic of this condition. However, this pattern has subsequently been reported in a variety of pulmonary diseases and is now considered to be nonspecific. The present report describes a case of a 74-year-old man in whom congestive heart failure presented with a crazy-paving appearance of the lungs on a chest computed tomography scan. This uncommon association illustrates the importance of the correlation of clinical and radiographic information. PMID:16896429

  5. A 42-Year-Old Woman With Abnormal Chest CT Scan and Chylous Ascites.

    PubMed

    Panchabhai, Tanmay S; Bandyopadhyay, Debabrata; Yadav, Ruchi; Arrossi, Andrea V; Mehta, Atul C; Faress, Jihane A

    2016-01-01

    A 42-year-old white woman presented to the pulmonary clinic for evaluation of abnormal chest imaging. Twenty years prior to presentation, she was noted to have an abnormal chest radiograph during a routine preemployment evaluation. A subsequent bronchoscopy was nondiagnostic. She was followed up with annual imaging, which demonstrated little or no progression of her disease. She remained symptom free throughout this period. A year before her visit to the pulmonary clinic, she developed abdominal discomfort and was found to have ascites. Subsequently, she underwent three paracenteses with analysis revealing chylous fluid. She was a nonsmoker without a history of exposures or travel. PMID:26757302

  6. A rib abnormality mimicking pulmonary nodule: a pitfall in the plain chest x-ray.

    PubMed

    Akturk, Yeliz; Günes, Serra Ozbal; Hekimoglu, Baki

    2016-01-01

    The ribs show a wide range of normal and pathologic radiographic appearences as well as congenital variations. Intrathoracic ribs are isolated and rare anomalies. They are usually super-numerary, more often right-sided, and involve the middle part of the thorax. We describe a case with intrathorasic rib abnormality mimicking a peripheral metastatic lung nodule in the plain chest x-ray and emphasize the use of coronal and sagittal reformatted images in thorasic imaging. Utilisation of multiplanar reformatted images in chest computerised tomography increase diagnostic quality. PMID:27374213

  7. An unusual cause for a relatively common radiographic abnormality.

    PubMed

    Odedra, Anand; Farrugia, Mark; Babiker, Zahir

    2014-01-01

    A 59-year-old Indian woman presented to the respiratory clinic with chest pains, long-standing swallowing difficulties and a chest radiograph, which was reported as showing a shadow in the right paratracheal region. A CT scan was obtained and was reported as demonstrating a right-sided paratracheal lymph node and varicosities adjacent to the inferior vena cava. Histology from an endobronchial ultrasound-guided biopsy revealed a heavily blood-stained sample but showed no evidence of granulomas or malignancy. Subsequently, the images were reviewed, with the conclusion that they were actually of an engorged azygos vein compressing the oesophagus. MRI confirmed the absence of mediastinal lymphadenopathy and the presence of a prominent hemiazygos vein compressing the oesophagus. This case highlights the importance of including anatomical abnormalities in the differential diagnosis and reassessing patients when the history and investigations do not correlate. PMID:25540206

  8. Contamination of dental radiographic solutions.

    PubMed

    Tamburus, J R; Pardini, L C; Watanabe, P C

    1995-01-01

    Thirteen groups of periapical radiographic films were evaluated to determine and compare within and between groups the effects of contamination of the fixer solution with developing solution during radiographic processing. An aluminum penetrometer was used as the radiographic object to produce different optical densities. The images were compared using radiographic density and contrast as parameters. There were significant differences between the control groups and the groups processed with a contaminated fixer solution. No statistically significant differences were observed in the intragroup comparisons. PMID:8688649

  9. Computer enhancement of radiographs

    NASA Technical Reports Server (NTRS)

    Dekaney, A.; Keane, J.; Desautels, J.

    1973-01-01

    Examination of three relevant noise processes and the image degradation associated with Marshall Space Flight Center's (MSFC) X-ray/scanning system was conducted for application to computer enhancement of radiographs using MSFC's digital filtering techniques. Graininess of type M, R single coat and R double coat X-ray films was quantified as a function of density level using root-mean-square (RMS) granularity. Quantum mottle (including film grain) was quantified as a function of the above film types, exposure level, specimen material and thickness, and film density using RMS granularity and power spectral density (PSD). For various neutral-density levels the scanning device used in digital conversion of radiographs was examined for noise characteristics which were quantified by RMS granularity and PSD. Image degradation of the entire pre-enhancement system (MG-150 X-ray device; film; and optronics scanner) was measured using edge targets to generate modulation transfer functions (MTF). The four parameters were examined as a function of scanning aperture sizes of approximately 12.5 25 and 50 microns.

  10. [Chest ultrasonography in pleurapulmonary disease].

    PubMed

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

    2014-01-01

    Although the initial diagnosis and follow-up of pleuropulmonary disease are normally done with plain chest films and the gold standard for chest disease is computed tomography, diverse studies have established the usefulness of chest ultrasonography in the diagnosis of different pleuropulmonary diseases like pleural effusion and lung consolidation, among others. In this article, we show the different ultrasonographic patterns for pleuropulmonary disease. The availability of ultrasonography in different areas (ICU, recovery areas) makes this technique especially important for critical patients because it obviates the need to transfer the patient. Moreover, ultrasonography is noninvasive and easy to repeat. On the other hand, it enables the direct visualization of pleuropulmonary disease that is necessary for interventional procedures. PMID:22819690

  11. 10 CFR 34.46 - Supervision of radiographers' assistants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Radiation Safety Requirements § 34.46 Supervision of radiographers' assistants. Whenever a radiographer's assistant uses radiographic exposure devices,...

  12. 10 CFR 34.46 - Supervision of radiographers' assistants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Radiation Safety Requirements § 34.46 Supervision of radiographers' assistants. Whenever a radiographer's assistant uses radiographic exposure devices,...

  13. 10 CFR 34.46 - Supervision of radiographers' assistants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Radiation Safety Requirements § 34.46 Supervision of radiographers' assistants. Whenever a radiographer's assistant uses radiographic exposure devices,...

  14. Chest Radiography using Patient-Specific Digitally-Prepared Compensating Filters

    NASA Astrophysics Data System (ADS)

    Hasegawa, Bruce H.; Naimuddin, Shaikh; Dobbins, James T.; Mistretta, Charles A.; Peppler, Walter W.; Hangiandreou, Nicholas J.; Cusma, Jack T.; McDermott, John C.; Kudva, Bakki V.; Melbve, Kenneth M.

    1985-09-01

    We have used a prototype digital beam attenuator (DBA) system to generate patient-specific digitally-prepared compensating filters for chest radiography of a human subject. The compensated radiographs demonstrate substantially more information in areas such as the mediastinum and upper abdomen which normally are underpenetrated in conventional chest radiographs. The compensated image was acquired with high contrast, high speed film-screen receptors improving the visibility of pulmonary parenchymal detail while minimizing patient radiation exposure. Currently we are limited by a two-hour preparation time and position the attenuator manually. We are developing a second generation DBA system featuring fast (15 second) fabrication times and automatic positioning of the attenuator. We expect that these features will relieve some of the misregistration errors present in our initial examination.

  15. Digital and conventional chest images: observer performance with Film Digital Radiography System.

    PubMed

    Goodman, L R; Foley, W D; Wilson, C R; Rimm, A A; Lawson, T L

    1986-01-01

    The Film Digital Radiography System (FilmDRS) is a device with a laser optical film digitizer, 2,000 X 2,000 X 12-bit memory, and a 1,000-line video display. To evaluate the adequacy of this device for general radiography of the chest, four readers independently analyzed both radiographs and the corresponding video display of the digitized chest images of 150 patients, consisting of 100 images of abnormalities and 50 normal images. The overall results indicate equal sensitivity for the two systems. The FilmDRS, with interactive windowing, proved superior in the detection of hilar and mediastinal disease. X-ray film was superior in allowing detection of hyperlucent states. There was equivalent sensitivity for other disease categories. Superior specificity was achieved with conventional radiographs. PMID:3940392

  16. [Panoramic radiographs in dental diagnostics].

    PubMed

    van der Stelt, P F

    2016-04-01

    Panoramic radiographs are frequently used in dental practice in addition to bitewing radiographs and periapical radiographs. The way a panoramic photograph is created is different from that of a projection image, such as bitewing and periapical radiographs. As a result, the sharpness of detail is much less, and overlap of structures occurs in different areas of the image. Consequently the diagnostic utility is limited to the recognition of anomalies for which small details play a lesser role. The advantage of a panoramic radiograph is that structures over a large area are shown in their relative location. Because of the lower resolution and the higher dose of radiation to the patient compared with a series of intraoral images, the panoramic radiograph is not indicated during a periodic check-up. If clinical inspection indicates a need for it and as a supplement to an intraoral radiograph, a panoramic radiograph can, however, be appropriate in cases of abnormalities that extend over a larger area, such as tumours and developmental disorders. PMID:27073808

  17. Chest pain syndromes in pregnancy.

    PubMed

    Sahni, Gagan

    2012-08-01

    Chest pain syndromes in pregnancy include numerous catastrophic cardiovascular events. Acute myocardial infarction, aortic dissection, pulmonary embolism, and amniotic fluid embolism are the most important causes of nonobstetric mortality and morbidity in pregnancy. Each of these could result in poor maternal and fetal outcomes if not diagnosed and treated in a timely fashion. However, their diagnosis and management is limited by fetal risks of diagnostic procedures, dangers of pharmacotherapy and interventions that have neither been widely studied nor validated. This article reviews the current literature on epidemiology, risk factors, pathogenesis, diagnosis, and management of 4 potentially lethal chest pain syndromes in pregnancy. PMID:22813362

  18. Contemporary management of flail chest.

    PubMed

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

    2014-06-01

    Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management. PMID:24887787

  19. Assessment of low-contrast detectability for compressed digital chest images

    NASA Astrophysics Data System (ADS)

    Cook, Larry T.; Insana, Michael F.; McFadden, Michael A.; Hall, Timothy J.; Cox, Glendon G.

    1994-04-01

    The ability of human observers to detect low-contrast targets in screen-film (SF) images, computed radiographic (CR) images, and compressed CR images was measured using contrast detail (CD) analysis. The results of these studies were used to design a two- alternative forced-choice (2AFC) experiment to investigate the detectability of nodules in adult chest radiographs. CD curves for a common screen-film system were compared with CR images compressed up to 125:1. Data from clinical chest exams were used to define a CD region of clinical interest that sufficiently challenged the observer. From that data, simulated lesions were introduced into 100 normal CR chest films, and forced-choice observer performance studies were performed. CR images were compressed using a full-frame discrete cosine transform (FDCT) technique, where the 2D Fourier space was divided into four areas of different quantization depending on the cumulative power spectrum (energy) of each image. The characteristic curve of the CR images was adjusted so that optical densities matched those of the SF system. The CD curves for SF and uncompressed CR systems were statistically equivalent. The slope of the CD curve for each was - 1.0 as predicted by the Rose model. There was a significant degradation in detection found for CR images compressed to 125:1. Furthermore, contrast-detail analysis demonstrated that many pulmonary nodules encountered in clinical practice are significantly above the average observer threshold for detection. We designed a 2AFC observer study using simulated 1-cm lesions introduced into normal CR chest radiographs. Detectability was reduced for all compressed CR radiographs.

  20. Acute Myocardial Infarction Following Blunt Chest Trauma and Coronary Artery Dissection.

    PubMed

    Abdolrahimi, Safar Ali; Sanati, Hamid Reza; Ansari-Ramandi, Mohammad Mostafa; Heris, Saeed Oni; Maadani, Mohsen

    2016-06-01

    Blunt chest traumatic coronary artery dissection is an uncommon cause of atherosclerotic and non-atherosclerotic Acute Myocardial Infarction (AMI). Injuries of the coronary artery after blunt chest trauma are caused by different mechanisms such as vascular spasm, dissection and intimal tear or rupture of an existing thrombus formation. Chest pain might be masked by other injuries in patients with multiple traumas in car accident. Present case report is on a 37-year-old male without any specific past medical history who reported to the emergency department of a hospital with chest discomfort and was discharged with the impression of chest wall pain. After three days he experienced severe chest pain and he was admitted with the impression of acute coronary syndrome and underwent coronary angiography which showed Left Anterior Descending (LAD) artery dissection. The possibility of injury of the coronary artery should be kept in mind after blunt trauma to the chest. This condition is sometimes underdiagnosed. Its diagnosis may be difficult because chest pain can be interpreted as being secondary to chest wall contusion or it may be overshadowed by other injuries. Coronary dissection diagnosis after chest trauma requires clinical suspicion and systematic evaluation. Electrocardiography (ECG) should be done for every patient with thoracic trauma as the clinical findings may be misleading. PMID:27504338

  1. Acute Myocardial Infarction Following Blunt Chest Trauma and Coronary Artery Dissection

    PubMed Central

    Abdolrahimi, Safar Ali; Sanati, Hamid Reza; Ansari-Ramandi, Mohammad Mostafa; Heris, Saeed Oni

    2016-01-01

    Blunt chest traumatic coronary artery dissection is an uncommon cause of atherosclerotic and non-atherosclerotic Acute Myocardial Infarction (AMI). Injuries of the coronary artery after blunt chest trauma are caused by different mechanisms such as vascular spasm, dissection and intimal tear or rupture of an existing thrombus formation. Chest pain might be masked by other injuries in patients with multiple traumas in car accident. Present case report is on a 37-year-old male without any specific past medical history who reported to the emergency department of a hospital with chest discomfort and was discharged with the impression of chest wall pain. After three days he experienced severe chest pain and he was admitted with the impression of acute coronary syndrome and underwent coronary angiography which showed Left Anterior Descending (LAD) artery dissection. The possibility of injury of the coronary artery should be kept in mind after blunt trauma to the chest. This condition is sometimes underdiagnosed. Its diagnosis may be difficult because chest pain can be interpreted as being secondary to chest wall contusion or it may be overshadowed by other injuries. Coronary dissection diagnosis after chest trauma requires clinical suspicion and systematic evaluation. Electrocardiography (ECG) should be done for every patient with thoracic trauma as the clinical findings may be misleading. PMID:27504338

  2. Radiographic appearance of maxillary sinus feed impaction in a horse.

    PubMed

    Montgomery, James E; Carmalt, James L

    2013-01-01

    A 15-year-old Belgian gelding presented in respiratory distress, with bilateral mucopurulent nasal discharge, and right-sided epistaxis. The horse had a 5-year history of dental disease and had been recently losing weight. Radiographs indicated tooth root abscessation of the right maxillary third molar tooth and probable maxillary sinus feed impaction. These findings were confirmed at surgery and necropsy. The stippled, granular radiographic appearance described here is highly characteristic of sinus feed impaction. PMID:24371923

  3. Oral health of individuals aged 3-80 years in Jönköping, Sweden during 40 years (1973-2013). II. Review of clinical and radiographic findings.

    PubMed

    Norderyd, Ola; Koch, Göran; Papias, Apostolos; Köhler, Alkisti Anastassaki; Helkimo, Anna Nydell; Brahm, Carl-Otto; Lindmark, Ulrika; Lindfors, Ninita; Mattsson, Anna; Rolander, Bo; Ullbro, Christer; Gerdin, Elisabeth Wärnberg; Frisk, Fredrik

    2015-01-01

    The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden. The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment. The frequency of edentulous individuals aged 40-70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture weareryounger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30-80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013. This was higher than earlier surveys, 4 in 1993, and 18 in 2003. The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10-20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013, 43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5-60 years, DFS was lower in 2013 compared to the earlier examinations.There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS

  4. Clinical utility of wavelet compression for resolution-enhanced chest radiography

    NASA Astrophysics Data System (ADS)

    Andriole, Katherine P.; Hovanes, Michael E.; Rowberg, Alan H.

    2000-05-01

    This study evaluates the usefulness of wavelet compression for resolution-enhanced storage phosphor chest radiographs in the detection of subtle interstitial disease, pneumothorax and other abnormalities. A wavelet compression technique, MrSIDTM (LizardTech, Inc., Seattle, WA), is implemented which compresses the images from their original 2,000 by 2,000 (2K) matrix size, and then decompresses the image data for display at optimal resolution by matching the spatial frequency characteristics of image objects using a 4,000- square matrix. The 2K-matrix computed radiography (CR) chest images are magnified to a 4K-matrix using wavelet series expansion. The magnified images are compared with the original uncompressed 2K radiographs and with two-times magnification of the original images. Preliminary results show radiologist preference for MrSIDTM wavelet-based magnification over magnification of original data, and suggest that the compressed/decompressed images may provide an enhancement to the original. Data collection for clinical trials of 100 chest radiographs including subtle interstitial abnormalities and/or subtle pneumothoraces and normal cases, are in progress. Three experienced thoracic radiologists will view images side-by- side on calibrated softcopy workstations under controlled viewing conditions, and rank order preference tests will be performed. This technique combines image compression with image enhancement, and suggests that compressed/decompressed images can actually improve the originals.

  5. Chest physiotherapy in acute bronchiolitis.

    PubMed Central

    Webb, M S; Martin, J A; Cartlidge, P H; Ng, Y K; Wright, N A

    1985-01-01

    Forty four children with acute bronchiolitis were given twice daily chest physiotherapy in addition to standard supportive measures and were compared with 46 controls who were not given physiotherapy. There was no clinically discernable benefit on the course of their illness. PMID:3907510

  6. Device Assists Cardiac Chest Compression

    NASA Technical Reports Server (NTRS)

    Eichstadt, Frank T.

    1995-01-01

    Portable device facilitates effective and prolonged cardiac resuscitation by chest compression. Developed originally for use in absence of gravitation, also useful in terrestrial environments and situations (confined spaces, water rescue, medical transport) not conducive to standard manual cardiopulmonary resuscitation (CPR) techniques.

  7. A 34-Year-Old Woman With Recurrent Right-Sided Chest Pain and Dyspnea.

    PubMed

    Albores, Jeffrey; Fishbein, Gregory; Bando, Joanne

    2015-11-01

    A 34-year-old woman presented with her third episode of acute-onset right-sided chest pain and dyspnea. She had two prior similar occurrences of right-sided sharp, pleuritic chest pain with radiation to the back and dyspnea. Chest radiographs during these presentations revealed a small apical right-sided pneumothorax that was managed conservatively with high-flow oxygen. All three presentations were associated with vigorous exercise and the first day of her menses. She denied cough, hemoptysis, fever, smoking history, airplane travel, scuba diving, or trauma during these presentations. The patient has been trying to conceive for the past year but has been unsuccessful because of uterine fibroids but no history of endometriosis. PMID:26527442

  8. Robust learning-based parsing and annotation of medical radiographs.

    PubMed

    Tao, Yimo; Peng, Zhigang; Krishnan, Arun; Zhou, Xiang Sean

    2011-02-01

    In this paper, we propose a learning-based algorithm for automatic medical image annotation based on robust aggregation of learned local appearance cues, achieving high accuracy and robustness against severe diseases, imaging artifacts, occlusion, or missing data. The algorithm starts with a number of landmark detectors to collect local appearance cues throughout the image, which are subsequently verified by a group of learned sparse spatial configuration models. In most cases, a decision could already be made at this stage by simply aggregating the verified detections. For the remaining cases, an additional global appearance filtering step is employed to provide complementary information to make the final decision. This approach is evaluated on a large-scale chest radiograph view identification task, demonstrating a very high accuracy ( > 99.9%) for a posteroanterior/anteroposterior (PA-AP) and lateral view position identification task, compared with the recently reported large-scale result of only 98.2% (Luo, , 2006). Our approach also achieved the best accuracies for a three-class and a multiclass radiograph annotation task, when compared with other state of the art algorithms. Our algorithm was used to enhance advanced image visualization workflows by enabling content-sensitive hanging-protocols and auto-invocation of a computer aided detection algorithm for identified PA-AP chest images. Finally, we show that the same methodology could be utilized for several image parsing applications including anatomy/organ region of interest prediction and optimized image visualization. PMID:20876012

  9. [Radiographic disappearance of lanthanum].

