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Sample records for abnormal chest radiographs

  1. Clinical predictors of chest radiographic abnormalities in young children hospitalized with bronchiolitis: a single center study

    PubMed Central

    Kim, Ga Ram; Na, Min Sun; Baek, Kyung Suk; Lee, Seung Jin; Lee, Kyung Suk; Jung, Young Ho; Jee, Hye Mi; Kwon, Tae Hee; Han, Man Yong

    2016-01-01

    Purpose Chest radiography is often performed on patients hospitalized with typical clinical manifestations of bronchiolitis. We aimed to determine the proportion of subjects with pathologic chest radiographic findings and the clinical predictors associated with pathologic chest radiographic findings in young children admitted with the typical presentation of bronchiolitis. Methods We obtained the following data at admission: sex, age, neonatal history, past history of hospitalization for respiratory illnesses, heart rate, respiratory rate, the presence of fever, total duration of fever, oxygen saturation, laboratory parameters (i.e., complete blood cell count, high-sensitivity C-reactive protein [hs-CRP], etc.), and chest radiography. Results The study comprised 279 young children. Of these, 26 had a chest radiograph revealing opacity (n=24) or atelectasis (n=2). Multivariate logistic regression analysis showed that after adjustment for confounding factors, the clinical predictors associated with pathologic chest radiographic findings in young children admitted with bronchiolitis were elevated hs-CRP level (>0.3 mg/dL) and past history of hospitalization for respiratory illnesses (all P<0.05). Conclusion The current study suggests that chest radiographs in young children with typical clinical manifestations of bronchiolitis have limited value. Nonetheless, young children with clinical factors such as high hs-CRP levels at admission or past history of hospitalization for respiratory illnesses may be more likely to have pathologic chest radiographic findings. PMID:28194212

  2. Abnormal distribution of pulmonary blood flow in aortic valve disease. Relation between pulmonary function and chest radiograph.

    PubMed

    Goodenday, L S; Simon, G; Craig, H; Dalby, L

    1970-05-01

    Wasted ventilatory volume (V(D)) and its ratio to tidal volume (V(D)/V(T)) were measured at rest and during exertion in 17 patients with aortic valve disease. We considered V(D)/V(T) to indicate abnormal ventilation: perfusion relations if it did not decrease on exertion, or if the exercising value was greater than 40 per cent. Plain chest radiographs were independently examined for evidence of diversion of pulmonary blood to the upper lobes. There was significant agreement (p<0.05) between radiographic and pulmonary function estimations of abnormality. This suggests that the raised pulmonary venous pressure associated with left ventricular failure creates an abnormal pattern of blood flow through the lung, which is responsible for causing inadequate perfusion with respect to ventilation.

  3. 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.

  4. Chest radiographic manifestations of scrub typhus

    PubMed Central

    Abhilash, KPP; Mannam, PR; Rajendran, K; John, RA; Ramasami, P

    2016-01-01

    Background and Rationale: Respiratory system involvement in scrub typhus is seen in 20–72% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications. Materials and Methods: Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed. Results: The study cohort contained 398 patients. Common presenting complaints included fever (100%), generalized myalgia (83%), headache (65%), dyspnea (54%), cough (24.3%), and altered sensorium (14%). Almost half of the patients (49.4%) had normal chest radiographs. Common radiological pulmonary abnormalities included pleural effusion (14.6%), acute respiratory distress syndrome (14%), airspace opacity (10.5%), reticulonodular opacities (10.3%), peribronchial thickening (5.8%), and pulmonary edema (2%). Cardiomegaly was noted in 3.5% of patients. Breathlessness, presence of an eschar, platelet counts of <20,000 cells/cumm, and total serum bilirubin >2 mg/dL had the highest odds of having an abnormal chest radiograph. Patients with an abnormal chest X-ray had a higher requirement of noninvasive ventilation (odds ratio [OR]: 13.98; 95% confidence interval CI: 5.89–33.16), invasive ventilation (OR: 18.07; 95% CI: 6.42–50.88), inotropes (OR: 8.76; 95% CI: 4.35–17.62), higher involvement of other organ systems, longer duration of hospital stay (3.18 ± 3 vs. 7.27 ± 5.58 days; P < 0.001), and higher mortality (OR: 4.63; 95% CI: 1.54–13.85). Conclusion: Almost half of the patients with scrub typhus have abnormal chest radiographs. Chest radiography should be included as part of basic evaluation at presentation in patients with scrub typhus, especially in those with breathlessness, eschar, jaundice, and severe

  5. 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

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

    PubMed Central

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

    2015-01-01

    Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P < .001) and positive smoking history (P = .001) were associated with increased likelihood of a recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in

  7. Pulmonary embolism findings on chest radiographs and multislice spiral CT.

    PubMed

    Coche, Emmanuel; Verschuren, Franck; Hainaut, Philippe; Goncette, Louis

    2004-07-01

    Multislice spiral CT is becoming an increasingly important tool for diagnosing pulmonary embolism. However, in many instances, a chest radiograph is usually performed as a first-line examination. Many parenchymal, vascular, and other ancillary findings may be observed on both imaging modalities with a highly detailed depiction of abnormalities on multislice CT. A comprehensive review of chest radiograph findings is presented with side-by-side correlations of CT images reformatted mainly in the frontal plane.

  8. 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.

  9. 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.

  10. 42 CFR 37.41 - Chest radiograph specifications-film.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Chest radiograph specifications-film. 37.41 Section... Specifications for Performing Chest Radiographic Examinations § 37.41 Chest radiograph specifications—film. (a... posteroanterior projection at full inspiration on a film being no less than 14 by 17 inches and no greater than...

  11. Detection of tuberculosis using hybrid features from chest radiographs

    NASA Astrophysics Data System (ADS)

    Fatima, Ayesha; Akram, M. Usman; Akhtar, Mahmood; Shafique, Irrum

    2017-02-01

    Tuberculosis is an infectious disease and becomes a major threat all over the world but still diagnosis of tuberculosis is a challenging task. In literature, chest radiographs are considered as most commonly used medical images in under developed countries for the diagnosis of TB. Different methods have been proposed but they are not helpful for radiologists due to cost and accuracy issues. Our paper presents a methodology in which different combinations of features are extracted based on intensities, shape and texture of chest radiograph and given to classifier for the detection of TB. The performance of our methodology is evaluated using publically available standard dataset Montgomery Country (MC) which contains 138 CXRs among which 80 CXRs are normal and 58 CXRs are abnormal including effusion and miliary patterns etc. The accuracy of 81.16% was achieved and the results show that proposed method have outperformed existing state of the art methods on MC dataset.

  12. Radiographic abnormalities among construction workers exposed to quartz containing dust

    PubMed Central

    Tjoe, N; Burdorf, A; Parker, J; Attfield, M; van Duivenbooden, C; Heederik, D

    2003-01-01

    Background: Construction workers are exposed to quartz containing respirable dust, at levels that may cause fibrosis in the lungs. Studies so far have not established a dose-response relation for radiographic abnormalities for this occupational group. Aims: To measure the extent of radiographic abnormalities among construction workers primarily exposed to quartz containing respirable dust. Methods: A cross sectional study on radiographic abnormalities indicative of pneumoconiosis was conducted among 1339 construction workers mainly involved in grinding, (jack)-hammering, drilling, cutting, sawing, and polishing. Radiological abnormalities were determined by median results of the 1980 International Labour Organisation system of three certified "B" readers. Questionnaires were used for assessment of occupational history, presence of respiratory diseases, and symptoms and smoking habits. Results: An abnormality of ILO profusion category 1/0 and greater was observed on 10.2% of the chest radiographs, and profusion category of 1/1 or greater on 2.9% of the radiographs. The average duration of exposure of this group was 19 years and the average age was 42. The predominant type of small opacities (irregularly shaped) is presumably indicative of mixed dust pneumoconiosis. The prevalence of early signs of nodular silicosis (small rounded opacities of category 1/0 or greater) was low (0.8%). Conclusions: The study suggests an elevated risk of radiographic abnormalities among these workers with expected high exposure. An association between radiographic abnormalities and cumulative exposure to quartz containing dust from construction sites was observed, after correction for potentially confounding variables. PMID:12771392

  13. 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.

  14. 42 CFR 37.41 - Chest radiograph specifications-film.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Chest radiograph specifications-film. 37.41 Section... specifications—film. (a) Miners must be disrobed from the waist up at the time the radiograph is given. The... single posteroanterior projection at full inspiration on a film being no less than 14 by 17 inches and...

  15. 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...

  16. [Lateral chest X-rays. Radiographic anatomy].

    PubMed

    García Villafañe, C; Pedrosa, C S

    2014-01-01

    Lateral chest views constitute an essential part of chest X-ray examinations, so it is fundamental to know the anatomy on these images and to be able to detect the variations manifested on these images in different diseases. The aim of this article is to review the normal anatomy and main normal variants seen on lateral chest views. For teaching purposes, we divide the thorax into different spaces and analyze each in an orderly way, especially emphasizing the anatomic details that are most helpful for locating lesions that have already been detected in the posteroanterior view or for detecting lesions that can be missed in the posteroanterior view.

  17. Computer-assisted diagnosis of chest radiographs for pneumoconioses

    NASA Astrophysics Data System (ADS)

    Soliz, Peter; Pattichis, Marios S.; Ramachandran, Janakiramanan; James, David S.

    2001-07-01

    A Computer-assisted Chest Radiograph Reader System (CARRS) was developed for the detection of pathological features in lungs presenting with pneumoconioses. CARRS applies novel techniques in automatic image segmentation, incorporates neural network-based pattern classification, and integrates these into a graphical user interface. The three aspects of CARRS are described: Chest radiograph digitization and display, rib and parenchyma characterization, and classification. The quantization of the chest radiograph film was optimized to maximize the information content of the digital images. Entropy was used as the benchmark for optimizing the quantization. From the rib-segmented images, regions of interest were selected by the pulmonologist. A feature vector composed of image characteristics such as entropy, textural statistics, etc. was calculated. A laterally primed adaptive resonance theory (LAPART) neural network was used as the classifier. LAPART classification accuracy averaged 86.8 %. Truth was determined by the two pulmonologists. The CARRS has demonstrated potential as a screening device. Today, 90% or more of the chest radiographs seen by the pulmonologist are normal. A computer-based system that can screen 50% or more of the chest radiographs represents a large savings in time and dollars.

  18. Automatic image hanging protocol for chest radiographs in PACS.

    PubMed

    Luo, Hui; Hao, Wei; Foos, David H; Cornelius, Craig W

    2006-04-01

    Chest radiography is one of the most widely used techniques in diagnostic imaging. It comprises at least one-third of all diagnostic radiographic procedures in hospitals. However, in the picture archive and communication system, images are often stored with the projection and orientation unknown or mislabeled, which causes inefficiency for radiologists' interpretation. To address this problem, an automatic hanging protocol for chest radiographs is presented. The method targets the most effective region in a chest radiograph, and extracts a set of size-, rotation-, and translation-invariant features from it. Then, a well-trained classifier is used to recognize the projection. The orientation of the radiograph is later identified by locating the neck, heart, and abdomen positions in the radiographs. Initial experiments are performed on the radiographs collected from daily routine chest exams in hospitals and show promising results. Using the presented protocol, 98.2% of all cases could be hung correctly on projection view (without protocol, 62%), and 96.1% had correct orientation (without protocol, 75%). A workflow study on the protocol also demonstrates a significant improvement in efficiency for image display.

  19. 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.

  20. The routine pre-employment screening chest radiograph: Should it be routine?

    PubMed Central

    Samuel, V John; Gibikote, Sridhar; Kirupakaran, Henry

    2016-01-01

    Background and Objective: A routine chest radiograph is mandatory in many institutions as a part of pre-employment screening. The usefulness of this has been studied over the years keeping in mind the added time, cost, and radiation concerns. Studies conducted outside India have shown different results, some for and some against it. To our knowledge, there is no published data from India on this issue. Materials and Methods: A retrospective review of the reports of 4113 pre-employment chest radiographs done between 2007 and 2009 was conducted. Results: Out of 4113 radiographs, 24 (0.58%) candidates required further evaluation based on findings from the screening chest radiograph. Out of these, 7 (0.17%) candidates required appropriate further treatment. Interpretation and Conclusions: The percentage of significant abnormalities detected which needed further medical intervention was small (0.17%). Although the individual radiation exposure is very small, the large numbers done nation-wide would significantly add to the community radiation, with added significant cost and time implications. We believe that pre-employment chest radiographs should be restricted to candidates in whom there is relevant history and/or clinical findings suggestive of cardiopulmonary disease. PMID:27857470

  1. 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...

  2. Sickle cell crisis in the adult: chest radiographic findings and comparison with pediatric sickle cell disease.

    PubMed Central

    Miller, J. A.; Hinrichs, C. R.

    2001-01-01

    With the advent of improved therapy, an increasing proportion of individuals suffering from sickle cell disease (SCD) are surviving into adulthood. In contrast to children, little has been documented concerning the typical radiographic findings in adults presenting with sickle cell crises (SCC). We describe the chest radiographic (CXR) manifestations of adults with SCD presenting in SSC, correlated to hemoglobin (Hb) values, and compare them to those of the pediatric sickle cell population. The chest radiographs of 66 consecutive adults presenting to our emergency department complaining of symptoms consistent with acute SCC were retrospectively reviewed over a 12-month period. The radiographic findings were correlated with admission Hb values and compared with those of 50 children with known SCD presenting with SCC. Chi square analysis revealed no significant difference between the cardiovascular and bony findings in the adults and in those of the pediatric controls (p > 0.08-p > 1.0). However, one important difference in the two cohorts was that upper lobe infiltrates occurred exclusively in the pediatric group (p = 0.06). There was a statistically significant (p < 0.05) difference in cardiovascular and skeletal abnormalities between adults with Hb above and below the mean (8.2 g/dL). The radiographic features of adults presenting in acute SCCs are similar to those of children. Although the chest radiograph is often normal, in decreasing frequency, cardiovascular abnormalities, pneumonia sparing the upper lobes, and aseptic osteonecrosis of the shoulders and spine are not uncommon. There is a significant relationship, however, between cardiovascular abnormalities and Hb levels. Images Figure 1 Figure 2 PMID:12653383

  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. Radiographic abnormalities and mortality in subjects with exposure to crocidolite.

    PubMed Central

    de Klerk, N H; Musk, A W; Cookson, W O; Glancy, J J; Hobbs, M S

    1993-01-01

    Plain chest radiographs from a one in six random sample of the workforce of the asbestos industry at Wittenoom, Western Australia between 1943 and 1966 have been classified for degree of profusion and pleural thickening by two independent observers according to the 1980 UICC-ILO Classification of Radiographs for the pneumoconioses to clarify the effect of degree of radiological abnormality on survival. A total of 1106 subjects were selected. Each subject's age, cumulative exposure to crocidolite, and time since first exposure were determined from employment records, the results of a survey of airborne concentrations of fibres > 5 mu in length conducted in 1966, and an exposure rating by an industrial hygienist and an ex-manager of the mine and mill at Wittenoom. By the end of 1986 193 subjects had died. Conditional logistic regression was used to model the relative risk of death in five separate case-control analyses in which the outcomes were deaths from: (1) all causes, (2) malignant mesothelioma, (3) lung cancer, (4) asbestosis, and (5) other causes excluding cancer and asbestosis. Up to 20 controls per case were randomly chosen from all men of the same age who were not known to have died before the date of death of the index case. After adjustment for exposure and time since first exposure, there were significant and independent effects of radiographic profusion and pleural thickening on all cause mortality. The effect of profusion was largely a result of the effect on mortality from malignant mesothelioma and asbestosis but not lung cancer. The effect of pleural thickening was greatest on mortality from other causes, mainly ischaemic heart disease. This study has shown that degree of radiographic abnormality has an independent effect on mortality from malignant mesothelioma, asbestosis, and all causes even after allowing for the effects of age, degree of exposure, and time since first exposure. PMID:8217849

  5. 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...

  6. 42 CFR 37.51 - Interpreting and classifying chest radiographs-digital radiography systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-digital radiography systems. 37.51 Section 37.51 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH... of Chest Radiographs § 37.51 Interpreting and classifying chest radiographs—digital radiography systems. (a) For each chest radiograph obtained at an approved facility using a digital radiography...

  7. 42 CFR 37.51 - Interpreting and classifying chest radiographs-digital radiography systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-digital radiography systems. 37.51 Section 37.51 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH..., and Submission of Chest Radiographs § 37.51 Interpreting and classifying chest radiographs—digital radiography systems. (a) For each chest radiograph obtained at an approved facility using a...

  8. 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.

  9. A level crossing enhancement scheme for chest radiograph images.

    PubMed

    Nagesha; Kumar, G Hemantha

    2007-10-01

    A new approach for contrast enhancement of chest radiograph image data is presented. Existing methods for image enhancement focus mainly on the properties of the image to be processed while excluding any consideration of the observer characteristics. In several applications, particularly in the medical imaging area, effective contrast enhancement for diagnostic purposes can be achieved by including certain basic human visual properties. In this paper we shall present a novel (recursive) algorithm that tailors the required amount of contrast enhancement based on a combination of the optimal phase representation and the theory of projection onto a convex set. Constraints of maximum bandwidth of the image data, appropriate knowledge of the amplitude value of the image data, heuristic limitations and level crossing measurements serve to impose additional information. So that, the enhanced image data may better converge to the good quality image.

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

    SciTech Connect

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

    1988-11-01

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

  11. Chest radiographic and CT findings in hyperleukocytic acute myeloid leukemia: A retrospective cohort study of 73 patients.

    PubMed

    Stefanski, Michael; Jamis-Dow, Carlos; Bayerl, Michael; Desai, Ruchi J; Claxton, David F; Van de Louw, Andry

    2016-11-01

    Hyperleukocytic acute myeloid leukemia (AML) is associated with pulmonary complications and high early mortality rate, but given its rarity, data on chest radiographic presentation are scarce.We retrospectively reviewed the charts of 73 AML patients admitted with white blood cell count >100 × 10/L between 2003 and 2014 in order to describe the chest radiographic and computed tomography (CT) findings and to correlate them with AML subtype and respiratory symptoms.Forty-two of the 73 patients (58%) overall and 36 of the 54 patients (67%) with clinical signs of pulmonary leukostasis had abnormal radiographs on admission. The presence of radiographic abnormalities was significantly associated with dyspnea and oxygen/ventilatory support requirements (P < 0.01) and with day 28 mortality (45% vs 13%, P = 0.005) but not with monocytic subtype of AML. Sixteen patients had isolated focal basilar airspace opacities, unilateral (n = 13) or bilateral (n = 3), while 16 patients had bilateral diffuse opacities, interstitial (n = 12) or airspace and interstitial (n = 4). Two patients had isolated pleural effusion, 2 patients had unilateral midlung airspace opacities, and 6 patients had a combination of focal airspace and diffuse interstitial opacities. Overall, 2 patterns accounted for 75% of abnormal findings: bilateral diffuse opacities tended to be associated with monocytic AML, whereas basilar focal airspace opacities were more frequent in nonmonocytic AML (P < 0.05). Eighteen patients had CT scans, revealing interlobular septal thickening (n = 12), airspace (n = 11) and ground-glass (n = 9) opacities, pleural effusions (n = 12), and acute pulmonary embolism (n = 2).Hyperleukocytic AML is frequently associated with abnormal chest radiographs, involving mostly focal basilar airspace opacities (more frequent in nonmonocytic AML) or diffuse bilateral opacities. CT scan should be considered broadly due to the suboptimal

  12. Relationship between the chest radiograph, regional lung function studies, exercise tolerance, and clinical condition in cystic fibrosis.

    PubMed Central

    Coates, A L; Boyce, P; Shaw, D G; Godfrey, S; Mearns, M

    1981-01-01

    This study evaluated the accuracy of the interpretation of the chest film in delineating localised abnormalities of ventilation and perfusion, as well as the overall severity of airways obstruction, exercise tolerance, and clinical condition in children with cystic fibrosis. Radiographic findings in various regions of the chest film were compared with the functional values obtained with regional lung function tests which evaluated the arrival and disappearance of boluses of radioactive nitrogen given by inhalation and infusion. While the more severely affected areas on the chest radiograph were found to correlate with similar regions on the lung function tests, as did overall scores, errors occurred in some cases if the x-ray film alone was used as a judge of regional physiological derangement. In addition the degree of airways obstruction, the exercise tolerance on a cycle ergometer, and clinical grading, each correlated significantly with the radiographic score. We conclude that the chest radiograph is a good indicator of the overall severity of the lung disease and that it correlates well with exercise tolerance and clinical condition in cystic fibrosis. PMID:7469460

  13. Computer-aided diagnosis for detection of cardiomegaly in digital chest radiographs

    NASA Astrophysics Data System (ADS)

    Ishida, Takayuki; Katsuragawa, Shigehiko; Chida, Koichi; MacMahon, Heber; Doi, Kunio

    2005-04-01

    The cardio-thoracic ratio (CTR) is commonly measured manually for the evaluation of cardiomegaly. To determine the CTR automatically, we have developed a computerized scheme based on gray-level histogram analysis and an edge detection technique with feature analysis. The database used in this study consisted of 392 chest radiographs, which included 304 normals and 88 abnormals with cardiomegaly. The pixel size and the quantization level of the image were 0.175 mm and 1024, respectively. We performed a nonlinear density correction to maintain consistency in the density and contrast of the image. Initial heart edge detection was performed by selection of a certain range of pixel values in the histogram of a rectangular area at the center of a low-resolution image. Feature analysis with use of an edge gradient and with the orientation obtained by a Sobel operator was applied for accurate identification of the heart edges, which tend to have large edge gradients in a certain range of orientations. In addition, to determine the CTR, we detected the ribcage edges automatically by using image profile analysis. In 94.9% of all of the cases, the heart edges were detected accurately by use of this scheme. The area under the ROC curve (Az value) in distinguishing between normals and abnormals with cardiomegaly based on the CTR was 0.912. Because the CTR is measured automatically and quickly (in less than 1 sec.), radiologists could save reading time. The computerized scheme will be useful for the assessment of cardiomegaly on chest radiographs.

  14. 78 FR 35575 - Black Lung Benefits Act: Standards for Chest Radiographs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ...Physicians and adjudicators use chest radiographs (X-rays) as a tool in evaluating whether a coal miner suffers from pneumoconiosis (black lung disease). Accordingly, the Department's regulations implementing the Black Lung Benefits Act allow the submission of radiographs in connection with benefit claims and set out quality standards for their performance. These standards are currently......

  15. 78 FR 35549 - Black Lung Benefits Act: Standards for Chest Radiographs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ...Physicians and adjudicators use chest radiographs (X-rays) as a tool in evaluating whether a coal miner suffers from pneumoconiosis (black lung disease). Accordingly, the Department's regulations implementing the Black Lung Benefits Act allow the submission of radiographs in connection with benefit claims and set out quality standards for their performance. These standards are currently......

  16. Radiographic abnormalities and exposure to asbestos-contaminated vermiculite in the community of Libby, Montana, USA.

    PubMed Central

    Peipins, Lucy A; Lewin, Michael; Campolucci, Sharon; Lybarger, Jeffrey A; Miller, Aubrey; Middleton, Dan; Weis, Christopher; Spence, Michael; Black, Brad; Kapil, Vikas

    2003-01-01

    Mining, handling, processing, and personal or commercial use of asbestos-contaminated vermiculite have led to widespread contamination of the Libby, Montana, area. We initiated a medical testing program in response to reports of respiratory illness in the community. The purpose of this analysis was to identify and quantify asbestos-related radiographic abnormalities among persons exposed to vermiculite in Libby and to examine associations between these outcomes and participants' self-reported exposures. A cross-sectional interview and medical testing were conducted in Libby from July through November 2000 and from July through September 2001. A total of 7,307 persons who had lived, worked, or played in Libby for at least 6 months before 31 December 1990 completed the interview. Of those, 6,668 participants > or = 18 years of age received chest radiographs to assess the prevalence of pleural and interstitial abnormalities. We observed pleural abnormalities in 17.8% of participants and interstitial abnormalities in < 1% of participants undergoing chest radiography. We examined 29 occupational, recreational, household, and other exposure pathways in the analysis. The prevalence of pleural abnormalities increased with increasing number of exposure pathways, ranging from 6.7% for those who reported no apparent exposures to 34.6% for those who reported > or = 12 pathways. The factors most strongly associated with pleural abnormalities were being a former W.R. Grace worker, being older, having been a household contact of a W.R. Grace worker, and being a male. In addition to being a former W.R. Grace worker, environmental exposures and other nonoccupational risk factors were also important predictors of asbestos-related radiographic abnormalities. PMID:14594627

  17. Radiographic abnormalities and exposure to asbestos-contaminated vermiculite in the community of Libby, Montana, USA.

    PubMed

    Peipins, Lucy A; Lewin, Michael; Campolucci, Sharon; Lybarger, Jeffrey A; Miller, Aubrey; Middleton, Dan; Weis, Christopher; Spence, Michael; Black, Brad; Kapil, Vikas

    2003-11-01

    Mining, handling, processing, and personal or commercial use of asbestos-contaminated vermiculite have led to widespread contamination of the Libby, Montana, area. We initiated a medical testing program in response to reports of respiratory illness in the community. The purpose of this analysis was to identify and quantify asbestos-related radiographic abnormalities among persons exposed to vermiculite in Libby and to examine associations between these outcomes and participants' self-reported exposures. A cross-sectional interview and medical testing were conducted in Libby from July through November 2000 and from July through September 2001. A total of 7,307 persons who had lived, worked, or played in Libby for at least 6 months before 31 December 1990 completed the interview. Of those, 6,668 participants > or = 18 years of age received chest radiographs to assess the prevalence of pleural and interstitial abnormalities. We observed pleural abnormalities in 17.8% of participants and interstitial abnormalities in < 1% of participants undergoing chest radiography. We examined 29 occupational, recreational, household, and other exposure pathways in the analysis. The prevalence of pleural abnormalities increased with increasing number of exposure pathways, ranging from 6.7% for those who reported no apparent exposures to 34.6% for those who reported > or = 12 pathways. The factors most strongly associated with pleural abnormalities were being a former W.R. Grace worker, being older, having been a household contact of a W.R. Grace worker, and being a male. In addition to being a former W.R. Grace worker, environmental exposures and other nonoccupational risk factors were also important predictors of asbestos-related radiographic abnormalities.

  18. 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

  19. Image-processing technique for suppressing ribs in chest radiographs by means of massive training artificial neural network (MTANN).

    PubMed

    Suzuki, Kenji; Abe, Hiroyuki; MacMahon, Heber; Doi, Kunio

    2006-04-01

    When lung nodules overlap with ribs or clavicles in chest radiographs, it can be difficult for radiologists as well as computer-aided diagnostic (CAD) schemes to detect these nodules. In this paper, we developed an image-processing technique for suppressing the contrast of ribs and clavicles in chest radiographs by means of a multiresolution massive training artificial neural network (MTANN). An MTANN is a highly nonlinear filter that can be trained by use of input chest radiographs and the corresponding "teaching" images. We employed "bone" images obtained by use of a dual-energy subtraction technique as the teaching images. For effective suppression of ribs having various spatial frequencies, we developed a multiresolution MTANN consisting of multiresolution decomposition/composition techniques and three MTANNs for three different-resolution images. After training with input chest radiographs and the corresponding dual-energy bone images, the multiresolution MTANN was able to provide "bone-image-like" images which were similar to the teaching bone images. By subtracting the bone-image-like images from the corresponding chest radiographs, we were able to produce "soft-tissue-image-like" images where ribs and clavicles were substantially suppressed. We used a validation test database consisting of 118 chest radiographs with pulmonary nodules and an independent test database consisting of 136 digitized screen-film chest radiographs with 136 solitary pulmonary nodules collected from 14 medical institutions in this study. When our technique was applied to nontraining chest radiographs, ribs and clavicles in the chest radiographs were suppressed substantially, while the visibility of nodules and lung vessels was maintained. Thus, our image-processing technique for rib suppression by means of a multiresolution MTANN would be potentially useful for radiologists as well as for CAD schemes in detection of lung nodules on chest radiographs.

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

    PubMed Central

    Dellios, Nikolaos; Teichgraeber, Ulf; Chelaru, Robert; Malich, Ansgar; Papageorgiou, Ismini E

    2017-01-01

    Aim: The most ubiquitous chest diagnostic method is the chest radiograph. A common radiographic finding, quite often incidental, is the nodular pulmonary lesion. The detection of small lesions out of complex parenchymal structure is a daily clinical challenge. In this study, we investigate the efficacy of the computer-aided detection (CAD) software package SoftView™ 2.4A for bone suppression and OnGuard™ 5.2 (Riverain Technologies, Miamisburg, OH, USA) for automated detection of pulmonary nodules in chest radiographs. Subjects and Methods: We retrospectively evaluated a dataset of 100 posteroanterior chest radiographs with pulmonary nodular lesions ranging from 5 to 85 mm. All nodules were confirmed with a consecutive computed tomography scan and histologically classified as 75% malignant. The number of detected lesions by observation in unprocessed images was compared to the number and dignity of CAD-detected lesions in bone-suppressed images (BSIs). Results: SoftView™ BSI does not affect the objective lesion-to-background contrast. OnGuard™ has a stand-alone sensitivity of 62% and specificity of 58% for nodular lesion detection in chest radiographs. The false positive rate is 0.88/image and the false negative (FN) rate is 0.35/image. From the true positive lesions, 20% were proven benign and 80% were malignant. FN lesions were 47% benign and 53% malignant. Conclusion: We conclude that CAD does not qualify for a stand-alone standard of diagnosis. The use of CAD accompanied with a critical radiological assessment of the software suggested pattern appears more realistic. Accordingly, it is essential to focus on studies assessing the quality-time-cost profile of real-time (as opposed to retrospective) CAD implementation in clinical diagnostics. PMID:28299236

  1. Hip arthroplasty. Part 2: normal and abnormal radiographic findings.

    PubMed

    Pluot, E; Davis, E T; Revell, M; Davies, A M; James, S L J

    2009-10-01

    This review addresses the normal and abnormal radiographic findings that can be encountered during the follow-up of patients with total hip arthroplasty (THA). The relative significance of different patterns of radiolucency, bone sclerosis, and component position is discussed. The normal or pathological significance of these findings is correlated with design, surface, and fixation of the prosthetic components. It is essential to have a good knowledge of expected and unexpected radiological evolution according to the different types of prostheses. This paper emphasizes the importance of serial studies compared with early postoperative radiographs during follow-up in order to report accurately any sign of prosthetic failure and trigger prompt specialist referral. Basic technical guidelines and schedule recommendations for radiological follow-up are summarized.

  2. 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

  3. 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.

  4. Interpretation of chest radiographs in AIDS patients: usefulness of CD4 lymphocyte counts.

    PubMed

    Shah, R M; Kaji, A V; Ostrum, B J; Friedman, A C

    1997-01-01

    Specific infections and neoplasms that are complications of acquired immunodeficiency syndrome (AIDS) occur within various CD4 lymphocyte count ranges. Knowledge of how these counts correlate with radiographic appearances of these entities can limit the differential diagnosis because certain conditions are uncommon above a specific count. In patients with CD4 lymphocyte counts above 200 cells/mm3 and radiographic findings of cavitary and noncavitary consolidation, bacterial pneumonia and Mycobacterium tuberculosis are the major diagnostic considerations. As the CD4 lymphocyte count falls, these infections are still common; however, cavitation is seen less frequently with Mycobacterium tuberculosis, and unusual bacterial infections, including those caused by Rhodococcus equi and Nocardia asteroides, should be considered. In patients with counts below 200 cells/mm3, Pneumocystis carinii pneumonia is the most common infection, usually manifesting radiographically as a reticular interstitial pattern. At CD4 lymphocyte counts of 50-200 cells/mm3, disseminated fungal infection and Kaposi sarcoma become prevalent. In patients with advanced AIDS and counts below 50 cells/mm3, radiographic nodular or reticular patterns may indicate AIDS-related lymphoma and cytomegalovirus and Mycobacterium avium-intracellulare infections. When CD4 lymphocyte counts are applied to interpretation of chest radiographs in AIDS patients, the working differential diagnosis of a radiographic pattern can be tailored to the clinical situation of a given patient.

  5. 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.

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

    PubMed

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

    2011-07-01

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

  7. Development of CAD based on ANN analysis of power spectra for pneumoconiosis in chest radiographs: effect of three new enhancement methods.

    PubMed

    Okumura, Eiichiro; Kawashita, Ikuo; Ishida, Takayuki

    2014-07-01

    We have been developing a computer-aided detection (CAD) scheme for pneumoconiosis based on a rule-based plus artificial neural network (ANN) analysis of power spectra. In this study, we have developed three enhancement methods for the abnormal patterns to reduce false-positive and false-negative values. The image database consisted of 2 normal and 15 abnormal chest radiographs. The International Labour Organization standard chest radiographs with pneumoconiosis were categorized as subcategory, size, and shape of pneumoconiosis. Regions of interest (ROIs) with a matrix size of 32 × 32 were selected from normal and abnormal lungs. Three new enhanced methods were obtained by window function, top-hat transformation, and gray-level co-occurrence matrix analysis. We calculated the power spectrum (PS) of all ROIs by Fourier transform. For the classification between normal and abnormal ROIs, we applied a combined analysis using the ruled-based plus the ANN method. To evaluate the overall performance of this CAD scheme, we employed ROC analysis for distinguishing between normal and abnormal ROIs. On the chest radiographs of the highest categories (severe pneumoconiosis) and the lowest categories (early pneumoconiosis), this CAD scheme achieved area under the curve (AUC) values of 0.93 ± 0.02 and 0.72 ± 0.03. The combined rule-based plus ANN method with the three new enhanced methods obtained the highest classification performance for distinguishing between abnormal and normal ROIs. Our CAD system based on the three new enhanced methods would be useful in assisting radiologists in the classification of pneumoconiosis.

  8. Lung imaging during acute chest syndrome in sickle cell disease: computed tomography patterns and diagnostic accuracy of bedside chest radiograph

    PubMed Central

    Mekontso Dessap, Armand; Deux, Jean-François; Habibi, Anoosha; Abidi, Nour; Godeau, Bertrand; Adnot, Serge; Brun-Buisson, Christian; Rahmouni, Alain; Galacteros, Frederic; Maitre, Bernard

    2014-01-01

    Introduction The lung computed tomography (CT) features of acute chest syndrome (ACS) in sickle cell disease patients is not well described and the diagnostic performance of bedside chest radiograph (CR) has not been tested. Our objectives were to describe CT features of ACS and evaluate the reproducibility and diagnostic performance of bedside CR. Methods We screened 127 consecutive patients during 166 ACS episodes and 145 CT scans (in 118 consecutive patients) were included in the study. Results Among the 145 CT scans, 139 (96%) exhibited a new pulmonary opacity and 84 (58%) exhibited at least one complete lung segment consolidation. Consolidations were predominant as compared to ground-glass opacities and atelectasis. Lung parenchyma was increasingly consolidated from apex to base; the right and left inferior lobes were almost always involved in patients with a new complete lung segment consolidation on CT scan (98% and 95% of cases respectively). Patients with a new complete lung segment consolidation on CT scan had a more severe presentation and course as compared to others. The sensitivity of bedside CR for the diagnosis of ACS using CT as a reference was good (>85%) whereas the specificity was weak (<60%). Conclusion ACS more frequently presented on CT as a consolidation pattern, predominating in lung bases. The reproducibility and diagnostic capacity of bedside CR were far from perfect. These findings may help improve the bedside imaging diagnosis of ACS. PMID:23925645

  9. 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

  10. Grids and high kilo-volt-peak-setting in bedside chest radiographic examinations.

    PubMed

    Grunert, J H; Boy, B; Busche, D; Groenewold, S K; Herrmann, H; Krahn-Peters, V; Maier, J; Meier, S; Penndorf-Wehner, F; Störl, C; Hendrickx, P

    2000-12-01

    Bedside chest radiographic examinations in intensive care units with grids are impaired by artefacts caused by angulation of the grid (grid cut-off). Two different grids--a grid with a high strip density of 70 lines per cm and the "InSight portable imaging system"--were examined in an intensive care unit with respect to their susceptibility to angulation, image quality and handling of the grid. Five radiologists compared 50 radiographs of each grid considering ten image quality criteria. Using the "InSight portable imaging system" major artefacts were undetectable even at an angulation of 10%; no adjustment of the grid was required, which reduced the amount of time needed to take the radiograph by 26%. The increase in dosage demanded by the employment of the grids at low kilovolt peak setting could be partially compensated by the use of high kilovolt peak setting. The image quality of the "InSight portable imaging system" together with a high kilovolt peak setting is satisfactory, and due to its simplified handling, the portable imaging system has proved to be suitable for bedside chest radiography in intensive care.

  11. 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.

  12. A Solitary Feature-based Lung Nodule Detection Approach for Chest X-Ray Radiographs.

    PubMed

    Li, Xuechen; Shen, Linlin; Luo, Suhuai

    2017-01-31

    Lung cancer is one of the most deadly diseases. It has a high death rate and its incidence rate has been increasing all over the world. Lung cancer appears as a solitary nodule in chest x-ray radiograph (CXR). Therefore, lung nodule detection in CXR could have a significant impact on early detection of lung cancer. Radiologists define a lung nodule in chest x-ray radiographs as "solitary white nodule-like blob". However, the solitary feature has not been employed for lung nodule detection before. In this paper, a solitary feature-based lung nodule detection method was proposed. We employed stationary wavelet transform and convergence index filter to extract the texture features and used AdaBoost to generate white nodule-likeness map. A solitary feature was defined to evaluate the isolation degree of candidates. Both the isolation degree and the white nodule-likeness were used as final evaluation of lung nodule candidates. The proposed method shows better performance and robustness than those reported in previous research. More than 80% and 93% of lung nodules in the lung field in the JSRT database were detected when the false positives per image was two and five, respectively. The proposed approach has the potential of being used in clinical practice.

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... shape or size, tuberculosis, lung cancer, or any other significant abnormal findings other than..., tuberculosis, cancer, complicated pneumoconiosis, and any other significant abnormal findings, NIOSH...

  14. 42 CFR 37.54 - Notification of abnormal radiographic findings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., abnormality of cardiac shape or size, tuberculosis, lung cancer, or any other significant abnormal findings... shape or size, tuberculosis, cancer, complicated pneumoconiosis, and any other significant...

  15. 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

  16. 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.

  17. 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.

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

    PubMed

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

    2016-03-21

    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.

  19. 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

  20. 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

  1. Computerized methods for determining respiratory phase on dynamic chest radiographs obtained by a dynamic flat-panel detector (FPD) system.

    PubMed

    Tanaka, Rie; Sanada, Shigeru; Kobayashi, Takeshi; Suzuki, Masayuki; Matsui, Takeshi; Matsui, Osamu

    2006-03-01

    Chest radiography using a dynamic flat-panel detector with a large field of view can provide sequential chest radiographs during respiration. These images provide information regarding respiratory kinetics, which is effective for diagnosis of pulmonary diseases. For valid analysis of respiratory kinetics in diagnosis of pulmonary diseases, it is crucial to determine the association between the kinetics and respiratory phase. We developed four methods to determine the respiratory phase based on image information associated with respiration and compared the results in dynamic chest radiographs of 37 subjects. Here, the properties of each method and future tasks are discussed. The method based on the change in size of the lung gave the most stable results, and that based on the change in distance from the lung apex to the diaphragm was the most promising method for determining the respiratory phase.

  2. Radiographic abnormalities in long-tenure Vermont granite workers and the permissible exposure limit for crystalline silica.

    PubMed

    Graham, W G; Vacek, P M; Morgan, W K; Muir, D C; Sisco-Cheng, B

    2001-04-01

    This study was undertaken to assess the prevalence of radiographic abnormalities consistent with silicosis in a group of 600 retired granite workers who were receiving pensions. Files of regional clinics and hospitals were searched for chest radiographs taken on these men, and 470 x-ray films suitable for interpretation were located. After exclusions (women, and men who had worked in the granite industry elsewhere), 408 x-ray films were independently read by three experienced readers using the 1980 International Labour Office scheme. Dust exposures were estimated for workers hired after 1940, when the dust-control standard of 10 million particles per cubic foot (mppcf) (equivalent to 0.1 mg/m3) was put in place and monitored by the Vermont Division of Industrial Hygiene. Dust levels were initially high but were gradually reduced from 1940 to 1954, after which average quartz exposures stabilized to a mean of approximately 0.05 to 0.06 mg/m3; however, about 10% to 15% of samples after 1954 exceeded 0.1 mg/m3. Of the 408 x-ray films, 58 were taken on workers hired before dust controls were instituted in 1940, and 25.9% showed abnormalities (a profusion score of 1/0 or greater). A total of 350 x-ray films were taken on workers hired in 1940 or after, and the prevalence in this group was 5.7%. The radiographic changes in workers hired after 1940 are likely due to excessive exposures during the first 15 years of dust control. We conclude that if the exposure standard of 0.1 mg/m3 is rigorously observed in the workplace, radiographic abnormalities caused by quartz dust in long-term workers will be rare.

  3. 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.

  4. 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

  5. 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.

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

    PubMed Central

    Rijal, Omar Mohd; Ebrahimian, Hossein; Noor, Norliza Mohd; 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

  7. Association of Lung Function, Chest Radiographs and Clinical Features in Infants with Cystic Fibrosis

    PubMed Central

    Rosenfeld, Margaret; Farrell, Philip M.; Kloster, Margaret; Swanson, Jonathan O.; Vu, Thuy; Brumback, Lyndia; Acton, James D.; Castile, Robert G.; Colin, Andrew A.; Conrad, Carol K.; Hart, Meeghan A.; Kerby, Gwendolyn S.; Hiatt, Peter W.; Mogayzel, Peter J.; Johnson, Robin C.; Davis, Stephanie D.

    2013-01-01

    Background The optimal strategy for monitoring cystic fibrosis (CF) lung disease in infancy remains unclear. Objective To describe longitudinal associations between infant pulmonary function tests (iPFTs), chest radiograph (CXR) scores and other characteristics. Methods CF patients ≤ 24 months old were enrolled in a 10-center study evaluating iPFTs 4 times over a year. CXRs ~1 year apart were scored with the Wisconsin and Brasfield systems. Associations of iPFT parameters with clinical characteristics were evaluated with mixed effects models. Results The 100 participants contributed 246 acceptable flow/volume (FEV0.5, FEF75) and 303 acceptable functional residual capacity (FRC) measurements and 171 CXRs. Both Brasfield and Wisconsin CXR scores worsened significantly over the 1 year interval. Worse Wisconsin CXR scores and S. aureus were both associated with hyperinflation (significantly increased FRC) but not with diminished FEV0.5 or FEF75. Parent-reported cough was associated with significantly diminished FEF75 but not with hyperinflation. Conclusions In this infant cohort in whom we previously reported worsening in average lung function, CXR scores also worsened over a year. The significant associations detected between both Wisconsin CXR score and S. aureus and hyperinflation, as well as between cough and diminished flows, reinforce the ability of iPFTs and CXRs to detect early CF lung disease. PMID:23722613

  8. Lung Field Segmentation in Chest Radiographs from Boundary Maps by a Structured Edge Detector.

    PubMed

    Yang, Wei; Liu, Yunbi; Lin, Liyan; Yun, Zhaoqiang; Lu, Zhentai; Feng, Qianjin; Chen, Wufan

    2017-03-27

    Lung field segmentation in chest radiographs (CXRs) is an essential preprocessing step in automatically analyzing such images. We present a method for lung field segmentation that is built on a high-quality boundary map detected by an efficient modern boundary detector, namely, a structured edge detector (SED). A SED is trained beforehand to detect lung boundaries in CXRs with manually outlined lung fields. Then, an ultrametric contour map (UCM) is transformed from the masked and marked boundary map. Finally, the contours with the highest confidence level in the UCM are extracted as lung contours. Our method is evaluated using the public JSRT database of scanned films. The average Jaccard index of our method is 95.2%, which is comparable with those of other state-of-the-art methods (95.4%). The computation time of our method is less than 0.1 s for a 256 × 256 CXR when executed on an ordinary laptop. Our method is also validated on CXRs acquired with different digital radiography units. The results demonstrate the generalization of the trained SED model and the usefulness of our method.

  9. Spatially varying scatter compensation for chest radiographs using a hybrid Madaline artificial neural network

    NASA Astrophysics Data System (ADS)

    Lo, Joseph Y.; Baydush, Alan H.; Floyd, Carey E., Jr.

    1994-05-01

    We developed a hybrid artificial neural network for scatter compensation in digital portable chest radiographs. The network inputs an image region of interest (ROI), and outputs the scatter estimate at the ROI's center. We segmented each image into four regions by relative detected exposure, then trained a separate Adaline (adaptive linear element) or adaptive filter for each region. We produced a spatially varying hybrid Madaline (mulitple Adaline) by combining outputs from weight matrices of different sizes trained for different durations. The network was trained with 20 patient or 1280 examples, then evaluated with another 5 patients or 320 examples. Scatter estimation errors were not very different, ranging from the Adaline's 6.9 percent to the hybrid Madaline's 5.5 percent. Primary errors (more relevant to quantitative radiography techniques like dual energy imaging) were 43 percent for the Adaline, reduced to 27 percent for the Madaline, and further reduced to 19 percent for the hybrid Madaline. The trained weight matrices, which act like convolution filters, resembled the shape and magnitude of scatter point spread functions. All networks outperformed conventional convolution-subraction techniques using analytical kernels. With its spatially varying neural network model, the hybrid Madaline provided the most accurate and robust estimation of scatter and primary exposures.

  10. 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

  11. Relationships between Th1/Th2 cytokine profiles and chest radiographic manifestations in childhood Mycoplasma pneumoniae pneumonia

    PubMed Central

    Zhao, Jiu-ling; Wang, Xin; Wang, Yu-shui

    2016-01-01

    Background Mycoplasma pneumoniae pneumonia (MPP) is one of the most common childhood community-acquired pneumonias, and the chest radiograph usually shows bronchial pneumonia, segmental/lobar pneumonia, or segmental/lobar pneumonia with pleural effusion. The imbalance of Th1/Th2 function after Mycoplasma pneumoniae infection is an important immunological mechanism of MPP. In this study, we aimed to evaluate the correlations between Th1/Th2 cytokine profiles and chest radiographic manifestations in MPP children. Patients and methods A total of 87 children with MPP were retrospectively reviewed in this study. According to the chest radiographic manifestations, they were divided into the following three groups: bronchial MPP group, segmental/lobar MPP group, and segmental/lobar MPP with pleural effusion group. Clinical features and changes in Th1/Th2 cytokines were further analyzed. Results The incidence of tachypnea and cyanosis was higher in children with segmental/lobar MPP with pleural effusion than in those with segmental/lobar or bronchial MPP. The peak body temperature of segmental/lobar MPP was higher than that of bronchial MPP, and the duration of fever and hospitalization was positively correlated with the severity of MPP. MPP children’s chest radiograph showed a relationship with the changes in Th1/Th2 cytokines. Serum interleukin-4, interleukin-10 (IL-10), interferon-γ, and tumor necrosis factor-α (TNF-α) of segmental/lobar MPP were significantly higher than those of bronchial MPP, and serum IL-10 (cutoff value: 27.25 pg/mL) can be used as a diagnostic predictor for segmental/lobar MPP. Serum TNF-α and interleukin-6 of segmental/lobar MPP with pleural effusion were significantly higher than those of segmental/lobar MPP without pleural effusion. Serum TNF-α (cutoff value: 60.25 pg/mL) can be used as a diagnostic predictor for segmental/lobar MPP with pleural effusion. Conclusion There were significant correlations between Th1/Th2 cytokine profiles

  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. Tuberculosis screening in immigrants from high-prevalence countries: interview first or chest radiograph first? A pro/con debate.

    PubMed

    Mor, Zohar; Leventhal, Alex; Diacon, Andreas H; Finger, Rebekka; Schoch, Otto D

    2013-04-01

    Immigration from high tuberculosis (TB) prevalence countries has a substantial impact on the epidemiology of TB in receiving countries with low TB incidence. Cross-border migration offers an ideal opportunity for active case finding that will result in a lower caseload in the host country and a reduced spread of disease to both the indigenous and migrant populations. Screening strategies can start 'offshore', thereby indirectly assisting and empowering public health systems in the source countries, or be performed at ports of entry with or without long-term engagement of 'onshore' facilities and systems to provide either preventive therapy or surveillance for reactivation of latent TB. The chest radiograph seems to be playing a key role in this process, but questions remain regarding when, where and in whom radiographs are best done for optimal yield and cost-effectiveness, and with what other tests they might best be combined to further increase the usefulness of transborder TB control.

  14. A Novel Scoring System to Measure Radiographic Abnormalities and Related Spirometric Values in Cured Pulmonary Tuberculosis

    PubMed Central

    Báez-Saldaña, Renata; López-Arteaga, Yesenia; Bizarrón-Muro, Alma; Ferreira-Guerrero, Elizabeth; Ferreyra-Reyes, Leticia; Delgado-Sánchez, Guadalupe; Cruz-Hervert, Luis Pablo; Mongua-Rodríguez, Norma; García-García, Lourdes

    2013-01-01

    Background Despite chemotherapy, patients with cured pulmonary tuberculosis may result in lung functional impairment. Objective To evaluate a novel scoring system based on the degree of radiographic abnormalities and related spirometric values in patients with cured pulmonary tuberculosis. Methods One hundred and twenty seven patients with cured pulmonary tuberculosis were prospectively enrolled in a referral hospital specializing in respiratory diseases. Spirometry was performed and the extent of radiographic abnormalities was evaluated twice by each of two readers to generate a novel quantitative score. Scoring reproducibility was analyzed by the intra-class correlation coefficient (ICC) and the Bland-Altman method. Multiple linear regression models were performed to assess the association of the extent of radiographic abnormalities with spirometric values. Results The intra-observer agreement for scoring of radiographic abnormalities (SRA) showed an ICC of 0.81 (CI:95%, 0.67–0.95) and 0.78 (CI:95%, 0.65–0.92), for reader 1 and 2, respectively. Inter-observer reproducibility for the first measurement was 0.83 (CI:95%, 0.71–0.95), and for the second measurement was 0.74 (CI:95%, 0.58–0.90). The Bland-Altman analysis of the intra-observer agreement showed a mean bias of 0.87% and -0.55% and an inter-observer agreement of -0.35% and -1.78%, indicating a minor average systematic variability. After adjustment for age, gender, height, smoking status, pack-years of smoking, and degree of dyspnea, the scoring degree of radiographic abnormalities was significantly and negatively associated with absolute and percent predicted values of FVC: -0.07 (CI:95%, -0.01 to -0.04); -2.48 (CI:95%, -3.45 to -1.50); and FEV1 -0.07 (CI:95%, -0.10 to -0.05); -2.92 (CI:95%, -3.87 to -1.97) respectively, in the patients studied. Conclusion The extent of radiographic abnormalities, as evaluated through our novel scoring system, was inversely associated with spirometric values, and

  15. 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…

  16. Automated contralateral subtraction of dental panoramic radiographs for detecting abnormalities in paranasal sinus

    NASA Astrophysics Data System (ADS)

    Hara, Takeshi; Mori, Shintaro; Kaneda, Takashi; Hayashi, Tatsuro; Katsumata, Akitoshi; Fujita, Hiroshi

    2011-03-01

    Inflammation in the paranasal sinus is often observed in seasonal allergic rhinitis or with colds, but is also an indication for odontogenic tumors, carcinoma of the maxillary sinus or a maxillary cyst. The detection of those findings in dental panoramic radiographs is not difficult for radiologists, but general dentists may miss the findings since they focus on treatments of teeth. The purpose of this work is to develop a contralateral subtraction method for detecting the odontogenic sinusitis region on dental panoramic radiographs. We developed a contralateral subtraction technique in paranasal sinus region, consisting of 1) image filtering of the smoothing and sobel operation for noise reduction and edge extraction, 2) image registration of mirrored image by using mutual information, and 3) image display method of subtracted pixel data. We employed 56 cases (24 normal and 32 abnormal). The abnormal regions and the normal cases were verified by a board-certified radiologist using CT scans. Observer studies with and without subtraction images were performed for 9 readers. The true-positive rate at a 50% confidence level in 7 out of 9 readers was improved, but there was no statistical significance in the difference of area-under-curve (AUC) in each radiologist. In conclusion, the contralateral subtraction images of dental panoramic radiographs may improve the detection rate of abnormal regions in paranasal sinus.

  17. Routine radiographer screening for fetal abnormalities by ultrasound in an unselected low risk population.

    PubMed

    Shirley, I M; Bottomley, F; Robinson, V P

    1992-07-01

    A screening programme for fetal abnormalities began at The Hillingdon Hospital in July 1986. Second trimester ultrasound scans are performed by radiographers. A combined prospective and retrospective study of the ultrasound findings and outcome in all pregnancies delivered in 1989-1990 was undertaken. 6412 babies were born during this period, of whom 6183 (96%) were examined by ultrasound in the second trimester; 29 pregnancies were terminated for fetal abnormality. Of the 89 fetuses who were abnormal at birth or at induced termination of the pregnancy (1.4%), 84 were scanned in the second trimester. In 51 cases the abnormality was detected before 22 weeks gestation (sensitivity, 60.7%). 56 of these 84 abnormal fetuses scanned had potentially lethal or major handicapping abnormalities of which 41 were detected by ultrasound before 22 weeks gestation (sensitivity, 73%). There was one false positive diagnosis of abnormality which did not affect outcome. 6352 babies were normal at delivery or on discharge from hospital (specificity, 99.98%).

  18. 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.

  19. 78 FR 53645 - Black Lung Benefits Act: Standards for Chest Radiographs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Office... final rule; withdrawal. SUMMARY: The Office of Workers' Compensation Programs (OWCP) published a direct... providing parallel standards for submission of digital radiographs in connection with claims filed under...

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  1. A parameterized logarithmic image processing method with Laplacian of Gaussian filtering for lung nodule enhancement in chest radiographs.

    PubMed

    Chen, Sheng; Yao, Liping; Chen, Bao

    2016-11-01

    The enhancement of lung nodules in chest radiographs (CXRs) plays an important role in the manual as well as computer-aided detection (CADe) lung cancer. In this paper, we proposed a parameterized logarithmic image processing (PLIP) method combined with the Laplacian of a Gaussian (LoG) filter to enhance lung nodules in CXRs. We first applied several LoG filters with varying parameters to an original CXR to enhance the nodule-like structures as well as the edges in the image. We then applied the PLIP model, which can enhance lung nodule images with high contrast and was beneficial in extracting effective features for nodule detection in the CADe scheme. Our method combined the advantages of both the PLIP algorithm and the LoG algorithm, which can enhance lung nodules in chest radiographs with high contrast. To test our nodule enhancement method, we tested a CADe scheme, with a relatively high performance in nodule detection, using a publically available database containing 140 nodules in 140 CXRs enhanced through our nodule enhancement method. The CADe scheme attained a sensitivity of 81 and 70 % with an average of 5.0 frame rate (FP) and 2.0 FP, respectively, in a leave-one-out cross-validation test. By contrast, the CADe scheme based on the original image recorded a sensitivity of 77 and 63 % at 5.0 FP and 2.0 FP, respectively. We introduced the measurement of enhancement by entropy evaluation to objectively assess our method. Experimental results show that the proposed method obtains an effective enhancement of lung nodules in CXRs for both radiologists and CADe schemes.

  2. Organ dose and effective dose estimation in paediatric chest radiographic examinations by using pin silicon photodiode dosemeters.

    PubMed

    Kawasaki, Toshio; Aoyama, Takahiko; Yamauchi-Kawaura, Chiyo; Fujii, Keisuke; Koyama, Shuji

    2013-01-01

    Organ and effective doses during paediatric chest radiographic examination were investigated for various tube voltages between 60 and 110 kV at a constant milliampere-second value and focus-to-film distance by using an in-phantom dose measuring system and a Monte Carlo (MC) simulation software (PCXMC), where the former was composed of 32 photodiode dosemeters embedded in various tissue and organ sites within a 6-y-old child anthropomorphic phantom. Lung doses obtained ranged from 0.010 to 0.066 mGy and effective doses from 0.004 to 0.025 mSv, where these doses varied by a factor of 6 with the change in the tube voltage. Effective doses obtained using the MC simulation software agreed with those obtained using the dose measuring system within 23 %, revealing the usefulness of PCXMC software for evaluating effective doses. The present study would provide helpful dose data for the selection of technical parameters in paediatric chest radiography in Japan.

  3. Impact of bone suppression imaging on the detection of lung nodules in chest radiographs: analysis of multiple reading sessions

    NASA Astrophysics Data System (ADS)

    Schalekamp, S.; van Ginneken, B.; Schaefer-Prokop, C. M.; Karssemeijer, N.

    2013-03-01

    Observer studies are frequently performed to test new modalities. Correct study design is important to generate reliable results. Two most frequently used observer study designs are the sequential and the independent reading design. We investigated the effect of different observer study designs on reader performance results and statistical power. The study included multiple assessments of chest radiographs (CXR) with bone suppression images (BSI) for the detection of lung nodules. In a fully crossed study design 8 observers assessed first radiographs without and with BSI sequentially. Secondly they scored radiographs independently having BSI available from the beginning. Five months later, the same readers scored the same cases again in an independent reading session, completing the three scorings for CXRs with BSI. Observer performance was compared using multi reader multi case (MRMC) receiver operating characteristics (ROC). To estimate reader variance, Dorfman, Berbaum, Metz (DBM) variance component estimates were calculated. No significant difference between the sequential and the independent reading sessions could be found (p=0.51; p=0.61). Both reading designs showed increased performance with BSI, with a significant increase for the sequential and the independent reading session after five months (p=0.002; p=0.007). Total observer variance between sequential and independent reading design remained the same. A strong increase of uncorrelated components was found in the independent reading sessions, masking the ability to demonstrate differences in observer performance across modalities. In conclusion, results of the sequential and the independent study design did not show a significant difference. The independent study design had less power compared to the sequential study design due to a strong increase of uncorrelated variance components.

  4. Symptomatic benign pleural effusions among asbestos insulation workers: residual radiographic abnormalities.

    PubMed Central

    Lilis, R; Lerman, Y; Selikoff, I J

    1988-01-01

    During a cross sectional medical survey of 2815 insulation workers with 30 years or more from onset of asbestos exposure conducted from 1981 to 1983, a positive history of benign pleural effusion was found in 20 (0.71%). Two or three such episodes had occurred in four of these 20 subjects. The chest x ray abnormalities in these cases were characterised by pleural fibrosis in 19 and diffuse pleural fibrosis with blunting of the corresponding costophrenic angle in 16. In the total group of 2815 insulation workers diffuse pleural fibrosis was found in 142 (5.0%). Thus diffuse pleural fibrosis with blunting of the corresponding costophrenic angle is a frequent residual abnormality after benign pleural effusion. Its impact on pulmonary function can be pronounced. Images PMID:3260799

  5. Chest radiology

    SciTech Connect

    Austin, J.H.M.

    1982-01-01

    This review of chest radiology reexamines normal findings on plain chest radiographs, and presents a new plain film view for detecting metastases in the lungs, and describes new findings on acute and chronic inflammatory diseases. Various chest radiologic procedures are examined. (KRM)

  6. Adult Spinal Cord Injury without Radiographic Abnormalities (SCIWORA): Clinical and Radiological Correlations

    PubMed Central

    Sharma, Siddhartha; Singh, Manjeet; Wani, Iftikhar H; Sharma, Sushil; Sharma, Narendra; Singh, Dara

    2009-01-01

    Background This study is aimed to determine the clinical and radiological corellations of adult patients with Spinal Cord Injury Without Radiographic Abnormalities (SCIWORA). Methods The study population consisted of all adult patients with suspected cervical spine injury. SCIWORA was defined as the presence of either no injury or a neural injury on Magnetic Resonance Imaging (MRI) in the absence of radiographic or Computed Tomographic (CT) Scan findings suggestive of trauma in patients with neurological deficit. Purely extra neural compressive lesions were excluded from the study. Results Twelve of ninety seven (12.4%) patients had a neural injury on MRI with normal radiographs and CT scan. These included cord contusion in five cases, cord edema in five cases and cord hemorrhage in two cases. Ten patients were managed conservatively and two patients with disc prolapse were managed surgically. All patients showed at least one ASIA Impairment Scale (AIS) grade improvement and three patients (25%) recovered completely. Conclusions Parenchymal spinal cord injury is the single most important determinant in the long term outcome of adult SCIWORA patients. Cord hemorrhage has the worst prognosis and cord edema has the best. Longitudinal signal extension and associated extra neural injuries are also associated with poorer outcomes. Cases with purely neural injuries can be managed conservatively, but associated extra neural injuries, especially disc prolapse and ligamentous instability, warrant surgical management. Keywords Post Traumatic Myelopathy; Spinal Cord Trauma; Computed tomography; Magnetic resonance imaging; SCIWORA PMID:22493651

  7. 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.

  8. Preliminary validation of a new methodology for estimating dose reduction protocols in neonatal chest computed radiographs

    NASA Astrophysics Data System (ADS)

    Don, Steven; Whiting, Bruce R.; Hildebolt, Charles F.; Sehnert, W. James; Ellinwood, Jacquelyn S.; Töpfer, Karin; Masoumzadeh, Parinaz; Kraus, Richard A.; Kronemer, Keith A.; Herman, Thomas; McAlister, William H.

    2006-03-01

    The risk of radiation exposure is greatest for pediatric patients and, thus, there is a great incentive to reduce the radiation dose used in diagnostic procedures for children to "as low as reasonably achievable" (ALARA). Testing of low-dose protocols presents a dilemma, as it is unethical to repeatedly expose patients to ionizing radiation in order to determine optimum protocols. To overcome this problem, we have developed a computed-radiography (CR) dose-reduction simulation tool that takes existing images and adds synthetic noise to create realistic images that correspond to images generated with lower doses. The objective of our study was to determine the extent to which simulated, low-dose images corresponded with original (non-simulated) low-dose images. To make this determination, we created pneumothoraces of known volumes in five neonate cadavers and obtained images of the neonates at 10 mR, 1 mR and 0.1 mR (as measured at the cassette plate). The 10-mR exposures were considered "relatively-noise-free" images. We used these 10 mR-images and our simulation tool to create simulated 0.1- and 1-mR images. For the simulated and original images, we identified regions of interest (ROI) of the entire chest, free-in-air region, and liver. We compared the means and standard deviations of the ROI grey-scale values of the simulated and original images with paired t tests. We also had observers rate simulated and original images for image quality and for the presence or absence of pneumothoraces. There was no statistically significant difference in grey-scale-value means nor standard deviations between simulated and original entire chest ROI regions. The observer performance suggests that an exposure >=0.2 mR is required to detect the presence or absence of pneumothoraces. These preliminary results indicate that the use of the simulation tool is promising for achieving ALARA exposures in children.

  9. 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.