    PubMed

    Pastori, Giordano

    2015-01-01

    In 2006, Cerny and Kunzendorf in the New England Journal of Medicine Images in clinical medicine, showed the radiographic appearance of lanthanum for the first time. After many years we noticed the inverse phenomenon. In a peritoneal dialysis patient treated with lanthanum carbonate, we had two radiography of the abdomen for monitoring the peritoneal catheter. In the first radiography contrast material was seen in colon. In the most recent radiography contrast material disappeared. The patient was always taking the same dose of lanthanum carbonate (1000 mg bid), although at the time of the first radiography he took the chewable tablets, for the last radiography he took the new powder formulation. We found a report in literature highlighting this phenomenon meanwhile indicating a greater chelating effect for the powder. Our hypothesis is that despite the same lanthanum dose, powder provides a greater surface area of binding and a more dispersed bowel distribution to explain a masked radio-opacity. Considering the wide availability of the powder, this must be taken into account especially in evaluating therapeutic compliance. PMID:25774580

  10. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound, weather-resistant, equipped...

  11. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  12. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  13. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound, weather-resistant, equipped...

  14. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  15. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound, weather-resistant, equipped...

  16. Chest pain in sickle cell disease.

    PubMed

    Tonino, S H; Nur, E; Otten, H M; Wykrzykowska, J J; Hoekstra, J B L; Biemond, B J

    2013-06-01

    The differential diagnosis of chest pain in a patient with sickle cell disease is difficult and may encompass several serious conditions, including chest syndrome, pulmonary embolism and infectious complications. In this manuscript we provide an overview on the various underlying diseases that may cause chest pain in patients with sickle cell disease and provide clues for a proper diagnostic workup. PMID:23799317

  17. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  18. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  19. RADIOGRAPHIC AND ANATOMIC CHARACTERISTICS OF DORSAL HOOF WALL LAYERS IN NONLAMINITIC HORSES.

    PubMed

    Goulet, Catherine; Olive, Julien; Rossier, Yves; Beauchamp, Guy

    2015-01-01

    Early radiographic diagnosis of acute laminitis is important for treatment planning and prognosis in horses. While four histopathologic layers make up the hoof wall, only two layers are distinguished on digital radiographs of horses' hooves. Objectives of this descriptive study were to determine which macroscopic layers correspond to the two radiographically visible layers, and to describe radiographic layer measurements in a group of clinically sound Warmblood horses. Twelve ex vivo equine hooves were examined at three different levels of the dorsal hoof wall. The four macroscopic layers were variably grouped and compared with radiographic layers. Stratum externum and stratum medium represented the superficial radiographic layer while stratum internum and dermis parietis represented the deep layer. In 27 clinically sound horses (54 thoracic feet), the superficial radiographic layer represented 64.3% ± 3.6% of the total dorsal hoof wall. Findings from this study provided baseline information for future studies of horses with acute laminitis. PMID:26226838

  20. Susuk - Black Magic Exposed “White” by Dental Radiographs

    PubMed Central

    Mohammed, Faraz

    2014-01-01

    Susuk or charm needles are a facial cum body art widely practiced among women of Malaysia, Brunei, Singapore, Thailand and Indonesia. These are small, needle-shaped metallic talismans inserted subcutaneously in different parts of the body. The concealed art of susuk was “exposed” by routine radiographic examination in the oral and maxillofacial region. This paper reports two such cases of unusual incidental radiographic finding in dental radiographs which were taken on a routine basis as part of the diagnostic work up. This article will also primarily enlighten the importance of radiographs in detecting such charm needles as the wearer keeps the body art a “hidden secret” thereby avoiding misdiagnosis. PMID:25177646

  1. Radiographic and scintigraphic evaluation of total knee arthroplasty

    SciTech Connect

    Schneider, R.; Soudry, M.

    1986-04-01

    Various radiographic and scintigraphic methods are used to supplement clinical findings in the evaluation of total knee arthroplasty and its complications. Serial roentgenograms offer reliable information for diagnosing mechanical loosening. Wide and extensive radiolucency at the cement-bone interface and shift in position and alignment of prosthetic components can be seen in almost all cases by the time revision is necessary. Radiographic abnormalities are usually not present in acute infection, but are often present in chronic infection. Bone scanning has a high sensitivity for diagnosis of infection or loosening, but is nonspecific because increased uptake is often present around asymptomatic total knee arthroplasties with normal radiographs. Differential bone and Gallium scanning and scanning with Indium 111-labeled leukocytes have a greater specificity for diagnosis of infection than does bone or Gallium scanning alone. Routine radiographic and scintigraphic studies have shown a high incidence of deep vein thrombosis in the calf after total knee arthroplasty. Clinically significant pulmonary embolization is infrequent.

  2. Chest tuberculosis: Radiological review and imaging recommendations

    PubMed Central

    Bhalla, Ashu Seith; Goyal, Ankur; Guleria, Randeep; Gupta, Arun Kumar

    2015-01-01

    Chest tuberculosis (CTB) is a widespread problem, especially in our country where it is one of the leading causes of mortality. The article reviews the imaging findings in CTB on various modalities. We also attempt to categorize the findings into those definitive for active TB, indeterminate for disease activity, and those indicating healed TB. Though various radiological modalities are widely used in evaluation of such patients, no imaging guidelines exist for the use of these modalities in diagnosis and follow-up. Consequently, imaging is not optimally utilized and patients are often unnecessarily subjected to repeated CT examinations, which is undesirable. Based on the available literature and our experience, we propose certain recommendations delineating the role of imaging in the diagnosis and follow-up of such patients. The authors recognize that this is an evolving field and there may be future revisions depending on emergence of new evidence. PMID:26288514

  3. Industrial application of radiographic paper

    NASA Astrophysics Data System (ADS)

    Domanus, J. C.; Ruault, P. A.

    1980-03-01

    The paper presents the results of a comparison made among high speed Kodak Industrex D X-ray film, Industrex Instant 600 and 620, and Agfa Gevaert Structuric IC radiograph papers. It is shown that the quality of the radiographic image was tested by the use of standard and special IQIs as well as Al step wedges and artificial and natural defects. The speeds, contrasts, and exposure latitudes were calculated from the characteristic curves. An analysis is made of the quality of information available in the radiograph and the merits of the constant exposure technique are stressed. Finally, conclusions are drawn about information quality, sensitometric properties, equipment, and areas of application for radiographic paper.

  4. Radiographically Severe but Clinically Mild Reexpansion Pulmonary Edema following Decompression of a Spontaneous Pneumothorax.

    PubMed

    Harner, William E; Crawley, Eric A

    2014-01-01

    The case is a 48-year-old female who presented with mild dyspnea on exertion and cough with unremarkable vital signs and was found to have a large right sided pneumothorax. She underwent small bore chest tube decompression with immediate reexpansion of the collapsed lung. However, she rapidly developed moderate hypoxemia and radiographic evidence of reexpansion pulmonary edema (REPE) on both the treated and contralateral sides. Within a week, she had a normal chest X-ray and was asymptomatic. This case describes a rare complication of spontaneous pneumothorax and highlights the lack of correlation between symptoms, sequelae, and radiographic severity of pneumothorax and reexpansion pulmonary edema. Proposed pathophysiologic mechanisms include increased production of reactive oxygen species with subsequent loss of surfactant and increased vascular permeability, and loss of vasoregulatory tone. PMID:25165607

  5. Evaluation of suspected aspirated beverage can pull tab: radiographs may not be enough.

    PubMed

    Kotsenas, Amy L; Campeau, Norbert G; Oeckler, Richard A; Kuzo, Ronald S

    2014-01-01

    A 67-year-old male presented to the emergency department with concern for accidental aspiration of an aluminum beverage can pull tab. Neck and chest radiographs did not reveal an aspirated foreign body. Despite ongoing complaint of dysgeusia and adamancy of aspiration by the patient, he was discharged to home without recommendation for further follow-up. Seven months later, a computed tomography (CT) scan of the chest performed as part of an unrelated lung cancer work up confirmed the presence of a left mainstem bronchus metallic foreign body compatible with a pull tab. This case report illustrates the poor negative predictive value of radiographs for a suspected aluminum foreign body and demonstrates the superiority of CT for this purpose. In such presentations it is imperative to have a low threshold for performing further diagnostic evaluation with CT due to the relatively high radiolucency of aluminum. PMID:25580344

  6. Noninvasive radiographic assessment of cardiovascular function in acute and chronic respiratory failure

    SciTech Connect

    Berger, H.J.; Matthay, R.A.

    1981-04-01

    Noninvasive radiographic techniques have provided a means of studying the natural history and pathogenesis of cardiovascular performance in acute and chronic respiratory failure. Chest radiography, radionuclide angiocardiography and thallium-201 imaging, and M mode and cross-sectional echocardiography have been employed. Each of these techniques has specific uses, attributes and limitations. For example, measurement of descending pulmonary arterial diameters on the plain chest radiograph allows determination of the presence or absence of pulmonary arterial hypertension. Right and left ventricular performance can be evaluated at rest and during exercise using radionuclide angiocardiography. The biventricular response to exercise and to therapeutic interventions also can be assessed with this approach. Evaluation of the pulmonary valve echogram and echocardiographic right ventricular dimensions have been shown to reflect right ventricular hemodynamics and size. Each of these noninvasive techniques has been applied to the study of patients with respiratory failure and has provided important physiologic data.

  7. Film holder for radiographing tubing

    DOEpatents

    Davis, Earl V.; Foster, Billy E.

    1976-01-01

    A film cassette is provided which may be easily placed about tubing or piping and readily held in place while radiographic inspection is performed. A pair of precurved light-impervious semi-rigid plastic sheets, hinged at one edge, enclose sheet film together with any metallic foils or screens. Other edges are made light-tight with removable caps, and the entire unit is held securely about the object to be radiographed with a releasable fastener such as a strip of Velcro.

  8. System for definition of the central-chest vasculature

    NASA Astrophysics Data System (ADS)

    Taeprasartsit, Pinyo; Higgins, William E.

    2009-02-01

    Accurate definition of the central-chest vasculature from three-dimensional (3D) multi-detector CT (MDCT) images is important for pulmonary applications. For instance, the aorta and pulmonary artery help in automatic definition of the Mountain lymph-node stations for lung-cancer staging. This work presents a system for defining major vascular structures in the central chest. The system provides automatic methods for extracting the aorta and pulmonary artery and semi-automatic methods for extracting the other major central chest arteries/veins, such as the superior vena cava and azygos vein. Automatic aorta and pulmonary artery extraction are performed by model fitting and selection. The system also extracts certain vascular structure information to validate outputs. A semi-automatic method extracts vasculature by finding the medial axes between provided important sites. Results of the system are applied to lymph-node station definition and guidance of bronchoscopic biopsy.

  9. Scanning radiographic apparatus

    SciTech Connect

    Albert, R.D.

    1980-04-01

    Visual display of dental, medical or other radiographic images is realized with an x-ray tube in which an electron beam is scanned through an x-y raster pattern on a broad anode plate, the scanning being synchronized with the x-y sweep signals of a cathode ray tube display and the intensity signal for the display being derived from a small x-ray detector which receives x-rays that have passed through the subject to be imaged. Positioning and support of the detector are provided for by disposing the detector in a probe which may be attached to the x-ray tube at any of a plurality of different locations and by providing a plurality of such probes of different configuration in order to change focal length, to accommodate to different detector placements relative to the subject, to enhance patient comfort and to enable production of both periapical images and wider angle pantomographic images. High image definition with reduced radiation dosage is provided for by a lead glass collimator situated between the x-ray tube and subject and having a large number of spaced-apart minute radiation transmissive passages convergent on the position of the detector. Releasable mounting means enable changes of collimator in conjunction with changes of the probe to change focal length. A control circuit modifies the x-y sweep signals applied to the x-ray tube and modulates electron beam energy and current in order to correct for image distortions and other undesirable effects which can otherwise be present in a scanning x-ray system.

  10. Computed tomography of the chest

    SciTech Connect

    Godwin, J.D.

    1984-01-01

    In this reference book readers have access to information pertaining to the role of thoracic CT, its limitations, normal anatomy and variations, scanning techniques, confusing artifacts, and pathologic anatomy. Major sections provide detailed, explicit data on lung cancer staging, the thoracic inlet, the heart, the esophagus, CT-guided invasive techniques, and the pediatric chest CT. Controversies are explored fully and presented fairly. This book is profusely illustrated with almost 500 CT scans for greater recognition and comprehension of the material presented.

  11. Radiology of occupational chest disease

    SciTech Connect

    Solomon, A. ); Kreel, L.

    1989-01-01

    Radiologic manifestations of occupational lung disease are summarized and classified in this book according to the ILO system. The interpretation of chest roentgenograms outlines the progression of each disease and is accompanied with clinically-oriented explanations. Some of the specific diseases covered include asbestosis, coal worker's pneumoconiosis, silicosis, non-mining inhalation of silica and silicates, beryllium induced disease, inhalation of organics and metallics, and occupationally induced asthma.

  12. Catastrophic chest pain: blinded by cardiopulmonary disease.

    PubMed

    Barreiro, Timothy John; Asiimwe, Denis D; Gemmel, David; Brine, Patrick

    2015-01-01

    A 53-year-old man with a history of diabetic foot ulcer, osteomyelitis, coronary artery disease, hypertension and hyperlipidaemia, presented with chest pain of 3 weeks duration. Eleven days earlier, the patient had had a drug-eluting stent (DES) placed in a branch of the right coronary artery (RCA) after similar chest pain, leading to the findings of a positive nuclear stress test. Since discharge, he was not compliant with taking clopidegrel (Plavix), a concern for in-stent thrombosis with recurrent myocardial ischaemia; but work up was negative and medications were restarted. Within 24 h of admission, he developed bilateral flaccid leg weakness, urine retention and loss of sensation from the umbilicus level down. MRI revealed a T4-T6 epidural abscess. Emergent decompression laminectomy and abscess drainage was completed. Neurological symptoms improved hours after surgery with complete resolution of sensory deficits. Cultures grew Streptococcus sp., treated with intravenous nafcillin for 8 weeks. He regained leg strength with continued improvement seen in rehabilitation. PMID:26135489

  13. Automatic anatomically selective image enhancement in digital chest radiography

    SciTech Connect

    Sezan, M.I. ); Minerbo, G.N. ); Schaetzing, R. )

    1989-06-01

    The authors develop a technique for automatic anatomically selective enhancement of digital chest radiographs. Anatomically selective enhancement is motivated by the desire to simultaneously meet the different enhancement requirements of the lung field and the mediastinum. A recent peak detection algorithm and a set of rules are applied to the image histogram to determine automatically a gray-level threshold between the lung field and mediastinum. The gray-level threshold facilitates anatomically selective gray-scale modification and/or unsharp masking. Further, in an attempt to suppress possible white-band or black-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 which varies asymmetrically with positive and negative values of the local image contrast.

  14. Computer-Aided Diagnostic System For Mass Survey Chest Images

    NASA Astrophysics Data System (ADS)

    Yasuda, Yoshizumi; Kinoshita, Yasuhiro; Emori, Yasufumi; Yoshimura, Hitoshi

    1988-06-01

    In order to support screening of chest radiographs on mass survey, a computer-aided diagnostic system that automatically detects abnormality of candidate images using a digital image analysis technique has been developed. Extracting boundary lines of lung fields and examining their shapes allowed various kind of abnormalities to be detected. Correction and expansion were facilitated by describing the system control, image analysis control and judgement of abnormality in the rule type programing language. In the experiments using typical samples of student's radiograms, good results were obtained for the detection of abnormal shape of lung field, cardiac hypertrophy and scoliosis. As for the detection of diaphragmatic abnormality, relatively good results were obtained but further improvements will be necessary.

  15. Massive chest wall resection and reconstruction for malignant disease

    PubMed Central

    Foroulis, Christophoros N; Kleontas, Athanassios D; Tagarakis, George; Nana, Chryssoula; Alexiou, Ioannis; Grosomanidis, Vasilis; Tossios, Paschalis; Papadaki, Elena; Kioumis, Ioannis; Baka, Sofia; Zarogoulidis, Paul; Anastasiadis, Kyriakos

    2016-01-01

    Objective Malignant chest wall tumors are rare neoplasms. Resection with wide-free margins is an important prognostic factor, and massive chest wall resection and reconstruction are often necessary. A recent case series of 20 consecutive patients is reported in order to find any possible correlation between tumor histology, extent of resection, type of reconstruction, and adjuvant treatment with short- and long-term outcomes. Methods Twenty patients were submitted to chest wall resection and reconstruction for malignant chest wall neoplasms between 2006 and 2014. The mean age (ten males) was 59±4 years. The size and histology of the tumor, the technique of reconstruction, and the short- and long-term follow-up records were noted. Results The median maximum diameter of tumors was 10 cm (5.4–32 cm). Subtotal sternal resection was performed in nine cases, and the resection of multiple ribs was performed in eleven cases. The median area of chest wall defect was 108 cm2 (60–340 cm2). Histology revealed soft tissue, bone, and cartilage sarcomas in 16 cases (80%), most of them chondrosarcomas. The rest of the tumors was metastatic tumors in two cases and localized malignant pleural mesothelioma and non-Hodgkin lymphoma in one case. The chest wall defect was reconstructed by using the “sandwich technique” (propylene mesh/methyl methacrylate/propylene mesh) in nine cases of large anterior defects or by using a 2 mm polytetrafluoroethylene (e-PTFE) mesh in nine cases of lateral or posterior defects. Support from a plastic surgeon was necessary to cover the full-thickness chest wall defects in seven cases. Adjuvant oncologic treatment was administered in 13 patients. Local recurrences were observed in five cases where surgical reintervention was finally necessary in two cases. Recurrences were associated with larger tumors, histology of malignant fibrous histiocytoma, and initial incomplete resection or misdiagnosis made by nonthoracic surgeons. Three patients died

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

    SciTech Connect

    Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

    2014-02-15

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

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

    PubMed Central

    Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

    2014-01-01

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

  18. National Survey of Radiation Doses of Pediatric Chest Radiography in Korea: Analysis of the Factors Affecting Radiation Doses

    PubMed Central

    Kim, Bo Hyun; Goo, Hyun Woo; Yang, Dong Hyun; Oh, Sang Young; Kim, Hyeog Ju; Lee, Kwang Yong; Lee, Jung Eun

    2012-01-01

    Objective To investigate radiation doses in pediatric chest radiography in a national survey and to analyze the factors that affect radiation doses. Materials and Methods The study was based on the results of 149 chest radiography machines in 135 hospitals nationwide. For each machine, a chest radiograph was obtained by using a phantom representing a 5-year-old child (ATOM® dosimetry phantom, model 705-D, CIRS, Norfolk, VA, USA) with each hospital's own protocol. Five glass dosimeters (M-GD352M, Asahi Techno Glass Corporation, Shizuoka, Japan) were horizontally installed at the center of the phantom to measure the dose. Other factors including machine's radiography system, presence of dedicated pediatric radiography machine, presence of an attending pediatric radiologist, and the use of automatic exposure control (AEC) were also evaluated. Results The average protocol for pediatric chest radiography examination in Korea was 94.9 peak kilovoltage and 4.30 milliampere second. The mean entrance surface dose (ESD) during a single examination was 140.4 microgray (µGy). The third quartile, median, minimum and maximum value of ESD were 160.8 µGy, 93.4 µGy, 18.8 µGy, and 2334.6 µGy, respectively. There was no significant dose difference between digital and non-digital radiography systems. The use of AEC significantly reduced radiation doses of pediatric chest radiographs (p < 0.001). Conclusion Our nationwide survey shows that the third quartile, median, and mean ESD for pediatric chest radiograph is 160.8 µGy, 93.4 µGy, and 140.4 µGy, respectively. No significant dose difference is noticed between digital and non-digital radiography systems, and the use of AEC helps significantly reduce radiation doses. PMID:22977329

  19. A comparative study of collimation in bedside chest radiography for preterm infants in two teaching hospitals

    PubMed Central

    Stollfuss, J.; Schneider, K.; Krüger-Stollfuss, I.

    2015-01-01

    Objective Unnecessary exposure of the abdomen, arms or head may lead to a substantial increase of the radiation dose in portable chest X-rays on the neonatal intensive care unit. The objective was to identify potential factors influencing inappropriate exposure of non-thoracic structures in two teaching hospitals. Methods The study analysed 200 consecutive digital chest radiographs in 20 preterm neonates (mean gestation 25 ± 1 weeks). Demographical data, tube settings and exposure parameters were recorded. To grade the collimation, we used a scoring system with a maximum of 12 exposed non-thoracic structures. Length of gestation, age, the radiographer, years of experience in performing X-rays and the number of in situ catheters or lines, were correlated with collimation quality. Results There was no significant difference between the rates of optimal images obtained in the two hospitals (0.32 vs 0.39, n.s.). Scores showed that most suboptimal images had only mildly reduced image quality (1.40 ± 1.38 vs 1.20 ± 1.43, n.s.). Length of gestation or presence of surgical drains, catheters and tubes had no obvious effects on the exposure of non-thoracic structures. Large intra-individual variation in optimal collimation (14–86%) was noted for the radiographers in both hospitals; this was unrelated to their respective years of experience. Conclusion In our study, the only identifiable factor influencing the collimation of portable chest radiographs in preterm infants was the radiographer’s dedication and awareness. There were no apparent differences between the hospitals investigated. Exposure of non-thoracic structures was relatively frequent and mainly involved the proximal humeri. PMID:26937444

  20. Single exposure simultaneous acquisition of digital and conventional radiographs utilizing unaltered dose.

    PubMed

    Oestmann, J W; Greene, R

    1988-11-01

    We describe the simultaneous acquisition of digital and conventional radiographs with a single standard radiographic exposure. A digitizable storage phosphor (ST Imaging Plate, FujiTM) is sandwiched into a radiographic cassette (X-Omatic, KodakTM) behind a conventional radiographic film-screen combination (Lanex medium screens, OC film, KodakTM). The barium fluorohalide storage phosphor is digitized with a helium-neon laser scanner (TCR 201, ToshibaTM), and the conventional radiograph is processed in the standard fashion (M7B, KodakTM). The storage phosphor is exposed by the "wasted" radiation normally exiting the back of the film-screen combination (32% of the cassette entrance dose at 141 kVp). At a standard exposure (6.3 mAs), the conventional radiograph is of unaltered quality, and the digital image appears to have an adequate signal-to-noise ratio for chest studies despite the lower exposure dose. This technique produces twin images of identical spatial and temporal registration and avoids the added radiation exposure normally required to carry out comparative studies. PMID:3234405

  1. Comparison of radiological findings and microbial aetiology of childhood pneumonia.

    PubMed

    Korppi, M; Kiekara, O; Heiskanen-Kosma, T; Soimakallio, S

    1993-04-01

    Sixty-one children were treated in hospital from 1981 to 1982 because of both radiologically and microbiologically verified viral or bacterial pneumonia. The chest radiographs were interpreted by two radiologists, not familiar with the clinical data, on two occasions three years apart, and only those patients with a definite alveolar (n = 27) or interstitial (n = 34) pneumonia at both evaluations were included in the present analysis. In addition, all patients had viral (n = 20), mixed viral-bacterial (n = 21) or bacterial (n = 20) infections diagnosed by viral or bacterial antibody or antigen assays. Viral infection alone was seen in 7 (26%), mixed viral-bacterial infection in 8 (30%) and bacterial infection alone in 12 (44%) of the 27 patients with alveolar pneumonia. The respective figures were 13 (38%), 13 (38%) and 8 (24%) for the 34 patients with interstitial pneumonia. C-reactive protein concentration was greater than 40 mg/l (a screening limit for viral and bacterial infections) in 15 (56%) of the patients with alveolar and in 11 (32%) of the patients with interstitial pneumonia. Thus 74% of the patients with alveolar and 62% with interstitial pneumonia had bacterial infection, either alone or as a mixed viral-bacterial infection. Our results suggest that the presence of an alveolar infiltrate in a chest radiograph is a specific but insensitive indicator of bacterial pneumonia. We conclude that patients with alveolar pneumonia should be treated with antibiotics. In patients with interstitial pneumonia, however, both viral and bacterial aetiology are possible. In those, the decision concerning antibiotic treatment should be based on clinical and laboratory findings. PMID:8318803

  2. Radiographic assessment of splinting bandages.

    PubMed

    Wytch, R; Ashcroft, G P; McKenzie, G; Wardlaw, D; Ledingham, W M

    1991-01-01

    The physical attenuation of X-rays by a variety of splinting bandages was measured and compared with the subjective opinion of nine radiologists. The radiolucency of the bandages and their interference with the interpretation of bony detail on radiographs (using a radiographic knee phantom) was assessed. Plaster-of-Paris (POP) bandages produced the greatest attenuation of X-rays and the greatest interference with interpretation of bony detail. All the polyurethane resin impregnated fabric bandages produced less attenuation than POP, but variations occurred due to the fabric type and knit of the bandage. The lowest attenuation occurred in those bandages using cotton, polyester or polypropylene fabric, and in all but one instance these caused least interference in radiographic interpretation. The exception was the polyester bandage, where the coarse knit of the fabric produced a large difference in X-ray beam absorption between the air spaces and the bandage. The distracting mesh pattern on the radiograph interfered with radiographic visualization. The glass fibre bandages caused intermediate attenuation, being better than POP but not as radiolucent as the non-glass fabrics. PMID:2030030

  3. Universal radiographic screening for tuberculosis among inmates upon admission to jail.

    PubMed Central

    Layton, M C; Henning, K J; Alexander, T A; Gooding, A L; Reid, C; Heyman, B M; Leung, J; Gilmore, D M; Frieden, T R

    1997-01-01

    OBJECTIVES: This study evaluated the efficacy of radiographic screening for tuberculosis in correctional facilities. METHODS: Inmates at an admission facility in New York, NY, were screened for tuberculosis by registry cross-match, symptom interviews, tuberculin testing, and chest radiography. RESULTS: Thirty-two cases of tuberculosis were detected among 4172 inmate admissions (767 cases per 100,000). Twenty-five inmates (78%) were previously diagnosed but incompletely treated; all were identified by registry cross-match. Seven inmates (22%) were newly diagnosed, of whom four (57%) were asymptomatic, had negative skin tests, and were detected only by their abnormal radiographs. CONCLUSIONS: Screening strategies that limit radiographic testing to inmates with either positive skin tests or symptoms may result in missed opportunities for diagnosing active tuberculosis. PMID:9279270

  4. Demonstration of digital radiographs by means of ink jet-printed paper copies: pilot study.

    PubMed

    Kirkhorn, T; Kehler, M; Nilsson, J; Lyttkens, K; Andersson, B; Holmer, N G

    1992-11-01

    Different digital medical images have been printed on paper with a continuous ink jet printer, and the quality has been evaluated. The emphasis has been on digital chest radiographs from a computed radiography system. The ink jet printing technique is described as well as the handling of the image data from image source to printer. Different versions of paper prints and viewing conditions were compared to find the optimum alternative. The evaluation has been performed to maximize the quality of the paper images to make them conform with the corresponding film prints and monitor images as much as possible. The continuous ink jet technique offers high-quality prints on paper at a considerably lower cost per copy compared with the cost of a film print. With a future switch-over from diagnosing of digital images on film to diagnosing them on monitors, hard copies for demonstration purposes will occasionally be needed. This need can be filled by ink jet-printed paper copies. PMID:1457540

  5. Age estimation of adults from dental radiographs.

    PubMed

    Kvaal, S I; Kolltveit, K M; Thomsen, I O; Solheim, T

    1995-07-28

    Previous studies have shown that with advancing age the size of the dental pulp cavity is reduced as a result of secondary dentine deposit, so that measurements of this reduction can be used as an indicator of age. The aim of the present study was to find a method which could be used to estimate the chronological age of an adult from measurements of the size of the pulp on full mouth dental radiographs. The material consisted of periapical radiographs from 100 dental patients who had attended the clinics of the Dental Faculty in Oslo. The radiographs of six types of teeth from each jaw were measured: maxillary central and lateral incisors and second premolars, and mandibular lateral incisors, canines and first premolars. To compensate for differences in magnification and angulation on the radiographs, the following ratios were calculated: pulp/root length, pulp/tooth length, tooth/root length and pulp/root width at three different levels. Statistical analyses showed that Pearson's correlation coefficient between age and the different ratios for each type of tooth was significant, except for the ratio between tooth and root length, which was, therefore, excluded from further analysis. Principal component analyses were performed on all ratios, followed by regression analyses with age as dependent variable and the principal components as independent variables. The principal component analyses showed that only the two first of them had significant influence on age, and a good and easily calculated approximation to the first component was found to be the mean of all the ratios. A good approximation to the second principal component was found to be the difference between the mean of two width ratios and the mean of two length ratios, and these approximations of the first and second principal components were chosen as predictors in regression analyses with age as the dependent variable. The coefficient of determination (r2) for the estimation was strongest when the ratios

  6. Radiographic Inspection of Fueled Clads

    SciTech Connect

    Timothy J. Roney; Karen M. Wendt

    2005-04-01

    Five general purpose heat source (GPHS) fueled clads were radiographically inspected at the Idaho National Laboratory (INL). The girth weld region of each clad had previously passed visual examination, ring gauge test, and leak test but showed “positive” indications on the ultrasonic (UT) test. Positive ultrasonic indications are allowable under certain weld conditions; radiographic inspection provides a secondary nonintrusive means of clad inspection and may confirm allowable anomalies from the UT inspection. All the positive UT indications were found to exhibit allowable weld shield fusion or mismatch conditions. No indication of void defects was found. One additional clad (FCO371) was deemed unacceptable for radiographic inspection due to an unknown black substance that obscured the angular origin on the weld so that the angular offset to the UT indication could not be found.

  7. Chest wall resection for extrapulmonary tumor.

    PubMed

    Long, W P; Kline, R; Levine, E A

    1997-09-01

    Despite progress in early detection of breast cancer, a minority of women continue to present with extensive disease which may necessitate chest wall resection. Between 1992 and 1996, 14 patients were treated by surgical resection of the chest wall and reconstruction by the LSU Sections of Surgical Oncology and Plastic Surgery. Indications included resection of primary tumor, resection of recurrent tumor, and resection of radiation therapy induced damage to the chest wall. We report chest wall excision and reconstruction with no operative mortality and minor surgical morbidity in 21% of cases. Local control was achieved in 13 of 14 cases. Additionally we report uniform success in the palliation of ulcerating, painful, or infected chest wall lesions. Approximately 25% of patients treated for breast cancer and followed up for more than 6 months have remained free of disease. Chest wall resection is a useful modality in selected patients with extensive disease. PMID:9316348

  8. Tonsillolith: A Panoramic Radiograph Presentation

    PubMed Central

    Babu B., Balaji; Tejasvi M.L., Avinash; Avinash, C.K. Anulekha; B., Chittaranjan

    2013-01-01

    Tonsilloliths are calcifications within a tonsillar crypt, involve primarily the palatine tonsil caused by dystrophic calcification as a result of chronic inflammation. Tonsilloliths are very uncommon and are microscopic. Tonsillar concretions sometimes produce symptoms which include non-specific chronic halitosis, irritable cough, dysphagia, otalgia and foreign body-like sensation or foul taste. Patients with tonsillolithiasis may also be asymptomatic, with their lesions being discovered incidentally on panoramic radiographs. This article presents an unusual case of multiple bilateral and asymptomatic tonsilloliths which were found during a routine panoramic radiographic examination. PMID:24298535

  9. Analog enhancement of radiographic images

    NASA Technical Reports Server (NTRS)

    Baily, N. A.; Nachazel, R. J.

    1976-01-01

    The paper shows how analog methods for edge sharpening, contrast enhancement, and expansion of the range of gray levels of particular interest are effective for easy on-line application to video viewing of X-ray roentgenograms or to fluoroscopy. The technique for analog enhancement of radiographic images is a modified version of the system designed by Fuchs et al. (1972), whereby an all directional second derivative signal called detail signal is used to produce both vertical and horizontal enhancement of the image. Particular attention is given to noise filtration and contrast enhancement. Numerous radiographs supplement the text.

  10. Technique for chest compressions in adult CPR

    PubMed Central

    2011-01-01

    Chest compressions have saved the lives of countless patients in cardiac arrest as they generate a small but critical amount of blood flow to the heart and brain. This is achieved by direct cardiac massage as well as a thoracic pump mechanism. In order to optimize blood flow excellent chest compression technique is critical. Thus, the quality of the delivered chest compressions is a pivotal determinant of successful resuscitation. If a patient is found unresponsive without a definite pulse or normal breathing then the responder should assume that this patient is in cardiac arrest, activate the emergency response system and immediately start chest compressions. Contra-indications to starting chest compressions include a valid Do Not Attempt Resuscitation Order. Optimal technique for adult chest compressions includes positioning the patient supine, and pushing hard and fast over the center of the chest with the outstretched arms perpendicular to the patient's chest. The rate should be at least 100 compressions per minute and any interruptions should be minimized to achieve a minimum of 60 actually delivered compressions per minute. Aggressive rotation of compressors prevents decline of chest compression quality due to fatigue. Chest compressions are terminated following return of spontaneous circulation. Unconscious patients with normal breathing are placed in the recovery position. If there is no return of spontaneous circulation, then the decision to terminate chest compressions is based on the clinical judgment that the patient's cardiac arrest is unresponsive to treatment. Finally, it is important that family and patients' loved ones who witness chest compressions be treated with consideration and sensitivity. PMID:22152601

  11. Chest pain evaluation in the emergency department.

    PubMed

    Foy, Andrew J; Filippone, Lisa

    2015-07-01

    Chest pain is a common complaint in the emergency department. Recognition of chest pain symptoms and electrocardiographic changes consistent with acute coronary syndrome (ACS) can lead to prompt initiation of goal-directed therapy. Cardiac troponin testing confirms the diagnosis of acute myocardial infarction, but does not reveal the mechanism of injury. When patients with chest pain rule out for ACS the use of advanced, noninvasive testing has not been found to be associated with better patient outcomes. PMID:26042885

  12. A preliminary study for exploring the luminance ratio of liquid-crystal displays required for display of radiographs.

    PubMed

    Takarabe, Shinya; Morishita, Junji; Yabuuchi, Hidetake; Akamine, Hiroshi; Hashimoto, Noriyuki; Nakamura, Yasuhiko; Matsuo, Yoshio; Hattori, Akiko

    2014-01-01

    Medical-grade liquid-crystal displays (LCDs) with high contrast ratio (CR) values have recently been developed and become available for soft-copy reading. When the LCD is used under ambient light conditions, the luminance ratio (LR) is a more appropriate indicator than the CR. Our aim was to explore the LR required for LCDs for soft-copy reading by comparing the effective LR values with the LR of the LCD. We defined "the luminance ratio in an image (LRimg)", the ratio of the maximum to minimum luminance in a radiograph displayed on the LCD, as the effective LR values required for the LCD. The maximum LRimg values in chest radiographs and those in mammograms ranged from 109 to 143 and 372 to 431, respectively. The LR of the LCD was higher than the LRimg values of the radiographs. Our results indicate that currently available medical-grade LCDs have enough LR for display of radiographs. PMID:24002707

  13. Hydatid disease of the chest

    PubMed Central

    Xanthakis, D.; Efthimiadis, M.; Papadakis, G.; Primikirios, N.; Chassapakis, G.; Roussaki, A.; Veranis, N.; Akrivakis, A.; Aligizakis, C. J.