  10. Radiographic basal ganglia abnormalities secondary to nonketotic hyperglycemia with unusual clinical features

    PubMed Central

    Choi, Ju Young; Park, Joon Min; Kim, Kyung Hwan; Park, Jun Seok; Shin, Dong Wun; Kim, Hoon; Jeon, Woo Chan; Kim, Hyun Jong

    2016-01-01

    A 77-year-old woman was admitted to a local clinic for altered consciousness and presented with a suspected basal ganglion hemorrhage detected on brain computed tomography. The patient was stuporous, but her vital signs were stable. Her initial blood glucose was 607 mg/dL, and a hyperdense lesion was found in the right basal ganglion on brain computed tomography. T1-weighted magnetic resonance imaging revealed high signal intensity in the right basal ganglion. Electroencephalography showed no seizure activity. The patient was treated with a fluid infusion, and serum glucose level was controlled with insulin. The patient gradually recovered consciousness and was alert within 24 hours as serum glucose level normalized. The basal ganglion lesion caused by hyperglycemia was not accompanied by involuntary limb movement. This is the first report of a patient presenting with decreased consciousness and typical neural radiographic changes associated with nonketotic hyperglycemia but without movement abnormalities. PMID:28168232

  11. Lower thoracic spinal cord injury without radiographic abnormality in an amateur rugby player.

    PubMed

    Smith, Hannah K; Durnford, Andrew J; Sherlala, Khaled; Merriam, William F

    2012-10-26

    A 37-year-old man, amateur rugby player sustained a hyperextension injury to his lower thoracic spine during a scrum collapse. The patient developed extreme hyperpathia in the T10-12 dermatome, and parasthesia from T12 to S1 in the left lower limb. Medical Research Council grade 5 power was regained rapidly within minutes of the accident, and the hyperpathia resolved within a week. MRI showed contusion of the spinal cord at T10 level but no associated osseoligamentous injury. Six months later, parasthesia and subjective weakness remained in the left lower limb. To our knowledge, this is the first description of a lower thoracic spinal cord injury without radiographic abnormality following an isolated low-energy injury in a skeletally mature patient.

  12. Routine chest radiographs in the surgical intensive care unit: can we change clinical habits with no proven benefit?

    PubMed

    Velicković, Jelena V; Hajdarević, Sanela A; Palibrk, Ivan G; Janić, Natasa R; Djukanović, Marija; Miljković, Bojana; Velicković, Dejan M; Bumbasirević, Vesna

    2013-01-01

    Daily routine chest radiographs (CR) are commonly performed in surgical ICU. Unnecessary CR increase costs and expose the staff and the patients to radiation risk. The goal of our study was to estimate the value of daily routine CR in the ICU and to determine the correlation between CR and physical findings in surgical ICU patients. Prospective observational study was conducted during period of two months at the ICU department at the Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade. It included 97 consecutive patients who underwent digestive surgery and stayed at the ICU for at least two days. During their ICU stay, CRs were obtained as a clinical routine or to monitor lung pathology. Patients were followed daily, and CRs (as the proportion of positive findings) were compared with physical examination and clinical presentation. A total of 717 CRs were obtained, median number per patient was 4.0 (2.0-7.0). Proportion of positive findings was significantly higher comparing to auscultation until the sixth day of ICU stay. There was no difference in CR findings from day to day after the sixth day. Therapeutic efficacy of CRs was low as only 56 (7.8%) resulted in a change of patient management. We conclude that daily routine CRs are justified in the first six days of ICU stay, and after that time they show no advantages over clinical examination.

  13. Interactive lung segmentation in abnormal human and animal chest CT scans

    SciTech Connect

    Kockelkorn, Thessa T. J. P. Viergever, Max A.; Schaefer-Prokop, Cornelia M.; Bozovic, Gracijela; Muñoz-Barrutia, Arrate; Rikxoort, Eva M. van; Brown, Matthew S.; Jong, Pim A. de; Ginneken, Bram van

    2014-08-15

    Purpose: Many medical image analysis systems require segmentation of the structures of interest as a first step. For scans with gross pathology, automatic segmentation methods may fail. The authors’ aim is to develop a versatile, fast, and reliable interactive system to segment anatomical structures. In this study, this system was used for segmenting lungs in challenging thoracic computed tomography (CT) scans. Methods: In volumetric thoracic CT scans, the chest is segmented and divided into 3D volumes of interest (VOIs), containing voxels with similar densities. These VOIs are automatically labeled as either lung tissue or nonlung tissue. The automatic labeling results can be corrected using an interactive or a supervised interactive approach. When using the supervised interactive system, the user is shown the classification results per slice, whereupon he/she can adjust incorrect labels. The system is retrained continuously, taking the corrections and approvals of the user into account. In this way, the system learns to make a better distinction between lung tissue and nonlung tissue. When using the interactive framework without supervised learning, the user corrects all incorrectly labeled VOIs manually. Both interactive segmentation tools were tested on 32 volumetric CT scans of pigs, mice and humans, containing pulmonary abnormalities. Results: On average, supervised interactive lung segmentation took under 9 min of user interaction. Algorithm computing time was 2 min on average, but can easily be reduced. On average, 2.0% of all VOIs in a scan had to be relabeled. Lung segmentation using the interactive segmentation method took on average 13 min and involved relabeling 3.0% of all VOIs on average. The resulting segmentations correspond well to manual delineations of eight axial slices per scan, with an average Dice similarity coefficient of 0.933. Conclusions: The authors have developed two fast and reliable methods for interactive lung segmentation in

  14. 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.

  15. Improved computerized detection of lung nodules in chest radiographs by means of 'virtual dual-energy' radiography

    NASA Astrophysics Data System (ADS)

    Chen, S.; Suzuki, K.; MacMahon, H.

    2011-03-01

    Major challenges in current computer-aided detection (CADe) of nodules in chest radiographs (CXRs) are to detect nodules that overlap with ribs and to reduce the frequent false positives (FPs) caused by ribs. Our purpose was to develop a CADe scheme with improved sensitivity and specificity by use of "virtual dual-energy" (VDE) CXRs where ribs are suppressed with a massive-training artificial neural network (MTANN). To reduce rib-induced FPs and detect nodules overlapping with ribs, we incorporated VDE technology in our CADe scheme. VDE technology suppressed ribs in CXR while maintaining soft-tissue opacity by use of an MTANN that had been trained with real DE imaging. Our scheme detected nodule candidates on VDE images by use of a morphologic filtering technique. Sixty-four morphologic and gray-level-based features were extracted from each candidate from both original and VDE CXRs. A nonlinear support vector classifier was employed for classification of the nodule candidates. A publicly available database containing 126 nodules in 126 CXRs was used for testing of our CADe scheme. Twenty nine percent (36/126) of the nodules were rated "extremely subtle" or "very subtle" by a radiologist. With the original scheme, a sensitivity of 76.2 (96/126) with 5 (630/126) FPs per image was achieved. By use of VDE images, more nodules overlapping with ribs were detected and the sensitivity was improved substantially to 84.1% (106/126) at the same FP rate in a leave-one-out cross-validation test, whereas the literature shows that other CADe schemes achieved sensitivities of 66.0% and 72.0% at the same FP rate.

  16. 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 Central

    2016-01-01

    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

  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

    Parperis, Konstantinos; Carrera, Guillermo; Baynes, Keith; Mautz, Alan; Dubois, Melissa; Cerniglia, Ross; Ryan, Lawrence M

    2013-09-01

    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.

  18. 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

  19. Computerized image-searching method for finding correct patients for misfiled chest radiographs in a PACS server by use of biological fingerprints.

    PubMed

    Toge, Risa; Morishita, Junji; Sasaki, Yasuo; Doi, Kunio

    2013-07-01

    We have developed an automated image-searching method based on biological fingerprints for identifying correct patients in misfiled chest radiographs in a picture archiving and communication system (PACS) server. We used five biological fingerprints including distinctive anatomic structures in a misfiled chest radiograph of an unknown patient to find another image of the same patient stored with correct patient information in a PACS server. The correlation values were determined for the corresponding biological fingerprints in all images in the image server. The correlation indices as a measure of the overall similarity of the two images were determined from the summation of five correlation values and the combination of correlation values with the weighting factors. Finally, the correct patient was identified automatically by the image with the highest correlation index. By use of the summation of five correlation values as the correlation index, 78.0% (156/200) of the 200 patients for misfiled images were correctly identified in the database. When we applied the weighting factors for each biological fingerprint to determine the correlation index, the performance in identifying the correct patient was improved to 87.5% (175/200). An additional 5.0% (10/200) of images were included in the Top 10 ranking of the correlation index in the database. These cases could be identified manually by radiology personnel. We conclude that the automated image-searching method based on biological fingerprints with weighting factors would be useful for identification of the correct patient in the case of misfiled chest radiographs in a PACS server.

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

    SciTech Connect

    Wells, J; Zhang, L; Samei, E

    2015-06-15

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

  1. Baseline sacroiliac joint magnetic resonance imaging abnormalities and male sex predict the development of radiographic sacroiliitis.

    PubMed

    Akar, Servet; Isik, Sibel; Birlik, Bilge; Solmaz, Dilek; Sari, Ismail; Onen, Fatos; Akkoc, Nurullah

    2013-10-01

    We evaluated the relationship between the baseline sacroiliac joint (SIJ) magnetic resonance imaging (MRI) findings and the development of radiographic sacroiliitis and tested their prognostic significance in cases of ankylosing spondylitis. Patients who had undergone an SIJ MRI at the rheumatology department were identified. Individuals for whom pelvic X-rays were available after at least 1 year of MRI were included in the analysis. All radiographs and MRI examinations were scored by two independent readers. Medical records of the patients were reviewed to obtain potentially relevant demographic and clinical data. We identified 1,069 SIJ MRIs, and 328 fulfilled our inclusion criteria. Reliability analysis revealed moderate to good inter- and intra-observer agreement. On presentation data, 14 cases were excluded because they had unequivocal radiographic sacroiliitis at baseline. After a mean of 34.8 months of follow-up, 24 patients developed radiographic sacroiliitis. The presence of active sacroiliitis (odds ratio (OR) 15.1) and structural lesions on MRI (OR 8.3), male sex (OR 4.7), fulfillment of Calin's inflammatory back pain criteria (P = 0.001), and total MRI activity score (P < 0.001) were found to be related to the development of radiographic sacroiliitis. By regression modeling, the presence of both active inflammatory and structural damage lesions on MRI and male sex were found to be predictive factors for the development of radiographic sacroiliitis. Our present results suggest that the occurrence of both active inflammatory and structural lesions in SIJs revealed by MRI is a significant risk factor for radiographic sacroiliitis, especially in male patients with early inflammatory back pain.

  2. 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

  3. 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.

  4. Development of a computerized scheme for detection of very subtle lung nodules located in opaque areas on chest radiographs

    NASA Astrophysics Data System (ADS)

    Shiraishi, Junji; Li, Qiang; Doi, Kunio

    2006-03-01

    The detection of lung nodules located in opaque areas including the mediastinum, retrocardiac lung, and lung projected below or on the diaphragm has been very difficult, because the contrast of these nodules is usually extremely low, and sometimes radiologists may not pay attention to these locations. In this study, we have developed a new computer-aided diagnostic (CAD) scheme designed specifically for the detection of these difficult-to-detect lung nodules located in opaque areas. We used 1,000 chest images with 1,076 lung nodules, which included 73 very difficult lung nodules in these opaque areas. In this new computerized scheme, opaque areas within a chest image were segmented by use of an adaptive multi-thresholding method based on edge-gradient values, and then the gray level and contrast of the chest image were adjusted for the opaque areas. Initial candidates were identified by use of the nodule-enhanced image obtained with the average radial-gradient (ARG) filtering technique based on radial gradient values. We employed a total of 35 image features for sequential application of artificial neural networks (ANNs) in order to reduce the number of false-positive candidates. The ANNs were trained and tested by use of a k-fold cross-validation test method (k=100), in which each of 100 different combinations of training and test image data sets included 990 and 10 chest images, respectively. The overall performance determined from the results of 100 test data sets indicated that the average sensitivity in detecting lung nodules was 52.1% with 1.89 false positives per image, which was considered "acceptable", because these nodules were very subtle and difficult to detect. By combination of this advanced CAD scheme with our standard CAD scheme for lung-nodule detection, the clinical usefulness of the CAD scheme would be improved significantly.

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

    PubMed

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

    2006-07-01

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

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

    SciTech Connect

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

    2006-07-15

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

  7. 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

  8. A retrospective study of radiographic abnormalities in the repositories of 2-year-old Thoroughbred in-training sales in Japan

    PubMed Central

    MIYAKOSHI, Daisuke; SENBA, Hiroyuki; SHIKICHI, Mitsumori; MAEDA, Masaya; SHIBATA, Ryo; MISUMI, Kazuhiro

    2016-01-01

    ABSTRACT This study aimed to evaluate the influence of radiographic abnormalities of 2-year-old Thoroughbred horses that were listed at in-training sales in Japan, on whether they started to race or not at 2–3 years of age. Radiographs of 850 2-year-old Thoroughbreds in the in-training sales repository from 2007 to 2010 were reviewed, and 26 categories of radiographic abnormalities were found. Forty-three horses (5.1%, 43/850) did not start a race at 2–3 years of age. In accordance with the racing results for this age category, as determined by Fisher’s exact test and multiple logistic regression analysis, none of the radiographic abnormalities were significantly related to failure to start a race. At 2 years of age, 198 horses (23.3%, 198/850) did not start a race. Horses with enlargement of the proximal sesamoid bones in the fore (9 of 19 horses) and hind limbs (5 of 9 horses) did not start a race at the age of 2 years, and fewer of these horses (fore, P=0.021; hind, P=0.030) started a race at the age of 2 years compared with the population of horses without these radiographic abnormalities. These results suggest that identification of radiographic enlargement of the proximal sesamoid bones during training sales could derail the racing debut of horses at the age of 2 years. However, this might not necessarily indicate a poor prognosis and resulting in retirement from racing at 2–3 years of age. PMID:27330400

  9. [Evaluation study of abnormal detectability with Thurstone and Scheffé (Nakaya) of paired comparison method using chest phantom].

    PubMed

    Mochizuki, Yasuo

    2014-01-01

    Monitors are increasingly being used as diagnostic imaging devices. In this study, using an all-purpose liquid-crystal display (LCD), the rate of detection of abnormalities was investigated using Thurstone's and Scheffé's (Nakaya) paired comparison methods. A chest phantom was prepared as a test sample with acryl and aluminum plates and intensities suggesting small adenocarcinomas. For the acquisition conditions for computed radiography, after setting the baseline at a dose at which the film density of the standard screen-film system at the same as those for the lung, costal bone, and mediastinum, 5 steps of 2-fold serial doses were then set: 1/4, 1/2, 1, 2, and 4. The test sample was observed by 10 students. On the Thurstone scale, detectability decreased with a decrease in the dose in the lung, costal bone, and mediastinum. When the significance of differences between the values at adjacent doses was investigated using the yardstick method, using Scheffé's method revealed a significant difference between the 4- and 2-fold doses and between the 1/2 and 1/4 doses in the pulmonary region. A significant difference was also noted between the baseline and 1/2 doses in the mediastinum. Changes in the order of the scale values may not occur in the intervals in which significant differences were noted using Scheffé's methods.

  10. Automated detection of abnormalities in paranasal sinus on dental panoramic radiographs by using contralateral subtraction technique based on mandible contour

    NASA Astrophysics Data System (ADS)

    Mori, Shintaro; Hara, Takeshi; Tagami, Motoki; Muramatsu, Chicako; Kaneda, Takashi; Katsumata, Akitoshi; Fujita, Hiroshi

    2013-02-01

    Inflammation in paranasal sinus sometimes becomes chronic to take long terms for the treatment. The finding is important for the early treatment, but general dentists may not recognize the findings because they focus on teeth treatments. The purpose of this study was to develop a computer-aided detection (CAD) system for the inflammation in paranasal sinus on dental panoramic radiographs (DPRs) by using the mandible contour and to demonstrate the potential usefulness of the CAD system by means of receiver operating characteristic analysis. The detection scheme consists of 3 steps: 1) Contour extraction of mandible, 2) Contralateral subtraction, and 3) Automated detection. The Canny operator and active contour model were applied to extract the edge at the first step. At the subtraction step, the right region of the extracted contour image was flipped to compare with the left region. Mutual information between two selected regions was obtained to estimate the shift parameters of image registration. The subtraction images were generated based on the shift parameter. Rectangle regions of left and right paranasal sinus on the subtraction image were determined based on the size of mandible. The abnormal side of the regions was determined by taking the difference between the averages of each region. Thirteen readers were responded to all cases without and with the automated results. The averaged AUC of all readers was increased from 0.69 to 0.73 with statistical significance (p=0.032) when the automated detection results were provided. In conclusion, the automated detection method based on contralateral subtraction technique improves readers' interpretation performance of inflammation in paranasal sinus on DPRs.

  11. 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…

  12. Radiographic appearance of nosocomial legionnaires' disease after erythromycin treatment.

    PubMed Central

    Domingo, C; Roig, J; Planas, F; Bechini, J; Tenesa, M; Morera, J

    1991-01-01

    Radiographic features of 71 patients (48 men, 23 women) with nosocomial Legionella pneumophila pneumonia were assessed and compared with those of other nosocomial series of L pneumophila pneumonia. Sixteen patients were assessed retrospectively and 55 prospectively. Chest radiographs were assessed at the onset of the illness, 10 days later, and at 3 months. Erythromycin was given to 67 patients at the time of the diagnosis and to the remaining four at a later stage. Forty eight patients were over the age of 60. On the initial chest radiograph 53 of the 71 patients had unilateral shadowing (23 of them in the right lung); 35 had unilobar shadowing and the remaining 36 had more than one affected lobe. Pleural effusion was present in 24 cases and cavitation in 2. One patient had evidence of a pericardial effusion. At 10 days 21 patients had evidence of radiographic progression (14 ipsilateral), but 28 had improved. At 3 months 36 patients had an abnormal radiograph, 30 showing residual scarring, 15 loss of volume, six pleural shadows and two cavitation. Our series shows a lesser incidence of unilateral shadowing and pleural effusion than other nosocomial series and a lesser tendency to progression, but more patients had radiographic abnormalities at long term follow up. PMID:1948796

  13. Relationships (I) of International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases with the ILO International Classification of Radiographs of Pneumoconioses for parenchymal abnormalities.

    PubMed

    Tamura, Taro; Suganuma, Narufumi; Hering, Kurt G; Vehmas, Tapio; Itoh, Harumi; Akira, Masanori; Takashima, Yoshihiro; Hirano, Harukazu; Kusaka, Yukinori

    2015-01-01

    The International Classification of High-resolution Computed Tomography (HRCT) for Occupational and Environmental Respiratory Diseases (ICOERD) has been developed for the screening, diagnosis, and epidemiological reporting of respiratory diseases caused by occupational hazards. This study aimed to establish a correlation between readings of HRCT (according to the ICOERD) and those of chest radiography (CXR) pneumoconiotic parenchymal opacities (according to the International Labor Organization Classification/International Classification of Radiographs of Pneumoconioses [ILO/ICRP]). Forty-six patients with and 28 controls without mineral dust exposure underwent posterior-anterior CXR and HRCT. We recorded all subjects' exposure and smoking history. Experts independently read CXRs (using ILO/ICRP). Experts independently assessed HRCT using the ICOERD parenchymal abnormalities grades for well-defined rounded opacities (RO), linear and/or irregular opacities (IR), and emphysema (EM). The correlation between the ICOERD summed grades and ILO/ICRP profusions was evaluated using Spearman's rank-order correlation. Twenty-three patients had small opacities on CXR. HRCT showed that 21 patients had RO; 20 patients, IR opacities; and 23 patients, EM. The correlation between ILO/ICRP profusions and the ICOERD grades was 0.844 for rounded opacities (p<0.01). ICOERD readings from HRCT scans correlated well with previously validated ILO/ICRP criteria. The ICOERD adequately detects pneumoconiotic micronodules and can be used for the interpretation of pneumoconiosis.

  14. Radiologic atlas of pulmonary abnormalities in children

    SciTech Connect

    Singleton, E.B.; Wagner, M.L.; Dutton, R.V.

    1988-01-01

    This book is an atlas about thoracic abnormalities in infants and children. The authors include computed tomographic, digital subtraction angiographic, ultrasonographic, and a few magnetic resonance (MR) images. They recognize and discuss how changes in the medical treatment of premature infants and the management of infection and pediatric tumors have altered some of the appearances and considerations in these diseases. Oriented toward all aspects of pulmonary abnormalities, the book starts with radiographic techniques and then discusses the normal chest, the newborn, infections, tumors, and pulmonary vascular diseases. There is comprehensive treatment of mediastinal abnormalities and a discussion of airway abnormalities.

  15. An investigation of the chest radiographs in a controlled trial of busulphan, cyclophosphamide, and a placebo after resection for carcinoma of the lung.

    PubMed Central

    Stott, H; Stephens, R; Fox, W; Simon, G; Roy, D C

    1976-01-01

    A standard series of radiographs of 588 patients allocated at random to treatment with busulphan (B patients), cyclophosphamide (C patients), or a placebo (P patients) for two years after surgery for bronchial carcinoma were viewed in three stages (following procedures which avoided bias) by an independent assessor, unaware of the allocated treatment of any patient, with a view to identifying pulmonary changes due to busulphan. Radiographic appearances consistent with busulphan lung were not reported in any of the 195 B patients (receiving a mean dosage of 464 mg of busulphan over 301 days) or of the 192 C patients but were present in one of the 201 patients receiving placebo. PMID:781905

  16. Reader characteristics linked to detection of pulmonary nodules on radiographs: ROC vs. JAFROC analyses of performance

    NASA Astrophysics Data System (ADS)

    Kohli, Akshay; Robinson, John W.; Ryan, John; McEntee, Mark F.; Brennan, Patrick C.

    2011-03-01

    The purpose of this study is to explore whether reader characteristics are linked to heightened levels of diagnostic performance in chest radiology using receiver operating characteristic (ROC) and jackknife free response ROC (JAFROC) methodologies. A set of 40 postero-anterior chest radiographs was developed, of which 20 were abnormal containing one or more simulated nodules, of varying subtlety. Images were independently reviewed by 12 boardcertified radiologists including six chest specialists. The observer performance was measured in terms of ROC and JAFROC scores. For the ROC analysis, readers were asked to rate their degree of suspicion for the presence of nodules by using a confidence rating scale (1-6). JAFROC analysis required the readers to locate and rate as many suspicious areas as they wished using the same scale and resultant data were used to generate Az and FOM scores for ROC and JAFROC analyses respectively. Using Pearson methods, scores of performance were correlated with 7 reader characteristics recorded using a questionnaire. JAFROC analysis showed that improved reader performance was significantly (p<=0.05) linked with chest specialty (p<0.03), hours per week reading chest radiographs (p<0.03) and chest readings per year (p<0.04). ROC analyses demonstrated only one significant relationship, hours per week reading chest radiographs (p<0.02).The results of this study have shown that radiologist's performance in the detection of pulmonary nodules on radiographs is significantly linked to chest specialty, hours reading per week and number of radiographs read per year. Also, JAFROC is a more powerful predictor of performance as compared to ROC.

  17. Interpretations of the chest roentgenogram

    SciTech Connect

    Landay, M.J.

    1986-01-01

    Sixteen brief chapters cover basic principles, techniques, and normal appearance of the lungs, hili, mediastinum, pleura, thoracic cage, and extrathoracic structures as seen in chest radiographs. Common pathologic findings are described and copiously illustrated. Four brief concluding chapters highlight findings in the neck, intensive care radiographs with special reference to tubes and catheters, clues to indicate site of disease, and a brief summary.

  18. Novel Logistic Regression Model of Chest CT Attenuation Coefficient Distributions for the Automated Detection of Abnormal (Emphysema or ILD) versus Normal Lung

    PubMed Central

    Chan, Kung-Sik; Jiao, Feiran; Mikulski, Marek A.; Gerke, Alicia; Guo, Junfeng; Newell, John D; Hoffman, Eric A.; Thompson, Brad; Lee, Chang Hyun; Fuortes, Laurence J.

    2015-01-01

    Rationale and Objectives We evaluated the role of automated quantitative computed tomography (CT) scan interpretation algorithm in detecting Interstitial Lung Disease (ILD) and/or emphysema in a sample of elderly subjects with mild lung disease.ypothesized that the quantification and distributions of CT attenuation values on lung CT, over a subset of Hounsfield Units (HU) range [−1000 HU, 0 HU], can differentiate early or mild disease from normal lung. Materials and Methods We compared results of quantitative spiral rapid end-exhalation (functional residual capacity; FRC) and end-inhalation (total lung capacity; TLC) CT scan analyses in 52 subjects with radiographic evidence of mild fibrotic lung disease to 17 normal subjects. Several CT value distributions were explored, including (i) that from the peripheral lung taken at TLC (with peels at 15 or 65mm), (ii) the ratio of (i) to that from the core of lung, and (iii) the ratio of (ii) to its FRC counterpart. We developed a fused-lasso logistic regression model that can automatically identify sub-intervals of [−1000 HU, 0 HU] over which a CT value distribution provides optimal discrimination between abnormal and normal scans. Results The fused-lasso logistic regression model based on (ii) with 15 mm peel identified the relative frequency of CT values over [−1000, −900] and that over [−450,−200] HU as a means of discriminating abnormal versus normal, resulting in a zero out-sample false positive rate and 15%false negative rate of that was lowered to 12% by pooling information. Conclusions We demonstrated the potential usefulness of this novel quantitative imaging analysis method in discriminating ILD and/or emphysema from normal lungs. PMID:26776294

  19. 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.

  20. 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.

  1. Radiographic appearance of the sternomanubrial joint in arthritis and related conditions.

    PubMed

    Parker, V S; Malhotra, C M; Ho, G; Kaplan, S R

    1984-11-01

    The sternomanubrial joint (SMJ) was evaluated on the lateral chest radiograph in 177 patients with rheumatic disease and 69 non-rheumatic controls. Abnormalities were categorized as inflammatory changes, proliferative changes, or bone fusion. Patients with rheumatoid arthritis, psoriatic arthritis, or gout were found to have an increased incidence of inflammatory changes. Rheumatoid variants predisposed to early fusion of the SMJ. Patients with diffuse idiopathic skeletal hyperostosis (DISH) exhibited massive and unique hyperostotic changes.

  2. Chest MRI

    MedlinePlus

    ... Topics Aneurysm Chest CT Scan Chest X Ray Pleurisy and Other Pleural Disorders Pulmonary Hypertension Send a ... X Ray Clinical Trials Implantable Cardioverter Defibrillators Pacemaker Pleurisy and Other Pleural Disorders Pulmonary Hypertension Rate This ...

  3. 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…

  4. Enhancement of chest radiographs with gradient operators.

    PubMed

    Daponte, J S; Fox, M D

    1988-01-01

    Reference is made to the Sobel and Roberts gradient operators used to enhance image edges. Overall, the Sobel operator was found to be superior to the Roberts operator in edge enhancement. A theoretical explanation for the superior performance of the Sobel operator was developed based on the concept of analyzing the x and y Sobel masks as linear filters. By applying pill-box, Gaussian, or median filtering prior to applying a gradient operator, noise was reduced. The pill-box and Gaussian filters were more computationally efficient than the median filter with approximately equal effectiveness in noise reduction.

  5. Development of functional chest imaging with a dynamic flat-panel detector (FPD).

    PubMed

    Tanaka, Rie; Sanada, Shigeru; Fujimura, Masaki; Yasui, Masahide; Nakayama, Kazuya; Matsui, Takeshi; Hayashi, Norio; Matsui, Osamu

    2008-07-01

    Dynamic FPD permits the acquisition of distortion-free radiographs with a large field of view and high image quality. In the present study, we investigated the feasibility of functional imaging for evaluating the pulmonary sequential blood distribution with an FPD, based on changes in pixel values during cardiac pumping. Dynamic chest radiographs of seven normal subjects were obtained in the expiratory phase by use of an FPD system. We measured the average pixel value in each region of interest that was located manually in the heart and lung areas. Subsequently, inter-frame differences and differences from a minimum-intensity projection image, which was created from one cardiac cycle, were calculated. These difference values were then superimposed on dynamic chest radiographs in the form of a color display, and sequential blood distribution images and a blood distribution map were created. The results were compared to typical data on normal cardiac physiology. The clinical effectiveness of our method was evaluated in a patient who had abnormal pulmonary blood flow. In normal cases, there was a strong correlation between the cardiac cycle and changes in pixel value. Sequential blood distribution images showed a normal pattern at determined by the physiology of pulmonary blood flow, with a symmetric distribution and no blood flow defects throughout the entire lung region. These findings indicated that pulmonary blood flow was reflected on dynamic chest radiographs. In an abnormal case, a defect in blood flow was shown as defective in color in a blood distribution map. The present method has the potential for evaluation of local blood flow as an optional application in general chest radiography.

  6. Abnormal distribution of pulmonary blood flow in aortic valve disease

    PubMed Central

    Goodenday, Lucy S.; Simon, George; Craig, Hazel; Dalby, Lola

    1970-01-01

    Wasted ventilatory volume (VD) and its ratio to tidal volume (VD/VT) were measured at rest and during exertion in 17 patients with aortic valve disease. We considered VD/VT to indicate abnormal ventilation: perfusion relations if it did not decrease on exertion, or if the exercising value was greater than 40 per cent. Plain chest radiographs were independently examined for evidence of diversion of pulmonary blood to the upper lobes. There was significant agreement (p<0·05) between radiographic and pulmonary function estimations of abnormality. This suggests that the raised pulmonary venous pressure associated with left ventricular failure creates an abnormal pattern of blood flow through the lung, which is responsible for causing inadequate perfusion with respect to ventilation. Images PMID:5420086

  7. Cash's textbook of chest, heart and vascular disorders for physiotherapists

    SciTech Connect

    Downie, P.A.; Innocenti, D.M.; Jackson, S.E.

    1987-01-01

    This book includes a chapter on chest radiographs. A very high proportion of the patients treated by physiotherapy will have had a chest radiograph (x-ray) either because their primary disease is pulmonary or there is some long standing heart or lung illness which should be taken into account during the management of an acute problem. The chapter outlines the principles involved in reading the radiograph.

  8. 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

  9. Computerized scheme for detection of diffuse lung diseases on CR chest images

    NASA Astrophysics Data System (ADS)

    Pereira, Roberto R., Jr.; Shiraishi, Junji; Li, Feng; Li, Qiang; Doi, Kunio

    2008-03-01

    We have developed a new computer-aided diagnostic (CAD) scheme for detection of diffuse lung disease in computed radiographic (CR) chest images. One hundred ninety-four chest images (56 normals and 138 abnormals with diffuse lung diseases) were used. The 138 abnormal cases were classified into three levels of severity (34 mild, 60 moderate, and 44 severe) by an experienced chest radiologist with use of five different patterns, i.e., reticular, reticulonodular, nodular, air-space opacity, and emphysema. In our computerized scheme, the first moment of the power spectrum, the root-mean-square variation, and the average pixel value were determined for each region of interest (ROI), which was selected automatically in the lung fields. The average pixel value and its dependence on the location of the ROI were employed for identifying abnormal patterns due to air-space opacity or emphysema. A rule-based method was used for determining three levels of abnormality for each ROI (0: normal, 1: mild, 2: moderate, and 3: severe). The distinction between normal lungs and abnormal lungs with diffuse lung disease was determined based on the fractional number of abnormal ROIs by taking into account the severity of abnormalities. Preliminary results indicated that the area under the ROC curve was 0.889 for the 44 severe cases, 0.825 for the 104 severe and moderate cases, and 0.794 for all cases. We have identified a number of problems and reasons causing false positives on normal cases, and also false negatives on abnormal cases. In addition, we have discussed potential approaches for improvement of our CAD scheme. In conclusion, the CAD scheme for detection of diffuse lung diseases based on texture features extracted from CR chest images has the potential to assist radiologists in their interpretation of diffuse lung diseases.