    1972-01-01

    Ninety-one cases of hydatid disease of the chest are reported. Eighty-eight were involving the lung, two the chest wall, and one the mediastinum. All the patients were treated surgically. Conservative operations (simple removal of the parasite and closure of the remaining cavity) were performed in 78 patients, 37 unruptured and 41 ruptured cysts. Late postoperative complications occurred in eleven. In 10 patients, recurrent haemoptysis was the main symptom due to residual cavity in four, bronchiectatic changes in two, and unknown aetiology in four. In one patient, recurrence of multiple cysts occurred in the affected lobe. Radical operations were carried out in 10 patients, including segmental resection in four and lobectomy in six. Conservative operations were performed in all cases of unruptured cysts, with the exception of a giant cyst in which resection was the operation of choice. For ruptured cysts with mild infection conservative operation was also performed. Resection was necessary only in patients with ruptured cysts with suppuration, bronchiectatic changes, and giant cysts replacing a whole lobe. There was no mortality. We believe that conservative operation is the treatment of choice for hydatid disease of the lung. Indications for resection are very limited. Images

  14. The quality of radiographs used in the pretreatment review of dental claims.

    PubMed

    Bailit, H L; Reisine, S T; Downes, W; Richards, N

    1979-01-01

    The purpose of the study was to assess the quality of radiographs accompanying claims submitted for pretreatment review, and to determine the relative importance of radiograph quality in dental consultants' decisions regarding the necessity and appropriateness of crown services. Findings indicate that: 1) the technical quality of radiographs in the sample is adequate for most criteria; and 2) radiograph quality, number, and type of film submitted do not explain much of the variation in disagreements between the direct and indirect assessments of crown services. The most important radiograph variables influencing pretreatment review decisions appear to be the number of periapical films submitted for review, and the density/contrast of the radiographs. PMID:287804

  15. Quantitative analysis of rib kinematics based on dynamic chest bone images: preliminary results

    PubMed Central

    Tanaka, Rie; Sanada, Shigeru; Sakuta, Keita; Kawashima, Hiroki

    2015-01-01

    Abstract. An image-processing technique for separating bones from soft tissue in static chest radiographs has been developed. The present study was performed to evaluate the usefulness of dynamic bone images in quantitative analysis of rib movement. Dynamic chest radiographs of 16 patients were obtained using a dynamic flat-panel detector and processed to create bone images by using commercial software (Clear Read BS, Riverain Technologies). Velocity vectors were measured in local areas on the dynamic images, which formed a map. The velocity maps obtained with bone and original images for scoliosis and normal cases were compared to assess the advantages of bone images. With dynamic bone images, we were able to quantify and distinguish movements of ribs from those of other lung structures accurately. Limited rib movements of scoliosis patients appeared as a reduced rib velocity field, resulting in an asymmetrical distribution of rib movement. Vector maps in all normal cases exhibited left/right symmetric distributions of the velocity field, whereas those in abnormal cases showed asymmetric distributions because of locally limited rib movements. Dynamic bone images were useful for accurate quantitative analysis of rib movements. The present method has a potential for an additional functional examination in chest radiography. PMID:26158097

  16. Dynamic chest radiography with a flat-panel detector (FPD): ventilation-perfusion study

    NASA Astrophysics Data System (ADS)

    Tanaka, R.; Sanada, S.; Fujimura, M.; Yasui, M.; Tsuji, S.; Hayashi, N.; Okamoto, H.; Nanbu, Y.; Matsui, O.

    2011-03-01

    Pulmonary ventilation and blood flow are reflected in dynamic chest radiographs as changes in X-ray translucency, i.e., pixel values. This study was performed to investigate the feasibility of ventilation-perfusion (V/Q) study based on the changes in pixel value. Sequential chest radiographs of a patient with ventilation-perfusion mismatch were obtained during respiration using a dynamic flat-panel detector (FPD) system. The lung area was recognized and average pixel value was measured in each area, tracking and deforming the region of interest. Inter-frame differences were then calculated, and the absolute values were summed in each respiratory phase. The results were visualized as ventilation, blood flow, V/Q ratio distribution map and compared to distribution of radioactive counts on ventilation and perfusion scintigrams. In the results, abnormalities were appeared as a reduction of changes in pixel values, and a correlation was observed between the distribution of changes in pixel value and those of radioactivity counts (Ventilation; r=0.78, Perfusion; r=0.77). V/Q mismatch was also indicated as mismatch of changes in pixel value, and a correlation with V/Q calculated by radioactivity counts (r=0.78). These results indicated that the present method is potentially useful for V/Q study as an additional examination in conventional chest radiography.

  17. Routine radiographic assessment of the scoliotic spine.

    PubMed

    Farren, J

    1981-04-01

    This paper is designed to give a brief account of the radiographic criteria necessary in order to demonstrate and evaluate the scoliotic spine. However, additional specialised radiographic examinations, including myelography, angiography, laminography and intravenous urography are occasionally necessary. PMID:7280196

  18. Radiographically guided percutaneous catheter drainage of pleural fluid collections.

    PubMed

    Merriam, M A; Cronan, J J; Dorfman, G S; Lambiase, R E; Haas, R A

    1988-12-01

    We reviewed the outcome of guided percutaneous catheter drainage of pleural fluid collections in 18 patients over a 5-year period. Catheter positioning was guided by fluoroscopy in 10 (56%) cases, CT in seven (39%), and sonography in one (6%). Included were 16 patients with empyemas and one each with a sterile hematoma and transudate. In nine of the patients, previous surgical chest tube drainage had been unsuccessful. The majority of collections were treated with a 12- or 14-French catheter and closed underwater seal drainage. Twelve (80%) of the 15 patients who had an adequate trial of guided drainage were cured. Propyliodone oil suspension contrast sinography after catheter placement showed two clinically unsuspected bronchopleural fistulas. Although an extensive multilocular pleural collection was a contraindication to percutaneous catheter drainage, the thick fibrous peel of a chronic empyema was not. Drainage of pleural fluid collections with radiographic guidance ensures proper catheter placement and is successful in a high percentage of cases. PMID:3055887

  19. Radiological findings of pulmonary tuberculosis in indigenous patients in Dourados, MS, Brazil*

    PubMed Central

    Lachi, Tatiana; Nakayama, Mauro

    2015-01-01

    Objective To describe the radiological findings of pulmonary tuberculosis in indigenous patients from the city of Dourados, MS, Brazil, according to age and sex. Materials and Methods Chest radiographic images of 81 patients with pulmonary tuberculosis, acquired in the period from 2007 to 2010, were retrospectively analyzed by two radiologists in consensus for the presence or absence of changes. The findings in abnormal radiographs were classified according to the changes observed and they were correlated to age and sex. The data were submitted to statistical analysis. Results The individuals’ ages ranged from 1 to 97 years (mean: 36 years). Heterogeneous consolidations, nodules, pleural involvement and cavities were the most frequent imaging findings. Most patients (55/81 or 67.9%) were male, and upper lung and right lung were the most affected regions. Fibrosis, heterogeneous consolidations and involvement of the left lung apex were significantly more frequent in males (p < 0.05). Presence of a single type of finding at radiography was most frequent in children (p < 0.05). Conclusion Based on the hypothesis that indigenous patients represent a population without genetically determined resistance to tuberculosis, the present study may enhance the knowledge about how the pulmonary form of this disease manifests in susceptible individuals. PMID:26543277

  20. A More Efficient, Radiation-Free Alternative to Systematic Chest X-Ray for the Detection of Embolized Seeds to the Lung

    SciTech Connect

    Morrier, Janelle; Chretien, Mario; Martin, Andre-Guy; Vigneault, Eric; Beaulieu, Luc

    2010-11-15

    Purpose: To evaluate the efficacy of a seed-migration detector and to compare its performance to fluoroscopy and postoperative chest radiographs. Methods and Materials: A gamma scintillation survey meter was converted to a seed-migration detector by adding a shield on the probe detection window. The detector response to three {sup 125}I seed activities was characterized for different source-to-detector distances in water. The detector was used to perform a chest evaluation on 737 patients at their first postoperative visit. When the detector showed positive activity, seed migration was confirmed by taking a chest radiograph and by looking at the region with fluoroscopy. Results: One hundred and three patients (14.0%) presented at least one embolized seed. This accounts for 123 of the 39,887 seeds. Eighty-seven, 12, and 4 patients had respectively one, two, and three seed embolization. Compared with the seed-migration detector, detection based on fluoroscopy would have led to 13 false-negative detections (of 103, or 12.6%), and the radiograph would have resulted in 31 or 30.1%. More important, standard chest X-ray would have required a survey and extra radiation dose to lung to 100% of the patients, rather than the 14% who required it. Conclusions: The usual recommendation to perform chest radiographs at the first follow-up visit to scan lungs for embolized seeds should be revised because of the high false-negative rate. Scintillator-based gamma counter detector provides superior detection sensitivity and should be adopted as a standard of practice. Chest X-ray could be limited to documenting cases of positive migration.

  1. Radiographic amplifier screens: Fabrication process and characteristics

    NASA Technical Reports Server (NTRS)

    Szepesi, Z. P.

    1977-01-01

    The fabrication process and transfer characteristics for solid state radiographic image transducers (radiographic amplifier screens) is described. These screens were developed for use in real time nondestructive evaluation procedures that require large format radiographic images with contrast and resolution capabilities unavailable with conventional fluoroscopic screens. This work was directed toward screens usable for inmotion, on-line radiographic inspection by means of closed circuit television.

  2. 42 CFR 37.42 - Chest radiograph specifications-digital radiography systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... pairs per millimeter. The storage phosphor cassette or digital image detector must be positioned either vertically or horizontally so that the image includes the apices and costophrenic angles of both right and... described, then two side-by-side images can be obtained that together include the apices and...

  3. 78 FR 35575 - Black Lung Benefits Act: Standards for Chest Radiographs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ... 1980. See 45 FR 13678, 13680-81 (February 29, 1980). Codified at 20 CFR 718.102, 718.202, and Appendix... standards on NIOSH's then-current regulations, which HHS had published on August 1, 1978. 43 FR 33713... generally 45 FR 13680-81 (February 29, 1980). Although NIOSH later revised two of the 42 CFR part...

  4. 78 FR 35549 - Black Lung Benefits Act: Standards for Chest Radiographs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ... X-rays in 1980. See 45 FR 13678, 13680-81 (February 29, 1980). Codified at 20 CFR 718.102, 718.202... standards on NIOSH's then-current regulations, which HHS had published on August 1, 1978. 43 FR 33713... generally 45 FR 13680-81 (February 29, 1980). Although NIOSH later revised two of the 42 CFR part...

  5. ROC Analysis of Chest Radiographs Using Computed Radiography and Conventional Analog Films

    NASA Astrophysics Data System (ADS)

    Morioka, Craig A.; Brown, Kathy; Hayrapetian, Alek S.; Kangarloo, Hooshang; Balter, Stephen; Huang, H. K.

    1989-05-01

    Receiver operating characteristic is used to compare the image quality of films obtained digitally using computed radiography (CR) and conventionally using analog film following fluoroscopic examination. Similar radiological views were obtained by both modalities. Twenty-four cases, some with a solitary noncalcified nodule and/or pneumothorax, were collected. Ten radiologists have been tested viewing analog and CR digital films separately. Final results indicate that there is no statistically significant difference in the ability to detect either a pneumothorax or a solitary noncalcified nodule when comparing CR digital film with conventional analog film. However, there is a trend that indicated the area under the ROC curves for detection of either a pneumothorax or solitary noncalcified nodule were greater for the analog film than for the digital film.

  6. The Importance of Esophageal and Gastric Diseases as Causes of Chest Pain

    PubMed Central

    Shin, Eun Jung; Kim, Nam Su; Lee, Young Ho; Nam, Eun Woo

    2015-01-01

    Purpose Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients. Methods The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients. Results Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) subsequently showed clinical improvement. Conclusion Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are important as well as cardiac and respiratory investigations. PMID:26770901

  7. Bronchial cancer - chest x-ray (image)

    MedlinePlus

    This is a chest x-ray of a person with bronchial cancer. This is a front view. The lungs are the two dark ... white areas visible in the middle of the chest. The light areas that appear as subtle branches ...

  8. 21 CFR 892.1840 - Radiographic film.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic film. 892.1840 Section 892.1840 Food... DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1840 Radiographic film. (a) Identification. Radiographic film is a device that consists of a thin sheet of radiotransparent material coated on one or...

  9. Imaging of Chest and Abdominal Trauma in Children.

    PubMed

    Goodwin, Susie J; Flanagan, Sean G; McDonald, Kirsteen

    2015-01-01

    Trauma is the commonest cause of death in children over a year old. The injuries sustained and management of these children differs to adults, due to differences in anatomy and physiology. Careful thought must also be given to exposing children to radiation, and CT scans should be performed only in select patients. This article reviews these important points and explains the imaging findings in chest and abdominal trauma. PMID:26219741

  10. [Wooden chests for the midwife's equipment].

    PubMed

    Carlén-Nilsson, C

    1993-01-01

    In the museum of medical history in Lund there are several wooden chests containing partly identical instruments apparently belonging to a midwife. The instruments dated from before 1900, e.g. lancets and horn cups for blood-letting, a pewter enema syringe, a wooden stethoscope, a "tobacco pipe" and glass bottles. The use of the tobacco pipe was first puzzling, but it appeared to be a breast reliver. What do we know about the date of the chests? One chest has belonged to Kjersti Nilsdotter, a midwife educated in Lund 1872-1873. Her certificate was in the chest. From Ronnie Hunt, Minnesota we have got information about another chest of the same type. That belonged to Nelly Gustafsson, a midwife educated in Lund probably about 1870. She emigrated to USA and was a practising midwife in Lindstrom, Minnesota from about 1900. PMID:11639439

  11. Intercostal hemangioma of the chest wall

    PubMed Central

    Hamzík, Julian

    2016-01-01

    The authors describe a case of a 36-year-old patient who had six months’ pain of the thoracic spine and left chest. A soft slowly growing resistance was present on the dorso-lateral side of the left chest wall, in the range of the seventh to ninth rib. According to the medical history, the patient did not have any prior trauma and malignancy. A well-defined tumor of the left chest wall with calcifications, which grew to the seventh and eighth intercostal space, was present on computed tomography (CT) and magnetic resonance (MR) scans. The patient underwent resection of the tumor with the chest wall and reconstruction with polypropylene mesh. Histologically, it was a venous hemangioma, one of very rare tumors of the chest wall. PMID:27212983

  12. [How to do - the chest tube drainage].

    PubMed

    Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

    2015-03-01

    A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." PMID:25734676

  13. Supine chest compression: alternative to prone ventilation in acute respiratory distress syndrome.

    PubMed

    Samanta, Sukhen; Samanta, Sujay; Soni, Kapil Dev

    2014-05-01

    Prone ventilation is usually used for severe acute respiratory distress syndrome. We applied an alternative method to prone position. We described 2 cases of trauma where prone position could not be done. Chest wall compression was performed by 2-kg weight in front of the chest wall bilaterally while the patient was in a supine position. Respiratory mechanics work to improve oxygenation almost as same as the mechanism proposed for prone position without any major adverse effects and serious complications. We suggest a larger randomized study to determine the efficacy and also to find out the optimum weight required to compress the chest. PMID:24332252

  14. Radiographic findings in patients with clinical Tietze syndrome.

    PubMed

    Jurik, A G; Justesen, T; Graudal, H

    1987-01-01

    Thirteen patients with similar painful tender swelling in the region of the sternocostal joint (SCJ) are reported. X-ray tomography revealed changes which might explain the swelling in 11 patients. Three patients had anatomical variants of the sternum. One of these and a further two patients had marginal osteophytes at the affected SCJ, as signs of osteoarthrosis. Six patients with psoriasis, pustulosis palmoplantaris, or psoriasis in the family had past or present arthritis of the involved SCJ or the manubriosternal joint. Tomography was found to be a useful confirmatory examination in patients with clinical Tietze syndrome. PMID:3423820

  15. Investigations into human tracheal cartilage osseocalcineus metaplasia. I. Radiographic findings.

    PubMed

    Sośnik, H; Sośnik, K

    2008-05-01

    Osseocalcineus metaplasia (OCM) of the tracheal cartilages is well known, but no exact data are available relating it to age and sex. To resolve this problem we analysed tracheal teleradiograms of 99 female (age: 0.4-92; x = 59.98 +/- +/- 22.75 years) and 110 male patients (age: 0-83; x = 53.53 +/- 19.95 years). As the first step we estimated the percentage of trachea that had complete lesions, those that had trace lesions and those that were unchanged in relation to the patient's age and sex. Secondly we determined the extent and growth of developing lesions during the process of ageing. Data were collected for all the cartilages, with two cartilages with trace lesions considered to be of similar value to one cartilage with complete remodelling. This enabled us to determine the correlation coefficient for changed cartilages and patient age and also the dynamism of OCM in the trachea examined. The chi2 and Student's t tests were used in determining the mean differences between subgroups. The lesions referred to above occurred in 66.35% of men and in 33.33% of women and correlated with age (r = 0.93, p < 0.001 in men, and r = 0.27, p < 0.01 in women). Total remodelling of the OCM occurred in the oldest age group, when both sexes were taken into consideration, while cartilages with trace changes were detected in the younger group of patients. The lowest mean patient age was observed in the group without tracheal changes. Osseocalcineus metaplasia of the tracheal cartilages was conditioned by patient age and sex. In male patients it occurred twice as often as in females. Until the age of 50 it occurred as much as nine times as often, while after this age it occurred only twice as often as in female patients. PMID:18521814

  16. Chest Compression-Only CPR: A Meta-Analysis

    PubMed Central

    Hüpfl, Michael; Selig, Harald F; Nagele, Peter

    2010-01-01

    Summary Background Evidence suggests that dispatcher-assisted chest compression-only bystander CPR may be superior to standard CPR (chest compressions and rescue ventilation) in out-of-hospital cardiac arrest, yet recent clinical trials did not observe improved outcomes. The goal of the study was to determine the association between chest compression-only CPR and survival after out-of-hospital cardiac arrest. Methods Studies published until August 2010 were systematically searched and identified in MEDLINE and EMBASE databases. For the primary meta-analysis only clinical trials were included that prospectively randomized dispatcher instructions to chest compression-only versus standard bystander CPR in out-of-hospital adult cardiac arrest patients; for the secondary meta-analysis observational cohort studies were included that distinguished between standard CPR and chest compression-only CPR. All studies were required to contain survival data. Data on study characteristics, methods and outcomes (return of spontaneous circulation, survival to discharge, 30-day survival, and favourable neurologic outcome) were extracted. A fixed-effects model was used for both meta-analyses for lack of heterogeneity among the studies (I2 0%). Findings All three published randomized clinical trials were included in the meta-analysis. The pooled analyses shows that dispatcher-assisted chest compression-only bystander CPR for adult out-of-hospital cardiac arrest was associated with a 22% improved chance of survival (risk ratio [RR] 1.22 [95% confidence interval {CI}, 1.01 – 1.47]; I2, 0%) compared to standard CPR. The absolute increase in survival was 2.4%; the number needed to treat was 41. The secondary meta-analysis included seven observational studies of bystander-CPR (not dispatcher-assisted) and showed no difference between the two CPR techniques (RR, 0.96 [95% CI, 0.83 – 1.11]; I2, 0%). Interpretation Dispatcher-assisted chest compression-only bystander CPR is associated with

  17. Radiographic Evaluations of Revision Total Knee Arthroplasty: A Plea for Uniform Assessments.

    PubMed

    Elmallah, Randa K; Scuderi, Giles R; Jauregui, Julio J; Meneghini, R Michael; Dennis, Doug A; Backstein, David B; Bourne, Robert B; Mont, Michael A

    2015-11-01

    Thorough radiographic evaluation is necessary for perioperative assessments in revision total knee arthroplasty. There has been a large degree of variability in reporting these findings within the peer-reviewed literature. Our purpose was to evaluate studies that radiographically assessed alignment in the coronal and sagittal plane, patella alignment and thickness, presence and characterization of implant interface, and radiolucency. Secondly, we reviewed studies using a standardized reporting system to evaluate radiographic findings (the Knee Society Roentgenographic Evaluation and Scoring System) and the number of times it was referenced. Only 62% of studies evaluated all radiographic parameters, 57% to 91% assessed each metric, and 55% used standardized reporting systems. This emphasizes the need for a uniform evaluation method to ensure consistent radiographic assessment and optimal standard of care. PMID:26364904

  18. Validation of a novel technique for creating simulated radiographs using computed tomography datasets.

    PubMed

    Mendoza, Patricia; d'Anjou, Marc-André; Carmel, Eric N; Fournier, Eric; Mai, Wilfried; Alexander, Kate; Winter, Matthew D; Zwingenberger, Allison L; Thrall, Donald E; Theoret, Christine

    2014-01-01

    Understanding radiographic anatomy and the effects of varying patient and radiographic tube positioning on image quality can be a challenge for students. The purposes of this study were to develop and validate a novel technique for creating simulated radiographs using computed tomography (CT) datasets. A DICOM viewer (ORS Visual) plug-in was developed with the ability to move and deform cuboidal volumetric CT datasets, and to produce images simulating the effects of tube-patient-detector distance and angulation. Computed tomographic datasets were acquired from two dogs, one cat, and one horse. Simulated radiographs of different body parts (n = 9) were produced using different angles to mimic conventional projections, before actual digital radiographs were obtained using the same projections. These studies (n = 18) were then submitted to 10 board-certified radiologists who were asked to score visualization of anatomical landmarks, depiction of patient positioning, realism of distortion/magnification, and image quality. No significant differences between simulated and actual radiographs were found for anatomic structure visualization and patient positioning in the majority of body parts. For the assessment of radiographic realism, no significant differences were found between simulated and digital radiographs for canine pelvis, equine tarsus, and feline abdomen body parts. Overall, image quality and contrast resolution of simulated radiographs were considered satisfactory. Findings from the current study indicated that radiographs simulated using this new technique are comparable to actual digital radiographs. Further studies are needed to apply this technique in developing interactive tools for teaching radiographic anatomy and the effects of varying patient and tube positioning. PMID:24219133

  19. Bedside Lung Ultrasound During Acute Chest Syndrome in Sickle Cell Disease

    PubMed Central

    Razazi, Keyvan; Deux, Jean-François; de Prost, Nicolas; Boissier, Florence; Cuquemelle, Elise; Galactéros, Frédéric; Rahmouni, Alain; Maître, Bernard; Brun-Buisson, Christian; Mekontso Dessap, Armand

    2016-01-01

    Abstract Lung ultrasound (LU) is increasingly used to assess pleural and lung disease in intensive care unit (ICU) and emergency unit at the bedside. We assessed the performance of bedside chest radiograph (CR) and LU during severe acute chest syndrome (ACS), using computed tomography (CT) as the reference standard. We prospectively explored 44 ACS episodes (in 41 patients) admitted to the medical ICU. Three imaging findings were evaluated (consolidation, ground-glass opacities, and pleural effusion). A score was used to quantify and compare loss of lung aeration with each technique and assess its association with outcome. A total number of 496, 507, and 519 lung regions could be assessed by CT scan, bedside CR, and bedside LU, respectively. Consolidations were the most common pattern and prevailed in lung bases (especially postero-inferior regions). The agreement with CT scan patterns was significantly higher for LU as compared to CR (κ coefficients of 0.45 ± 0.03 vs 0.30 ± 0.03, P < 0.01 for the parenchyma, and 0.73 ± 0.08 vs 0.06 ± 0.09, P < 0.001 for pleural effusion). The Bland and Altman analysis showed a nonfixed bias of −1.0 (P = 0.12) between LU score and CT score whereas CR score underestimated CT score with a fixed bias of −5.8 (P < 0.001). The specificity for the detection of consolidated regions or pleural effusion (using CT scan as the reference standard) was high for LU and CR, whereas the sensitivity was high for LU but low for CR. As compared to others, ACS patients with an LU score above the median value of 11 had a larger volume of transfused and exsanguinated blood, greater oxygen requirements, more need for mechanical ventilation, and a longer ICU length of stay. LU outperformed CR for the diagnosis of consolidations and pleural effusion during ACS. Higher values of LU score identified patients at risk of worse outcome. PMID:26886600

  20. A clinical and radiographic study of coir workers.

    PubMed Central

    Uragoda, C G

    1975-01-01

    Processing of coir, which is the fibre obtained from the husk of the coconut, is a dusty procedure; 779 workers in two coir processing factories in Sri Lanka were examined clincally and radiographically for evidence of respiratory disease. Respiratory symptoms were present in 20 (2-6%) of them, which is no higher than in the general population. Respiratory disease such as asthma, chronic bronchitis, byssinosis, and pulmonary tuberculosis which may occur from occupational exposures were considered, but there was no evidence to suggest a definite association between these conditions and coir dust. Twenty-two workers had abnormal chest radiographs, but when compared with a control group of 591 workers from an engineering firm where lesions were found in 20 cases, there was no significant difference. In the opinion of the medical officer, management and workers of the large factory investigated, coir dust does not produce any respiratory disability. The chemical composition of coir dust is similar to that of sisal which is also relatively inert. PMID:1125129

  1. Procarbazine-induced interstitial pneumonitis with a normal chest x-ray: a case report

    SciTech Connect

    Garbes, I.D.; Henderson, E.S.; Gomez, G.A.; Bakshi, S.P.; Parthasarathy, K.L.; Castillo, N.B.

    1986-01-01

    Pulmonary toxicity due to cytotoxic drugs is well described in the literature. This is most commonly described in association with bleomycin, busulfan, and methotrexate. This report presents a case of interstitial pneumonitis with a normal chest x-ray that is most certainly due to procarbazine. In addition, the role of gallium-67 citrate scintigraphy in early diagnosis is discussed. This is especially important since discontinuation of the drug before radiographic manifestations of pulmonary toxicity become evident may prevent permanent pulmonary injury and its sequelae.

  2. Radiographic instrumentation for DPM experiments

    NASA Technical Reports Server (NTRS)

    Fripp, Archie L.; Debnam, W. J.; Simchick, Richard T.; Barber, P. G.

    1990-01-01

    New developments in x-ray radiography that may be applicable to containerless experimentation are presented. The two features discussed are the use of radiography to determine the position and shape of the solid-liquid interface and, with the aid of appropriate markers, the flow patterns in either the surface or bulk of the liquid state. Both surface energy and fluid viscosity measurements can be made with the aid of the described radiographic system.

  3. Non-Radiographic Axial Spondyloarthritis.

    PubMed

    Slobodin, Gleb; Eshed, Iris

    2015-12-01

    The term non-radiographic axial spondyloarthritis (nrAxSpA) was coined for patients who have a clinical picture of ankylosing spondylitis (AS) but do not exhibit radiographic sacroiliitis. The ASAS classification criteria for nrAxSpA, ensuring the recruitment of homogenous study cohorts, were accepted in 2009, although the respective diagnostic criteria for daily clinical practice have not yet been developed. The clinical diagnosis should be based on the composite of clinical symptoms and signs of the disease, HLA B27 status, and magnetic resonance imaging (MRI) of sacroiliac joints. Notably, a negative MRI or HLA B27 does not exclude the diagnosis in patients with a high clinical suspicion for nrAxSpA. The prevalence of nrAxSpA is similar to that of AS, but the former has a higher female preponderance. The rate of progression of nrAxSpA to the radiographic stage of disease (AS) ranges from 10% to 20% over 2 years. Current treatment strategies for nrAxSpA are the same as for AS and include non-steroidal anti-inflammatory drugs and inhibitors of tumor necrosis factor-alpha. While this review summarizes the current achievements in the field of nrAxSpA, further understanding of the epidemiology and natural history of the disease and, particularly, mechanisms of inflammation and subsequent new bone formation is essential for the development of new treatment strategies for nrAxSpA patients. PMID:26897981

  4. Investigation of the dosimetry of chest tomosynthesis

    NASA Astrophysics Data System (ADS)

    Svalkvist, Angelica; Zachrisson, Sara; Månsson, Lars Gunnar; Båth, Magnus

    2009-02-01

    Chest tomosynthesis has recently been introduced to healthcare as a low-dose alternative to CT or as a tool for improved diagnostics in chest radiography with only a modest increase in radiation dose to the patient. However, no detailed description of the dosimetry for this type of examination has been presented. The aim of this work was therefore to investigate the dosimetry of chest tomosynthesis. The chest tomosynthesis examination was assumed to be performed using a stationary detector and a vertically moving x-ray tube, exposing the patient from different angles. The Monte Carlo based computer software PCXMC was used to determine the effective dose delivered to a standard-sized patient from various angles using different assumptions of the distribution of the effective dose over the different projections. The obtained conversion factors between input dose measures and effective dose for chest tomosynthesis for different angular intervals were then compared with the horizontal projection. The results indicate that the error introduced by using conversion factors for the PA projection in chest radiography for estimating the effective dose of chest tomosynthesis is small for normally sized patients, especially if a conversion factor between KAP and effective dose is used.

  5. Role of conventional chest radiography in diagnosis and exclusion of emphysema.

    PubMed

    Pratt, P C

    1987-05-01

    Although recognizing that the subject is controversial, most authors of textbooks about diagnostic radiology conclude that chest radiography is of little value for either confirmation or exclusion of the diagnosis of emphysema. Yet several reports in the literature show a high degree of accuracy in the interpretation of films for presence of this disease. Some of the controversy results from continuing confusion over the current definition of emphysema in terms of lung structure rather than symptoms or physiologic evidence relating to impaired ventilation. Many autopsy studies have shown that emphysema is often present at postmortem examination and can involve as much as 30 percent of the lung tissue, even in subjects with no respiratory symptoms or impairment during life. Since radiographs deal with structure rather than function, interpreters of chest films should have the intention to recognize the presence of structural emphysema. The correct recognition of emphysema is useful even in a patient without symptoms, and the ability to exclude this diagnosis in symptomatic patients is of equal, if not greater value. The degree of success reported in various studies depends upon the criteria used and the strictness applied by the authors in matching their interpretations to the presence or absence of structural emphysema. This review of existing literature deals solely with papers in which radiographic observations have been related to morphologic evidence of emphysema in inflation-fixed autopsy lung specimens. It identifies reasons for discrepancies among reports and emphasizes the very high predictive value of validated radiographic criteria. Applications of radiographic interpretation both for diagnosis and for exclusion of emphysema in clinical situations are described. PMID:3555069

  6. Compensation, radiographic changes, and survival in applicants for asbestosis compensation.

    PubMed Central

    Cookson, W O; Musk, A W; Glancy, J J; de Klerk, N H; Yin, R; Mele, R; Carr, N G; Armstrong, B K; Hobbs, M S

    1985-01-01

    The survival of 354 claimants for compensation for pulmonary asbestosis among former workers of the Wittenoom crocidolite mine and mill in Western Australia has been examined. There were 118 deaths up to December 1982. The median time between start of work and claim for compensation was 17 years. The standardised mortality ratio (SMR) for deaths from all causes was 2.65 (p less than 0.0001). The SMR for pneumoconiosis was 177.2 (p less than 0.0001), bronchitis and emphysema 2.6 (p = 0.04), tuberculosis 44.6 (p less than 0.0001), respiratory cancer (including five deaths from malignant pleural mesothelioma) 6.4 (p less than 0.0001), gastrointestinal cancer 1.6 (p = 0.22), all other cancers 1.6 (p = 0.17), heart disease 1.4 (p = 0.07), and all other causes 2.18 (p = 0.004). Plain chest radiographs taken within two years of claiming compensation were found for 238 subjects and were categorised independently by two observers according to the International Labour Organisation criteria without knowledge of exposure or compensation details. Profusion of radiographic opacities, age at claiming compensation, work in the Wittenoom mill, and degree of disability awarded by the pneumoconiosis medical board were significant predictors of survival, but total estimated exposure to asbestos was not. Radiographic profusion and degree of disability were, however, predictable by total exposure. The median survival from claim for compensation was 17 years in subjects with ILO category 1 pneumoconiosis, 12 years in category 2, and three years in category 3. PMID:2990524

  7. Prevalence of radiographic appearance of pneumoconiosis in an unexposed blue collar population

    SciTech Connect

    Castellan, R.M.; Sanderson, W.T.; Petersen, M.R.

    1985-05-01

    Blue collar employees currently working in environments free from exposure to respiratory hazards were examined with chest radiography and a standard occupational history questionnaire. Workers who had worked for a total of 5 yr or more in previous jobs with possible hazardous respiratory exposures were excluded. Each radiograph was read independently by 3 NIOSH-certified ''B'' readers. For small opacities, the median profusion was accepted as a summary reading. The 1,422 readable films represented a population of 50.6% males, 49.4% females, 52.5% whites, 44.2% blacks, 47.0% current smokers, and 38.5% nonsmokers. The mean age was 33.8 yr, with a range from 16 to 70 yr. Small opacities of profusion greater than or equal to 1/0 were identified in only 3 (0.21%) of the radiographs--2 with small rounded opacities and 1 with small irregular opacities. Small irregular opacities of profusion category greater than or equal to 0/1 were statistically associated with age, gender, and pack-years of smoking. The results suggest that using the median of 3 independent readings should rarely result in interpretation of chest radiographs as ''positive'' for pneumoconiosis in active workers who have not had significant dust exposure.

  8. Impact of routine admission chest X-ray films on patient care

    SciTech Connect

    Hubbell, F.A.; Greenfield, S.; Tyler, J.L.; Chetty, K.; Wyle, F.A.

    1985-01-24

    The authors evaluated the impact of routine chest X-ray films, obtained on admission, on the treatment of patients on internal medicine wards of the Veterans Administration Medical Center, Long Beach, California - a population known to have a high prevalence of cardiopulmonary disease. The reasons for ordering chest films were determined prospectively, and three Department of Medicine faculty members reviewed the charts of admitted patients to determine the impact of chest-film results on patient care. Routine chest X-ray films were ordered for 294 (60 per cent) of the 491 patients studied. Abnormalities were noted in 106 (36 per cent) of these 294 patients. The findings were previously known, chronic, and stable in 86 patients; they were new in only 20. Treatment was changed because of chest-film results in only 12 (4 per cent) of the patients. In only one of these patients would appropriate treatment probably have been omitted if a chest film had not been obtained, and the patient's outcome was not improved by the treatment instituted. The authors conclude that the impact of routine admission chest X-ray films on patient care is very small, even in a population with a high prevalence of cardiopulmonary disease. They recommend that such films not be ordered solely because of admission. 16 references, 3 tables.

  9. Impacts to the chest of PMHSs - Influence of impact location and load distribution on chest response.

    PubMed

    Holmqvist, Kristian; Svensson, Mats Y; Davidsson, Johan; Gutsche, Andreas; Tomasch, Ernst; Darok, Mario; Ravnik, Dean

    2016-02-01

    The chest response of the human body has been studied for several load conditions, but is not well known in the case of steering wheel rim-to-chest impact in heavy goods vehicle frontal collisions. The aim of this study was to determine the response of the human chest in a set of simulated steering wheel impacts. PMHS tests were carried out and analysed. The steering wheel load pattern was represented by a rigid pendulum with a straight bar-shaped front. A crash test dummy chest calibration pendulum was utilised for comparison. In this study, a set of rigid bar impacts were directed at various heights of the chest, spanning approximately 120mm around the fourth intercostal space. The impact energy was set below a level estimated to cause rib fracture. The analysed results consist of responses, evaluated with respect to differences in the impacting shape and impact heights on compression and viscous criteria chest injury responses. The results showed that the bar impacts consistently produced lesser scaled chest compressions than the hub; the Middle bar responses were around 90% of the hub responses. A superior bar impact provided lesser chest compression; the average response was 86% of the Middle bar response. For inferior bar impacts, the chest compression response was 116% of the chest compression in the middle. The damping properties of the chest caused the compression to decrease in the high speed bar impacts to 88% of that in low speed impacts. From the analysis it could be concluded that the bar impact shape provides lower chest criteria responses compared to the hub. Further, the bar responses are dependent on the impact location of the chest. Inertial and viscous effects of the upper body affect the responses. The results can be used to assess the responses of human substitutes such as anthropomorphic test devices and finite element human body models, which will benefit the development process of heavy goods vehicle safety systems. PMID:26687541

  10. Compression of digital chest x-rays

    NASA Astrophysics Data System (ADS)

    Cohn, Michael; Trefler, Martin; Young, Tzay S.

    1990-07-01

    The application of digital technologies to chest radiography holds the promise of routine application of intage processing techniques to effect image enhancement. However, due to their inherent spatial resolution, digital chest images impose severe constraints on data storage devices. Compression of these images will relax such constraints and facilitate image transmission on a digital network. We have evaluated image processing algorithms aimed at compression of digital chest images while improving the diagnostic quality of the image. The image quality has been measured with respect to the task of tumor detection. Compression ratios of as high as 2:1 have been achieved. This compression can then be supplemented by irreversible methods.

  11. Classification of chest wall diseases.

    PubMed

    Pozzi, E; Gulotta, C

    1993-01-01

    Several disorders of the thoracic cage are known to cause respiratory failure, by means of relatively simple mechanisms, such as the increased work of breathing, which results in alveolar hypoventilation. A variety of pathogenic mechanisms may be considered, as functions of the types of thoracic disorders present. As causes of these additional potential mechanisms, we considered the following: 1) ventilation-perfusion (V/Q) inhomogeneity; 2) inability to cough; 3) malformation or acquired defect of the respiratory centres; and 4) excess blood volume and fluid retention, which aggravate work of breathing and V/Q inhomogeneity. All of these disorders can be grouped into two major categories (which nevertheless have some of the pathophysiology in common): the mechanical syndrome and the neuromuscular or paralytic syndrome. In this paper we discuss chest wall diseases falling into the first category; namely, kyphoscoliosis, fibrothorax, thoracoplasty, ankylosing spondylitis and obesity-hypoventilation. Congenital deformities of the thoracic cage, which do not have important effects on ventilatory apparatus (e.g. pectus excavatum and pectus carinatum), were also considered. PMID:8472068

  12. SU-E-I-48: The Behavior of AEC in Scan Regions Outside the Localizer Radiograph FOV: An In Phantom Study of CT Systems From Four Vendors

    SciTech Connect

    Supanich, M; Bevins, N

    2014-06-01

    Purpose: This review of scanners from 4 major manufacturers examines the clinical impact of performing CT scans that extend into areas of the body that were not acquired in the CT localizer radiograph. Methods: Anthropomorphic chest and abdomen phantoms were positioned together on the tables of CT scanners from 4 different vendors. All of the scanners offered an Automatic Exposure Control (AEC) option with both lateral and axial tube current modulation. A localizer radiograph was taken covering the entire extent of both phantoms and then the scanner's Chest-Abdomen-Pelvis (CAP) study was performed with the clinical AEC settings employed and the scan and reconstruction range extending from the superior portion of the chest phantom through the inferior portion of the abdomen phantom. A new study was then initiated with a localizer radiograph extending the length of the chest phantom (not covering the abdomen phantom). The same CAP protocol and AEC settings were then used to scan and reconstruct the entire length of both phantoms. Scan parameters at specific locations in the abdomen phantom from both studies were investigated using the information contained in the DICOM metadata of the reconstructed images. Results: The AEC systems on all scanners utilized different tube current settings in the abdomen phantom for the scan completed without the full localizer radiograph. The AEC system behavior was also scanner dependent with the default manual tube current, the maximum tube current and the tube current at the last known position observed as outcomes. Conclusion: The behavior of the AEC systems of CT scanners in regions not covered by the localizer radiograph is vendor dependent. To ensure optimal image quality and radiation exposure it is important to include the entire planned scan region in the localizer radiograph.