  10. Chest Pain

    MedlinePlus

    ... causes Chest pain can also be caused by: Panic attack. If you have periods of intense fear accompanied ... fear of dying, you may be experiencing a panic attack. Shingles. Caused by a reactivation of the chickenpox ...

  11. Chest trauma.

    PubMed

    Budassi, S A

    1978-09-01

    For any patient with obvious or suspected chest trauma, one must first assure an adequate airway and adequate ventilation. One should never hesitate to administer oxygen to a victim with a chest injury. The nurse should be concerned with adequate circulation--this may mean the administration of intravenous fluids, specifically volume expanders, via large-bore cannulae. Any obvious open chest wound should be sealed, and any fractures should be splinted. These patients should be rapidly transported to the nearest Emergency Department capable of handling this type of injury. The majority of patients who arrive in the Emergency Department following blunt or penetrating trauma should be considered to be in critical condition until proven otherwise. On presentation, it is essential to recognize those signs, symptoms, and laboratory values that identify the patient's condition as life-threatening. Simple recognition of these signs and symptoms and early appropriate intervention may alter an otherwise fatal outcome.

  12. Evaluation of prediagnosis emergency department presentations in patients with active tuberculosis: the role of chest radiography, risk factors and symptoms

    PubMed Central

    Appleton, S C; Connell, D W; Singanayagam, A; Bradley, P; Pan, D; Sanderson, F; Cleaver, B; Rahman, A; Kon, O M

    2017-01-01

    Introduction London has a high rate of tuberculosis (TB) with 2572 cases reported in 2014. Cases are more common in non-UK born, alcohol-dependent or homeless patients. The emergency department (ED) presents an opportunity for the diagnosis of TB in these patient groups. This is the first study describing the clinico-radiological characteristics of such attendances in two urban UK hospitals for pulmonary TB (PTB) and extrapulmonary TB (EPTB). Methods We conducted a retrospective cohort study using the London TB Register (LTBR) and hospital records to identify patients who presented to two London ED's in the 6 months prior to their ultimate TB diagnosis 2011–2012. Results 397 TB cases were identified. 39% (154/397) had presented to the ED in the 6 months prior to diagnosis. In the study population, the presence of cough, weight loss, fever and night sweats only had prevalence rates of 40%, 34%, 34% and 21%, respectively. Chest radiography was performed in 76% (117/154) of patients. For cases where a new diagnosis of TB was suspected, 73% (41/56) had an abnormal radiograph, compared with 36% (35/98) of patients where it was not. There was an abnormality on a chest radiograph in 73% (55/75) of PTB cases and also in 40% (21/52) of EPTB cases where a film was requested. Conclusions A large proportion of patients with TB present to ED. A diagnosis was more likely in the presence of an abnormal radiograph, suggesting opportunities for earlier diagnosis if risk factors, symptoms and chest radiograph findings are combined. PMID:28123749

  13. Male Pectoral Implants: Radiographic Appearance of Complications

    PubMed Central

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

    2016-01-01

    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

  14. Chest X-Ray

    MedlinePlus

    ... by Image/Video Gallery Your radiologist explains chest x-ray. Transcript Welcome to Radiology Info dot org! Hello, ... you about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed ...

  15. Interpretation of the neonatal chest X-ray.

    PubMed

    Barnes, N; Pilling, D W

    1999-11-01

    Most neonatal X-rays are seen initially by a paediatrician without formal training in interpretation of chest X-rays. This article aims to help improve the information obtained from these X-rays which are often complex. Many factors affect accurate interpretation of the neonatal chest X-ray, including good quality radiographs, appropriate viewing conditions and thorough education.

  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. Quantitative analysis of rib kinematics based on dynamic chest bone images: preliminary results.

    PubMed

    Tanaka, Rie; Sanada, Shigeru; Sakuta, Keita; Kawashima, Hiroki

    2015-04-01

    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.

  18. Radiographic findings of Proteus Syndrome.

    PubMed

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

    2014-01-01

    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.

  19. 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

  20. [Delayed hemothorax due to blunt chest trauma].

    PubMed

    Saito, Gaku; Sakaizawa, Takao; Takasuna, Keiichiro; Eguchi, Takashi; Kobayashi, Nobutaka; Hyougotani, Akira; Hamanaka, Kazutoshi; Shiina, Takayuki; Kurai, Makoto; Kondo, Ryouichi; Yoshida, Kazuo; Amano, Jun

    2010-03-01

    We report 2 cases of delayed hemothorax due to blunt chest trauma. A 48-year-old man who fell down and got a blow at the right chest had a checkup with a 1st aid outpatient. By the X-rays at the time of the 1st examination, the hemothorax was not noted. The next day, He has been transported to our hospital for atypical absence. Hemothorax was suggested by computed tomography (CT) and chest drainage was enforced. A 79-year-old man got a blow at the anterior chest by traffic accident and had a checkup in the 1st hospital. The abnormality was not recognized in the chest CT at that time. For the left hemiparesis, he was transported to our hospital the next day. Hemothorax was suggested by CT and chest drainage was enforced.

  1. 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 head. Sometimes, ...

  2. CT angiography - chest

    MedlinePlus

    Computed tomography angiography - thorax; CTA - lungs; Pulmonary embolism - CTA chest; Thoracic aortic aneurysm - CTA chest; Venous thromboembolism - CTA lung; Blood clot - CTA lung; Embolus - CTA lung; CT ...

  3. Computed tomography of the abnormal thymus

    SciTech Connect

    Baron, R.L.; Lee, J.K.T.; Sagel, S.S.; Levitt, R.G.

    1982-01-01

    Computed tomography (CT) should be the imaging method of choice following plain chest radiographs when a suspected thymic abnormality requires further evaluation. Based upon a six-year experience, including the evaluation of 25 patients with thymic pathology, CT was found useful in suggesting or excluding a diagnosis of thymoma and in distinguishing thymic hyperplasis from thymoma in patients with myasthenia gravis. The thickness of the thymic lobes determined by CT was found to be a more accurate indicator of infiltrative disease (thymic hyperplasia and lymphoma) than the width. CT was helpful in differentiating benign thymic cysts from solid tumors, and in defining the extent of a thymic neoplasms. On occasion, CT may suggest the specific histologic nature of a thymic lesion.

  4. The role of postoperative chest radiography in pediatric tracheotomy.

    PubMed

    Greenberg, J S; Sulek, M; de Jong, A; Friedman, E M

    2001-07-30

    A postoperative chest radiograph has traditionally been obtained after tracheotomies to evaluate for the presence of a pneumothorax and to assess tube position. Several recent studies in adults have questioned the usefulness of routine postoperative chest radiography in uncomplicated cases, but the role of post-operative chest radiography in pediatric patients has not been previously reviewed. We performed this study to examine the clinical utility of post-tracheotomy chest radiography in pediatric patients and determine if this routine practice impacts patient management enough to merit continued usage. A retrospective review was performed of 200 consecutive pediatric patients who underwent tracheotomies by the otolaryngology service in a tertiary care pediatric hospital from January 1994 to June 1999. All patients received postoperative chest radiographs. Five of 200 patients had a new postoperative radiographic finding, with three requiring interventions. Two patients required chest tube placement for pneumothorax, and one patient required tracheostomy tube change for repositioning. Fifty-one patients, including both pneumothoraces, exhibited clinical signs of pneumothorax (decreased breath sounds or oxygen saturation) in the immediate postoperative period. Chest X-ray ruled out a pneumothorax in the remaining 49 patients. The majority of these 51 patients were less than 2 years old (94%, P=0.002) or weighed less than 17 kg (89%, P=0.004). Postoperative chest X-rays yielded clinically relevant information in 168 patients that fell into one or more of four high risk categories: age less than 2, weight less than 17 kg, emergent procedures, or concomitant central line placement. Avoiding chest X-rays in the remaining 32 patients would have resulted in potential savings of $5000, which does not reflect the actuarial cost of a missed complication. Since the majority of our patients (84%) fell into a high-risk category, we feel it would be prudent to continue

  5. Colon in the Chest: An Incidental Dextrocardia

    PubMed Central

    Abd Elrazek, Abd Elrazek; Shehab, Abdullah; Elnour, Asim A.; Al Nuaimi, Saif K.; Baghdady, Shazly

    2015-01-01

    Abstract Diaphragmatic injury is an uncommon traumatic injury (<1%). Although most diaphragmatic injuries can be obvious (eg, herniation of abdominal contents on chest radiograph), some injuries may be subtle and imaging studies can be nondiagnostic in many situations. Patients with diaphragmatic hernia either traumatic or nontraumatic may initially have no symptoms or signs to suggest an injury to the diaphragm. Here, we report a case of a 75-year-old woman diagnosed with irritable bowel syndrome –associated dominant constipation, presented with shortness of breath, cough, expectoration, tachycardia, and chest pain. Dextrocardia was an incidental finding, diagnosed by electrocardiography, chest radiograph, and CT chest. Parts of the colon, small intestine, and stomach were within the thorax in the left side due to left diaphragmatic hernia of a nontraumatic cause. Acquired incidental dextrocardia was the main problem due to displacement of the heart to contralateral side by the GI (gastrointestinal) viscera (left diaphragmatic hernia). The patient was prepared for the laparoscopic surgical repair, using a polyethylene mesh 20 cm to close the defect, and the patient recovered with accepted general condition. However, 5 days postoperative, the patient passed away suddenly due to unexplained cardiac arrest. Intrathoracic herniation of abdominal viscera should be considered in patients presented with sudden chest pain concomitant with a history of increased intra-abdominal pressure. PMID:25674744

  6. 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

  7. Interpretation of dental radiographs.

    PubMed

    Woodward, Tony M

    2009-02-01

    Interpretation of dental radiographs is fairly straightforward, with a handful of common patterns making up the majority of pathology. This article covers normal radiographic anatomy, endodontic disease, periodontal disease, neoplastic changes, tooth resorption, caries, and radiographic signs of oral trauma.

  8. Radiological findings in megaesophagus secondary to Chagas disease: chest X-ray and esophagogram*

    PubMed Central

    Abud, Thiago Giansante; Abud, Lucas Giansante; Vilar, Vanessa Sales; Szejnfeld, Denis; Reibscheid, Samuel

    2016-01-01

    Objective To identify and classify the radiographic patterns of megaesophagus in Chagas disease, as seen on esophagograms and chest X-rays. Materials and Methods This was a prospective study of 35 patients diagnosed with esophageal disease via manometry. The changes found on esophagograms were stratified according to Rezende's classification, divided into four categories (grades I through IV) determined by the degree of dilatation and impairement of esophageal motility. We subsequently correlated that ranking with the chest X-ray findings: gastric air bubble; air-fluid level; and mediastinal widening. Results Among the 35 patients, the esophageal disease was classified as grade I in 9 (25.7%), grade II in 3 (8.6%), grade III in 19 (54.3%), and grade IV in 4 (11.4%). None of the patients with grade I esophageal disease showed changes on chest X-rays. In two of the three patients with grade II disease, there was no gastric air-bubble, although there were no other findings in any of the grade II patients. Of the 19 patients with grade III disease, 15 had abnormal findings on X-rays. All four patients with grade IV disease showed abnormalities. Conclusion The use of Rezende's classification is feasible, encompassing findings ranging from the subtle changes that characterize the initial phases of esophageal disease to the complete akinesia seen in dolicomegaesophagus. Chest X-ray findings are more common in patients with advanced stages of the disease and indicate the degree of esophageal involvement in Chagas disease. PMID:28100930

  9. [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.

  10. Complete blood counts, liver function tests, and chest x-rays as routine screening in early-stage breast cancer: value added or just cost?

    PubMed

    Louie, Raphael J; Tonneson, Jennifer E; Gowarty, Minda; Goodney, Philip P; Barth, Richard J; Rosenkranz, Kari M

    2015-11-01

    Current National Comprehensive Cancer Network guidelines for breast cancer staging include pre-treatment complete blood count (CBC) and liver function tests (LFT) to screen for occult metastatic disease. To date, the relevance of these tests in detecting metastatic disease in asymptomatic women with early-stage breast cancer (Stage I/II) has not been demonstrated. Although chest x-rays are no longer recommended in the NCCN guidelines, many centers continue to include this imaging as part of their screening process. We aim to determine the clinical and financial impact of these labs and x-rays in the evaluation of early-stage breast cancer patients. A single institution IRB-approved retrospective chart review was conducted of patients with biopsy-proven invasive breast cancer treated from January 1, 2005–December 31, 2009. We collected patient demographics, clinical and pathologic staging, chest x-ray, CBC, and LFT results at the time of referral. Patients were stratified according to radiographic stage at the time of diagnosis. We obtained Medicare reimbursement fees for cost analysis. From 2005 to 2009, 1609 patients with biopsy-proven invasive breast cancer were treated at our institution. Of the 1082 patients with radiographic stage I/II disease, 27.3 % of patients had abnormal CBCs. No additional testing was performed to evaluate these abnormalities. In the early-stage population, 24.7 % of patients had elevated LFTs, resulting in 84 additional imaging studies. No metastatic disease was detected. The cost of CBC, LFTs and chest x-rays was $110.20 per patient, totaling $106,410.99. Additional tests prompted by abnormal results cost $58,143.30 over the five-year period. We found that pre-treatment CBCs, LFTs, and chest x-rays did not improve detection of occult metastatic disease but resulted in additional financial costs. Avoiding routine ordering of these tests would save the US healthcare system $25.7 million annually.

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

    SciTech Connect

    Tanaka, R; Sanada, S; Sakuta, K; Kawashima, H; Kishitani, Y

    2015-06-15

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

  12. 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.

  13. Abnormal ventilation scans in middle-aged smokers. Comparison with tests of overall lung function

    SciTech Connect

    Barter, S.J.; Cunningham, D.A.; Lavender, J.P.; Gibellino, F.; Connellan, S.J.; Pride, N.B.

    1985-07-01

    The uniformity of regional ventilation during tidal breathing has been assessed using continuous inhalation of krypton-81m in 43 male, lifelong nonsmokers and 46 male, current cigarette smokers (mean daily consumption 24.1 cigarettes/day) between 44 and 61 yr of age and with mild or no respiratory symptoms. All subjects had normal chest radiographs. The results of the ventilation scans were compared with tests of overall lung function (spirometry, maximal expiratory flow-volume curves, and single-breath N2 test). Diffuse abnormalities of the ventilation scan were found in 19 (41%) of the 46 smokers but in none of the nonsmokers. Focal abnormalities were found in 7 smokers and 3 nonsmokers. Smokers showed the expected abnormalities in overall lung function (reduced FEV1 and VC, increased single-breath N2 slope, and closing volume), but in individual smokers there was only a weak relation between the severity of abnormality of overall lung function and an abnormal ventilation scan. Abnormal scans could be found when overall lung function was normal and were not invariably found when significant abnormalities in FEV1/VC or N2 slope were present. There was no relation between the presence of chronic expectoration and an abnormal scan. The prognostic significance of an abnormal ventilation scan in such smokers remains to be established.

  14. 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.

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

    PubMed Central

    Pompe, E.; van der Bruggen, T.; van Rhenen, A.; Lammers, J. W. J.; Wessels, F.; Sprengers, R. W.; de Jong, P. A.; Minnema, M. C.

    2017-01-01

    We performed a prospective study in patients with chemotherapy induced febrile neutropenia to investigate the diagnostic value of low-dose computed tomography compared to standard chest radiography. The aim was to compare both modalities for detection of pulmonary infections and to explore performance of low-dose computed tomography for early detection of invasive fungal disease. The low-dose computed tomography remained blinded during the study. A consensus diagnosis of the fever episode made by an expert panel was used as reference standard. We included 67 consecutive patients on the first day of febrile neutropenia. According to the consensus diagnosis 11 patients (16.4%) had pulmonary infections. Sensitivity, specificity, positive predictive value and negative predictive value were 36%, 93%, 50% and 88% for radiography, and 73%, 91%, 62% and 94% for low-dose computed tomography, respectively. An uncorrected McNemar showed no statistical difference (p = 0.197). Mean radiation dose for low-dose computed tomography was 0.24 mSv. Four out of 5 included patients diagnosed with invasive fungal disease had radiographic abnormalities suspect for invasive fungal disease on the low-dose computed tomography scan made on day 1 of fever, compared to none of the chest radiographs. We conclude that chest radiography has little value in the initial assessment of febrile neutropenia on day 1 for detection of pulmonary abnormalities. Low-dose computed tomography improves detection of pulmonary infiltrates and seems capable of detecting invasive fungal disease at a very early stage with a low radiation dose. PMID:28235014

  16. A Description of Skeletal Manifestation in Adult Case of Morquio Syndrome: Radiographic and MRI Appearance

    PubMed Central

    Di Cesare, Annalisa; Di Cagno, Alessandra; Moffa, Stefano; Teresa, Paolucci; Luca, Innocenzi; Giombini, Arrigo

    2012-01-01

    We report on a rare case of Morquio syndrome, an autosomal recessive mucopolysaccharidosis including type IVA, a deficiency of N-acetylgalctosamine-6-sulfatase and type IVB a deficiency of β-galactosidase. A 43-year-old female patient affected by IVB Morquio syndrome underwent instrumental investigation. Conventional plain films of the entire spine, pelvis, chest and knees together with magnetic resonance imaging of the entire column, hip, knees, and ankles demonstrated the characteristics of skeletal changes of this disease. The main abnormalities were platyspondily and hypoplasia of the odontoid process, genua valga deformity and severe multiple degenerative changes of the hips, knees, and ankle joints. Radiographs and above all magnetic resonance imaging are crucial to provide substantial information about the gravity, evolution of the skeletal and joints changes, and the rehabilitation strategies to be followed. PMID:22829837

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Chest Roentgenographic Examinations Specifications for Interpretation, Classification, and Submission of... the property of NIOSH. (1) When the radiograph is digital, the image file for each radiograph... when it has received the image files and forms from the examination. After this notification,...

  18. 42 CFR 37.60 - Submitting required chest roentgenograms and miner identification documents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Chest Roentgenographic Examinations Specifications for Interpretation, Classification, and Submission of... the property of NIOSH. (1) When the radiograph is digital, the image file for each radiograph... when it has received the image files and forms from the examination. After this notification,...

  19. Radiographic signs and diagnosis of dental disease.

    PubMed

    Bellows, J

    1993-08-01

    Dental radiographs are critical for the complete assessment and treatment of dental diseases. Dental radiography is commonly used to evaluate congenital dental defects, periodontal disease, orthodontic manipulations, oral tumors, endodontic treatments, oral trauma, and any situation where an abnormality is suspected. Although standard radiographic equipment and film can be used to produce dental radiographs, dental X-ray equipment and film provide superior quality images and greater convenience of animal patient positioning. An understanding of normal dental radiographic anatomy is important when interpreting dental radiographs. Stage III periodontitis is the earliest stage of periodontal disease at which radiographic abnormalities become apparent. Bone loss associated with periodontal disease can be classified as either horizontal or vertical. Periapical radiolucencies can represent granulomas, cysts, or abscesses, whereas periapical radiodensities may represent sclerotic bone or condensing osteitis. Lytic lesions of the bone of the jaw often represent oral neoplasms. Neoplasms also can displace or disrupt teeth in the dental arch. Resorptive lesions can be external or internal and appear as radiolucent areas involving the external surface of the root or the pulp cavity, respectively. Feline dental resorptive lesions, also known as odontoclastic resorptions, are a specific form of dental resorptive lesions unique to cats.

  20. The patterns of false positive lesions for chest radiography observer performance: insights into errors and locations

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

    To examine the lobar distribution of false positives on a set of nodule-free and nodule-containing chest radiographs when radiologists are requested to perform an unframed task (oral report) compared to a framed task (nodule/s identification). A set of 40 chest images, 21 nodule-free (NF) and 19 nodule-containing (NC), was used. Ten radiologists participated in the study; first an oral clinical report was performed (unframed task, UFT) naming any abnormality seen, a confidence score and the location of reported abnormalities. The second (framed task, FT) had the same images randomly presented and radiologists were asked to locate any lung nodule/s and record their confidence and location of nodules. There was no statistical difference between the mean number of false positives (FPs) per lobe per case type (UFT or FT) with the exception of the right lower lobe (RLL) P=0.021. When the comparison of FPs for tasks and case types was carried out there were significant changes. For the NF cases there are significant differences for right upper lobe (RUL) P=0.0003, left upper lobe (LUL) P=0.0412; for NC cases there are significant differences for RUL P=0.009, RLL P=0.0112, LUL P=0.0337 and left lower lobe (LLL) P=0.0209. There was no significant correlation between the presence of a nodule in a given lobe and the occurrence of a FP in that lobe. The number and lobar location of FPs identified on a chest image by a radiologist is influenced by the task and case type.

  1. Automated chest-radiography as a triage for Xpert testing in resource-constrained settings: a prospective study of diagnostic accuracy and costs

    NASA Astrophysics Data System (ADS)

    Philipsen, R. H. H. M.; Sánchez, C. I.; Maduskar, P.; Melendez, J.; Peters-Bax, L.; Peter, J. G.; Dawson, R.; Theron, G.; Dheda, K.; van Ginneken, B.

    2015-07-01

    Molecular tests hold great potential for tuberculosis (TB) diagnosis, but are costly, time consuming, and HIV-infected patients are often sputum scarce. Therefore, alternative approaches are needed. We evaluated automated digital chest radiography (ACR) as a rapid and cheap pre-screen test prior to Xpert MTB/RIF (Xpert). 388 suspected TB subjects underwent chest radiography, Xpert and sputum culture testing. Radiographs were analysed by computer software (CAD4TB) and specialist readers, and abnormality scores were allocated. A triage algorithm was simulated in which subjects with a score above a threshold underwent Xpert. We computed sensitivity, specificity, cost per screened subject (CSS), cost per notified TB case (CNTBC) and throughput for different diagnostic thresholds. 18.3% of subjects had culture positive TB. For Xpert alone, sensitivity was 78.9%, specificity 98.1%, CSS $13.09 and CNTBC $90.70. In a pre-screening setting where 40% of subjects would undergo Xpert, CSS decreased to $6.72 and CNTBC to $54.34, with eight TB cases missed and throughput increased from 45 to 113 patients/day. Specialists, on average, read 57% of radiographs as abnormal, reducing CSS ($8.95) and CNTBC ($64.84). ACR pre-screening could substantially reduce costs, and increase daily throughput with few TB cases missed. These data inform public health policy in resource-constrained settings.

  2. Digital tomosynthesis of the chest: current and emerging applications.

    PubMed

    Chou, Shinn-Huey S; Kicska, Greg A; Pipavath, Sudhakar N; Reddy, Gautham P

    2014-01-01

    Digital tomosynthesis (DTS) of the chest is a technique whose basic components are similar to those of digital radiography, but that also provides some of the benefits of computed tomography (CT). The major advantages of DTS over conventional chest radiography are improved visibility of the pulmonary parenchyma and depiction of abnormalities such as pulmonary nodules. Calcifications, vessels, airways, and chest wall abnormalities are also much more readily visualized at DTS than at chest radiography. DTS could potentially be combined with chest radiography to follow up known nodules, confirm or rule out suspected nodules seen at radiography, or evaluate individuals who are at high risk for lung cancer or pulmonary metastases. DTS generates coronal "slices" through the chest whose resolution is superior to that of coronal reconstructed CT images, but it is limited by its suboptimal depth resolution and susceptibility to motion; consequently, potential pitfalls in recognizing lesions adjacent to the pleura, diaphragm, central vessels, and mediastinum can occur. However, the radiation dose and projected cost of chest DTS are lower than those of standard chest CT. Besides pulmonary nodule detection, specific applications of DTS that are under investigation include evaluation of pulmonary tuberculous and nontuberculous mycobacterial disease, cystic fibrosis, interstitial lung disease, and asbestos-related thoracic diseases. A basic understanding of chest DTS and of the emerging applications of this technique can prove useful to the radiologist. Online supplemental material is available for this article.

  3. Does Expectation of Abnormality Affect the Search Pattern of Radiologists When Looking for Pulmonary Nodules?

    PubMed

    Littlefair, Stephen; Brennan, Patrick; Reed, Warren; Mello-Thoms, Claudia

    2017-02-01

    This experiment investigated whether there might be an effect on the visual search strategy of radiologists during image interpretation of the same adult chest radiographs when given different clinical information. Each of 17 experienced radiologists was asked to interpret a set of 57 (10 abnormal) posteroanterior chest images to identify the presence of pulmonary lesions using differing clinical information (leading to unknown, low and high expectations of prevalence). Eye position metrics (search time, dwell time and time to first fixation) were compared for normal and abnormal images, as well as between conditions. For all images, there was a significantly longer search time at high prevalence expectation compared to low prevalence expectation (W = 75.19, P = <0.0001). Mann-Whitney analysis of the abnormal images demonstrated that the dwell time on correctly identified lesions was significantly shorter at low prevalence expectation compared to both unknown (U = 364.5, P = 0.02) and high prevalence expectation (U = 397.0, P = 0.0002). Visual search patterns of radiologists appear to be affected by changing a priori information where such information fosters an expectation of abnormality.

  4. Chest X-Ray (Chest Radiography)

    MedlinePlus

    ... x-rays. top of page What does the equipment look like? The equipment typically used for chest x-rays consists of ... tube is positioned about six feet away. The equipment may also be arranged with the x-ray ...

  5. Use of chest sonography in acute-care radiology().

    PubMed

    De Luca, C; Valentino, M; Rimondi, M R; Branchini, M; Baleni, M Casadio; Barozzi, L

    2008-12-01

    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.

  6. Prephonatory chest wall posturing in stutterers.

    PubMed

    Baken, R J; McManus, D A; Cavallo, S A

    1983-09-01

    The possibility that prephonatory chest wall posturing is abnormal in stutterers was explored by observing rib cage and abdominal hemicircumference changes during the interval between the presentation of a stimulus and the production of/alpha/by a group of stutterers (N = 5). It was found that the patterns of chest wall adjustment for phonation were qualitatively identical in the stutterers and in a comparable group of normal men studied previously. There was, however, a significant difference in the way in which lung volume changed during the execution of the chest wall adjustment. This was considered to be indicative of delayed glottal closure among the stutterers rather than representative of a primary ventilatory disturbance.

  7. 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.

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

    PubMed Central

    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

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

    PubMed Central

    Wong, Matthew L.; Chiu, David; Shapiro, Nathan I; Grossman, Shamai A

    2016-01-01

    Introduction Syncope has myriad etiologies, ranging from benign to immediately life threatening. This frequently leads to over testing. Chest radiographs (CXR) are among these commonly performed tests despite their uncertain diagnostic yield. The objective is to study the distribution of normal and abnormal chest radiographs in patients presenting with syncope, stratified by those who did or did not have an adverse event at 30 days. Methods We performed a post-hoc analysis of a prospective cohort of consecutive patients presenting to an urban tertiary care academic medical center with a chief complaint of syncope from 2003–2006. The frequency and findings for each CXR were reviewed, as well as emergency department and hospital discharge diagnoses, and 30-day outcome. Results There were 575 total subjects, 39.7% were male, and the mean age was 57.2 (SD 24.6). Of the 575 subjects, 403 (70.1%) had CXRs performed, and 116 (20.2%) had an adverse event after their syncope. Of the 116 people who had an adverse event, 15 (12.9%) had a positive CXR, 81 (69.8%) had a normal CXR, and 20 (17.2%) did not have a CXR as part of the initial evaluation. Among the 459 people who did not have an adverse event, 3 (0.7%) had a positive CXR, 304 (66.2%) had a normal CXR, and 152 (33.1%) did not have a CXR performed. Fifteen of the 18 patients (83.4%) with an abnormal CXR had an adverse event. Eighty-one of the 385 patients (21.0%) with a normal CXR had an adverse event. Among those who had a CXR performed, an abnormal CXR was associated with increased odds of adverse event (OR: 18.77 (95% CI= [5.3–66.4])). Conclusion Syncope patients with abnormal CXRs are likely to experience an adverse event, though the majority of CXRs performed in the work up of syncope are normal. PMID:27833675

  10. Atlas of computed body tomography: normal and abnormal anatomy

    SciTech Connect

    Chiu, L.C.; Schapiro, R.L.

    1980-01-01

    This atlas contains comparative sections on normal and abnormal computed tomography of the neck, chest, abdomen, pelvis, upper and lower limbs, fascia, and peritoneum. Also included is a subject index to aid in the identification of abnormal scans. (DLS)

  11. Chest CT Scan

    MedlinePlus

    ... inside the scanner. For some diagnoses, a contrast dye, often iodine-based, may be injected into a ... your arm before the imaging test. This contrast dye highlights areas inside your chest and creates clearer ...

  12. Chest tube insertion - slideshow

    MedlinePlus

    ... Health Topics Chest Injuries and Disorders Collapsed Lung Critical Care Lung Diseases Pleural Disorders A.D.A. ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map ...

  13. 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 ...

  14. Chest x-ray

    MedlinePlus

    ... also be done if you have signs of tuberculosis , lung cancer , or other chest or lung diseases . ... the blood vessels Pneumonia Scarring of lung tissue Tuberculosis In the heart: Problems with the size or ...

  15. Radiographic film package

    SciTech Connect

    Muylle, W. E.

    1985-08-27

    A radiographic film package for non-destructive testing, comprising a radiographic film sheet, an intensifying screen with a layer of lead bonded to a paper foil, and a vacuum heat-sealed wrapper with a layer of aluminum and a heat-sealed easy-peelable thermoplastic layer.

  16. Talc: understanding its manifestations in the chest.

    PubMed

    Feigin, D S

    1986-02-01

    Four distinct forms of pulmonary disease caused by talc have been defined. The first form, talcosilicosis, is caused by talc mined with high-silica-content mineral. Findings in this form are identical with those of silicosis. Talcoasbestosis closely resembles asbestosis and is produced by crystalline talc, generally inhaled with asbestos fibers. Pathologic and radiographic abnormalities are virtually identical with those of asbestosis, including calcifications and malignant tumor formation. The third form, talcosis, caused by inhalation of pure talc, may include acute or chronic bronchitis as well as interstitial inflammation; radiographically, it appears as interstitial reticulations or small, irregular nodules, typical of small-airway obstruction. The fourth form, due to intravenous administration of talc, is usually associated with abuse of oral medications and production of vascular granulomas manifested by consolidations, large nodules, and masses. Radiographic abnormalities associated with talc can be predicted when there is sufficient history of the nature of exposure, including the region of origin of the talc in cases of inhalation. Radiographic changes, such as diaphragmatic plaques, often attributed to both talc and asbestos have not been documented to be caused by talc alone. The author provides review of 18 well-documented cases.