  13. Drug-Related Pneumonitis During Mammalian Target of Rapamycin Inhibitor Therapy: Radiographic Pattern-Based Approach in Waldenström Macroglobulinemia as a Paradigm

    PubMed Central

    Boswell, Erica N.; Hatabu, Hiroto; Ghobrial, Irene M.; Ramaiya, Nikhil H.

    2015-01-01

    Background. This study determined the frequency of drug-related pneumonitis during mammalian target of rapamycin (mTOR) inhibitor therapy in Waldenström macroglobulinemia patients and investigated the imaging characteristics and radiographic patterns of pneumonitis. Materials and Methods. A total of 40 patients (23 men, 17 women; 43–84 years old) with Waldenström macroglobulinemia treated in 2 trials of the mTOR inhibitor everolimus were retrospectively studied. Chest computed tomography (CT) scans during therapy were reviewed for abnormalities suspicious for drug-related pneumonitis by the consensus of three radiologists, evaluating the extent, distributions, and specific findings. The radiographic patterns of pneumonitis were classified using the American Thoracic Society/European Respiratory Society classification of interstitial pneumonia. Results. Drug-related pneumonitis was noted in 23 patients (58%). The median time from the initiation of therapy to the onset of pneumonitis was 5.7 months. Lower lungs were involved in all 23 patients, with a higher extent than in the other zones (p < .001). The distribution was peripheral and lower in 11 patients (48%) and mixed and multifocal in 10 (44%). The findings were bilateral in 20 patients (87%). Ground glass opacities (GGOs) and reticular opacities were present in all 23 patients, with consolidation in 12, traction bronchiectasis in 2, and centrilobular nodularity in 1. The pattern of pneumonitis was classified as cryptogenic organizing pneumonia (COP) in 16 (70%) and nonspecific interstitial pneumonia (NSIP) in 7 (30%), with overlapping features of COP and NSIP in 7 patients. Conclusion. Drug-related pneumonitis was noted on CT in 58% of Waldenström macroglobulinemia patients treated with mTOR inhibitor therapy. Most common findings were bilateral GGOs and reticular opacities, with or without consolidation, in peripheral and lower lungs, demonstrating COP and NSIP patterns. Implications for Practice: The

  14. Obesity Increases the Risk of Chest Wall Pain From Thoracic Stereotactic Body Radiation Therapy

    SciTech Connect

    Welsh, James; Thomas, Jimmy; Shah, Deep; Allen, Pamela K.; Wei, Xiong; Mitchell, Kevin; Gao, Song; Balter, Peter; Komaki, Ritsuko; Chang, Joe Y.

    2011-09-01

    Purpose: Stereotactic body radiation therapy (SBRT) is increasingly being used to treat thoracic tumors. We attempted here to identify dose-volume parameters that predict chest wall toxicity (pain and skin reactions) in patients receiving thoracic SBRT. Patients and Methods: We screened a database of patients treated with SBRT between August 2004 and August 2008 to find patients with pulmonary tumors within 2.5 cm of the chest wall. All patients received a total dose of 50 Gy in four daily 12.5-Gy fractions. Toxicity was scored according to the NCI-CTCAE V3.0. Results: Of 360 patients in the database, 265 (268 tumors) had tumors within <2.5 cm of the chest wall; 104 (39%) developed skin toxicity (any grade); 14 (5%) developed acute pain (any grade), and 45 (17%) developed chronic pain (Grade 1 in 22 cases [49%] and Grade 2 or 3 in 23 cases [51%]). Both skin toxicity and chest wall pain were associated with the V{sub 30}, or volume of the chest wall receiving 30 Gy. Body mass index (BMI) was also strongly associated with the development of chest pain: patients with BMI {>=}29 had almost twice the risk of chronic pain (p = 0.03). Among patients with BMI >29, diabetes mellitus was a significant contributing factor to the development of chest pain. Conclusion: Safe use of SBRT with 50 Gy in four fractions for lesions close to the chest wall requires consideration of the chest wall volume receiving 30 Gy and the patient's BMI and diabetic state.

  15. Aspergillosis - chest x-ray (image)

    MedlinePlus

    ... usually occurs in immunocompromised individuals. Here, a chest x-ray shows that the fungus has invaded the lung ... are usually seen as black areas on an x-ray. The cloudiness on the left side of this ...

  16. Tuberculosis, advanced - chest x-rays (image)

    MedlinePlus

    ... tissue, and can cause tissue death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light ... location of cavities within these light areas. The x-ray on the left clearly shows that the opacities ...

  17. Imaging of diseases of the chest

    SciTech Connect

    Armstrong, P.; Dee, P.; Wilson, A.

    1988-01-01

    This book promises to be the first intermediate length chest imaging book that successfully integrates material on the newer modalities (MRI, Nuclear Medicine) with that on conventional techniques (plain film radiography).

  18. Chest pain in focal musculoskeletal disorders.

    PubMed

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-03-01

    The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice. PMID:20380955

  19. [Dedifferentiated Chondrosarcoma of the Chest Wall].

    PubMed

    Saitoh, Genkichi; Yoneshima, Yasuto; Nakamura, Toshihiko; Kitagawa, Dai; Kinjo, Nao; Ohgaki, Kippei; Maehara, Shinichiro; Teramoto, Seiichi; Adachi, Eisuke; Ikeda, Yoichi; Mine, Mari

    2016-08-01

    A 79-year-old man complaining of an anterior chest mass with pain had an abnormal shadow on chest X-ray. A mass, 7 cm in size, with destruction of the right 4th rib was found on chest computed tomography. A F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) corresponding to the lesion showed an abnormal accumulation of FDG with the standardized uptake value(SUV) max=16.19. A malignant tumor of the chest wall origin was suspected and the tumor was resected with the 3th, 4th, and 5th ribs. Histologically, the tumor was diagnosed as dedifferentiated chondrosarcoma. He died of local recurrence about 5 months after the operation. PMID:27476566

  20. Tuberculosis, advanced - chest x-rays (image)

    MedlinePlus

    Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, ... death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying ...

  1. Thymic carcinoma presenting as atypical chest pain.

    PubMed

    Siddiqui, Sadiq; Connelly, Tara; Keita, Luther; Blazkova, Sylvie; Veerasingam, Dave

    2015-01-01

    A 58-year-old woman with a 2-month history of atypical chest pain was referred to the chest pain clinic by the general practitioner. Exercise stress test was positive and subsequent coronary angiogram revealed significant triple vessel disease with left ventricular impairment requiring a coronary artery bypass graft (CABG). The patient had a chest X-ray as part of the preoperative work up. Chest X-ray revealed a large anterior mediastinal mass. Subsequent thorax CT revealed a 7.2 cm anterior mediastinal mass. CT-guided biopsy of the mass revealed the diagnosis of a poorly differentiated thymic basaloid carcinoma. The patient was successfully treated with concomitant surgery involving complete resection of the mass and a CABG procedure. PMID:26607199

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

    PubMed

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

    1999-01-01

    The purpose of the study was to compare the image quality for one conventional and four digital chest radiography techniques. Three storage phosphor systems, one selenium drum system, and one film-screen system were compared using a modified receiver-operating-characteristics method. Simulated pathology was randomly positioned over the parenchymal regions and the mediastinum of an anthropomorphic phantom. Eight observers (four chest radiologists, one specialist in general radiology, one hospital physicist, and two radiographers) evaluated 60 images for each technique. The selenium drum system (Philips, Eindhoven, The Netherlands) rated best for the detection of parenchymal nodules. Together with the storage phosphor system of generation IIIN (Philips/Fuji), the selenium drum system also rated best for detection of thin linear structures. The storage phosphor system of generation V (Fuji) rated best for the detection of mediastinal nodules. The first generation of the storage phosphor system from Agfa (Mortsel, Belgium) rated worst for the detection of parenchymal nodules and thin linear structures. These differences were significant (p < 0.0001). Averaging the results for all test objects, the selenium drum system and the storage phosphor system of generation V were significantly better than the other systems tested. The film/screen system performed significantly better than the first-generation storage phosphor system from Agfa, equal to the generation IIIN storage phosphor system (Philips/Fuji) and significantly worse than the selenium drum system (Philips) and the generation-V storage phosphor system (Fuji). The conclusion is therefore that the image quality of selenium-based digital technique and of the more recent generations of storage phosphor systems is superior to both conventional technique and storage phosphor systems using image plates of older types. PMID:10602958

  3. Radiographic comparison of a fractured clavicle exhibiting a pseudo-arthrosis.

    PubMed

    Rhode, Matthew P; Goodhue, William W; Stephan, Carl N

    2012-07-01

    Bone remodeling is a natural process that is potentially problematic for radiographic comparisons because it can occur after antemortem (AM) imaging, thus interfering with the comparability of AM and postmortem (PM) radiographs from the same individual. While the effects of age-related remodeling have been studied, limited attention has been given to trauma-related remodeling with respect to radiographic comparisons. This report adds to the latter topic by presenting a case of AM clavicle fracture that developed into a pseudo-arthrosis over a 12-month period prior to the individual's death. Even though remodeling was discernable along the fracture margins, adjacent skeletal features on the PM radiograph remained unaltered and constituted compelling evidence for the identification. This case illustrates the potential of using both normal and pathological anatomy concurrently to maximize the surety of findings from radiographic comparisons. PMID:22409353

  4. Fluoroscopic chest tube insertion and patient care.

    PubMed Central

    Collins, J. D.; Shaver, M. L.; Disher, A. C.; Miller, T. Q.

    1992-01-01

    Catheters and chest tubes may be placed under fluoroscopic control to reduce pleural effusions. This procedure has been adopted as a routine procedure at the UCLA School of Medicine in Los Angeles, California to improve patient care. This technique was modified for the placement of large chest tubes, which can be placed by a radiologist without multiple attempts or complications. Our experience with 2234 patients who underwent this procedure between 1977 and 1990 is described. PMID:1404463

  5. Mechanical properties of chest protectors and the likelihood of ventricular fibrillation due to commotio cordis.

    PubMed

    Drewniak, Elizabeth I; Spenciner, David B; Crisco, Joseph J

    2007-11-01

    Sudden death resulting from ventricular fibrillation (VF) caused by a nonpenetrating chest wall impact, known as commotio cordis (CC), is the second leading cause of death among young athletes. To date, seven young athletes wearing chest protectors have died from CC. The purpose of this study was to determine whether a relationship exists between mechanical properties of chest protectors and occurrence of VF, previously determined by Weinstock et al., using an established swine model. A servo-hydraulic material tester was used to determine properties of the chest protectors, including displacement, permanent deformation, stiffness, and area of pressure distribution. These properties were then compared with the occurrence of VF. We found that a decreased proportion of hits resulting in VF was significantly associated (R2 = 0.59, p = 0.001) with an increase in the area of pressure distribution. These findings are a limited, but crucial, first step in understanding the prevention of this complex and perplexing phenomenon. PMID:18089926

  6. Cavernous hemangioma with hematoma in the chest wall due to penetration from the anterior mediastinum.

    PubMed

    Nakamura, Hiroshige; Miwa, Ken; Miyoshi, Kenichirou; Adachi, Yoshin; Fujioka, Shinji; Taniguchi, Yuji; Yaniguchi, Yuji

    2007-04-01

    The patient was a 51-year-old man who visited the hospital with swelling of the anterior chest. Chest computed tomography detected a tumor developing from the anterior mediastinum to the anterior chest wall. There was weak contrast enhancement inside the tumor, and calcification was observed in the central region. A soft tumor with an obscure border and that adhered to the back of the left sternum was surgically removed with thymic fat including the region of the chest wall that had been penetrated by the tumor. The tumor measured 30 x 25 mm, and a phlebolith was observed in the center. The pathological tissue was diagnosed to be a cavernous hemangioma, and there were no malignant findings in the endothelial cells. Mediastinal hemangioma should therefore be kept in mind during an evaluation of mediastinal tumors, and one must also take into account the effect on the surrounding organs. PMID:17491358

  7. Estimated Probabililty of Chest Injury During an International Space Station Mission

    NASA Technical Reports Server (NTRS)

    Lewandowski, Beth E.; Milo, Eric A.; Brooker, John E.; Weaver, Aaron S.; Myers, Jerry G., Jr.

    2013-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to spaceflight mission planners and medical system designers when assessing risks and optimizing medical systems. The IMM project maintains a database of medical conditions that could occur during a spaceflight. The IMM project is in the process of assigning an incidence rate, the associated functional impairment, and a best and a worst case end state for each condition. The purpose of this work was to develop the IMM Chest Injury Module (CIM). The CIM calculates the incidence rate of chest injury per person-year of spaceflight on the International Space Station (ISS). The CIM was built so that the probability of chest injury during one year on ISS could be predicted. These results will be incorporated into the IMM Chest Injury Clinical Finding Form and used within the parent IMM model.

  8. Management of chest trauma: a review.

    PubMed

    Adebonojo, S A

    1993-01-01

    The incidence of chest trauma has increased significantly since the turn of the century especially in developed countries where rapid means of transportation has become part of daily life. Although gunshot wounds (GSWs) were the commonest causes of chest trauma in wartime, road traffic accidents (RTAs) have become the scourge of peacetime and modern civilization. Chest trauma is more common in males during the 2nd to the 5th decades of life with an average age of 40 years reducing their life expectancy by another 40 years at the most productive and active period of their lives. Despite improvement in ambulance service and rapid mobilization of victims from the scene of accident, about 10% of chest injured patients will die on the spot and another 5% die within an hour of reaching the hospital. Of the remaining 85%, five percent will require emergency thoracotomy for various reasons while 80% will respond to resuscitative measures and tube thoracostomy drainage alone. The primary aims in the management of chest trauma are prompt restoration of normal cardiorespiratory functions, control of haemorrhage, treatment of associated injuries and prevention of sepsis. Although the overall survival rate of trauma has improved in recent years, deaths are often due to airway obstruction, exsanguinating haemorrhage, flail chest, tension pneumothorax, cardiac tamponade and associated intracranial, intraabdominal and skeletal injuries. PMID:8398932

  9. [Differential diagnosis "non-cardiac chest pain"].

    PubMed

    Frieling, Thomas

    2015-07-01

    Non cardiac chest pain (NCCP) are recurrent angina pectoris like pain without evidence of coronary heart diesease in conventional diagnostic evaluation. The prevalence of NCCP is up to 70% and may be detected in this order at all levels of the medical health care system (general practitioner, emergency department, chest pain unit, coronary care). Reduction of quality of life in NCCP is comparable, partially even higher compared to cardiac chest pain. Reasons for psychological strain are symptom recurrence in app. 50%, nonspecific diagnosis with resulting uncertainty and insufficient integration of other medical disciplines in diagnostic work-up. Managing of patients with NCCP has to be interdisciplinary because non cardiac causes of chest pain may be found frequently. This are musculosceletal in app. 40%, gastrointestinal in app. 20%, psychiatric in app. 10% and pulmonary and mediastinal diseases in app. 5% of cases. Also gastroenterological expertise is required because here gastroesophageal reflux disease (GERD) in app. 60%, hypercontractile esophageal motility disorders with nutcracker, jackhammer esophagus or distal esophageal spasmus or achalasia in app. 20% and other esophageal alterations (e. g. infectious esophageal inflammation, drug-induced ulcer, rings, webs, eosinophilic esophagits) in app. 30% of cases may be detected as cause of chest pain may. This implicates that regular interdisciplinary round wards and interdisciplinary management of chest pain units are mandatory. PMID:26230070

  10. How to remove a chest drain.

    PubMed

    Allibone, Elizabeth

    2015-10-01

    RATIONALE AND KEY POINTS: This article aims to help nurses to undertake the removal of a chest drain in a safe, effective and patient-centred manner. This procedure requires two practitioners. The chest drain will have been inserted aseptically to remove air, blood, fluid or pus from the pleural cavity. ▶ Chest drains may be small or wide bore depending on the underlying condition and clinical setting. They may be secured with a mattress suture and/or an anchor suture. ▶ Chest drains are usually removed under medical instructions when the patient's lung has inflated, the underlying condition has resolved, there is no evidence of respiratory compromise or failure, and their anticoagulation status has been assessed as satisfactory. ▶ Chest drains secured with a mattress suture should be removed by two practitioners. One practitioner is required to remove the tube and the other to tie the mattress suture (if present) and secure the site. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice. 2. How this article could be used to educate patients with chest drains. Subscribers can upload their reflective accounts at: rcni.com/portfolio . PMID:26443174

  11. Surgical stabilization of traumatic flail chest.

    PubMed Central

    París, F; Tarazona, V; Blasco, E; Cantó, A; Casillas, M; Pastor, J; París, M; Montero, R

    1975-01-01

    Since 1970 we have stabilized the ribs to correct paradoxical movement of the chest wall in chest injuries, using an original technique, in order to avoid as far as possible the need for long-term chest wall stabilization by intermittent positive pressure respiration (IPPR). The technical details of surgical stabilization are described, and the different types of stainless steel struts are shown. Type I was originally used either as an intramedullary nail or as an external brace. Types II and III were designed for external fixation of the strut to the rib. Treatment of 29 patients with severe flail chest, classified into four groups is shown: group I was treated by IPPR, group II by IPPR plus surgical stabilization, group III by surgical stabilization only, and group IV by surgical stabilization after exploratory thoracotomy. The clinical results are discussed. We conclude that surgical stabilization of the paradoxial movement of the chest wall can avoid the use of the respirator or at least reduce the interval of IPPR to a short period during the initial recovery from trauma. Using type III struts, we have obtained stabilization of the flail chest in all cases even in patients with severe anterior paradoxical movement. The patients' tolerance of surgical stainless steel struts was good. Images PMID:1105874

  12. Developments in Dual-Energy Single-Exposure Chest Radiography.

    NASA Astrophysics Data System (ADS)

    Ho, Jung-Tsuoe

    1990-01-01

    Conventional chest radiography is the most commonly performed technique for the detection and diagnosis of lung cancer, which is the leading cause of cancer deaths in the United States. Nevertheless, a high percentage of cancer tumors are missed with this technique. One reason for errors is the overlap of tumor image with bone image in a chest radiograph. Dual-energy radiography has been suggested as the most effective method to eliminate bone contrast for better lung tumor visualization. Dual-energy radiography also provides a bone image from which benign nodules can be identified by the presence of nodule calcification. The purpose of this study is to evaluate the performance of a film-screen based dual-energy, single-exposure technique in lung nodule detection and to improve its performance by both hardware and software developments to increase the accuracy of lung cancer diagnosis. Our previous implementation of the technique resulted in small residual tissue contrast and incomplete tissue subtraction due to screen selection and x-ray beam hardening, respectively. Hardware developments, including uses of a new screen pair (Y_2O _2S/CaWO_4) and a K-edge filter (europium), were studied to improve residual tissue contrast by increasing the energy separation. As software developments, a three-dimensional interpolation algorithm and noise suppression methods were studied to achieve complete tissue subtraction and noise reduction, respectively. The results show that the Y_2O _2S/CaWO_4 performed better than LaOBr/CaWO_4; the use of K-edge filter produced more residual tissue contrast than that obtained without it; the interpolation algorithm effectively compensated for beam hardening and resulted in more complete tissue subtraction than image subtraction; and the noise suppression methods reduced noise by half. Even though the dual-exposure technique performed better than the single-exposure technique in a simulated lung nodule detection study, the difference between

  13. Dynamic chest radiography: flat-panel detector (FPD) based functional X-ray imaging.

    PubMed

    Tanaka, Rie

    2016-07-01

    Dynamic chest radiography is a flat-panel detector (FPD)-based functional X-ray imaging, which is performed as an additional examination in chest radiography. The large field of view (FOV) of FPDs permits real-time observation of the entire lungs and simultaneous right-and-left evaluation of diaphragm kinetics. Most importantly, dynamic chest radiography provides pulmonary ventilation and circulation findings as slight changes in pixel value even without the use of contrast media; the interpretation is challenging and crucial for a better understanding of pulmonary function. The basic concept was proposed in the 1980s; however, it was not realized until the 2010s because of technical limitations. Dynamic FPDs and advanced digital image processing played a key role for clinical application of dynamic chest radiography. Pulmonary ventilation and circulation can be quantified and visualized for the diagnosis of pulmonary diseases. Dynamic chest radiography can be deployed as a simple and rapid means of functional imaging in both routine and emergency medicine. Here, we focus on the evaluation of pulmonary ventilation and circulation. This review article describes the basic mechanism of imaging findings according to pulmonary/circulation physiology, followed by imaging procedures, analysis method, and diagnostic performance of dynamic chest radiography. PMID:27294264

  14. Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement

    SciTech Connect

    Mothiram, Ursula; Brennan, Patrick C; Robinson, John; Lewis, Sarah J; Moran, Bernadette

    2013-12-15

    Following X-ray exposure, radiographers receive immediate feedback on detector exposure in the form of the exposure index (EI). To identify whether radiographers are meeting manufacturer-recommended EI (MREI) ranges for routine chest, abdomen and pelvis X-ray examinations under a variety of conditions and to examine factors affecting the EI. Data on 5000 adult X-ray examinations including the following variables were collected: examination parameters, EI values, patient gender, date of birth, date and time of examination, grid usage and the presence of implant or prosthesis. Descriptive statistics were used to summarize each data set and the Mann–Whitney U test was used to determine significant differences, with P < 0.05 indicating significance for all tests. Most examinations demonstrated EI values that were outside the MREI ranges, with significantly higher median EI values recorded for female patient radiographs than those for male patients for all manufacturers, indicating higher detector exposures for all units except for Philips digital radiography (DR), where increased EI values indicate lower exposure (P = 0.01). Median EI values for out of hours radiography were also significantly higher compared with normal working hours for all technologies (P ≤ 0.02). Significantly higher median EI values were demonstrated for Philips DR chest X-rays without as compared to those with the employment of a grid (P = 0.03), while significantly lower median EI values were recorded for Carestream Health computed radiography (CR) chest X-rays when an implant or prosthesis was present (P = 0.02). Non-adherence to MREIs has been demonstrated with EI value discrepancies being dependent on patient gender, time/day of exposure, grid usage and the presence of an implant or prosthesis. Retrospective evaluation of EI databases is a valuable tool to assess the need of quality improvement in routine DR.

  15. Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement

    PubMed Central

    Mothiram, Ursula; Brennan, Patrick C; Robinson, John; Lewis, Sarah J; Moran, Bernadette

    2013-01-01

    Introduction Following X-ray exposure, radiographers receive immediate feedback on detector exposure in the form of the exposure index (EI). Purpose To identify whether radiographers are meeting manufacturer-recommended EI (MREI) ranges for routine chest, abdomen and pelvis X-ray examinations under a variety of conditions and to examine factors affecting the EI. Methods Data on 5000 adult X-ray examinations including the following variables were collected: examination parameters, EI values, patient gender, date of birth, date and time of examination, grid usage and the presence of implant or prosthesis. Descriptive statistics were used to summarize each data set and the Mann–Whitney U test was used to determine significant differences, with P < 0.05 indicating significance for all tests. Results Most examinations demonstrated EI values that were outside the MREI ranges, with significantly higher median EI values recorded for female patient radiographs than those for male patients for all manufacturers, indicating higher detector exposures for all units except for Philips digital radiography (DR), where increased EI values indicate lower exposure (P = 0.01). Median EI values for out of hours radiography were also significantly higher compared with normal working hours for all technologies (P ≤ 0.02). Significantly higher median EI values were demonstrated for Philips DR chest X-rays without as compared to those with the employment of a grid (P = 0.03), while significantly lower median EI values were recorded for Carestream Health computed radiography (CR) chest X-rays when an implant or prosthesis was present (P = 0.02). Conclusions Non-adherence to MREIs has been demonstrated with EI value discrepancies being dependent on patient gender, time/day of exposure, grid usage and the presence of an implant or prosthesis. Retrospective evaluation of EI databases is a valuable tool to assess the need of quality improvement in routine DR. PMID:26229619

  16. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  17. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  18. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  19. 42 CFR 37.4 - Plans for chest roentgenographic examinations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Plans for chest roentgenographic examinations. 37.4... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations § 37.4 Plans for chest roentgenographic examinations. (a) Every plan for chest...

  20. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  1. 42 CFR 37.4 - Plans for chest roentgenographic examinations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Plans for chest roentgenographic examinations. 37.4... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations § 37.4 Plans for chest roentgenographic examinations. (a) Every plan for chest...

  2. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  3. Early radiographic changes in radiation bone injury

    SciTech Connect

    Fujita, M.; Tanimoto, K.; Wada, T.

    1986-06-01

    A chronologic series of periapical radiographs was evaluated for the purpose of detecting damage to bone and tooth-supporting tissues in a patient receiving radiation therapy for a basal cell carcinoma of the mandibular gingiva. Widening of the periodontal space was one of the early radiographic changes observed. It is suggested, from the sequence of radiographic changes, that radiation-induced changed in the circulatory system of the bone might be primarily responsible for the resulting changes.

  4. Photographic Effect Of Darkroom Exposure On Radiographs

    NASA Astrophysics Data System (ADS)

    Bollen, R. H.

    1982-12-01

    Fogging of radiographic films can be characterized by a photographically equivalent radiographic exposure dose (Ex-eq). It is shown that within the limits of the experiments Ex-eq is independent of the moment of fogging i.e. before or after the radiographic imaging, and of the radiation intensity levels in the radiographic beam in case of no-screenexposure, but is dependent in case of an exposure with fluorescent screens and fogging by light. A dependent Ex-eq causes apparent sensitometric anomalies. The study warns against darkroom light fogging mainly when unloading cassettes.

  5. Digital processing of radiographic images

    NASA Technical Reports Server (NTRS)

    Bond, A. D.; Ramapriyan, H. K.

    1973-01-01

    Some techniques are presented and the software documentation for the digital enhancement of radiographs. Both image handling and image processing operations are considered. The image handling operations dealt with are: (1) conversion of format of data from packed to unpacked and vice versa; (2) automatic extraction of image data arrays; (3) transposition and 90 deg rotations of large data arrays; (4) translation of data arrays for registration; and (5) reduction of the dimensions of data arrays by integral factors. Both the frequency and the spatial domain approaches are presented for the design and implementation of the image processing operation. It is shown that spatial domain recursive implementation of filters is much faster than nonrecursive implementations using fast fourier transforms (FFT) for the cases of interest in this work. The recursive implementation of a class of matched filters for enhancing image signal to noise ratio is described. Test patterns are used to illustrate the filtering operations. The application of the techniques to radiographic images of metallic structures is demonstrated through several examples.

  6. Cardio-embolic stroke following remote blunt chest trauma.

    PubMed

    Arora, Sonali; Atreya, Auras R; Penumetsa, Srikanth C; Hiser, William L

    2013-03-01

    A cardio-embolic stroke as a sequela of remote blunt chest trauma is a rare clinical presentation. Blunt chest trauma can cause various acute cardiac complications like arrhythmias, cardiac contusion etc. However, delayed consequences such as left ventricular thrombus resulting in thromboembolic phenomena are reported infrequently. A 30-year-old healthy man presented to an outside facility with transient neurological deficits. An MRI brain showed lesions suggestive of embolic etiology. A trans-thoracic echocardiogram (TTE) showed a 1.5 × 1.5 cm mass present in the left ventricular (LV) apex. Patient was transferred to our institution for cardiac surgery evaluation. On detailed questioning, he reported an incident of blunt chest trauma during a martial arts exhibition fight that took place 2 years back. Given this history, a cardiac catheterization was done, which showed 30% stenosis in mid-left anterior descending artery (LAD) without any other significant obstructive lesion. A trans-esophageal echocardiogram (TEE) showed akinesis of the LV apex and confirmed TTE finding of a mass, consistent with an apical thrombus. Surgery was deferred and patient was started on anticoagulation. A cardiac MRI done 2 weeks later showed evidence of apical infarction in the LAD territory. LAD is the most commonly affected coronary vessel by blunt traumatic injuries, likely due to its vulnerable anatomical position on the anterior aspect of the heart. A variety of mechanisms including intimal tear, rupture and spasm have been implicated in the pathogenesis of myocardial infarction after blunt chest trauma. PMID:24023477

  7. Signal/Noise and Sensitometry Limitations in Chest Radiography: Implications of Regional Exposure Control

    NASA Astrophysics Data System (ADS)

    Plewes, D. B.; Shaw, C. G.; Ivanovich, M.

    1985-09-01

    The field of medical imaging has experienced many significant advances in recent years with the evolution of a host of computer assisted imaging methods. This growth has also been evident in the areas of more conventional radiography through improved resolution and sensitivity in screen/film technologies. However, in spite of these improvements the fundamental principles of radiographic projection imaging have not significantly changed since its earliest demonstration. A case in point is the nature of the irradiation technique itself which routinely uses a field. of radiation of spatially uniform intensity. These uniform fields can result in large variations in transmitted exposure when used in radio graphy of the chest, head and neck. These wide exposure variations often exceed the useful exposure range of conventional radiographic film/screen combinations and result in large portions of the image being rendered with suboptimal contrast. In chest radiography this is particularly evident, resulting in images where the thick mediastinal, diaphragmatic and heart regions are rendered with negligible contrast when the thinner lung zones are properly. exposed.

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

    NASA Astrophysics Data System (ADS)

    Tsuchiya, Yuichiro; Kodera, Yoshie

    2006-03-01

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

  9. Radiographic Comparison of Human Lung Shape During Normal Gravity and Weightlessness

    NASA Technical Reports Server (NTRS)

    Michels, D. B.; Friedman, P. J.; West, J. B.

    1979-01-01

    Chest radiographs in five seated normal volunteers at 1 G and 0 G were made with a view toward comparing human lung shape during normal gravity and weightlessness. Lung shape was assessed by measuring lung heights and widths in upper, middle and lower lung regions. No significant differences were found between any of the 1-G and 0-G measurements, although there was a slight tendency for the lung to become shorter and wider at 0 G. The evidence that gravity causes regional differences in ventilation by direct action on the lung is consistent with the theoretical analysis of West and Matthews (1972).

  10. Vertical expandable prosthetic titanium rib (VEPTR): a review of indications, normal radiographic appearance and complications.

    PubMed

    Parnell, Shawn E; Effmann, Eric L; Song, Kit; Swanson, Jonathon O; Bompadre, Viviana; Phillips, Grace S

    2015-04-01

    Vertical expandable prosthetic titanium rib (VEPTR) is increasingly used in the treatment of thoracic insufficiency, idiopathic and neuromuscular scoliosis and chest wall defects in children. In contrast to spinal fusion surgery, the VEPTR allows for growth while stabilizing the deformity. We illustrate the common indications and normal radiographic appearance of the three common configurations of VEPTR (cradle-to-cradle assembly, cradle with lumbar extension assembly, cradle-to-ala hook assembly). There is a relatively high rate of reported complications with VEPTR in the literature. We discuss the potential complications of VEPTR, including infection, rib fracture, dislodged hardware and neurological injury, with an emphasis on imaging diagnosis. PMID:25241040

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

  12. Correlation of radiographic thoracic area and oxygenation impairment in bronchopulmonary dysplasia.

    PubMed

    Dassios, Theodore; Curley, Anna; Krokidis, Miltiadis; Morley, Colin; Ross-Russell, Robert

    2016-01-01

    We hypothesized that radiographically-assessed hyperinflation in bronchopulmonary dysplasia (BPD) is related to the degree of oxygenation impairment. Our objective was to explore the relation of chest radiographic thoracic area (CRTA) with right-to-left shunt, right shift of the oxyhemoglobin dissociation curve and ventilation/perfusion ratio (VA/Q) in infants with BPD. Twenty-two infants born at median (IQR) gestation of 26 (24-28) weeks with BPD were prospectively studied at 39 (30-69) days. Inspired oxygen (FiO2) was varied to obtain transcutaneous oxygen saturation (SpO2) values between 85 and 96%. Shunt, shift and VA/Q were derived by plotting and analysing pairs of SpO2 and FiO2. CRTA was measured by free hand-tracing the perimeter of the thoracic area in anterio-posterior chest radiographs. Median (IQR) shunt was 8 (1-14)%, shift was 13 (11-19)kPa and VA/Q 0.42 (0.30-0.48). Median (IQR) CRTA/kg was 2495 (1962-2838)mm(2) and was significantly related to shift (r=0.674, p<0.001), VA/Q (r=-0.633, p<0.001), weight at study (r=-0.457, p=0.003) and day of life (r=-0.406, p=0.009), but not to shunt. CRTA in BPD is significantly related to oxygenation impairment as quantified by shift and VA/Q. CRTA can be used as a simple radiographic test to quantify BPD severity. PMID:26410458

  13. Quantitative kinetic analysis of lung nodules by temporal subtraction technique in dynamic chest radiography with a flat panel detector

    NASA Astrophysics Data System (ADS)

    Tsuchiya, Yuichiro; Kodera, Yoshie; Tanaka, Rie; Sanada, Shigeru

    2007-03-01

    Early detection and treatment of lung cancer is one of the most effective means to reduce cancer mortality; chest X-ray radiography has been widely used as a screening examination or health checkup. The new examination method and the development of computer analysis system allow obtaining respiratory kinetics by the use of flat panel detector (FPD), which is the expanded method of chest X-ray radiography. Through such changes functional evaluation of respiratory kinetics in chest has become available. Its introduction into clinical practice is expected in the future. In this study, we developed the computer analysis algorithm for the purpose of detecting lung nodules and evaluating quantitative kinetics. Breathing chest radiograph obtained by modified FPD was converted into 4 static images drawing the feature, by sequential temporal subtraction processing, morphologic enhancement processing, kinetic visualization processing, and lung region detection processing, after the breath synchronization process utilizing the diaphragmatic analysis of the vector movement. The artificial neural network used to analyze the density patterns detected the true nodules by analyzing these static images, and drew their kinetic tracks. For the algorithm performance and the evaluation of clinical effectiveness with 7 normal patients and simulated nodules, both showed sufficient detecting capability and kinetic imaging function without statistically significant difference. Our technique can quantitatively evaluate the kinetic range of nodules, and is effective in detecting a nodule on a breathing chest radiograph. Moreover, the application of this technique is expected to extend computer-aided diagnosis systems and facilitate the development of an automatic planning system for radiation therapy.

  14. Towards the development of a reflective radiographer: challenges and constraints

    PubMed Central

    Baird, MA

    2008-01-01

    Currently there is overwhelming support from the health professions for universities to devise curricular approaches that lead to the development of undergraduate reflective skills, and over time, reflective practice. However, in the case of radiography, irrespective of the degree to which radiographers might engage in reflective practice they constantly struggle to shed the perception they are little more than technical operatives. The four-year Bachelor of Radiography and Medical Imaging was introduced by Monash University in 1998 with an overt commitment to the development of a reflective radiographer. Findings from student and supervisor surveys generally support the program and its aims. However, as the findings and student feedback will attest, many challenges and constraints continue to face educators who seek to situate their curriculum within the reflective practice paradigm. PMID:21614320

  15. Use of a titanium alloy (Chest Way) in the surgical stabilization of flail chest.

    PubMed

    Nakagawa, Tomoki; Matsuzaki, Tomohiko; Aruga, Naohiro; Imamura, Naoko; Hamanaka, Rurika; Ikoma, Yoichiro; Masuda, Ryota; Iwazaki, Masayuki

    2016-09-01

    To avoid the complications of internal pneumatic stabilization for flail chest, we performed stabilization of the chest wall with a metal bar using the Nuss procedure. Here, we used a highly elastic lightweight biocompatible titanium alloy Chest Way (Solve Corporation, Kanagawa, Japan), enabling magnetic resonance imaging. The patient was a 37-year-old man who sustained injuries in a car crash. Gradually increasing subcutaneous emphysema was present. Bilateral pleural drainage and tracheal intubation were conducted on the scene, and a peripheral venous line was established. The patient was then transferred to our hospital by helicopter. A titanium alloy Chest Way was inserted to manage his flail chest accompanied by multiple rib fractures on the left side. Two days later, artificial respiration was no longer required. PMID:26096325

  16. A Review of Esophageal Chest Pain

    PubMed Central

    Coss-Adame, Enrique

    2015-01-01

    Noncardiac chest pain is a term that encompasses all causes of chest pain after a cardiac source has been excluded. This article focuses on esophageal sources for chest pain. Esophageal chest pain (ECP) is common, affects quality of life, and carries a substantial health care burden. The lack of a systematic approach toward the diagnosis and treatment of ECP has led to significant disability and increased health care costs for this condition. Identifying the underlying cause(s) or mechanism(s) for chest pain is key for its successful management. Common etiologies include gastroesophageal reflux disease, esophageal hypersensitivity, dysmotility, and psychological conditions, including panic disorder and anxiety. However, the pathophysiology of this condition is not yet fully understood. Randomized controlled trials have shown that proton pump inhibitor therapy (either omeprazole, lansoprazole, or rabeprazole) can be effective. Evidence for the use of antidepressants and the adenosine receptor antagonist theophylline is fair. Psychological treatments, notably cognitive behavioral therapy, may be useful in select patients. Surgery is not recommended. There remains a large unmet need for identifying the phenotype and prevalence of pathophysiologic mechanisms of ECP as well as for well-designed multicenter clinical trials of current and novel therapies. PMID:27134590

  17. A Review of Esophageal Chest Pain.

    PubMed

    Coss-Adame, Enrique; Rao, Satish S C

    2015-11-01

    Noncardiac chest pain is a term that encompasses all causes of chest pain after a cardiac source has been excluded. This article focuses on esophageal sources for chest pain. Esophageal chest pain (ECP) is common, affects quality of life, and carries a substantial health care burden. The lack of a systematic approach toward the diagnosis and treatment of ECP has led to significant disability and increased health care costs for this condition. Identifying the underlying cause(s) or mechanism(s) for chest pain is key for its successful management. Common etiologies include gastroesophageal reflux disease, esophageal hypersensitivity, dysmotility, and psychological conditions, including panic disorder and anxiety. However, the pathophysiology of this condition is not yet fully understood. Randomized controlled trials have shown that proton pump inhibitor therapy (either omeprazole, lansoprazole, or rabeprazole) can be effective. Evidence for the use of antidepressants and the adenosine receptor antagonist theophylline is fair. Psychological treatments, notably cognitive behavioral therapy, may be useful in select patients. Surgery is not recommended. There remains a large unmet need for identifying the phenotype and prevalence of pathophysiologic mechanisms of ECP as well as for well-designed multicenter clinical trials of current and novel therapies. PMID:27134590

  18. Changes of nodule detection after radiologists read bone opacity suppressed chest radiography

    NASA Astrophysics Data System (ADS)

    Lo, Shih-Chung B.; Freedman, Matthew T.