  17. Pulmonary imaging of pandemic influenza H1N1 infection: relationship between clinical presentation and disease burden on chest radiography and CT

    PubMed Central

    Abbo, L; Quartin, A; Morris, M I; Saigal, G; Ariza-Heredia, E; Mariani, P; Rodriguez, O; Muñoz-Price, L S; Ferrada, M; Ramee, E; Rosas, M I; Gonzalez, I A; Fishman, J

    2010-01-01

    The potential for pulmonary involvement among patients presenting with novel swine-origin influenza A (H1N1) is high. To investigate the utility of chest imaging in this setting, we correlated clinical presentation with chest radiographic and CT findings in patients with proven H1N1 cases. Subjects included all patients presenting with laboratory-confirmed H1N1 between 1 May and 10 September 2009 to one of three urban hospitals. Clinical information was gathered retrospectively, including symptoms, possible risk factors, treatment and hospital survival. Imaging studies were re-read for study purposes, and CXR findings compared with CT scans when available. During the study period, 157 patients presented with subsequently proven H1N1 infection. Hospital admission was necessary for 94 (60%) patients, 16 (10%) were admitted to intensive care and 6 (4%) died. An initial CXR, carried out for 123 (78%) patients, was abnormal in only 40 (33%) cases. Factors associated with increased likelihood for radiographic lung abnormalities were dyspnoea (p<0.001), hypoxaemia (p<0.001) and diabetes mellitus (p = 0.023). Chest CT was performed in 21 patients, and 19 (90%) showed consolidation, ground-glass opacity, nodules or a combination of these findings. 4 of 21 patients had negative CXR and positive CT. Compared with CT, plain CXR was less sensitive in detecting H1N1 pulmonary disease among immunocompromised hosts than in other patients (p = 0.0072). A normal CXR is common among patients presenting to the hospital for H1N1-related symptoms without evidence of respiratory difficulties. The CXR may significantly underestimate lung involvement in the setting of immunosuppression. PMID:20551254

  18. Congenital Abnormalities

    MedlinePlus

    ... Listen Español Text Size Email Print Share Congenital Abnormalities Page Content Article Body About 3% to 4% ... of congenital abnormalities earlier. 5 Categories of Congenital Abnormalities Chromosome Abnormalities Chromosomes are structures that carry genetic ...

  19. Role of HRCT Chest in Post Stem Cell Transplant Recipients Suspected of Pulmonary Complications

    PubMed Central

    Kumar, R Ravi; Sharma, Ajay; Pannu, S K

    2016-01-01

    Introduction Stem cell transplantation is today’s procedure of choice for management of various hematopoietic malignant and severe immunogenic disorders. High Resolution Computed Tomography (HRCT) is a common technique for the diagnosis of pulmonary complications in stem cell transplant recipients. There are a large number of complications which can complicate the post-transplant period. Aim To study the role of HRCT chest in stem cell transplant patients developing pulmonary complications, detect any evidence of infection, detect clinical signs of lung infections, Graft versus Host Disease (GvHD) or other regimen related toxicities outlined earlier, detect any evidence of GvHD and correlate these clinical signs with radiological changes in the lungs. Materials and Methods The study was a prospective study of 52 participants with indication of stem cell transplantation. The study included recipients of HSCT transplant and the exclusion criteria was patients who failed for engraftment and having an associated history of pulmonary embolism. Patients were screened for pre-transplant chemotherapy, clinical examination, laboratory investigations including blood and biochemical examinations, imaging by ultrasound, chest radiography, baseline HRCT and a follow-up for post-transplant infections and complications with 16 slice Siemens CT scan. Statistical analysis was done using Pearson’s chi-squared test. Results Four patients among the total 56 were excluded due to non-engraftment. The most common associated findings in decreasing order are (these patients died): consolidation, pancytopenia and gastrointestinal tract symptoms with VOD (Veno-Occlusive Disease). These findings were seen on HRCT as consolidation, cavities, ground glass opacities, fibrotic changes, bronchiectatic changes and tree in bud appearance. Conclusion The study highlights the significant positive findings on the HRCT which were missed on routine chest radiograph and can be used for early diagnoses

  20. 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

  1. A Rare Case of Hamartoma Chest Wall Following Trauma in a 42-year-old Man

    PubMed Central

    Ahmadinejad, Mojtaba; Pour, Asghar Alie; Hosseini, Peyman Khadem; Hashemian, Amir Masoud; Ahmadi, Koorosh

    2016-01-01

    Background: Chest wall mesenchymal hamartoma (CWH) is a distinct and extremely rare tumor-like lesion of the thorax. It usually presents in the neonatal period or in infancy. The common presentation is in the form of a visible chest wall mass with or without respiratory distress. Case presentation: A 42-year-old man with a history of chest wall trauma since 5 years ago was admitted with a swelling of the anterior of the chest wall and during this period has grown slowly. Physical examination showed a left anterior chest wall deformity. Chest radiographs and chest CT showed a left anterolateral chest wall mass involving the fourth and fifth ribs. Thoracotomy was performed. The tumor and involved ribs were resected with a 5cm safe margin. The histopathologic examination showed hamartoma. The patient has been fallowed up since 60 month ago, and has not had any complaints in this time. Result: Despite the rarity of chest wall hematoma, this side effect must always be taken into consideration while studying the chest wall injuries especially in the case of trauma history due to other differential diagnosis and her side effects such as respiratory problems. Conclusion: Although rare, this condition ought to be kept in mind while dealing with hamartoma Chest wall following trauma in order to avoid its complications such as respiratory problems. Surgical excision is usually curative in combination with conservative therapy if possible. PMID:27994306

  2. Aspects of chest imaging in the intensive care unit.

    PubMed

    Cascade, P N; Kazerooni, E A

    1994-04-01

    Timely performance and accurate interpretation of portable chest radiographs in the ICU setting are fundamental components of quality care. Teamwork between intensive care clinicians and radiologists is necessary to assure that the appropriate studies, of high technical quality, are obtained. By working together to integrate available clinical information with systematic comprehensive analysis of images, accurate diagnoses can be made, optimal treatment instituted, and successful outcomes optimized.

  3. Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

    SciTech Connect

    Reiss, T.F.; Golden, J. )

    1990-05-01

    Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population.

  4. Chest X-Ray

    MedlinePlus Videos and Cool Tools

    ... Site Index A-Z Spotlight Recently posted: Anal Cancer Facet Joint Block Video: Lung Cancer Screening Video: Upper GI Tract X-ray Video: ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  5. Radiographic appearance of confirmed pulmonary lymphoma in cats and dogs.

    PubMed

    Geyer, Nicole E; Reichle, Jean K; Valdés-Martínez, Alejandro; Williams, Jamie; Goggin, Justin M; Leach, Lesley; Hanson, Jennifer; Hill, Steve; Axam, Tasha

    2010-01-01

    Herein we describe the thoracic radiographic appearance of confirmed pulmonary lymphoma. Patients with thoracic radiographs and cytologically or histologically confirmed pulmonary lymphoma were sought by contacting American College of Veterinary Radiology members. Seven cats and 16 dogs met the inclusion criteria, ranging in age from 4 to 15 years. Method of diagnosis was via ultrasound-guided cytology (four), surgical biopsy (two), ultrasound-guided biopsy (one), and necropsy (16). Radiographic findings varied but ranged from normal (one) to alveolar (six) and/or unstructured interstitial infiltrates (11), nodules and/or masses (eight), and bronchial infiltrates (four). Additional thoracic radiographic findings included pleural effusion and lymphadenopathy. The results of this evaluation indicate a wide variability in thoracic radiographic abnormalities in cats and dogs with pulmonary lymphoma.

  6. Non-Cardiac Chest Pain

    MedlinePlus

    ... No other specific risk factors have been identified. Diagnosis What do I do if I’ve been treated for chest pain, but told I didn’t have a heart attack? Patients suffering from chest pain must have thorough ...

  7. Radiographic total lung capacity determination aided by a programmable calculator.

    PubMed

    Bencowitz, H A; Shigeoka, J W

    1980-11-01

    This report describes a method that was used to determine total lung capacity from routine chest radiographs, using a programmable calculator to facilitate computation. The results correlated closely with those obtained by a computerized method. The technique was rapid, inexpensive (the necessary equipment cost less than $400), and could be used in any pulmonary laboratory or office. The program is listed, and an example provided.

  8. 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.

  9. Role of Cross Sectional Imaging in Isolated Chest Wall Tuberculosis

    PubMed Central

    Sanyal, Shantiranjan; Sharma, Barun K.; Prakash, Arjun; Dhingani, Dhabal D.; Bora, Karobi

    2017-01-01

    Introduction Isolated chest wall tuberculosis though a rare entity, the incidence of it has been on rise among immunocompromised population making it an important challenging diagnosis for the physicians. Its clinical presentation may resemble pyogenic chest wall abscess or chest wall soft tissue tumour. Sometimes it is difficult to detect clinically or on plain radiograph. Aim The present study was conducted with an aim to evaluate the common sites and varying appearances of isolated chest wall tuberculosis. Materials and Methods A hospital based cross-sectional retrospective study was conducted in Assam Medical College and Hospital, a tertiary care centre in North East India. The study group comprise of 21 patients (n=15 male and n=6 females) with isolated chest wall tuberculosis without associated pulmonary or spinal involvement who were subjected to Computed Tomography/Magnetic Resonance Imaging (CT/MRI) of the thorax following initial Ultrasonogram (USG) evaluation of the local site. Pathological correlation was done from imaging guided sampling of the aspirate or surgery. Results Variable sites of involvement were seen in the chest wall in our patients (n=21), with chest wall abscess formation being the most common presentation and rib being the most common bony site affected in the thoracic cage. Bony sclerosis was noted in 11 patients (52.4%), periosteal reaction in 10 patients (47.6%) and sequestration in five patients (23.8%). CT/MRI not only localized the exact site and extent of the abscesses which facilitated guided aspirations, but also helped in detecting typical bony lesions thereby, differentiating from pyogenic osteomyelitis besides ruling out associated pulmonary or pleural involvement in such patients. Conclusion Cross-sectional imaging plays an important role by giving a wholesome picture of both soft tissue and bony pathology. It is important to have adequate understanding of the radiologic manifestations of the chest wall involvement and

  10. Angina - when you have chest pain

    MedlinePlus

    ... pain; ACS - chest pain; Heart attack - chest pain; Myocardial infarction - chest pain; MI - chest pain ... AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College ...

  11. Suppression of translucent elongated structures: applications in chest radiography.

    PubMed

    Hogeweg, Laurens; Sanchez, Clara I; van Ginneken, Bram

    2013-11-01

    Projection images, such as those routinely acquired in radiological practice, are difficult to analyze because multiple 3-D structures superimpose at a single point in the 2-D image. Removal of particular superimposed structures may improve interpretation of these images, both by humans and by computers. This work therefore presents a general method to isolate and suppress structures in 2-D projection images. The focus is on elongated structures, which allows an intensity model of a structure of interest to be extracted using local information only. The model is created from profiles sampled perpendicular to the structure. Profiles containing other structures are detected and removed to reduce the influence on the model. Subspace filtering, using blind source separation techniques, is applied to separate the structure to be suppressed from other structures. By subtracting the modeled structure from the original image a structure suppressed image is created. The method is evaluated in four experiments. In the first experiment ribs are suppressed in 20 artificial radiographs simulated from 3-D lung computed tomography (CT) images. The proposed method with blind source separation and outlier detection shows superior suppression of ribs in simulated radiographs, compared to a simplified approach without these techniques. Additionally, the ability of three observers to discriminate between patches containing ribs and containing no ribs, as measured by the area under the receiver operating characteristic curve (AUC), reduced from 0.99-1.00 on original images to 0.75-0.84 on suppressed images. In the second experiment clavicles are suppressed in 253 chest radiographs. The effect of suppression on clavicle visibility is evaluated using the clavicle contrast and border response, showing a reduction of 78% and 34%, respectively. In the third experiment nodules extracted from CT were simulated close to the clavicles in 100 chest radiographs. It was found that after

  12. Asbestotic radiological abnormalities among United States merchant marine seamen.

    PubMed

    Selikoff, I J; Lilis, R; Levin, G

    1990-05-01

    There has been limited information concerning the prevalence of radiologically evident parenchymal and pleural fibrosis consistent with prior exposure to asbestos among merchant marine seamen, despite the wide use of asbestos in ship construction until the late 1970s and subsequent exposure of seamen to the asbestos that had been installed. A total of 3324 chest radiographs (1985-7) of long term United States seamen were reviewed. One third (34.8%) had parenchymal or pleural abnormalities, or both (ILO classification); pleural changes were predominant. Abnormalities increased with longer duration from onset of shipboard exposure (as defined by first year at sea). The prevalence of asbestotic changes was greater among seamen who had served in the engine department (391/420; 42.5%) compared with seamen in other departments, including deck (301/820; 36.6%), steward (278/981; 28.4%), or with service in multiple departments (167/541; 30.9%). Since many vessels, particularly those built before 1978, contain asbestos materials, appropriate engineering controls (including complete removal, if possible) are required as well as appropriate medical surveillance for those who served aboard such ships.

  13. Comparison Of Digital Radiographic Units

    NASA Astrophysics Data System (ADS)

    Wang, Yen

    1986-06-01

    A total PACS will be inevitable for radiology practice within several years. To achieve a total PACS for radiology, a satisfactory digital radiographic unit is required, because approximately 65% of digital data for PACS comes from digital radiographs. There are several possibilities for producing digital radiographs, and 3 - 4 companies have been marketing digital radiographic devices. Some data regarding the digital radiographic units on the market are compared. It will aid in assessing the current status and availability of this aspect of development, as well as providing a summary of further development of digital radiographic technology.

  14. Chest wall reconstruction with methacrylate prosthesis in Poland syndrome.

    PubMed

    Arango Tomás, Elisabet; Baamonde Laborda, Carlos; Algar Algar, Javier; Salvatierra Velázquez, Angel

    2013-10-01

    Poland syndrome is a rare congenital malformation. This syndrome was described in 1841 by Alfred Poland at Guy's Hospital in London. It is characterized by hypoplasia of the breast and nipple, subcutaneous tissue shortages, lack of the costosternal portion of the pectoralis major muscle and associated alterations of the fingers on the same side. Corrective treatment of the chest and soft tissue abnormalities in Poland syndrome varies according to different authors. We report the case of a 17-year-old adolescent who underwent chest wall reconstruction with a methyl methacrylate prosthesis. This surgical procedure is recommended for large anterior chest wall defects, and it prevents paradoxical movement. Moreover it provides for individual remodeling of the defect depending on the shape of the patient's chest.

  15. 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.

  16. An unusual case of flail chest: surgical repair using Marlex mesh

    PubMed Central

    Heriot, A. G.; Wells, F. C.

    1997-01-01

    The case history is presented of a patient with neurofibromatosis with a chest wall defect present from birth. Abnormal rib development had resulted in a flail segment with painful paradoxical movement and unsightly costal cartilage protrusion. Chest wall reconstruction using Marlex mesh resulted in an excellent cosmetic and functional repair. 


 PMID:9176546

  17. Elbow clinical, ultrasonographic and radiographic study in patients with inflammatory joint diseases.

    PubMed

    Uson, Jacqueline; Miguélez-Sánchez, Roberto; de Los Riscos, Marina; Martínez-Blasco, María Jesús; Fernández-Espartero, Cruz; Villaverde-García, Virginia; Garrido, Jesús; Naredo, Esperanza

    2016-03-01

    The main objective of this cross-sectional observational study was to investigate the relationship between clinical, ultrasonographic (US) and radiographic elbow features in patients with inflammatory joint diseases (IJD). The secondary objective was to evaluate the association between regional clinical elbow diagnoses and imaging findings. Consecutive patients with IJD attending follow-up visits were assessed for elbow pain and standardized elbow examination. Seven regional clinical diagnoses were defined. Digital elbow radiographs were read for 9 abnormalities. A standardized elbow grayscale (GS) and power Doppler (PD) scan recorded 13 defined abnormalities. Analysis encompassed 361 clinical, 361 US and 340 radiographic elbow assessments from 181 patients. US and clinical assessments showed an overall higher agreement than radiographic and clinical assessments (68.8 vs 59.1%, p = 0.001). When structural US abnormalities were compared with radiographic findings, agreement was slightly higher than when comparing all US abnormalities with radiographic findings (77.3%, k 0.533 and 73.5%, k 0.492). Enthesophytes, the most common abnormalities, were not associated with clinical findings. Subclinical US-synovitis and US-enthesopathy were found, respectively, in 17.3 and 14.1% of the clinically normal elbows. Clinical elbow arthritis prevalence and bias-adjusted kappa (PABAK) agreement was good for radiographic fat pad sign, PD-synovitis and GS-synovitis. Clinical elbow enthesopathy PABAK agreement was moderate for GS-enthesopathy and radiographic calcifications. US showed acceptable agreement with clinical and radiographic assessments for detecting elbow inflammatory and structural abnormalities in patients with IJD. Because US detected more abnormalities than radiography and has the capability to detect more subclinical abnormalities, US may be potentially used as a first-line elbow diagnostic tool in this clinical setting.

  18. 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…

  19. Alveolar abnormalities

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001093.htm Alveolar abnormalities To use the sharing features on this page, please enable JavaScript. Alveolar abnormalities are changes in the tiny air sacs in ...

  20. Nail abnormalities

    MedlinePlus

    Beau's lines; Fingernail abnormalities; Spoon nails; Onycholysis; Leukonychia; Koilonychia; Brittle nails ... 2012:chap 71. Zaiac MN, Walker A. Nail abnormalities associated with systemic pathologies. Clin Dermatol . 2013;31: ...

  1. 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).

  2. DARHT Radiographic Grid Scale Correction

    SciTech Connect

    Warthen, Barry J.

    2015-02-13

    Recently it became apparent that the radiographic grid which has been used to calibrate the dimensional scale of DARHT radiographs was not centered at the location where the objects have been centered. This offset produced an error of 0.188% in the dimensional scaling of the radiographic images processed using the assumption that the grid and objects had the same center. This paper will show the derivation of the scaling correction, explain how new radiographs are being processed to account for the difference in location, and provide the details of how to correct radiographic image processed with the erroneous scale factor.

  3. Para-acetabular periarthritis calcarea: its radiographic manifestations.

    PubMed

    Kawashima, A; Murayama, S; Ohuchida, T; Russell, W J

    1988-01-01

    On retrospective reviews of radiographs, periarthritis calcarea was distinguished from os acetabula by interval radiographic progression and regression. Among 59 men and 51 women, there were 137 instances of para-acetabular calcifications and ossifications, which were morphologically classified as 58 discrete, 58 amorphous, and 21 segmented types. Correlations with other radiographic abnormalities, symptoms, signs, and laboratory abnormalities were sought, but not established. Out of 93 serially imaged opacities, 90 changed, including 37 of the 40 instances (92.5%) of the discrete type and 53 instances (100%) of the amorphous and segmented types--due to periarthritis calcarea. At least 43 of 90 densities were newly developed. Mean age at first detection was 47.7 years. Three of the discrete densities were unchanged and represented os acetabula. Thus, recognition of para-acetabular periarthritis calcarea is not only of academic importance; it can facilitate proper treatment as well.

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

    PubMed Central

    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

    2015-01-01

    Abstract. 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

  5. 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.

  6. Radiographic Evaluation of Common Pediatric Elbow Injuries

    PubMed Central

    DeFroda, Steven F.; Hansen, Heather; Gil, Joseph A.; Hawari, Ashraf H.; Cruz, Aristides I.

    2017-01-01

    Normal variations in anatomy in the skeletally immature patient may be mistaken for fracture or injury due to the presence of secondary centers of ossification. Variations in imaging exist from patient to patient based on sex, age, and may even vary from one extremity to the other on the same patient. Despite differences in the appearance of the bony anatomy of the elbow there are certain landmarks and relationships, which can help, distinguish normal from abnormal. We review common radiographic parameters and pitfalls associated in the evaluation of pediatric elbow imaging. We also review common clinical diagnoses in this population. PMID:28286625

  7. Non-invasive quick diagnosis of cardiovascular problems from visible and invisible abnormal changes with increased cardiac troponin I appearing on cardiovascular representation areas of the eyebrows, left upper lip, etc. of the face & hands: beneficial manual stimulation of hands for acute anginal chest pain, and important factors in safe, effective treatment.

    PubMed

    Omura, Yoshiaki; Jones, Marilyn K; Duvvi, Harsha; Shimotsuura, Yasuhiro; Ohki, Motomu; Rodriques, Aaron

    2014-01-01

    Our previous study indicated that there are at least 7 cardiovascular representation areas on the face, including the "Eyebrows", both sides of the "Nose", "Lelt Upper Lip" and the "Outside of the corner of both sides of the mouth," in addition to 2 areas in each hand. When there are cardiovascular problems, some of the heart representation areas of these areas often show the following changes: 1) Most distinctive visible changes such as the initial whitening with or without long white hair, then hair loss and complete disappearance of the hairs of the heart representation area of "Eyebrows" 2) Invisible biochemical changes that happen in heart representation areas at the "Left Upper Lips", 3) "Nose" below eye level as well as 4) "3rd segment of Middle Finger of Hands." Most distinctive visible & invisible changes are found in heart representation areas on the "Eyebrow", located nearest to the midline of face, where the color of the hairs becomes white compared with the rest of the Eyebrow. Then the cardiovascular problem advances, and hair starts disappearing. When there are no hairs at the heart representation areas of the Eyebrow, usually Cardiac Troponin I is increased to a very serious, abnormal high value. Most of the cardiovascular representation areas of the face show, regardless of presence or absence of visible change. When there is a cardiovascular problem, not only simple Bi-Digital O-Ring Test can detect without using any instrument in several minutes but also, corresponding biochemical changes of abnormally increased Cardiac Troponin I level can often be detected non-invasively from these Organ Representation Areas of Face & Hands, although changes in Eyebrows, L-Upper Lip & 3rd segment of middle fingers are clinically the most reliable changes & easy to identify the locations. Manual Stimulation of Hand's heart representation areas often eliminated acute anginal chest pain before medical help became available. Important factors for safe, effective

  8. Respiratory distress in newborn: evaluation of chest X-rays.

    PubMed

    Roggini, M; Pepino, D; D'Avanzo, M; Andreoli, G M; Ceccanti, S; Capocaccia, P

    2010-06-01

    We discuss the anatomic and pathophysiological patterns of preterm and term newborn. Particular attention is directed to technical artefacts relating to the interpretation of chest radiography. We analyze the reading of chest X-Ray of preterm with low birth weight and poor lung maturation. Are also taken into account X-Ray features relating to alveolar "recruitment" and radiographic changes after surfactant's administration. We highlight the most important paintings of bruncopulmonary dysplasia and its evolution. The most frequent neonatal pulmonary inflammation and thoraco-pulmonary malformation, that may affect more the neonatologist, are mentioned. We discuss the new diagnostic approach with non invasive techniques (ultrasound) in the neonatal distress. Some easily recognizable congenital heart disease are finally describes.

  9. Impact of chest X-ray before discharge in asymptomatic children after cardiac surgery--prospective evaluation.

    PubMed

    Quandt, Daniel; Knirsch, Walter; Niesse, Oliver; Schraner, Thomas; Dave, Hitendu; Kretschmar, Oliver

    2013-01-01

    In many paediatric cardiac units chest radiographs are performed routinely before discharge after cardiac surgery. These radiographs contribute to radiation exposure. To evaluate the diagnostic impact of routine chest X-rays before discharge in children undergoing open heart surgery and to analyze certain risk factors predicting pathologic findings. This was a prospective (6 months) single-centre observational clinical study. One hundred twenty-eight consecutive children undergoing heart surgery underwent biplane chest X-ray at a mean of 13 days after surgery. Pathologic findings on chest X-rays were defined as infiltrate, atelectasis, pleural effusion, pneumothorax, or signs of fluid overload. One hundred nine asymptomatic children were included in the final analysis. Risk factors, such as age, corrective versus palliative surgery, reoperation, sternotomy versus lateral thoracotomy, and relevant pulmonary events during postoperative paediatric intensive care unit (PICU) stay, were analysed. In only 5.5 % (6 of 109) of these asymptomatic patients were pathologic findings on routine chest X-ray before discharge found. In only three of these cases (50 %), subsequent noninvasive medical intervention (increasing diuretics) was needed. All six patients had relevant pulmonary events during their PICU stay. Risk factor analysis showed only pulmonary complications during PICU stay to be significantly associated (p = 0.005) with pathologic X-ray findings. Routine chest radiographs before discharge after cardiac surgery can be omitted in asymptomatic children with an uneventful and straightforward perioperative course. Chest radiographs before discharge are warrantable if pulmonary complications did occur during their PICU stay, as this is a risk factor for pathologic findings in chest X-rays before discharge.

  10. 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.

  11. Peri- and paracardial involvement in lymphoma: a radiographic study of 11 cases

    SciTech Connect

    Jochelson, M.S.; Balikian, J.P.; Mauch, P.; Liebman, H.

    1983-03-01

    Eleven patients with pericardiac and paracardiac lymphomatous involvement were studied. Computed tomography (CT) of the chest was compared to plain chest films for its ability to define the sites and extent of involvement in the paracardiac area. Nine of the 11 patients had abnormalities on chest radiography, which included abnormal contours in the fat pad areas and along the heart border, or an enlarged cardiac silhouette. Two patients had normal cardiac silhouettes; however, CT showed definite abnormalities. CT differentiated adenopathy from fat pads in two patients and pericardial effusion from cardiomegaly or paracardiac adenopathy in two patients. The exact location and extent of the paracardiac adenopathy initially seen on chest film was defined by CT. Careful analysis of the peri- and paracardiac areas by plain films and CT is essential to the diagnosis and the proper management of patients with Hodgkin and non-Hodgkin lymphoma.

  12. Meiotic abnormalities

    SciTech Connect

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  13. Inflammation and Rupture of a Congenital Pericardial Cyst Manifesting Itself as an Acute Chest Pain Syndrome

    PubMed Central

    Cheong, Benjamin Y.C.; Lufschanowski, Roberto

    2016-01-01

    We present the case of a 63-year-old woman with a remote history of supraventricular tachycardia and hyperlipidemia, who presented with recurrent episodes of acute-onset chest pain. An electrocardiogram showed no evidence of acute coronary syndrome. A chest radiograph revealed a prominent right-sided heart border. A suspected congenital pericardial cyst was identified on a computed tomographic chest scan, and stranding was noted around the cyst. The patient was treated with nonsteroidal anti-inflammatory drugs, and the pain initially abated. Another flare-up was treated similarly. Cardiac magnetic resonance imaging was then performed after symptoms had resolved, and no evidence of the cyst was seen. The suspected cause of the patient's chest pain was acute inflammation of a congenital pericardial cyst with subsequent rupture and resolution of symptoms. PMID:28100978

  14. 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.

  15. Textbook of radiographic science

    SciTech Connect

    Bentley, H.B.

    1987-01-01

    This book has been written to provide an outline of scientific background of specialized radiologic procedures for candidates studying for the higher examination of the College of Radiographers (United Kingdom). The book contains nine chapters on various areas such as emergency/trauma; pediatrics; neurologic, angiographic, and urodynamic studies; and a final chapter on research. An index concludes the book. Information on historical and scientific procedural background, equipment, anatomic and pathologic correlates, and positioning of the patient is organized and presented. Scientific data are inserted in the text where appropriate. Metrizamide is given an extensive write-up as the contrast medium of choice for imaging of the spinal cord and is said to be ''less toxic than other forms of water-soluble contrast.''

  16. Dynamic Radiographic Imaging

    SciTech Connect

    Volkov, A.; Turley, D.; Veeser, L.; Lukyanov, N.; Yegorov, N.; Baker, S.A.; Mirenko, V.; Lewis, W.; Kuropatkin, Y.

    1999-06-01

    A radiographic system recently developed by American and Russian collaborators is designed to capture multiple images of a dynamic event lasting less than 10 microseconds. Various optical and electro-optical components were considered and their performance compared. The final system employed a solid crystal of lutetium oxyorthosilicate doped with cerium (LSO:Ce or LSO) for X-ray-to-light conversion with a coherent fiber optic bundle to relay the scintillator image to a streak camera with charge coupled device (CCD) readout. Resolution and sensitivity studies were carried out for this system on two different sources of X-rays: a 20 MeV microtron and a 70 MeV betatron.

  17. 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

  18. American College of Chest Physicians

    MedlinePlus

    ... April 10, 2017 CHEST Foundation and Foundation for Sarcoidosis Research campaign aims to raise awareness of little-known condition, sarcoidosis To coincide with National Sarcoidosis Awareness Month in ...

  19. Radiographic Assessment for Back Pain

    MedlinePlus

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

  20. Alcohol and radiographs in the accident and emergency department

    PubMed Central

    Rust, P; Hunt, I; Wallis, D; Jowett, A; Rottenberg, G

    2001-01-01

    Objective—To investigate the contribution of alcohol ingestion to the radiological workload of an inner city accident and emergency (A&E) department. Methods—A prospective survey of patients presenting to A&E who required radiographs was performed over a seven day period. The A&E clinician questioned patients about alcohol intake during the six hours before the onset of the presenting complaint or injury, and made an objective assessment of signs of alcohol ingestion or intoxication. An assessment was made also of the relative contribution of alcohol as a cause of patients' injuries. Results—A total of 419 patients who had radiography fulfilled the inclusion criteria, and a questionnaire was completed for 351 (84%). Forty (11%) of 351 were found to have ingested alcohol. Thirty five (87%) of 40 patients who had ingested alcohol were radiographed for trauma, as compared with 171 (55%) of the 311 who had not (p<0.001). Alcohol was considered to have been causative of injury in 30% and a contributory factor in an additional 58%. Radiographs of the skull, face and jaw accounted for 18 (33%) of 55 radiographs from trauma patients who had ingested alcohol compared with 20 (9%) of 212 radiographs from those who had not (p<0.001). There was no significant difference in the proportion of abnormal radiographs between these two groups (27% of radiographs from trauma patients who had ingested alcohol compared with 23% of radiographs from those who had not, p>0.2). Conclusion—Patients with alcohol related injuries requiring radiography have a significant impact on the radiological workload of an A&E department, although the prevalence of alcohol ingestion detected in this study was less than expected from previous studies. PMID:11696496

  1. Reestablishment of radiographic kidney size in Miniature Schnauzer dogs

    PubMed Central

    SOHN, Jungmin; YUN, Sookyung; LEE, Jeosoon; CHANG, Dongwoo; CHOI, Mincheol; YOON, Junghee

    2016-01-01

    Kidney size may be altered in renal diseases, and the detection of kidney size alteration has diagnostic and prognostic values. We hypothesized that radiographic kidney size, the kidney length to the second lumbar vertebra (L2) length ratio, in normal Miniature Schnauzer dogs may be overestimated due to their shorter vertebral length. This study was conducted to evaluate radiographic and ultrasonographic kidney size and L2 length in clinically normal Miniature Schnauzers and other dog breeds to evaluate the effect of vertebral length on radiographic kidney size and to reestablish radiographic kidney size in normal Miniature Schnauzers. Abdominal radiographs and ultrasonograms from 49 Miniature Schnauzers and 54 other breeds without clinical evidence of renal disease and lumbar vertebral abnormality were retrospectively evaluated. Radiographic kidney size, in the Miniature Schnauzer (3.31 ± 0.26) was significantly larger than that in other breeds (2.94 ± 0.27). Relative L2 length, the L2 length to width ratio, in the Miniature Schnauzer (1.11 ± 0.06) was significantly shorter than that in other breeds (1.21 ± 0.09). However, ultrasonographic kidney sizes, kidney length to aorta diameter ratios, were within or very close to normal range both in the Miniature Schnauzer (6.75 ± 0.67) and other breeds (7.16 ± 1.01). Thus, Miniature Schnauzer dogs have breed-specific short vertebrae and consequently a larger radiographic kidney size, which was greater than standard reference in normal adult dogs. Care should be taken when evaluating radiographic kidney size in Miniature Schnauzers to prevent falsely diagnosed renomegaly. PMID:27594274

  2. Oral tuberculosis: unusual radiographic findings.

    PubMed

    Sansare, K; Gupta, A; Khanna, V; Karjodkar, F

    2011-05-01

    Oral tuberculosis and its radiographic findings are not commonly encountered in an oral and maxillofacial radiology practice. Literature has occasional mention of the radiographic findings of oral tuberculosis, which are still ambiguous. When affected, it is manifested majorly in the oral mucosa and rarely in the jaw bones. Here, we report certain unusual radiographic findings of oral tuberculosis which have been rarely mentioned in the literature. Four illustrative cases describe bony resorption, condylar resorption, resorption of the inferior border of the mandible and rarefaction of the alveolar bone as radiographic findings of oral tuberculosis. Follow up of the first case demonstrated regeneration of the condylar head after anti-Kochs therapy was completed, a hitherto unreported phenomenon. The importance of including tuberculosis in the differential diagnosis of some of the unusual radiographic manifestations is emphasized.