    2012-03-01

    A bone opacity suppressed technique using shape-index processing approach has been developed for frontal chest radiography. The image function preserves original lung image textures but equalizing the image contrast of the lungs as a part of post-processing. To determine the benefit of this computerized processing, particular on the investigation of the effect of the bone opacity removal, we conducted a reader study where radiologists read standard chest radiograph alone (unaided) followed by bone opacity suppressed image (aided). Posterioranterior (PA) standard chest radiographs in 368 subjects (122 had confirmed lung cancer) were used for this study. Fifteen Board Certified radiologists participated in the reader study. Each radiologist interpreted the standard image and then the bone suppressed image. Each reader recorded the location of the most suspicious nodule, if any, their level of suspicion and recommendation for clinical action. Detailed analyses were performed to evaluate the observers' performance by tabulating changes of nodule detection inclusive of false-negative turned to true-positive (FN->TP), true-positive turned to false-negative (TP->FN), false-positive turned to turn-negative (FP->TN), and turn-negative turned to false-positive (TN- >FP). Our results indicated that changing rates of FN->TP was 12.35%, TP->FN was 1.37%, FP->TN was 1.14%, and TN->FP was 4.82%, respectively. We also found that 81.85% of the FN->TP events occurred at nodules significantly covered by the rib (50% or more area overlapped with bone opacity). Two major situations caused TP->FN events: (1) other nodule like areas were also enhanced and (2) non-solid nodules were well preserved but less suspicious with the contract equalization.

  19. Quantitative analysis of rib movement based on dynamic chest bone images: preliminary results

    NASA Astrophysics Data System (ADS)

    Tanaka, R.; Sanada, S.; Oda, M.; Mitsutaka, M.; Suzuki, K.; Sakuta, K.; Kawashima, H.

    2014-03-01

    Rib movement during respiration is one of the diagnostic criteria in pulmonary impairments. In general, the rib movement is assessed in fluoroscopy. However, the shadows of lung vessels and bronchi overlapping ribs prevent accurate quantitative analysis of rib movement. Recently, an image-processing technique for separating bones from soft tissue in static chest radiographs, called "bone suppression technique", has been developed. Our purpose in this study was to evaluate the usefulness of dynamic bone images created by the bone suppression technique in quantitative analysis of rib movement. Dynamic chest radiographs of 10 patients were obtained using a dynamic flat-panel detector (FPD). Bone suppression technique based on a massive-training artificial neural network (MTANN) was applied to the dynamic chest images to create bone images. Velocity vectors were measured in local areas on the dynamic bone images, which formed a map. The velocity maps obtained with bone and original images for scoliosis and normal cases were compared to assess the advantages of bone images. With dynamic bone images, we were able to quantify and distinguish movements of ribs from those of other lung structures accurately. Limited rib movements of scoliosis patients appeared as reduced rib velocity vectors. Vector maps in all normal cases exhibited left-right symmetric distributions, whereas those in abnormal cases showed nonuniform distributions. In conclusion, dynamic bone images were useful for accurate quantitative analysis of rib movements: Limited rib movements were indicated as a reduction of rib movement and left-right asymmetric distribution on vector maps. Thus, dynamic bone images can be a new diagnostic tool for quantitative analysis of rib movements without additional radiation dose.

  20. Lower threshold for adenosine-induced chest pain in patients with angina and normal coronary angiograms

    PubMed Central

    Lagerqvist, Bo; Sylvén, Christer; Waldenström, Anders

    1992-01-01

    Objective—To investigate whether patients with angina-like chest pain and normal coronary angiograms are more sensitive to adenosine as an inducer of chest pain. Design—Increasing doses of adenosine were given in a single blind study as intravenous bolus injections. Chest pain and the electrocardioǵraphic findings were noted. Patients—Eight patients with anginalike chest pain but no coronary stenoses (group A), nine patients with angina and coronary stenoses (group B), and 16 healthy volunteers (group C). Results—In the absence of ischaemic signs on the electrocardiogram adenosine provoked angina-like pain in all patients in groups A and B. The pain was located in the chest, and its quality and location were described as being no different from the patient's habitual angina. In group C, 14 of 16 subjects reported chest pain. The lowest dose resulting in chest pain was lower in group A (0·9 (0·6) mg) than in group B (3·1 (1·5) mg) (p < 0·005) and in group C (6·2 (3·7) mg) (p < 0·005). The maximum tolerable dose was lower in group A (4·7 (2·1) mg) than in group B (9·2 (3·8) mg) (p < 0·05) and in group C (12·0 (4·1) mg) (p < 0·005). Conclusions—Patients with anginalike chest pain and normal coronary angiograms have a low pain threshold and low tolerance to pain induced by adenosine. PMID:1389759

  1. 21 CFR 892.1840 - Radiographic film.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic film. 892.1840 Section 892.1840 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1840 Radiographic film. (a)...

  2. 21 CFR 892.1840 - Radiographic film.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film. 892.1840 Section 892.1840 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1840 Radiographic film. (a)...

  3. 21 CFR 892.1840 - Radiographic film.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic film. 892.1840 Section 892.1840 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1840 Radiographic film. (a)...

  4. 21 CFR 892.1840 - Radiographic film.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic film. 892.1840 Section 892.1840 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1840 Radiographic film. (a)...

  5. Doping explosive materials for neutron radiographic enhancement.

    NASA Technical Reports Server (NTRS)

    Golliher, K. G.

    1971-01-01

    Discussion of studies relating to the selection of doping materials of high neutron absorption usable for enhancing the neutron radiographic imaging of explosive mixtures, without interfering with the proper chemical reaction of the explosives. The results of the studies show that gadolinium oxide is an excellent material for doping explosive mixtures to enhance the neutron radiographic image.

  6. [Allergy to radiographic contrast media].

    PubMed

    Vionnet, Julien; Petitpierre, Stéphanie; Fumeaux, Alexandre; Meuli, Reto; Spertini, Francois; Comte, Denis

    2013-04-17

    Allergy to radiographic contrast media Hypersensitivity reactions to radio-contrast media are common in the daily practice. These products are responsible for immediate (< or = 1 hour after administration) and non immediate (> 1 hour after administration) hypersensitivity reactions. A diagnostic work-up by an allergologist with skin tests and in some cases provocation tests is of value in reducing the risk of recurrent hypersensitivity reactions to iodinated contrast media. A careful selection of the patients is required because the incidence of breakthrough reactions is still concerning, even with proper premedication. Practical recommendations are presented in this article. For gadolinium-based contrast agents, data in the literature is not sufficient for suggesting guidelines. PMID:23667970

  7. Improvement of the clinical use of computed radiography for mobile chest imaging: Image quality and patient dose

    NASA Astrophysics Data System (ADS)

    Rill, Lynn Neitzey

    Chest radiography is technically difficult because of the wide variation of tissue attenuations in the chest and limitations of screen-film systems. Mobile chest radiography, performed bedside on hospital inpatients, presents additional difficulties due to geometrical and equipment limitations inherent to mobile x-ray procedures and the severity of illness in patients. Computed radiography (CR) offers a new approach for mobile chest radiography by utilizing a photostimulable phosphor. Photostimulable phosphors are more efficient in absorbing lower-energy x-rays than standard intensifying screens and overcome some image quality limitations of mobile chest imaging, particularly because of the inherent latitude. This study evaluated changes in imaging parameters for CR to take advantage of differences between CR and screen-film radiography. Two chest phantoms, made of acrylic and aluminum, simulated x-ray attenuation for average-sized and large- sized adult chests. The phantoms contained regions representing the lungs, heart and subdiaphragm. Acrylic and aluminum disks (1.9 cm diameter) were positioned in the chest regions to make signal-to-noise ratio (SNR) measurements for different combinations of imaging parameters. Disk thicknesses (contrast) were determined from disk visibility. Effective dose to the phantom was also measured for technique combinations. The results indicated that using an anti-scatter grid and lowering x- ray tube potential improved the SNR significantly; however, the dose to the phantom also increased. An evaluation was performed to examine the clinical applicability of the observed improvements in SNR. Parameter adjustments that improved phantom SNRs by more than 50% resulted in perceived image quality improvements in the lung region of clinical mobile chest radiographs. Parameters that produced smaller improvements in SNR had no apparent effect on clinical image quality. Based on this study, it is recommended that a 3:1 grid be used for

  8. Deep learning with non-medical training used for chest pathology identification

    NASA Astrophysics Data System (ADS)

    Bar, Yaniv; Diamant, Idit; Wolf, Lior; Greenspan, Hayit

    2015-03-01

    In this work, we examine the strength of deep learning approaches for pathology detection in chest radiograph data. Convolutional neural networks (CNN) deep architecture classification approaches have gained popularity due to their ability to learn mid and high level image representations. We explore the ability of a CNN to identify different types of pathologies in chest x-ray images. Moreover, since very large training sets are generally not available in the medical domain, we explore the feasibility of using a deep learning approach based on non-medical learning. We tested our algorithm on a dataset of 93 images. We use a CNN that was trained with ImageNet, a well-known large scale nonmedical image database. The best performance was achieved using a combination of features extracted from the CNN and a set of low-level features. We obtained an area under curve (AUC) of 0.93 for Right Pleural Effusion detection, 0.89 for Enlarged heart detection and 0.79 for classification between healthy and abnormal chest x-ray, where all pathologies are combined into one large class. This is a first-of-its-kind experiment that shows that deep learning with large scale non-medical image databases may be sufficient for general medical image recognition tasks.

  9. Radiographic liver size in Pekingese dogs versus other dog breeds.

    PubMed

    Choi, Jihye; Keh, Seoyeon; Kim, Hyunwook; Kim, Junyoung; Yoon, Junghee

    2013-01-01

    Differential diagnoses for canine liver disease are commonly based on radiographic estimates of liver size, however little has been published on breed variations. Aims of this study were to describe normal radiographic liver size in Pekingese dogs and to compare normal measurements for this breed with other dog breeds and Pekingese dogs with liver disease. Liver measurements were compared for clinically normal Pekingese (n = 61), normal non-Pekingese brachycephalic (n = 45), normal nonbrachycephalic (n = 71), and Pekingese breed dogs with liver disease (n = 22). For each dog, body weight, liver length, T11 vertebral length, thoracic depth, and thoracic width were measured on right lateral and ventrodorsal abdominal radiographs. Liver volume was calculated using a formula and ratios of liver length/T11 vertebral length and liver volume/body weight ratio were determined. Normal Pekingese dogs had a significantly smaller liver volume/body weight ratio (16.73 ± 5.67, P < 0.05) than normal non-Pekingese brachycephalic breed dogs (19.54 ± 5.03) and normal nonbrachycephalic breed dogs (18.72 ± 6.52). The liver length/T11 vertebral length ratio in normal Pekingese (4.64 ± 0.65) was significantly smaller than normal non-Pekingese brachycephalic breed dogs (5.16 ± 0.74) and normal nonbrachycephalic breed dogs (5.40 ± 0.74). Ratios of liver volume/body weight and liver length/T11 vertebral length in normal Pekingese were significantly different from Pekingese with liver diseases (P < 0.05). Findings supported our hypothesis that Pekingese dogs have a smaller normal radiographic liver size than other breeds. We recommend using 4.64× the length of the T11 vertebra as a radiographic criterion for normal liver length in Pekingese dogs. PMID:23094756

  10. Multiplane gallium tomography in assessment of occupational chest diseases

    SciTech Connect

    Cordasco, E.M.; O'Donnell, J.; MacIntyre, W.; Demeter, S.; Gonzalez, L.; Eren, M.; McMahon, W.; Burns, D.; Feiglin, D.H. )

    1990-01-01

    Gallium-67 scintigraphy is helpful in the evaluation of inflammatory, respiratory diseases. Single-photon emission computed tomography (SPECT) provides three-dimensional tomographic reconstruction of radioisotope distribution in the body. The addition of SPECT to gallium-67 scanning in 27 patients demonstrated an improvement in the sensitivity for detecting the presence and extent of interstitial occupational lung disease. This technique may provide earlier detection of parenchymal lung changes than can the chest x-ray and planar scanning in some patients with asbestosis. Findings in six patients with asbestosis are reported.

  11. VAC® for external fixation of flail chest

    PubMed Central

    Winge, Rikke; Berg, Jais O.; Albret, Rikke; Krag, Christen

    2012-01-01

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC®) resulted in immediate chest wall stability and a decrease in the patient's need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU). This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation. PMID:24765464

  12. VAC® for external fixation of flail chest.

    PubMed

    Winge, Rikke; Berg, Jais O; Albret, Rikke; Krag, Christen

    2012-05-29

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC®) resulted in immediate chest wall stability and a decrease in the patient's need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU). This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation. PMID:24765464

  13. Pulmonary complications of crack cocaine use: high-resolution computed tomography of the chest.

    PubMed

    Mançano, Alexandre; Marchiori, Edson; Zanetti, Gláucia; Escuissato, Dante Luiz; Duarte, Beatriz Cunha; Apolinário, Lourenço de Araujo

    2008-05-01

    Here, we report high-resolution computed tomography (HRCT) findings in a patient who developed sudden hemoptysis, dyspnea and chest pain after smoking crack cocaine. Chest X-rays showed consolidations, primarily in the upper lobes, and HRCT scans showed ground glass attenuation opacities, consolidations and air-space nodules. A follow-up CT, after drug use discontinuation and administration of corticosteroids, showed partial resolution of pulmonary lesions and the appearance of cavitations. Clinical, imaging and laboratory findings led to a diagnosis of 'crack lung'. PMID:18545829

  14. Squamous Odontogenic Tumor: Literature Review Focusing on the Radiographic Features and Differential Diagnosis

    PubMed Central

    Mardones, Nilson do Rosário; Gamba, Thiago de Oliveira; Flores, Isadora Luana; de Almeida, Solange Maria; Lopes, Sérgio Lúcio Pereira de Castro

    2015-01-01

    Since its first publication in 1975, the squamous odontogenic tumor remains the rarest odontogenic lesion, with around 50 cases in the English-language literature in which the microscopic characteristics are frequently very well demonstrated. However, articles which discuss the radiographic aspects are scarce, especially with emphasis on the differential diagnosis. The present treatise proposes an assessment of jaw lesions with the same radiographic characteristics of the squamous odontogenic tumor to clarify the main findings for dental clinicians during routine diagnosis. PMID:26140060

  15. Hemophilus influenzae pneumonia in the adult: radiographic appearance with clinical correlation

    SciTech Connect

    Pearlberg, J.; Haggar, A.M.; Saravolatz, L.; Beute, G.H.; Popovich, J.

    1984-04-01

    Hemophilus influenzae septicemia is an important cause of life-threatening pneumonia in an immunocompromised patient. Eleven cases proved by blood culture were analyzed. Multilobar involvement with lobar or segmental consolidation pleural effusion were common radiographic findings, but there were no signs of lobar expansion, bulging fissures, or cavitation. In general, predisposing factors such as alcoholism and chemotherapy place patients at risk. Radiographic response to therapy is variable but often lags behind clinical improvement.

  16. Noninvasive ventilation in large postoperative flail chest.

    PubMed

    Piastra, Marco; De Luca, Daniele; Zorzi, Giulia; Ruggiero, Antonio; Antonelli, Massimo; Conti, Giorgio; Pietrini, Domenico

    2008-12-01

    An 11-year-old male developed a severe respiratory failure due to a iatrogenic flail chest following a surgery for removing a large chest wall area. A rare Ewing sarcoma was histologically diagnosed and intensive chemotherapy was administered. Postoperatively, because of the failure in ventilation weaning, the patient was electively extubated and noninvasive positive pressure ventilation through face-mask was provided. Respiratory support avoided asynchronous paradoxical movements and achieved pneumatic stabilization. Clinical and respiratory improvement allowed a successful weaning from ventilator. PMID:18798557

  17. Homicidal tandem bullet wound of the chest.

    PubMed

    Bentley, A J; Busuttil, A; Clifton, B; Sibbald, P

    1997-03-01

    An unusual case of a homicidal gunshot wound to the chest is reported in which two bullets were fired in unison as tandem bullets from a handgun. At autopsy, two intact bullets were retrieved from the body of the victim, yet there was only one entrance wound and a single bullet track across the chest wall and thoracic organs. An examination of the weapon and ammunition supported the likelihood of tandem bullets and suggested the probable mechanism for this event. Very few similar cases have been documented. PMID:9095302

  18. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    PubMed Central

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  19. [Coronary artery dissection following blunt chest trauma].

    PubMed

    Seven, Ekim; Henningsen, Kristoffer; Abildgaard, Ulrik

    2015-03-16

    A previously healthy 38-year-old man was admitted to hospital with chest pain. The day before the patient had been to a karate session and had received multiple punches and kicks to the chest region. An ECG showed Q-waves in V1 and V2 and flattening of the T-waves in V1-V6. Levels of cardiac enzyme markers were elevated. The patient subsequently underwent coronary angiography with supplemental optical coherence tomography that revealed a bifurcate dissection involving the proximal parts of left ramus interventricularis anterior and circumflex coronary artery. Two drug-eluting stents were implanted with good angiographic result. PMID:25786846

  20. Case Report of Fire Eater’s Pneumonia in Adolescent Female Patient – Evolution of Radiologic Findings

    PubMed Central

    Olchowy, Cyprian; Łasecki, Mateusz; Inglot, Marcin; Zaleska-Dorobisz, Urszula

    2015-01-01

    Summary Background We present a case of a 16-year-old girl with fire-eater’s pneumonia (hydrocarbon pneumonitis). The goal of this report was to assess evolution of radiological findings. Case Report The reported case was unique because that was the first completely described case of fire-eater’s pneumonia reported in an under-aged person. Moreover, this disease is very rare even in adults and only a few scientific reports can be found, mostly because of a small occupational group. Conclusions The aim of this report was to show that the problem of fire-eater’s pneumonia can occur in under-aged patients and should be taken into consideration in case of severe pneumonia. Another objective was to point out that chest radiograph is not sufficient to depict the evolution of radiological manifestations. PMID:25593634