  3. Newer imaging methods in chest radiography.

    PubMed

    Wandtke, J C

    1990-01-01

    In recent years the application of computers to chest radiography has resulted in a wide variety of innovative research. Major research efforts have resulted in the development of new types of x-ray detectors, such as storage phosphor technology, for use with computers. Storage phosphor imaging is one of the most promising new techniques, and almost 100 systems have been installed worldwide. Radiologists are quickly evaluating the image quality provided by this new detector system, which has the potential to improve image quality. It has wide latitude and is coupled with a computer to perform image processing. Another promising technology, originally studied in the form of scan equalization radiography, is now commercially available in the form of advanced multiple-beam equalization radiography. This film technique uses computers to modulate the x-ray exposure to take maximum advantage of the imaging capabilities of radiographic film. Digital solid-state detectors have been studied in conjunction with computerized image enhancement systems. These currently show improvement in nodule detection and quantification of the calcium content of a lesion. Application of large image intensifiers to a digital image system is being studied, but there are currently limitations on spatial resolution.

  4. Assessment of dental abnormalities by full-mouth radiography in small breed dogs.

    PubMed

    Kim, Chun-Geun; Lee, So-Young; Kim, Ju-Won; Park, Hee-Myung

    2013-01-01

    This study was performed to evaluate full-mouth radiographic findings to determine the prevalence of dental abnormalities and analyze the relationship between dental abnormalities and age in small breed dogs. Sixteen predetermined categories of abnormal radiographic findings were evaluated in 233 small breed dogs. In total, 9,786 possible permanent teeth could be evaluated. Of those, 8,308 teeth were evaluated and abnormal radiographic findings were found in 2,458 teeth (29.6%). The most common teeth with abnormal radiographic findings were the mandibular first molars (74.5% on the left and 63.9% on the right) and the maxillary fourth premolars (40.5% on the left and 38.2% on the right). Bone loss of any type (15.8%) was the most commonly detected radiographic abnormal finding among the 16 categories. Dental conditions with a genetic predisposition were frequently occurred in the mandibular premolar teeth. Shih tzu frequently had unerupted teeth and dentigerous cysts. Among the teeth with abnormal radiographic findings, 4.5%, 19.8%, and 5.3% were considered incidental, additional, and important, respectively. Findings that were only detected on radiographs, which were not noted on routine oral examination, were more common in older dogs. Full-mouth radiographic evaluation should be performed to obtain important information for making accurate diagnoses.

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

    PubMed Central

    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

  6. Incidentally detected breast lesions on chest CT with US correlation: a pictorial essay

    PubMed Central

    Son, Jung Hee; Jung, Hyun Kyung; Song, Jong Woon; Baek, Hye Jin; Doo, Kyung Won; Kim, Woogyeong; Kim, Yeon Mee; Kim, Woon Won; Lee, Jung Sun; Cho, Een Young

    2016-01-01

    With the increasing use of computed tomography (CT), incidental breast lesions are detected more frequently. When interpreting chest CT findings, it is important for radiologists to carefully review the breast to recognize any abnormal findings that could affect patient management. The purpose of this study is to discuss incidental breast lesions on chest CT with ultrasonography correlation that may be encountered in routine clinical practice. PMID:27707680

  7. Lung Ultrasound in Early Diagnosis of Neonatal Ventilator Associated Pneumonia before Any Radiographic or Laboratory Changes

    PubMed Central

    Ibrahim, Mohammed; Ibrahim, Mostafa; Bioumy, Nouran; El-Sharkawy, Sonya

    2016-01-01

    Neonatal pneumonia is reported to be the primary cause of neonatal respiratory failure and one of the common causes of neonatal hospitalization and death in developing countries. Chest X-ray was considered the gold standard for diagnosis of neonatal pneumonia. Lung ultrasonography has been described as a valuable noninvasive tool for the diagnosis of many neonatal pulmonary diseases. We report a case of ventilation associated neonatal pneumonia with very early diagnosis using lung ultrasound before any significant radiographic changes in chest X-ray or laboratory findings suggestive of infection. PMID:27891280

  8. Heimlich valve for chest drainage.

    PubMed

    Heimlich, H J

    1983-01-01

    The Heimlich chest drainage valve was developed so that the process of draining the pleural cavity could be accomplished in a safe, relatively simple, and efficient manner. Replacing the cumbersome underwater drainage bottle system, the Heimlich valve connects to chest tubing and allows fluid and air to pass in one direction only. The valve, which functions in any position, need never be clamped, and regulated suction can be attached to it if necessary. The valve drains into a plastic bag that can be held at any level, allowing the patient undergoing chest drainage to be ambulatory simply by carrying the bag. The construction and function of the valve is easily understood by medical and nursing staffs. It is presterilized, stored in a sterile package, and readily utilized on emergency vehicles and in the operating room.

  9. [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.

  10. 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.

  11. Comparison of dual and single exposure techniques in dual-energy chest radiography.

    PubMed

    Ho, J T; Kruger, R A; Sorenson, J A

    1989-01-01

    Conventional chest radiography is the most effective tool for lung cancer detection and diagnosis; nevertheless, a high percentage of lung cancer tumors are missed because of the overlap of lung nodule image contrast with bone image contrast in a chest radiograph. Two different energy subtraction strategies, dual exposure and single exposure techniques, were studied for decomposing a radiograph into bone-free and soft tissue-free images to address this problem. For comparing the efficiency of these two techniques in lung nodule detection, the performances of the techniques were evaluated on the basis of residual tissue contrast, energy separation, and signal-to-noise ratio. The evaluation was based on both computer simulation and experimental verification. The dual exposure technique was found to be better than the single exposure technique because of its higher signal-to-noise ratio and greater residual tissue contrast. However, x-ray tube loading and patient motion are problems.

  12. Vitamin D-dependent rickets type 2 with characteristic radiographic changes in a 4-month-old kitten.

    PubMed

    Tanner, Emma; Langley-Hobbs, Sorrel J

    2005-10-01

    This report describes the presenting signs, biochemical abnormalities, and radiographic changes in a 4-month-old kitten with vitamin D-dependent rickets type 2. Details of therapy are described and possible reasons for treatment failure are discussed.

  13. 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.

  14. 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.

  15. Leukocyte abnormalities.

    PubMed

    Gabig, T G

    1980-07-01

    Certain qualitative abnormalities in neutrophils and blood monocytes are associated with frequent, severe, and recurrent bacterial infections leading to fatal sepsis, while other qualitative defects demonstrated in vitro may have few or no clinical sequelae. These qualitative defects are discussed in terms of the specific functions of locomotion, phagocytosis, degranulation, and bacterial killing.

  16. Mechanically induced sudden death in chest wall impact (commotio cordis).

    PubMed

    Link, Mark S

    2003-01-01

    Sudden death due to nonpenetrating chest wall impact in the absence of injury to the ribs, sternum and heart is known as commotio cordis. Although once thought rare, an increasing number of these events have been reported. Indeed, a significant percentage of deaths on the athletic field are due to chest wall impact. Commotio cordis is most frequently observed in young individuals (age 4-18 years), but may also occur in adults. Sudden death is instantaneous or preceded by several seconds of lightheadedness after the chest wall blow. Victims are most often found in ventricular fibrillation, and successful resuscitation is more difficult than expected given the young age, excellent health of the victims, and the absence of structural heart disease. Autopsy examination is notable for the lack of any significant cardiac or thoracic abnormalities. In an experimental model of commotio cordis utilizing anesthetized juvenile swine, ventricular fibrillation can be produced by a 30 mph baseball strike if the strike occurred during the vulnerable period of repolarization, on the upslope of the T-wave. Energy of the impact object was also found to be a critical variable with 40 mph baseballs more likely to cause ventricular fibrillation than velocities less or greater than 40 mph. In addition, more rigid impact objects and blows directly over the center of the chest were more likely to cause ventricular fibrillation. Peak left ventricular pressure generated by the chest wall blow correlated with the risk of ventricular fibrillation. Activation of the K(+)(ATP) channel is a likely cause of the ventricular fibrillation produced by chest wall blows. Successful resuscitation is attainable with early defibrillation.

  17. Radiographic Prevalence of Femoroacetabular Impingement in a Young Population with Hip Complaints Is High

    DTIC Science & Technology

    2010-01-27

    impingement (abnormal alpha angle or pistol grip deformity only), whereas 16 patients (18%) had signs of pure pincer -type impingement (abnormal center-edge or...care and orthopaedic clinics. Radiographs were analyzed for signs of FAI (herniation pits, pistol grip deformity, center-edge angle, alpha angle, and...11, 12]. Two types of FAI have been described: cam and pincer . In cam-type impingement, the abnormally shaped femoral head-neck junction abuts the

  18. 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.

  19. Reconstruction of chest wall defects.

    PubMed

    Hasse, J

    1991-12-01

    A series of 61 consecutive procedures of chest wall resection and reconstruction in 58 patients during the period between August, 1986 and December, 1990 is reported. The ages ranged between 6-77 years. The chest wall resection was indicated for malignant affections in 54 cases. Among these, there were 24 patients with bronchial carcinoma invading the chest wall, 17 patients with primary or metastatic sarcoma, 11 patients with recurrent breast cancer and 3 with cancer metastases of varying origin. Pulmonary resection included pneumonectomy in 8 cases, lobectomy in 19, segmental and wedge resections in 26. In the majority of resections, the reconstruction was accomplished without implants. In cases with full thickness removal of the chest wall, the plane of the rib cage and/or the sternum was reconstructed using Vicryl mesh (n = 7), PTFE soft tissue patch (n = 11), marlex-mesh (n = 1), or methyl-methacrylate (n = 3). There was one case of hospital mortality, 6 weeks postoperatively, due to neurological failure from an independent preoperatively undiagnosed brain tumor. There were 4 reoperations: one early and one late (4 months) infection, one case of limited superficial necrosis of a flap and one with chronic lymphous drainage from a large myocutaneous flap. In no instance was primary postoperative ventilation therapy necessary. Mechanical ventilation was instituted only on day 8 in the patient who accounts for the mortality in this series. In the presence of primary infection, the greater omentum was used for the restoration of the integument.

  20. 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.

  1. Radiographically Severe but Clinically Mild Reexpansion Pulmonary Edema following Decompression of a Spontaneous Pneumothorax

    PubMed Central

    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

  2. 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

  3. 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

  4. Symptomatic sacroiliac joint disease and radiographic evidence of femoroacetabular impingement.

    PubMed

    Morgan, Patrick M; Anderson, Anthony W; Swiontkowski, Marc F

    2013-01-01

    Symptomatic sacroiliac (SI) joint disease is poorly understood. The literature provides no clear aetiology for SI joint pathology, making evaluation and diagnosis challenging. We hypothesised that patients with documented sacroiliac pain might provide insight into the aetiology of these symptoms. Specifically, we questioned whether SI joint symptoms might be associated with abnormal hip radiographs. We reviewed the pelvic and hip radiographs of a prospectively collected cohort of 30 consecutive patients with SI joint pathology. This database included 33 hips from 30 patients. Radiographic analysis included measurements of the lateral centre edge angle, Tönnis angle, and the triangular index, of the ipsilateral hip. Evidence for retrotorsion of the hemipelvis was recorded. Hips were graded on the Tönnis grading system for hip arthrosis. In this cohort 14/33 (42%) of hips had evidence of significant osteoarthrosis indicated by Tönnis grade 2 or greater and 15/33 (45%) displayed subchondral cyst formation around the hip or head neck junction. In assessing acetabular anatomy, 21% (7/33) had retroversion, 12% (4/33) had a lateral centre edge angle >40° with 3% (1/33) >45°. Tönnis angle was <0° in 27% (9/33). Coxa profunda and acetabuli protrusio were present in 47% (17/33) and 3% (1/33), respectively. When femoral head morphology was assessed, 33% (11/33) showed evidence of cam impingement. Overall, 76% (25/33) had at least one abnormality on their hip radiograph. A significant number of patients meeting strict diagnostic criteria for SI joint pain had radiographic evidence of femoroacetabular impingement (FAI) and hip arthrosis. The clinician should maintain FAI in the differential diagnosis when investigating patients with buttock pain.

  5. [Radiographic manifestations in teeth and jaws in chronic kidney insufficiency].

    PubMed

    Scutellari, P N; Orzincolo, C; Bedani, P L; Romano, C

    1996-10-01

    Forty-five patients affected with chronic renal failure (29 men and 16 women; mean age: 47.8 years), treated with hemodialysis for 4 to 245 months (mean: 66.9 months) were examined with panoramic and skeletal radiographs-the latter of the skull, hands, shoulders and clavicles, pelvis and spine. The control group (45 subjects with no renal diseases) was examined only with panoramic radiography. Dental and skeletal radio-graphs were given an 0-6 score and then compared to assess a possible relationship between skeletal and dental changes at radiography. Twenty-six dialysis patients (57.7%) had radiographic abnormalities in the maxillary bones-i.e., osteoporosis (100% of patients), focal osteosclerosis adjacent to the roots (11.5%), lamina dura reduction or loss (26.9%), calcifications of soft tissues or salivary glands (15.3%) and brown tumors (7.6%). In the teeth of dialysis patients, the dental pulp chamber was narrowed in 11.1% and hypercementosis of the roots was observed in 4.5%. Radiographic abnormalities in the hand, shoulder and pelvis were depicted in 51.1% of dialysis patients-in 86.9% of them with maxillary lesions. In the control group, 15.5% had mandibular bone lesions-i.e., osteopenia, cortex reduction at the mandibular angles and cyst-like lesions -but the evidence of caries and periodontal disease did not differ from that in the dialysis group. The diagnosis and follow-up of dialysis patients are currently made with serum biochemistry, radiography and histology. The purpose of skeletal radiology is to monitor the progression or regression of musculoskeletal abnormalities. Panoramic radiography might be useful in monitoring renal osteodystrophy, especially to assess the response to therapy-i.e., parathyroidectomy, calcium or vitamin-D therapy and renal transplant.

  6. Investigation of non-cardiac chest pain — which oesophageal test?

    PubMed Central

    Lee, R J E; Collins, B J; Spence, R A J; Crookes, P F; Campbell, N P S; Adgey, A A J

    1986-01-01

    Five different tests were used to evaluate oesophageal function in 22 patients who presented to a cardiac unit with acute chest pain but whose cardiological investigations were negative. Eight patients had an abnormality on oesophagoscopy, 10 had an abnormal pH monitoring study, six had a positive acid infusion test, 10 had an abnormal manometric study and six had an abnormal oseophageal transit scintiscan. Concordance for the three tests of gastro-oesophageal reflux disease was low at 28%, and for the two tests of oesophageal motility only 55%. Only two patients had normal results in all five tests. PMID:3739062

  7. Acid corrosive esophagitis: radiographic findings.

    PubMed

    Muhletaler, C A; Gerlock, A J; de Soto, L; Halter, S A

    1980-06-01

    Thirty-nine esophagograms of 24 patients after ingestion of muriatic acid (27% HCI) in suicide attempts were reviewed. All esophagograms were obtained in the acute, subacute, and chronic phases. In the acute and subacute phases, the radiographic findings consisted of mucosal edema, submucosal edema or hemorrhage, ulcerations, sloughing of the mucosa, atony, and dilatation. Strictures of the esophagus were present in the chronic phase. These radiographic findings were not different from those found in alkaline corrosive esophagitis. The severity of the corrosive esophagitis is considered related to the concentration, amount, viscosity, and duration of contact between the caustic agent and the esophageal mucosa.

  8. Tonsillolith: a panoramic radiograph presentation.

    PubMed

    Babu B, Balaji; Tejasvi M L, Avinash; Avinash, C K Anulekha; B, Chittaranjan

    2013-10-01

    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.

  9. [Cardiac causes of chest pain].

    PubMed

    Wächter, C; Markus, B; Schieffer, B

    2017-01-01

    Because of the life-threatening character and a high prevalence in emergency rooms, cardiac causes are important differential diagnoses of acute chest pain with the need for rapid clarification. In this context the working diagnosis "acute coronary syndrome" (ACS) plays a major role. In a synopsis of the clinical presentation, medical history, electrocardiogram and analysis of cardiac biomarkers, ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris can be specified as entities of ACS. The treatment of ACS consists of an immediate anti-ischemic therapy, anti-thrombotic therapy and invasive coronary diagnostics with subsequent interventional or operative revascularization therapy. The timing of invasive management is essentially determined by the individual patient risk, with the exception of STEMI where interventional revascularization must be undertaken within 120 min of diagnosis. In this context the GRACE 2.0 and TIMI risk score have become established as reliable tools. Another rare but fatal cause of acute chest pain is aortic dissection. An abrupt onset of tearing and sharp chest pains, deficits in pulse as well as the presence of high-risk factors, such as advanced age, arterial hypertension, atherosclerosis, known collagenosis and previous aortic or coronary artery procedures are highly indicative for aortic dissection and additional diagnostic imaging and the highly sensitive D‑dimer should be undertaken. Additionally, inflammatory diseases, such as pericarditis and myocarditis can be associated with chest pains and mimic the character of ACS and should also be considered in the differential diagnostics.

  10. A survey of radiographers' confidence and self-perceived accuracy in frontline image interpretation and their continuing educational preferences

    SciTech Connect

    Neep, Michael J; Steffens, Tom; Owen, Rebecca; McPhail, Steven M

    2014-06-15

    The provision of a written comment on traumatic abnormalities of the musculoskeletal system detected by radiographers can assist referrers and may improve patient management, but the practice has not been widely adopted outside the United Kingdom. The purpose of this study was to investigate Australian radiographers' perceptions of their readiness for practice in a radiographer commenting system and their educational preferences in relation to two different delivery formats of image interpretation education, intensive and non-intensive. A cross-sectional web-based questionnaire was implemented between August and September 2012. Participants included radiographers with experience working in emergency settings at four Australian metropolitan hospitals. Conventional descriptive statistics, frequency histograms, and thematic analysis were undertaken. A Wilcoxon signed-rank test examined whether a difference in preference ratings between intensive and non-intensive education delivery was evident. The questionnaire was completed by 73 radiographers (68% response rate). Radiographers reported higher confidence and self-perceived accuracy to detect traumatic abnormalities than to describe traumatic abnormalities of the musculoskeletal system. Radiographers frequently reported high desirability ratings for both the intensive and the non-intensive education delivery, no difference in desirability ratings for these two formats was evident (z = 1.66, P = 0.11). Some Australian radiographers perceive they are not ready to practise in a frontline radiographer commenting system. Overall, radiographers indicated mixed preferences for image interpretation education delivered via intensive and non-intensive formats. Further research, preferably randomised trials, investigating the effectiveness of intensive and non-intensive education formats of image interpretation education for radiographers is warranted.

  11. [The management of chest injuries].

    PubMed

    Reshad, K; Hirata, T; Itoi, K; Takahashi, Y; Muro, K

    1989-10-01

    The mortality from chest injuries is so high due to severe physiologic imbalance that an immediate and accurate diagnosis of the injured organ and prompt treatment can salvage the patient from the strategy. This study comprises 1329 injured cases including 145 patients with crushed chests. The cause of injury was traffic accident in 537 cases (40.5%), fall or degradation in 332 cases (25%). There was a correlation between the cause of injury and age, as that traffic accident was a major one in young aged and fall in elders. Treatment against crushed patients included 150 surgical operations, 206 plaster bandages, 56 drainage of thoracic, peritoneal and cranial cavities. Thoracotomies performed in patients with flail chest (2), lung contusion (4), rupture of the bronchi and diaphragm (each 1) and for evacuation of clotted hemothorax in 3 patients. The prognosis of all these patients was good. Lastly we conclude that since the prognosis of injured patients depends on how fast the patient can be carried to the hospital and how quickly the physician or surgeon can evaluate the trauma and institute a prompt treatment, the education of the primary staff is the most important.

  12. Chest wall reconstruction after extended resection

    PubMed Central

    Seder, Christopher W.

    2016-01-01

    Extensive chest wall resection and reconstruction is a challenging procedure that requires a multidisciplinary approach, including input from thoracic surgeons, plastic surgeons, neurosurgeons, and radiation oncologists. The primary goals of any chest wall reconstruction is to obliterate dead space, restore chest wall rigidity, preserve pulmonary mechanics, protect intrathoracic organs, provide soft tissue coverage, minimize deformity, and allow patients to receive adjuvant radiotherapy. Successful chest wall reconstruction requires the re-establishment of skeletal stability to prevent chest wall hernias, avoids thoracoplasty-like contraction of the operated side, protects underlying viscera, and maintain a cosmetically-acceptable appearance. After skeletal stability is established, full tissue coverage can be achieved using direct closure, skin grafts, local advancement flaps, pedicled myocutaneous flaps, or free flaps. This review examines the indications for chest wall reconstruction and describes techniques for establishment of chest wall rigidity and soft tissue coverage. PMID:27942408

  13. Reference for radiographic film interpreters

    NASA Technical Reports Server (NTRS)

    Austin, D. L.

    1970-01-01

    Reference of X-ray film images provides examples of weld defects, film quality, stainless steel welded tubing, and acceptable weld conditions. A summary sheet details the discrepancies shown on the film strip. This reference aids in interpreting and evaluating radiographic film of weldments.

  14. Improved radiographic image amplifier panel

    NASA Technical Reports Server (NTRS)

    Brown, R. L., Sr.

    1968-01-01

    Layered image amplifier for radiographic /X ray and gamma ray/ applications, combines very high radiation sensitivity with fast image buildup and erasure capabilities by adding a layer of material that is both photoconductive and light-emitting to basic image amplifier and cascading this assembly with a modified Thorne panel.

  15. Chemical intensification of dental radiographs

    SciTech Connect

    Price, C.

    1983-04-01

    The potential applications of chemical intensification in dental radiography are explored. Three standard photographic intensifiers and three methods designed for radiographic use are evaluated. One of these methods is shown to be capable of reducing radiation dose to one half, without loss of diagnostic quality. Further work is necessary to achieve a system sufficiently practicable to deserve widespread use in routine clinical dental radiography.

  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. Roentgenographic abnormalities in Rocky Mountain Spotted Fever.

    PubMed

    McCook, T A; Briley, C; Ravin, C E

    1982-02-01

    Rock Mountain spotted fever (RMSF) is a tick-borne rickettsial disease which produces a widespread vasculitis. A mortality of 7% to 13% has been reported in the United States which is due at least in part to delay in diagnosis and appropriate treatment. The classic features of this disease include a history of tick bite with the clinical presentation of skin rash and fever in association with thrombocytopenia. Few reports have emphasized the radiologic chest abnormalities in this disease or their relationship to thrombocytopenia. We review 70 cases of RMSF with abnormal roentgenographic features and their pathologic correlation.

  18. Penetrating chest wound of the foetus.

    PubMed

    Wandaogo, Albert; Tapsoba, Toussaint Wendlamita; Ouédraogo, Isso; Béré, Bernadette; Ouédraogo, S F; Bandré, E

    2016-01-01

    Traumas of the foetus caused by stabbings are rare but actually life-threatening for both the foetus and the mother. We report a case of penetrating chest wound on a baby taken from the obstetrics unit to the paediatric surgical department. His mother was assaulted by his father, a mentally sick person with no appropriate follow-up. The foetus did not show any sign of vital distress. Surgical exploration of the wound has revealed a section of the 10 th rib, a laceration of the pleura and a tearing of the diaphragm. A phrenorraphy and a pleural drainage were performed. The new-born and its mother were released from hospital after 5 days and the clinical control and X-ray checks 6 months later showed nothing abnormal. We insisted a medical, psychiatric follow-up be initiated for the father. As regards pregnant women with penetrating wounds, the mortality rate of the foetus is 80%. The odds are good for our newborn due to the mild injuries and good professional collaboration of the medical staff. Penetrating transuterine wounds of the foetus can be very serious. The health care needed should include many fields due to the mother and the foetus' lesions extreme polymorphism. In our case, it could have prevented by a good psychiatric followed up of the offender.

  19. 21 CFR 892.1840 - Radiographic film.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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 both... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic film. 892.1840 Section 892.1840...

  20. 21 CFR 892.1840 - Radiographic film.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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 both... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film. 892.1840 Section 892.1840...

  1. 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... 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...

  2. 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... 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...

  3. 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... 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...

  4. Radiographic techniques for investigating cereal grains

    SciTech Connect

    Winkler, M.A.

    1981-10-01

    Radiographic examination of cereal grain can determine nondestructively the presence of internal structural damage and other defects, which can be correlated to associated problems such as disease and infestation. Radiographs of several representative grains demonstrate the capabilities of the radiographic technique to detect structural deviations in the grains.

  5. Report to Congress on abnormal occurrences

    SciTech Connect

    Not Available

    1991-03-01

    Section 208 of the Energy Reorganization Act of 1974 identified an abnormal occurrence as an unscheduled incident or event that the Nuclear Regulatory Commission determines to be significant from the standpoint of public health or safety and requires a quarterly report of such events to be made to Congress. This report covers the period from October 1 through December 31, 1990. The report discusses five abnormal occurrences, none of which involved a nuclear power plant. Two involved significant overexposures to the hands of two radiographers, two involved medical therapy misadministrations, and one involved a medical diagnostic misadministration. No abnormal occurrences were reported by the Agreement States. The report also contains information that updates a previously reported abnormal occurrence. 8 refs.

  6. Noncardiac chest pain: current treatment.

    PubMed

    Schey, Ron; Villarreal, Autumn; Fass, Ronnie

    2007-04-01

    Noncardiac chest pain (NCCP) is very common, affecting up to 25% of the adult population in the United States. Treatment for NCCP has markedly evolved in the past decade and is presently focused on gastroesophageal reflux disease (GERD) and visceral hypersensitivity. Aggressive treatment with proton pump inhibitors has become the standard of care for GERD-related NCCP. Pain modulators such as tricyclics, trazodone, and selective serotonin reuptake inhibitors are considered the mainstay of therapy for non-GERD-related NCCP Other therapeutic modalities such as botulinum toxin injections and hypnotherapy have demonstrated promise in small clinical trials.

  7. [Chest modelling and automotive accidents].

    PubMed

    Trosseille, Xavier

    2011-11-01

    Automobile development is increasingly based on mathematical modeling. Accurate models of the human body are now available and serve to develop new means of protection. These models used to consist of rigid, articulated bodies but are now made of several million finite elements. They are now capable of predicting some risks of injury. To develop these models, sophisticated tests were conducted on human cadavers. For example, chest modeling started with material characterization and led to complete validation in the automobile environment. Model personalization, based on medical imaging, will permit studies of the behavior and tolerances of the entire population.

  8. Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography

    PubMed Central

    Omid, Reza; Kidd, Chris; Villacis, Diego; White, Eric

    2016-01-01

    Background Nonoperative management of midshaft clavicle fractures has resulted in widely disparate outcomes and there is growing evidence that clavicle shortening poses the risk of unsatisfactory functional outcomes due to shoulder weakness and nonunion. Unfortunately, the literature does not clearly demonstrate the superiority of one particular method for measuring clavicle shortening. The purpose of this study was to compare the accuracy of clavicle shortening measurements based on plain radiographs with those based on computed tomography (CT) reconstructed images of the clavicle. Methods A total of 51 patients with midshaft clavicle fractures who underwent both a chest CT scan and standardized anteroposterior chest radiography on the day of admission were included in this study. Both an orthopedic surgeon and a musculoskeletal radiologist measured clavicle shortening for all included patients. We then determined the accuracy and intraclass correlation coefficients for the imaging modalities. Bland-Altman plots were created to analyze agreement between the modalities and a paired t-test was used to determine any significant difference between measurements. Results For injured clavicles, radiographic measurements significantly overestimated the clavicular length by a mean of 8.2 mm (standard deviation [SD], ± 10.2; confidence interval [CI], 95%) compared to CT-based measurements (p < 0.001). The intraclass correlation was 0.96 for both plain radiograph- and CT-based measurements (p = 0.17). Conclusions We found that plain radiograph-based measurements of midshaft clavicle shortening are precise, but inaccurate. When clavicle shortening is considered in the decision to pursue operative management, we do not recommend the use of plain radiograph-based measurements. PMID:27904717

  9. 42 CFR 37.42 - Chest radiograph specifications-digital radiography systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... must conform to the following components of the Digital Imaging and Communications in Medicine (DICOM) standard (incorporated by reference, see § 37.10): (A) DICOM Standard PS 3.3-2011, Annex A—Composite... Grayscale Softcopy Presentation State Information Object Definition. (B) DICOM Standard PS3.4-2011, Annex...

  10. 42 CFR 37.42 - Chest radiograph specifications-digital radiography systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Digital Imaging and Communications in Medicine (DICOM) standard (incorporated by reference, see § 37.10): (A) DICOM Standard PS 3.3-2011, Annex A—Composite Information Object Definitions, sections: Computed... Object Definition. (B) DICOM Standard PS3.4-2011, Annex B—Storage Service Class; Annex...

  11. HADES, A Radiographic Simulation Code

    SciTech Connect

    Aufderheide, M.B.; Slone, D.M.; Schach von Wittenau, A.E.

    2000-08-18

    We describe features of the HADES radiographic simulation code. We begin with a discussion of why it is useful to simulate transmission radiography. The capabilities of HADES are described, followed by an application of HADES to a dynamic experiment recently performed at the Los Alamos Neutron Science Center. We describe quantitative comparisons between experimental data and HADES simulations using a copper step wedge. We conclude with a short discussion of future work planned for HADES.

  12. 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.

  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. Breathing chest radiography using a dynamic flat-panel detector combined with computer analysis.

    PubMed

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

    2004-08-01

    Kinetic information is crucial when evaluating certain pulmonary diseases. When a dynamic flat-panel detector (FPD) can be used for a chest examination, kinetic information can be obtained simply and cost-effectively. The purpose of this study was to develop methods for analyzing respiratory kinetics, such as movement of the diaphragm and lung structures, and the respiratory changes in x-ray translucency in local lung fields. Postero-anterior dynamic chest radiographs during respiration were obtained with a modified FPD, which provided dynamic chest radiographs at a rate of 3 frames/s. Image registration for correction of physical motion was followed by measurement of the distance from the lung apex to the diaphragm. Next, we used a cross-correlation technique to measure the vectors of respiratory movement in specific lung areas. Finally, the average pixel value for a given local area was calculated by tracing the same local area in the lung field. This method of analysis was used for six healthy volunteers and one emphysema patient. The results reported here represent the initial stage in the development of a method that may constitute a new method for diagnosing certain pulmonary diseases, such as chronic obstructive pulmonary disease, fibroid lung, and pneumonia. A clinical evaluation of our method is now in progress.

  15. Relevant surgical anatomy of the chest wall.

    PubMed

    Naidu, Babu V; Rajesh, Pala B

    2010-11-01

    The chest wall, like other regional anatomy, is a remarkable fusion of form and function. Principal functions are the protection of internal viscera and an expandable cylinder facilitating variable gas flow into the lungs. Knowledge of the anatomy of the whole cylinder (ribs, sternum, vertebra, diaphragm, intercostal spaces, and extrathoracic muscles) is therefore not only important in the local environment of a specific chest wall resection but also in its relation to overall function. An understanding of chest wall kinematics might help define the loss of function after resection and the effects of various chest wall substitutes. Therefore, this article is not an exhaustive anatomic description but a focused summary and discussion.

  16. Chest wall hypoplasia--principles and treatment.

    PubMed

    Mayer, Oscar Henry

    2015-01-01

    The chest is a dynamic structure. For normal movement it relies on a coordinated movement of the multiple bones, joints and muscles of the respiratory system. While muscle weakness can have clear impact on respiration by decreasing respiratory motion, so can conditions that cause chest wall hypoplasia and produce an immobile chest wall. These conditions, such as Jarcho-Levin and Jeune syndrome, present significantly different challenges than those faced with early onset scoliosis in which chest wall mechanics and thoracic volume may be much closer to normal. Because of this difference more aggressive approaches to clinical and surgical management are necessary.

  17. Microbiology of endotracheal aspirates in intubated pediatric intensive care unit patients: correlations with radiographic findings.

    PubMed

    Golden, S E; Shehab, Z M; Bjelland, J C; Ryan, K J; Ray, C G

    1987-07-01

    We studied the utility of Gram-stained smears and semiquantitative cultures of endotracheal aspirates (ETAs) in diagnosing pneumonia in intubated patients in a pediatric intensive care unit. The chest radiographs of 35 intubated patients were independently reviewed by a pediatric radiologist and classified into probable, possible and unlikely pneumonias. Concomitant bacteriologic and radiographic information was available in 15 episodes of probable and 13 of possible pneumonia. These findings were compared with the ETAs obtained during the study from patients with no radiographic evidence of pneumonia (N = 21). There was a good correlation between ETA findings and radiographic evidence of pneumonia when ETAs were obtained within 60 minutes of initial intubation. Only a growth of greater than or equal to 3+ of a pathogen was associated with probable pneumonia when ETAs were obtained more than 60 minutes from initial intubation. There was a poor correlation between the microbiologic findings from ETAs and the results of blood cultures and postmortem examinations. Moreover 5 of 10 pairs of ETAs obtained within 18 hours of each other demonstrated discordant results. The ETAs from patients with indwelling endotracheal tubes correlated poorly with radiographic findings and are of questionable value in diagnosing the presence of pneumonia or its etiology in this group. They must be cautiously interpreted in critically ill patients.

  18. Detecting Disease in Radiographs with Intuitive Confidence

    PubMed Central

    Jaeger, Stefan

    2015-01-01

    This paper argues in favor of a specific type of confidence for use in computer-aided diagnosis and disease classification, namely, sine/cosine values of angles represented by points on the unit circle. The paper shows how this confidence is motivated by Chinese medicine and how sine/cosine values are directly related with the two forces Yin and Yang. The angle for which sine and cosine are equal (45°) represents the state of equilibrium between Yin and Yang, which is a state of nonduality that indicates neither normality nor abnormality in terms of disease classification. The paper claims that the proposed confidence is intuitive and can be readily understood by physicians. The paper underpins this thesis with theoretical results in neural signal processing, stating that a sine/cosine relationship between the actual input signal and the perceived (learned) input is key to neural learning processes. As a practical example, the paper shows how to use the proposed confidence values to highlight manifestations of tuberculosis in frontal chest X-rays. PMID:26495433

  19. Simulation of radiographic images for quality and dose analysis

    NASA Astrophysics Data System (ADS)

    Winslow, Mark P.

    A software package, Virtual Photographic Radiographic Imaging Simulator (ViPRIS), has been developed for optimizing x-ray radiographic imaging. A tomographic phantom, VIP-Man, constructed from Visible Human anatomical color images is used to simulate the scattered portion of an x-ray system and to compute organ doses using the ESGnrc Monte Carlo code. The primary portion of an x-ray image is simulated using the projection ray-tracing method through the Visible Human CT data set. To produce a realistic image, the software simulates quantum noise, blurring effects, lesions, detector absorption efficiency, and other imaging artifacts. The primary and scattered portions of an x-ray chest image are combined to form a final image for observer studies using computerized simulated observers. Absorbed doses in organs and tissues of the segmented VIP-Man phantom were also obtained from the Monte Carlo simulations to derive effective dose, which is a radiation risk indicator. Approximately 2000 simulated images and 200,000 vectorized image data files were analyzed using ROC/AUC analysis. Results demonstrated the usefulness of this approach and the software for studying x-ray image qualify and radiation dose.

  20. Radiographic findings in the nail-patella syndrome

    PubMed Central

    Louis, Thomas H.

    2015-01-01

    Nail-patella syndrome is a rare disorder characterized classically by the tetrad of nail hypoplasia or aplasia, aplastic or hypoplastic patellae, elbow dysplasia, and the presence of iliac horns. Iliac horns are considered pathognomonic, and the presence of hypoplastic or aplastic patellae in conjunction with nail abnormalities is a cardinal feature of diagnosis. Elbow dysplasia is present in most cases and can exhibit features typical of the syndrome. Herein we present the radiographic findings of the elbows, knees, and pelvis of a woman with nail-patella syndrome. PMID:26130880

  1. Exercise radionuclide ventriculographic responses in hypertensive patients with chest pain

    SciTech Connect

    Wasserman, A.G.; Katz, R.J.; Varghese, P.J.; Leiboff, R.H.; Bren, G.G.; Schlesselman, S.; Varma, V.M.; Reba, R.C.; Ross, A.M.

    1984-11-15

    The effectiveness of exercise-treadmill testing in diagnosing coronary-artery disease in hypertensive patients is limited by a high rate of false positivity. Exercise radionuclide ventriculography, however, relies on different criteria (ejection fraction and wall motion), and we have evaluated this procedure in 37 hypertensive and 109 normotensive patients with chest pain, using coronary arteriography as an indicator of coronary disease. In the hypertensive cohort there was no difference in the ejection fraction at rest between the 17 patients with coronary disease and the 20 without it. Neither group had a significant mean (+/- S.E.M.) change in ejection fraction from rest to exercise (-1.9 +/- 2 and 1.4 +/- 1%, respectively). A wall-motion abnormality developed during exercise in 5 of the 17 hypertensive patients with coronary disease (29%) and in 4 of the 20 without it (20%) (P = not significant). In the normotensive cohort, however, the peak-exercise ejection fractions were significantly different. The 71 patients with coronary disease had a mean decrease of 3.6 +/- 1%, in contrast to the patients without coronary disease, who had an increase of +/- 1% (P < 0.001). An exercise-induced wall-motion abnormality was seen in 35 of the 71 patients with coronary disease (48%), as compared with 3 of the 38 without it (8%) (P < 0.001). We conclude that exercise radionuclide ventriculography is inadequate as a screening test for coronary atherosclerosis in hypertensive patients with chest pain. 28 references, 2 figures, 3 tables.

  2. High-Throughput Classification of Radiographs Using Deep Convolutional Neural Networks.

    PubMed

    Rajkomar, Alvin; Lingam, Sneha; Taylor, Andrew G; Blum, Michael; Mongan, John

    2017-02-01

    The study aimed to determine if computer vision techniques rooted in deep learning can use a small set of radiographs to perform clinically relevant image classification with high fidelity. One thousand eight hundred eighty-five chest radiographs on 909 patients obtained between January 2013 and July 2015 at our institution were retrieved and anonymized. The source images were manually annotated as frontal or lateral and randomly divided into training, validation, and test sets. Training and validation sets were augmented to over 150,000 images using standard image manipulations. We then pre-trained a series of deep convolutional networks based on the open-source GoogLeNet with various transformations of the open-source ImageNet (non-radiology) images. These trained networks were then fine-tuned using the original and augmented radiology images. The model with highest validation accuracy was applied to our institutional test set and a publicly available set. Accuracy was assessed by using the Youden Index to set a binary cutoff for frontal or lateral classification. This retrospective study was IRB approved prior to initiation. A network pre-trained on 1.2 million greyscale ImageNet images and fine-tuned on augmented radiographs was chosen. The binary classification method correctly classified 100 % (95 % CI 99.73-100 %) of both our test set and the publicly available images. Classification was rapid, at 38 images per second. A deep convolutional neural network created using non-radiological images, and an augmented set of radiographs is effective in highly accurate classification of chest radiograph view type and is a feasible, rapid method for high-throughput annotation.

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

    PubMed

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

    1984-10-01

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

  4. 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.

  5. Non-cardiac, non-oesophageal chest pain: the relevance of psychological factors

    PubMed Central

    Ho, K; Kang, J; Yeo, B; Ng, W

    1998-01-01

    Background—No cause has been determined for chest pain that is neither cardiac nor oesophageal in origin. 
Aims—To compare the prevalence of lifetime psychiatric disorders and current psychological distress in three consecutive series of patients with chronic chest or abdominal pain. 
Patients—Thirty nine patients with non-cardiac chest pain and no abnormality on oesophagogastroduodenoscopy, oesophageal manometry, and 24 hour pH monitoring; 22 patients with non-cardiac chest pain having endoscopic abnormality, oesophageal dysmotility, and/or pathological reflux; and 36 patients with biliary colic. 
Methods—The Diagnostic Interview Schedule and the 28 item General Health Questionnaire were administered to all patients. 
Results—Patients with non-cardiac chest pain and no upper gastrointestinal disease had a higher proportion of panic disorder (15%), obsessive-compulsive disorder (21%), and major depressive episodes (28%) than patients with gallstone disease (0%, p<0.02; 3%, p<0.02; and 8%, p<0.05, respectively). In contrast, there were no differences between patients with non-cardiac chest pain and upper gastrointestinal disease and patients with gallstone disease in any of the DSM-111 defined lifetime psychiatric diagnoses. Using the General Health Questionnaire, 49% of patients with non-cardiac chest pain without upper gastrointestinal disease scored above the cut off point (that is, more than 4), which was considered indicative of non-psychotic psychiatric disturbance, whereas only 14% of patients with gallstones did so (p<0.005). The proportions of such cases were however similar between patients with non-cardiac chest pain and upper gastrointestinal disease (27%) and patients with gallstones. 
Conclusions—Psychological factors may play a role in the pathogenesis of chest pain that is neither cardiac nor oesophagogastric in origin. Keywords: chest pain;  oesophageal manometry;  gastro-oesophageal reflux disease;  oesophageal p

  6. Material identification with multichannel radiographs

    NASA Astrophysics Data System (ADS)

    Collins, Noelle; Jimenez, Edward S.; Thompson, Kyle R.

    2017-02-01

    This work aims to validate previous exploratory work done to characterize materials by matching their attenuation profiles using a multichannel radiograph given an initial energy spectrum. The experiment was performed in order to evaluate the effects of noise on the resulting attenuation profiles, which was ignored in simulation. Spectrum measurements have also been collected from various materials of interest. Additionally, a MATLAB optimization algorithm has been applied to these candidate spectrum measurements in order to extract an estimate of the attenuation profile. Being able to characterize materials through this nondestructive method has an extensive range of applications for a wide variety of fields, including quality assessment, industry, and national security.

  7. [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.

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

    PubMed

    Okumura, Eiichiro; Kawashita, Ikuo; Ishida, Takayuki

    2017-01-20

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

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

    PubMed

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

    2016-03-23

    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.

  10. 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.

  11. 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.

  12. 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.

  13. DIGITAL SPALL RADIOGRAPH ANALYSIS SYSTEM

    SciTech Connect

    CURTIS L. HARRIS - LATA

    1990-01-01

    This report describes progress on work to develop a cost effective, rapid response system for measuring Technology Assessment National Laboratory. momentum and kinetic energy of span for the Advanced Center (ATAC) Armor/Anti-Armor (As) program at Los Alamos The system will exploit data contained in two sets of simultaneous co-planar flash radiographs taken along the center line of anticipated span motion. Data contained in each set (which is proportional to the mass and z-number of the span material intersected by the exposing x-ray at each point) is digitized and used to construct a three dimensional model (called the reconstructed span image) that approximates the original span cloud. From the model the mass of span fragments is computed. The two sets of radiographs, separated in time, represent the span configuration at two instants of time. Span fragments from the first instant are matched with those from the second instant to determine velocity. Evaluation of the fidelity of candidate reconstruction algorithms is the highest priority task in. this development program for the obvious reason that the efficacy of the projected span analysis system depends upon the fidelity of the reconstruction techniques.

  14. 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.

  15. [Screening chest X-ray examination with kinetic analysis using flat-panel detector].

    PubMed

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

    2003-11-01

    We are developing dynamic screening radiography to provide kinetic information for lung respiratory examination using a flat-panel-detector (FPD) system. We modified the FPD system (CANON CXDI-22) to take sequential images for a short period of time (10 seconds, 3 frames/sec). Sequential chest radiographs from full inspiration to expiration were taken and analyzed for diaphragm movement and density changes in local lung areas to objectively detect respiratory anomalies. Our methods derived some respiratory functions such as regional air passage and lung structure movement, and suggested that the degree of chronic obstructive pulmonary disease and interstitial pneumonia could be evaluated quantitatively.

  16. Incidental Findings on Knee Radiographs in Children and Adolescents

    PubMed Central

    Seo, Sang Gyo; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Choi, Young; Kim, Tae Gyun; Baek, Jeong Kook; Kwon, Soon-Sun; Kwon, Dae Gyu; Choi, In Ho; Cho, Tae-Joon; Yoo, Won Joon; Park, Moon Seok

    2014-01-01

    Background Despite the wide use of knee radiography in children and adolescent patients visiting the outpatient clinic, there has been no analysis about the prevalence and type of incidental findings yet. This study was performed to investigate the incidental findings on knee radiographs in children and adolescents according to age. Methods A total of 1,562 consecutive patients younger than 18 years of age were included. They who visited Seoul National University Bundang Hospital's outpatient clinic with a chief complaint of knee pain or malalignment between 2010 and 2011. We reviewed the knee radiographs and analyzed the prevalence and type of incidental findings, such as metaphyseal lucent area, epiphyseal cortical irregularity, osteochondroma and Harris growth arrest line. Results The mean age of the patients was 10.2 years (range, 1 month to 18 years). We identified 355 incidental findings in 335 patients (21.4%) and 98 abnormal findings (6.3%). The most common incidental finding was metaphyseal lucent area (131, 8.4%), followed by epiphyseal cortical irregularity (105, 6.7%), Harris growth arrest line (75, 4.8%), and osteochondroma (44, 2.8%). An epiphyseal cortical irregularity tended to have a higher prevalence at younger age (p < 0.001) and the prevalences of metaphyseal lucent area and Harris growth arrest line were also higher at a younger age (p = 0.001 and p < 0.001, respectively). However, the osteochondroma tended to have a higher prevalence at an older age (p = 0.004). Conclusions This study describes the incidental findings on knee radiographs in children and adolescents and provides effective information from a viewpoint of an orthopedic doctor. The authors recommend considering those incidental findings if unfamiliar findings appear on a knee radiograph in the pediatric outpatient clinic. PMID:25177456

  17. [Chest pains in the dental environment].

    PubMed

    Garfunkel, A; Galili, D; Findler, M; Zusman, S P; Malamed, S F; Elad, S; Kaufman, E

    2002-01-01

    Chest pain does not necessarily indicate cardiac disease. The most common causes of acute chest pain encountered in dental situations include hyperventilation, pulmonary embolism, angina pectoris and myocardial infarction. Stress and fear often cause rapid breathing or hyperventilation. This usually occurs in young adults and although the hyperventilating patient often complains of chest pain, this is rarely a manifestation of cardiac disease. Pulmonary embolism usually indicates the occlusion of a pulmonary artery causing severe chest pain. The primary clinical manifestation of angina pectoris is chest pain. Although most instances of anginal pain are easily terminated, the dentist must always consider the possibility that the supposed anginal attack is actually a sign of acute myocardial infarction (AMI). AMI is a clinical syndrome caused by a deficient coronary arterial blood supply to a region of myocardium that results in cellular death. There is a high incidence of mortality among AMI with death often occurring within 2 hours of the onset of signs and symptoms. The initial clinical manifestations of all types of chest pain can be similar. Therefore the dentist must develop proficiency in constituting a differential diagnosis and an efficient management protocol. As in most medical situations prevention is the most powerful tool. However, if chest pains do occur, measures such as airway management, oxygen supplementation, coronary artery dilation, analgesis and in extreme cases, cardiopulmonary resuscitation and evacuation to the emergency room, may be necessary.

  18. Thallium myocardial scanning in the emergency department evaluation of chest pain

    SciTech Connect

    Mace, S.E.

    1989-05-01

    Chest pain is a common complaint of patients seen in the emergency department. The causes are legion, and range from the non-life threatening to the potentially catastrophic. Thallium heart scanning was done prospectively in 20 patients with a ''classic'' history for myocardial infarction (eight patients) or atypical chest pain and/or associated symptoms plus an abnormal ECG (12 patients) to discern a subset of patients from whom thallium scintography may be indicated in the emergency department. Although further investigation is needed, our preliminary study suggests that myocardial scanning with thallium can be a safe, fairly rapid, and useful objective parameter in the emergency department detection of suspected myocardial infarction, and in differential diagnosis of chest pain when other data such as the history, physical examination, ECG, or enzymes are inconclusive.

  19. 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.

  20. 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

  1. 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.

  2. Cardiointegram: detection of coronary artery disease in males with chest pain and a normal resting electrocardiogram

    SciTech Connect

    Teichholz, L.E.; Steinmetz, M.Y.; Escher, D.; Herman, M.V.; Naimi, S.; Mahony, D.V.; Ellestad, M.H.

    1986-07-01

    The cardiointegram is a non-invasive technique for the analysis of the electrical signals of the heart obtained by a transformation of the voltage vs. time format by a series of integrations. This multicenter study compares the results of the cardiointegram with coronary arteriography in 140 male patients with chest pain and a normal resting electrocardiogram. The cardiointegram was determined on two resting complexes of Leads I, II, V4, V5 and V6 and called abnormal if greater than or equal to four of ten complexes were abnormal, i.e., fell outside of a previously determined template of normality. The sensitivity was 73% and specificity was 78% for the diagnosis of occlusive coronary artery disease. When greater than or equal to five of ten abnormal complexes were used as the cut-off for an abnormal test and ''equivocal'' results (four of ten abnormal, n = 18) were excluded from analysis there was a sensitivity of 69% and specificity of 88%. Thirty-seven of 38 patients (97%) with an abnormal cardiointegram and a positive exercise stress test had coronary artery disease. Thus, the cardiointegram appears to be a useful non-invasive test for the detection of coronary artery disease in males with chest pain and a normal resting electrocardiogram in whom the diagnosis of coronary artery disease is being considered.

  3. Radiographical evaluation of ulcerative colitis

    PubMed Central

    Deepak, Parakkal; Bruining, David H.

    2014-01-01

    Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis (UC). Imaging can be used non-invasively to determine the extent of involvement, severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease (IBD) manifestations. While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings, the use of computed tomography enterography (CTE) or magnetic resonance enterography (MRE) are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation. Additionally, CT colonography and MR colonography are emerging techniques with potential applications in UC. Ultrasonography, leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations. This plethora of radiological imaging options has become a vital component of UC assessments. PMID:24843072

  4. 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).

  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. Radiographic simulations and analysis for ASCI

    SciTech Connect

    Aufderheide, M.; Stone, D.; VonWittenau, A.

    1998-12-18

    In this paper, the authors describe their work on developing quantitatively accurate radiographic simulation and analysis tools for ASCI hydro codes. they have extended the ability of HADES, the code which simulates radiography through a mesh, to treat the complex meshes used in ASCI calculations. The ultimate goal is to allow direct comparison between experimental radiographs and full physics simulated radiographs of ASCI calculations. They describe the ray-tracing algorithm they have developed for fast, accurate simulation of dynamic radiographs with the meshes used in ALE3D, an LLNL ASCI code. Spectral effects and material compositions are included. In addition to the newness of the mesh types, the distributed nature of domain decomposed problems requires special treatment by the radiographic code. Because of the size of such problems, they have parallelized the radiographic simulation, in order to have quick turnaround time. presently, this is done using the domain decomposition from the hydro code. They demonstrate good parallel scaling as the size of the problem is increased. They show a comparison between an experimental radiograph of a high explosive detonation and a simulated radiograph of an ALE3D calculation. They conclude with a discussion of future work.

  7. 21 CFR 892.1910 - Radiographic grid.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic grid. 892.1910 Section 892.1910 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1910 Radiographic grid. (a) Identification....

  8. 21 CFR 892.1910 - Radiographic grid.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic grid. 892.1910 Section 892.1910 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1910 Radiographic grid. (a) Identification....

  9. 21 CFR 892.1910 - Radiographic grid.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic grid. 892.1910 Section 892.1910 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1910 Radiographic grid. (a) Identification....

  10. 21 CFR 892.1910 - Radiographic grid.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic grid. 892.1910 Section 892.1910 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1910 Radiographic grid. (a) Identification....

  11. 21 CFR 892.1910 - Radiographic grid.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic grid. 892.1910 Section 892.1910 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1910 Radiographic grid. (a) Identification....

  12. Abdominal Plain Radiograph in Neonatal Intestinal Obstruction

    PubMed Central

    Prasad, G Raghavendra; Aziz, Amtul

    2017-01-01

    A comprehensive all-inclusive resource on plain radiograph in neonatal intestinal obstruction is presented. This is an attempt to develop a protocol and to regain expertise in evaluating a plain radiograph that most often yields more than enough clues to diagnose and to decide a plan of action. PMID:28083492

  13. 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 ...

  14. 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 ...

  15. 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

  16. Eigen analysis for classifying chest x-ray images

    NASA Astrophysics Data System (ADS)

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

    2004-10-01

    A method first employed for face recognition has been employed to analyse a set of chest x-ray images. After marking certain common features on the images, they are registered by means of an affine transformation. The differences between each registered image and the mean of all images in the set are computed and the first K principal components are found, where K is less than or equal to the number of images in the set. These form eigenimages (we have coined the term 'eigenchests') from which an approximation to any one of the original images can be reconstructed. Since the method effectively treats each pixel as a dimension in a hyperspace, the matrices concerned are huge; we employ the method developed by Turk and Pentland for face recognition to make the computations tractable. The K coefficients for the eigenimages encode the variation between images and form the basis for discriminating normal from abnormal. Preliminary results have been obtained for a set of eigenimages formed from a set of normal chests and tested on separate sets of normals and patients with pneumonia. The distributions of coefficients have been observed to be different for the two test sets and work is continuing to determine the most sensitive method for detecting the differences.

  17. A woman with recurrent chest pain and ST-segment elevation.

    PubMed

    Omar, Hesham R; Mangar, Devanand; Camporesi, Enrico M

    2016-05-01

    A 32-year-old female presents with recurrent episodes of unprovoked chest pain associated with inferior ST-segment elevation and reciprocal ST-segment depression. Coronary angiography during one of these episodes revealed coronary artery spasm that spontaneously resolved followed by resolution of these electrocardiographic changes. There was no atherosclerotic occlusive disease. Her cardiac markers were normal and echocardiogram showed no regional wall motion abnormalities. Electrocariogram and angiography findings are shown in Fig. 1.

  18. Ultrasound for Localization of Central Venous Catheter: A Good Alternative to Chest X-Ray?

    PubMed Central

    Kamalipour, Hamid; Ahmadi, Sedigheh; Kamali, Karmella; Moaref, Alireza; Shafa, Masih; Kamalipour, Parsa

    2016-01-01

    Background Chest radiography after central venous catheter (CVC) insertion is the main method of verifying the catheter location. Despite the widespread use of radiography for detecting catheter position, x-ray may not always be readily available, especially in the operating room. Objectives We aimed to compare contrast-enhanced ultrasonography (CEUS) and chest radiography for detecting the correct location of CVCs. Methods One hundred sixteen consecutive patients with indications for CVC before cardiac surgery were enrolled in this observational study. After catheter insertion, CEUS was performed. Portable radiography was obtained postoperatively in the intensive care unit. Sensitivity, specificity, and predictive values were determined by comparing the ultrasonography results with radiographic findings as a reference standard. Results Chest radiography revealed 16 CVC misplacements: two cases of intravascular and 14 cases of right atrium (RA) misplacement. CEUS detected 11 true catheter malpositionings in the RA, while it could not recognize seven catheter placements correctly. CEUS showed two false RA misplacements and five falsely correct CVC positions. A sensitivity of 98% and specificity of 69% were achieved for CEUS in detecting CVC misplacements. Positive and negative predictive values were 95% and 85%, respectively. The interrater agreement (kappa) between CEUS and radiography was 0.72 (P < 0.001). Conclusions Despite close concordance between ultrasonography and chest radiography, CEUS is not a suitable alternative for standard chest radiography in detecting CVC location; however, considering its high sensitivity and acceptable specificity in our study, its usefulness as a triage method for detecting CVC location on a real-time basis in the operating room cannot be ignored. PMID:27847699

  19. 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 —...

  20. Endovascular Treatment of Hemoptysis by Abnormal Systemic Pulmonary Artery Supply

    SciTech Connect

    Munoz, J.J. Garcia, J.A.; Bentabol, M.; Padin, M.I.; Serrano, F.

    2008-03-15

    We report the case of a 29-year-old man with hemoptysis. The patient came to the emergency department, where a laboratory test and chest radiograph were reported as normal. The following day the patient again had hemoptysis, though less than previously. He reported no chest pain, dyspnea, fever, catarrh, changes in urine or feces, contact with patients with bacillus disease or constitutional symptoms. Doppler ultrasound of the chest showed right basal parenchymatous condensation containing a vessel with arterial flow (in the opposite direction to the aortic flow) compatible with an aberrant vessel, possibly a sequestration, leaving the aorta above the celiac trunk. Because of the findings of the chest echogram and magnetic resonance study, thoracoabdominal computed tomography angiography was undertaken; this showed right basal condensation and an anomalous vessel originating 1 cm above the celiac trunk, supplying the right lower lobe. An aortic and pulmonary arteriogram via an arterial and right femoral vein approach confirmed the findings. The patient was treated successfully with percutaneous embolization with coils. The relevant literature is reviewed.

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

    PubMed

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

    1993-01-01

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

  2. Principles of image processing in digital chest radiography.

    PubMed

    Prokop, Mathias; Neitzel, Ulrich; Schaefer-Prokop, Cornelia

    2003-07-01

    Image processing has a major impact on image quality and diagnostic performance of digital chest radiographs. Goals of processing are to reduce the dynamic range of the image data to capture the full range of attenuation differences between lungs and mediastinum, to improve the modulation transfer function to optimize spatial resolution, to enhance structural contrast, and to suppress image noise. Image processing comprises look-up table operations and spatial filtering. Look-up table operations allow for automated signal normalization and arbitrary choice of image gradation. The most simple and still widely applied spatial filtering algorithms are based on unsharp masking. Various modifications were introduced for dynamic range reduction and MTF restoration. More elaborate and more effective are multi-scale frequency processing algorithms. They are based on the subdivision of an image in multiple frequency bands according to its structural composition. This allows for a wide range of image manipulations including a size-independent enhancement of low-contrast structures. Principles of the various algorithms will be explained and their impact on image appearance will be illustrated by clinical examples. Optimum and sub-optimum parameter settings are discussed and pitfalls will be explained.

  3. 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.

  4. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet... for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  5. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet... for medical purposes to expose radiographic film. (b) Classification. Class I (general controls)....

  6. Unusual radiographic appearance of adamantinoma.

    PubMed

    Cappuccio, Michele; Montalti, Maurizio; Bosco, Giuseppe; Gasbarrini, Alessandro; Boriani, Stefano

    2009-12-01

    Adamantinoma is a rare tumor with an indolent course that occurs most commonly in the tibia. It is locally aggressive, and local recurrences are described after resection. Pain is the most common symptom. Since the lesion is typically slow growing, the pain can be present for many years before the patient seeks medical attention. Microscopically, adamantinoma consists of islands of epithelial cells in a fibrous stroma. Nuclear atypia is minimal, and mitotic figures are rare. The most common radiographic appearance is that of multiple sharply demarcated radiolucent lesions surrounded by areas of dense, sclerotic bone. This tumor most often affects the tibial diaphysis and produces lytic lesions that can cause fractures. A 31-year-old man presented with a rapidly growing lytic lesion of the distal tibia. On histological examination, many areas of epithelial cells in a fibrous stroma were identified. Diagnosis of adamantinoma was performed. The lesion was treated with en bloc resection and reconstruction with distal tibia allograft and ankle arthrodesis with retrograde nail. At 2-year follow-up, there were no clinical or radiological signs of recurrence of disease.

  7. 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.

  8. 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.

  9. Effects of the dual chest banding using elastic bands on the shoulder pain of scapular dyskinesis patient with winging and elevated scapular

    PubMed Central

    Yoo, Won-Gyu

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effect of dual chest banding using elastic bands on the shoulder pain of a scapular dyskinesis patient with winging and an elevated scapula. [Subject] The subject was a 40-year-old male scapular dyskinesis patient with winging, an elevated scapula, and shoulder pain. [Methods] This study developed a method of dual chest banding using elastic bands, and the subject applied this method for 1 month [Results] After applying dual chest banding for one month, the scapular position and scapular winging were improved when compared to the initial conditions. The upper trapezius pressure pain threshold was increased. [Conclusion] The present study suggests that dual chest banding provides a mechanical effect and increases proprioception and therefore reduces abnormal scapular mobility. The present study suggests that dual chest banding using elastic bands could be applied to patients with scapular dyskinesis in the clinic. PMID:27064764

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

    PubMed

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

    1992-10-01

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

  11. 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.

  12. Urine - abnormal color

    MedlinePlus

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  13. Tooth - abnormal colors

    MedlinePlus

    ... medlineplus.gov/ency/article/003065.htm Tooth - abnormal colors To use the sharing features on this page, please enable JavaScript. Abnormal tooth color is any color other than white to yellowish- ...

  14. Abnormal Head Position

    MedlinePlus

    ... cause. Can a longstanding head turn lead to any permanent problems? Yes, a significant abnormal head posture could cause permanent ... occipitocervical synostosis and unilateral hearing loss. Are there any ... postures? Yes. Abnormal head postures can usually be improved depending ...

  15. Skeletal limb abnormalities

    MedlinePlus

    ... medlineplus.gov/ency/article/003170.htm Skeletal limb abnormalities To use the sharing features on this page, please enable JavaScript. Skeletal limb abnormalities refers to a variety of bone structure problems ...

  16. 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.

  17. [Diagnosis and management of esophageal chest pain].

    PubMed

    Hong, Su Jin

    2010-04-01

    Esophageal pain that manifests as heartburn or chest pain, is a prevalent problem. Esophageal chest pain is most often caused by gastroesophageal reflux disease (GERD), but can also result from inflammatory processes, infections involving the esophagus, and contractions of the esophageal muscle. The mechanisms and pathways of esophageal chest pain are poorly understood. Vagal and spinal afferent pathways carry sensory information from the esophagus. Recently, esophageal hypersensitivity is identified as an important factor in the development of esophageal pain. A number of techniques are available to evaluate esophageal chest pain such as endoscopy and/or proton-pump inhibitor trial, esophageal manometry, a combined impedance-pH study, and esophageal ultrasound imaging. Proton pump inhibitors (PPIs) have the huge success in the treatment of GERD. Other drugs such as imipramine, trazadone, sertraline, tricyclics, and theophylline have been introduced for the control of esophageal chest pain in partial responders to PPI and the patients with esophageal hypersensitivity. Novel drugs which act on different targets are anticipated to treat esophageal pain in the future.

  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. Elbow Radiographic Anatomy: Measurement Techniques and Normative Data

    PubMed Central

    Goldfarb, Charles A.; Patterson, J. Megan M.; Sutter, Melanie; Krauss, Melissa; Steffen, Jennifer A.; Galatz, Leesa

    2011-01-01

    Background An increase in elbow pathology in adolescents has paralleled an increase in sports participation. Evaluation and classification of these injuries is challenging because of limited information regarding normal anatomy. The purpose of this study was to evaluate normal radiographic anatomy in adolescents to establish parameters for diagnosing abnormal development. Established and new measurements were evaluated for reliability and variance based on age and sex. Methods Three orthopaedic surgeons independently and in a standardized fashion evaluated the normal anteroposterior and lateral elbow radiographs of 178 adolescent and young adult subjects. Fourteen measurements were performed including radial neck- shaft angle, articular surface angle, articular surface morphologic assessment (subjective and objective evaluation of the patterns of ridges and sulci), among others. We performed a statistical analysis by age and sex for each measure and assessed for inter and intra-observer reliability. Results The distal humerus articular surface was relatively flat in adolescence and became more contoured with age as objectively demonstrated by increasing depth of the trochlear and trochleocapitellar sulci, and decreasing trochlear notch angle. Overall measurements were similar between males and females, with an increased carrying angle in females. There were several statistically significant differences based on age and sex but these were small and unlikely to be clinically significant. Inter and intra-observer reliability were variable; some commonly utilized tools had poor reliability. Conclusions Most commonly utilized radiographic measures were consistent between sexes, across the adolescent age group, and between adolescents and young adults. Several commonly used assessment tools show poor reliability. Level of evidence Basic Science Study, Anatomic Study, Imaging PMID:22329911

  20. 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

  1. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures

    PubMed Central

    Chapman, Brandon C.; Overbey, Douglas M.; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T.; French, Andrew; Johnson, Jeffrey L.; Burlew, Clay C.; Barnett, Carlton; Moore, Ernest E.; Pieracci, Fredric M.

    2016-01-01

    Background Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. Objectives The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Methods Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student’s t-test and chi-square analysis were used for comparison. Results We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. Conclusions The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes. PMID:28144607

  2. Radiographic Evaluation of Valvular Heart Disease With Computed Tomography and Magnetic Resonance Correlation.

    PubMed

    Lempel, Jason K; Bolen, Michael A; Renapurkar, Rahul D; Azok, Joseph T; White, Charles S

    2016-09-01

    Valvular heart disease is a group of complex entities with varying etiologies and clinical presentations. There are a number of imaging tools available to supplement clinical evaluation of suspected valvular heart disease, with echocardiography being the most common and clinically established, and more recent emergence of computed tomography and magnetic resonance imaging as additional supportive techniques. Yet even with these newer and more sophisticated modalities, chest radiography remains one of the earliest and most common diagnostic examinations performed during the triage of patients with suspected cardiac dysfunction. Recognizing the anatomic and pathologic features of cardiac radiography including the heart's adaptation to varying hemodynamic changes can provide clues to the radiologist regarding the underlying etiology. In this article, we will elucidate several principles relating to chamber modifications in response to pressure and volume overload as well as radiographic appearances associated with pulmonary fluid status and cardiac dysfunction. We will also present a pattern approach to optimize analysis of the chest radiograph for valvular heart disease, which will help guide the radiologist down a differential diagnostic pathway and create a more meaningful clinical report.

  3. Impact of resolution and noise characteristics of digital radiographic detectors on the detectability of lung nodules.

    PubMed

    Saunders, Robert S; Samei, Ehsan; Hoeschen, Christoph

    2004-06-01

    One of the unanswered questions in digital radiography is the connection between physical image quality metrics and clinical detection performance. In this paper, we examine the impact of two physical metrics, resolution and noise, on the detectability of nodules in a pulmonary background for specific digital radiographic detectors. A detection experiment was performed on a simulated image set using anatomical backgrounds from a high-quality lung radiograph and three different simulated nodule sizes (2-3.5 mm). The resolution and noise of the resulting images were modified using existing routines to simulate a selenium-based and a cesium iodide-based flat-panel detector at comparable exposures. A location-known-exactly (LKE) observer performance experiment was performed in which four experienced chest radiologists and three physicists specializing in chest radiology scored the images. The data from the observer experiment were analyzed by receiver operating characteristic (ROC) methodology. The detectability, as measured by the parameter Az, was higher for the selenium detector than the cesium iodide detector for all nodule sizes by an average of 8.5%. For one nodule size (2.75 mm), the difference between detectors was statistically significant (p < 0.01). The findings indicate that for the particular task studied, the superior resolution performance of the selenium-based detector provided better detectability of subtle lung nodules even though the images had greater noise than images obtained with the cesium iodide detector.

  4. Solid state radiographic image amplifiers, part C

    NASA Technical Reports Server (NTRS)

    Szepesi, Z.

    1971-01-01

    The contrast sensitivity of the radiographic amplifiers, both the storage type and nonstorage type, their absolute sensitivity, and the reproducibility of fabrication were investigated. The required 2-2T quality level was reached with the radiographic storage screen. The sensitivity threshold was 100 to 200 mR with 45 to 100 kV filtered X-rays. The quality level of the radiographic amplifier screen (without storage) was 4-4T; for a 6 mm (0.25 in.) thick aluminum specimen, a 1 mm (0.040 in.) diameter hole in a 0.25 mm (0.010 in.) thick penetrameter was detected. Its sensitivity threshold was 2 to 6 mR/min. The developed radiographic screens are applicable for uses in nondestructive testing.

  5. Radiographic selection criteria: new guidelines, old challenges.

    PubMed

    Horner, K

    2013-02-01

    Radiographic selection criteria are a legal requirement for any establishment using ionising radiation for medical purposes, including dental practices. The Faculty of General Dental Practice (UK) pioneered the development of radiographic selection criteria for dentistry in the UK in 1998 and followed this with a second edition in 2004. This year will see a third edition, updated by new research evidence and developments in X-ray imaging for dentistry, including cone beam computed tomography (CT). Radiographic selection criteria are not rules but are one form of clinical guideline designed to help in clinical decision making. There are many influences on the use of radiography in dental practice including non-clinical factors. Evidence-based radiographic selection criteria can help to reinforce good practice, but require a multi-faceted implementation strategy including incorporation into clinical audit, easy availability to users and education.

  6. Film adhesive enhances neutron radiographic images

    NASA Technical Reports Server (NTRS)

    Reed, M. W.

    1978-01-01

    Resolution of neutron radiographic images of thermally conductive film is increased by replacing approximately 5 percent of aluminum powder, which provides thermal conductivity, with gadolinium oxide. Oxide is also chemically stable.

  7. Gastroduodenal lesions of ingested acids: radiographic findings.

    PubMed

    Muhletaler, C A; Gerlock, A J; de Soto, L; Halter, S A

    1980-12-01

    Abdominal radiographs and barium studies of the stomach and duodenum of 27 patients after ingestion of muriatic acid (27% HCl) in suicidal attempts were reviewed. Eleven patients were studied in the acute phase (1-10 days), nine in the subacute phase (11-20 days), and 15 in the chronic phase (21 days or more). Extensive gastric and duodenal mucosal and submucosal damage was radiographically demonstrated in all patients studied in the acute and subacute phase. Four patients had gastric perforation. The radiographic findings in the chronic phase were characterized by marked contraction of the lesser curvature, antral stenosis, irregular gastric contours, and deformed duodenal bulb. Esophageal mucosal and submucosal lesions were radiographically demonstrated in all these patients.

  8. Method prevents secondary radiation in radiographic inspection

    NASA Technical Reports Server (NTRS)

    Struckus, A. A.

    1967-01-01

    Thin-walled neoprene containers prevent secondary radiation, scatter, and undercut during radiographic inspection. The containers are filled with a mixture of barium sulfate, red lead, and petroleum jelly that achieves the required absorption rate.

  9. The forensic importance of frontal sinus radiographs.

    PubMed

    da Silva, Rhonan Ferreira; Prado, Felippe Bevilacqua; Caputo, Isamara Geandra Cavalcanti; Devito, Karina Lopes; Botelho, Tessa de Luscena; Daruge Júnior, Eduardo

    2009-01-01

    The identification of unidentified human remains through the comparison of antemortem and postmortem radiographs has found wide acceptance in recent years. Reported here is the forensic case of an unidentified adult male who had died as the result of a traffic accident, after which the body was identified by matching images of ante- and postmortem radiographs of the frontal sinus. A general discussion on identification using frontal sinus radiographs is presented, highlighting the reliability of this method, in reference to the uniqueness of the frontal sinus in humans. However, it also notes a few difficulties, especially in reference to the X-ray technique in cases where antemortem radiographs are available and a potentially larger number of anatomical, pathological or traumatic features are present. The comparison of frontal sinus outlines is recommended when it may become necessary to provide quantitative substantiation for forensic identification based on these structures.

  10. Age-related thoracic radiographic changes in golden and labrador retriever muscular dystrophy.

    PubMed

    Bedu, Anne-Sophie; Labruyère, Julien J; Thibaud, Jean Laurent; Barthélémy, Inès; Leperlier, Dimitri; Saunders, Jimmy H; Blot, Stéphane

    2012-01-01

    Golden retriever and Labrador retriever muscular dystrophy are inherited progressive degenerative myopathies that are used as models of Duchenne muscular dystrophy in man. Thoracic lesions were reported to be the most consistent radiographic finding in golden retriever dogs in a study where radiographs were performed at a single-time point. Muscular dystrophy worsens clinically over time and longitudinal studies in dogs are lacking. Thus our goal was to describe the thoracic abnormalities of golden retriever and Labrador retriever dogs, to determine the timing of first expression and their evolution with time. To this purpose, we retrospectively reviewed 390 monthly radiographic studies of 38 golden retrievers and six Labrador retrievers with muscular dystrophy. The same thoracic lesions were found in both golden and Labrador retrievers. They included, in decreasing frequency, flattened and/or scalloped diaphragmatic shape (43/44), pulmonary hyperinflation (34/44), hiatal hernia (34/44), cranial pectus excavatum (23/44), bronchopneumonia (22/44), and megaesophagus (14/44). The last three lesions were not reported in a previous radiographic study in golden retriever dogs. In all but two dogs the thoracic changes were detected between 4 and 10 months and were persistent or worsened over time. Clinically, muscular dystrophy should be included in the differential diagnosis of dogs with a combination of these thoracic radiographic findings.

  11. 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.

  12. Abnormal Uterine Bleeding FAQ

    MedlinePlus

    ... PROBLEMS Abnormal Uterine Bleeding • What is a normal menstrual cycle? • When is bleeding abnormal? • At what ages is ... treat abnormal bleeding? •Glossary What is a normal menstrual cycle? The normal length of the menstrual cycle is ...

  13. 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.

  14. Lead Scales for X-Radiographs

    NASA Technical Reports Server (NTRS)

    Burley, Richard K.; Adams, James F.

    1987-01-01

    Indentations made by typing on lead tape. Lead scales for inclusion in x-radiographs as length and position references created by repeatedly imprinting character like upper-case I, L, or V, or lower-case L into lead tape with typewriter. Character pitch of typewriter serves as length reference for scale. Thinning of tape caused by impacts of type shows up dark in radiograph.

  15. The one-leg standing radiograph

    PubMed Central

    Naratrikun, K.; Kanitnate, S.; Sangkomkamhang, T.

    2016-01-01

    Objectives The purpose of this study was to compare the joint space width between one-leg and both-legs standing radiographs in order to diagnose a primary osteoarthritis of the knee. Methods Digital radiographs of 100 medial osteoarthritic knees in 50 patients were performed. The patients had undergone one-leg standing anteroposterior (AP) views by standing on the affected leg while a both-legs standing AP view was undertaken while standing on both legs. The severity of the osteoarthritis was evaluated using the joint space width and Kellgren-Lawrence (KL) radiographic classification. The t-test was used for statistical analysis. Results The mean medial joint space width found in the one-leg and in the both-legs standing view were measured at 1.8 mm and 2.4 mm, respectively (p < 0.001, 95% CI 0.5 to 0.7). 33%, 47.4% and 23.1% of the knees diagnosed with a KL grade of I, II and III in the both-legs standing views were changed to KL grade II, III and IV in the one-leg standing views, respectively. No changes for KL IV osteoarthritis diagnoses have been found between both- and one-leg standing views. Conclusions One-leg standing radiographs better represent joint space width than both-legs standing radiographs. 32% of both-legs standing radiographs have changed the KL grading to a more severe grade than that in the one-leg standing radiographs. Cite this article: P. Pinsornsak, K. Naratrikun, S. Kanitnate, T. Sangkomkamhang. The one-leg standing radiograph: An improved technique to evaluate the severity of knee osteoarthritis. Bone Joint Res 2016;5:436–441. DOI: 10.1302/2046-3758.59.BJR-2016-0049.R1. PMID:27683299

  16. Radiation recommendation series: administratively required dental radiographs

    SciTech Connect

    Not Available

    1981-09-01

    Administrative requirements for radiographs are found in many segments of the United States health care system. This document presents an FDA radiation recommendation on administratively required dental x-ray examinations. In general, such examinations are not requested to further the patient's dental health, but rather as a means of monitoring claims. However, the administrative use of radiographs that have been taken in the normal course of patient care is usually appropriate, as long as the patient's right to privacy is respected.

  17. 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

  18. 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.

  19. Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

    PubMed Central

    ter Braak, Bert P. M.; van Erkel, Arian R.; Bloem, Rolf M.; Napoleon, L. J.; Coene, M. N.; van Luijt, Peter A.; de Lange, Sam; Bloem, Johan L.

    2007-01-01

    Objective The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Materials and methods Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks’ duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Results Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs

  20. Trabecular architecture analysis in femur radiographic images using fractals.

    PubMed

    Udhayakumar, G; Sujatha, C M; Ramakrishnan, S

    2013-04-01

    Trabecular bone is a highly complex anisotropic material that exhibits varying magnitudes of strength in compression and tension. Analysis of the trabecular architectural alteration that manifest as loss of trabecular plates and connection has been shown to yield better estimation of bone strength. In this work, an attempt has been made toward the development of an automated system for investigation of trabecular femur bone architecture using fractal analysis. Conventional radiographic femur bone images recorded using standard protocols are used in this study. The compressive and tensile regions in the images are delineated using preprocessing procedures. The delineated images are analyzed using Higuchi's fractal method to quantify pattern heterogeneity and anisotropy of trabecular bone structure. The results show that the extracted fractal features are distinct for compressive and tensile regions of normal and abnormal human femur bone. As the strength of the bone depends on architectural variation in addition to bone mass, this study seems to be clinically useful.

  1. Evaluation and treatment of musculoskeletal chest pain.

    PubMed

    Ayloo, Amba; Cvengros, Teresa; Marella, Srimannarayana

    2013-12-01

    This article summarizes the evaluation and treatment of musculoskeletal causes of chest pain. Conditions such as costochondritis, rib pain caused by stress fractures, slipping rib syndrome, chest wall muscle injuries, fibromyalgia, and herpes zoster are discussed, with emphasis on evaluation and treatment of these and other disorders. Many of these conditions can be diagnosed by the primary care clinician in the office by history and physical examination. Treatment is also discussed, including description of manual therapy and exercises as needed for some of the conditions.

  2. Lung boundary detection in pediatric chest x-rays

    NASA Astrophysics Data System (ADS)

    Candemir, Sema; Antani, Sameer; Jaeger, Stefan; Browning, Renee; Thoma, George R.

    2015-03-01

    Tuberculosis (TB) is a major public health problem worldwide, and highly prevalent in developing countries. According to the World Health Organization (WHO), over 95% of TB deaths occur in low- and middle- income countries that often have under-resourced health care systems. In an effort to aid population screening in such resource challenged settings, the U.S. National Library of Medicine has developed a chest X-ray (CXR) screening system that provides a pre-decision on pulmonary abnormalities. When the system is presented with a digital CXR image from the Picture Archive and Communication Systems (PACS) or an imaging source, it automatically identifies the lung regions in the image, extracts image features, and classifies the image as normal or abnormal using trained machine-learning algorithms. The system has been trained on adult CXR images, and this article presents enhancements toward including pediatric CXR images. Our adult lung boundary detection algorithm is model-based. We note the lung shape differences during pediatric developmental stages, and adulthood, and propose building new lung models suitable for pediatric developmental stages. In this study, we quantify changes in lung shape from infancy to adulthood toward enhancing our lung segmentation algorithm. Our initial findings suggest pediatric age groupings of 0 - 23 months, 2 - 10 years, and 11 - 18 years. We present justification for our groupings. We report on the quality of boundary detection algorithm with the pediatric lung models.

  3. Does Radial Styloid Abnormality in de Quervain’s Disease Affect the Outcome of Management?

    PubMed Central

    Zaki, Hosam; Ali, Atif

    2010-01-01

    Radiological changes have been described in de Quervain’s disease of the wrist. The author analyzed the clinical data of 114 patients who reported to the orthopedic clinic of a Regional Referral Hospital for a period of 4 years [2003 to 2007]. Radiographs of the wrist were available for 39 cases, of which 14 [35.89%] were found abnormal. Two patients with abnormal radiographs [14.28%] required surgery where as 7 out of 25 [28%] with normal radiographs were managed surgically. Radial styloid abnormality was not found statistically significant [p < 0.05], and the outcome of management was irrespective of the changes in the radial styloid. PMID:22131918

  4. Reducing missing fracture clinic radiographs by entrusting them to patients.

    PubMed Central

    Calder, Peter R.; Hynes, Matthew C.; Goodier, W. David

    2004-01-01

    BACKGROUND: Missing radiographs in fracture clinics may compromise fracture management and lead to inappropriate use of clerical resources. METHODS: We prospectively compared the number of missing radiographs in two hospitals over a period of two months. In hospital A the radiographs were retained and in hospital B they were entrusted to the patients. RESULTS: At the completion of the study, entrusting patients with their radiographs resulted in statistically less radiographs missing from the clinic. PMID:15333169

  5. Hereditary gingival fibromatosis with distinct dental, skeletal and developmental abnormalities.

    PubMed

    Katz, Joseph; Guelmann, Marcio; Barak, Shlomo

    2002-01-01

    A case of a 9-year-old child with hereditary gingival fibromatosis, supernumerary tooth, chest deformities, auricular cartilage deformation, joint laxity and undescended testes is described. The exact mode of inheritance is unclear; a new mutation pattern is possible. These features resemble but differ from the previously reported Laband syndrome. The dental treatment consisted of surgical removal of the fibrous tissue and conservative restorative treatment under general anesthesia. The dental practitioner should be alert for developmental abnormalities such as supernumerary teeth and delayed tooth eruption. A comprehensive medical history and physical systemic evaluation is essential to rule out other systemic abnormalities. Genetic consultation is mandatory for future family planing.

  6. Salmonella typhimurium abscess of the chest wall

    PubMed Central

    Tonziello, Gilda; Valentinotti, Romina; Arbore, Enrico; Cassetti, Paolo; Luzzati, Roberto

    2013-01-01

    Patient: Male, 73 Final Diagnosis: Salmonella typhimurium abscess of the chest wall Symptoms: — Medication: Ciprofloxacin Clinical Procedure:— Specialty: Infectious Diseases Objective: Unusual clinical course Background: Non-typhoid Salmonella extra-intestinal infections usually develop in infants and in adult patients with pre-existing predisposing conditions. Blood stream infections and urinary tract infections are the most common clinical presentations, but other sites of infection may be involved as well. Case Report: We describe a case of invasive salmonellosis caused by Salmonella typhimurium involving the chest wall in a 73-year-old man. The patient had suffered from gastroenteritis followed by left basal pneumonia with pleural effusion 7 weeks before. The CT scan of the chest wall showed a pericostal abscess with shirt-stud morphology near the left last cartilaginous arch. The abscess was surgically drained and patient was cured after a 40-day ciprofloxacin treatment. Conclusions: A review of the literature on extra-intestinal non-typhoid salmonellosis shows that pleuropulmonary and soft-tissue infections are uncommon. We argue that non-typhoid Salmonella might be considered as a possible cause of chest wall abscess in individuals with recent history of gastroenteritis complicated by pneumonia and pleural effusion. PMID:24298305

  7. When to Remove a Chest Tube.

    PubMed

    Novoa, Nuria M; Jiménez, Marcelo F; Varela, Gonzalo

    2017-02-01

    Despite the increasing knowledge about the pleural physiology after lung resection, most practices around chest tube removal are dictated by personal preferences and experience. This article discusses recently published data on the topic and suggests opportunities for further investigation and future improvements.

  8. 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 ...

  9. Adenocarcinoma - chest x-ray (image)

    MedlinePlus

    This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side ... density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and ...

  10. Alexithymia and anxiety sensitivity in patients with non-cardiac chest pain.

    PubMed

    White, Kamila S; McDonnell, Cassandra J; Gervino, Ernest V

    2011-12-01

    The aim of this study was to examine independent and combined influences of alexithymia and anxiety sensitivity on chest pain and life interference in patients with non-cardiac chest pain (NCCP). Theories of NCCP posit a central role for emotion in the experience of chest pain, however, studies have not examined how alexithymia characterized by a difficulty identifying or verbalizing emotions, may influence this relationship. This study examined 231 patients (56% females, M age=50 years) with chest pain seeking cardiac evaluation, who showed no abnormalities during exercise tolerance testing. Forty percent (40%) scored at or above the moderate range of alexithymia. Whereas health care utilization was associated with elevated alexithymia among men, health care utilization was associated with elevated anxiety sensitivity among women. Hierarchical regression analyses revealed that alexithymia and anxiety sensitivity were both uniquely and independently associated with pain severity and life interference due to pain. Alexithymia-pain links were stronger for men compared to women. Secondary analyses conducted with a subsample suggest that alexithymia may be increasingly stable over time (i.e., 18-month follow-up). Findings are largely congruent with theoretical models of NCCP showing that personality and emotional factors are important in this medically unexplained syndrome.

  11. 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

  12. Radiological surveillance of formerly asbestos-exposed power industry workers: rates and risk factors of benign changes on chest X-ray and MDCT

    PubMed Central

    2014-01-01

    Background To determine the prevalence of asbestos-related changes on chest X-ray (CXR) and low-dose multidetector-row CT (MDCT) of the thorax in a cohort of formerly asbestos-exposed power industry workers and to assess the importance of common risk factors associated with specific radiological changes. Methods To assess the influence of selected risk factors (age, time since first exposure, exposure duration, cumulative exposure and pack years) on typical asbestos-related radiographic changes, we employed multiple logistic regression and receiver operating characteristic (ROC) analysis. Results On CXR, pleural changes and asbestosis were strongly associated with age, years since first exposure and exposure duration. The MDCT results showed an association between asbestosis and age and between plaques and exposure duration, years since first exposure and cumulative exposure. Parenchymal changes on CXR and MDCT, and diffuse pleural thickening on CXR were both associated with smoking. Using a cut-off of 55 years for age, 17 years for exposure duration and 28 years for latency, benign radiological changes in the cohort with CXR could be predicted with a sensitivity of 82.0% for all of the three variables and a specificity of 47.4%, 39.0% and 40.6%, respectively. Conclusions Participants aged 55 years and older and those with an asbestos exposure of at least 17 years or 28 years since first exposure should be seen as having an increased risk of abnormal radiological findings. For implementing a more focused approach the routine use of low-dose MDCT rather than CXR at least for initial examinations would be justified. PMID:24808921

  13. Upper Third to Lower Third Width Ratio on Chest X-Ray May Predict Severity of Obstruction in Obstructive Lung Disease

    PubMed Central

    Hamidi, Sahand; Shakiba, Maryam; Massahnia, Sara

    2014-01-01

    Background The symptoms and functional limitations due to obstructive lung disease (OLD) are the direct results of airway and lung parenchymal destruction. In these conditions, airflow obstruction leads to increased work of breathing, and gas exchange abnormalities. Hyperinflation, which is inferred from a standard chest radiograph (CXR), may imply increased total lung capacity that can be seen in patients with OLD. Based on experimental observations in OLD patients, we proposed that upper third width in posterioranterior (PA) CXR could be used as a rapid screening method for suggestion of OLD. Materials and Methods In this cross-sectional study, 99 patients admitted to the Respiratory Ward of Razi Medical Center, a teaching referral hospital affiliated to Guilan University of Medical Sciences (GUMS), were entered in the study. The inclusion criteria were any FEV1 with FEV1/FVC <70% or FEV1/FVC>70% with MMEF 75/25 <65%. All cases with diagnostic possibilities other than OLD were excluded. The PA and lateral CXR were performed and 13 measurements – including previous well-known measurements and our proposed new ones- were made by an ordinary ruler on the films. Results There was no significant correlation between the upper third width and superior/inferior (sup/inf) ratio with spirometric indices in patients. When considering only patients with FEV1/FVC <70%, middle third proportion width had a significant correlation with FEV1/FVC. In subgroup analysis when considering sup/inf ratio > 0.8, superior and inferior third widths were correlated with FEV1/FVC and when considering sup/inf ratio > 0.9, sup/inf ratio was significantly correlated with FEV1/FVC and FEV1. Conclusion The sup/inf ratio >0.9 in PA CXR, may be a predictor of obstructive pattern in OLD patients. For better correlation determination, larger and more extensive studies are needed. PMID:25191489

  14. Abnormal Canine Bone Development Associated with Hypergravity Exposure

    NASA Technical Reports Server (NTRS)

    Morgan, J. P.; Fisher, G. L.; McNeill, K. L.; Oyama, J.

    1979-01-01

    Chronic centrifugation of 85- to 92-day-old Beagles at 2.0 x g and 2.6 x g for 26 weeks during the time of active skeletal growth caused skeletal abnormalities in the radius and the ulna of ten of 11 dogs. The pattern of change mimicked that found in naturally occurring and experimentally induced premature distal ulnar physeal closure or delayed growth at this physis. Minimal changes in bone density were detected by sensitive photon absorptiometric techniques. Skeletal abnormalities also were found in five of the six cage-control dogs, although the run-control dogs were radiographically normal.

  15. Quantitative kinetic analysis of lung nodules using the temporal subtraction technique in dynamic chest radiographies performed with a flat panel detector.

    PubMed

    Tsuchiya, Yuichiro; Kodera, Yoshie; Tanaka, Rie; Sanada, Shigeru

    2009-04-01

    Early detection and treatment of lung cancer is one of the most effective means of reducing cancer mortality, and to this end, chest X-ray radiography has been widely used as a screening method. A related technique based on the development of computer analysis and a flat panel detector (FPD) has enabled the functional evaluation of respiratory kinetics in the chest and is expected to be introduced into clinical practice in the near future. In this study, we developed a computer analysis algorithm to detect lung nodules and to evaluate quantitative kinetics. Breathing chest radiographs obtained by modified FPD and breath synchronization utilizing diaphragmatic analysis of vector movement were converted into four static images by sequential temporal subtraction processing, morphological enhancement processing, kinetic visualization processing, and lung region detection processing. An artificial neural network analyzed these density patterns to detect the true nodules and draw their kinetic tracks. Both the algorithm performance and the evaluation of clinical effectiveness of seven normal patients and simulated nodules showed sufficient detecting capability and kinetic imaging function without significant differences. 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.

  16. Quality assessment of digital X-ray chest images using an anthropomorphic chest phantom

    NASA Astrophysics Data System (ADS)

    Vodovatov, A. V.; Kamishanskaya, I. G.; Drozdov, A. A.; Bernhardsson, C.

    2017-02-01

    The current study is focused on determining the optimal tube voltage for the conventional X-ray digital chest screening examinations, using a visual grading analysis method. Chest images of an anthropomorphic phantom were acquired in posterior-anterior projection on four digital X-ray units with different detector types. X-ray images obtained with an anthropomorphic phantom were accepted by the radiologists as corresponding to a normal human anatomy, hence allowing using phantoms in image quality trials without limitations.

  17. Development of a Chest Wall Protector Effective in Preventing Sudden Cardiac Death by Chest Wall Impact (Commotio Cordis)

    PubMed Central

    Kumar, Kartik; Mandleywala, Swati N.; Gannon, Michael P.; Estes, Nathan Anthony Mark; Weinstock, Jonathan

    2017-01-01

    Objective: Commotio cordis, sudden death with chest impact, occurs clinically despite chest wall protectors worn in sports. In an experimental model of commotio cordis, commercially available chest wall protectors failed to prevent ventricular fibrillation (VF). The goal of the current investigation was to develop a chest wall protector effective in the prevention of commotio cordis. Design: In the Tufts experimental model of commotio cordis the ability of chest protectors to prevent VF was assessed. Impacts were delivered with a 40-mph lacrosse ball, timed to the vulnerable period for VF. Intervention: A chest wall protector or no chest wall protector (control) was randomly assigned to be placed over the chest. Four iterative series of 2 to 4 different chest wall material combinations were assessed. Materials included 3 different foams (Accelleron [Unequal Technologies, Glen Mills, PA], closed cell high density foam; Airilon [Unequal Technologies, Glen Mills, PA], closed cell low density soft foam; and an open cell memory foam) that were adhered to a layer of TriDur (Unequal Technologies, Glen Mills, PA), a flexible elastomeric coated aramid that was bonded to a semirigid polypropylene polymer (ImpacShield, Unequal Technologies, Glen Mills, PA). Main Outcome Measure: Induction of VF by chest wall impact was the primary outcome. Results: Of 80 impacts without chest protectors, 43 (54%) resulted in VF. Ventricular fibrillation with chest protectors ranged from a high of 60% to a low of 5%. Of 12 chest protectors assessed, only 3 significantly lowered the risk of VF compared with impacts without chest protectors. These 3 chest protectors were combinations of Accelleron, Airilon, TriDur, and ImpacShield of different thicknesses. Protection increased linearly with the thicker combinations. Conclusions: Effective protection against VF with chest wall protection can be achieved in an experimental model of commotio cordis. Clinical Relevance: Chest protector designs

  18. Abnormalities of proximal femoral growth after severe Perthes' disease.

    PubMed

    Sponseller, P D; Desai, S S; Millis, M B

    1989-08-01

    We studied the pattern of proximal femoral growth after severe Perthes' disease (Catterall grade III or IV) by retrospective analysis of serial radiographs in 52 hips (46 patients). Our aim was to determine the relationship between proximal femoral growth abnormalities and metaphyseal cysts, epiphyseal extrusion, physeal narrowing, and extensive epiphyseal necrosis. The average follow-up after treatment was 9.8 years (range 4 to 16 years), and 37 of the hips were followed to skeletal maturity. Slowing of proximal femoral growth was common: symmetrical abnormality was seen in 26 hips and asymmetrical abnormality in nine. However, definite premature closure of the proximal femoral physis was seen in only three hips. Abnormality seemed to be due to altered growth velocity rather than to bar formation in most cases. Metaphyseal cysts, epiphyseal extrusion and physeal narrowing during the active stage of the disease, alone or in combination, were found to be neither sensitive nor specific predictors of the subsequent growth pattern.

  19. Tube thoracostomy; chest tube implantation and follow up

    PubMed Central

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Papaiwannou, Antonis; Zaric, Bojan; Branislav, Perin; Porpodis, Konstantinos

    2014-01-01

    Pneumothorax is an urgent medical situation that requires urgent treatment. We can divide this entity based on the etiology to primary and secondary. Chest tube implantation can be performed either in the upper chest wall or lower. Both thoracic surgeons and pulmonary physicians can place a chest tube with minimal invasive techniques. In our current work, we will demonstrate chest tube implantation to locations, methodology and tools. PMID:25337405

  20. A radiographic scanning technique for cores

    USGS Publications Warehouse

    Hill, G.W.; Dorsey, M.E.; Woods, J.C.; Miller, R.J.

    1979-01-01

    A radiographic scanning technique (RST) can produce single continuous radiographs of cores or core sections up to 1.5 m long and up to 30 cm wide. Changing a portable industrial X-ray unit from the normal still-shot mode to a scanning mode requires simple, inexpensive, easily constructed, and highly durable equipment. Additional components include a conveyor system, antiscatter cylinder-diaphragm, adjustable sample platform, developing tanks, and a contact printer. Complete cores, half cores, sample slabs or peels may be scanned. Converting the X-ray unit from one mode to another is easy and can be accomplished without the use of special tools. RST provides the investigator with a convenient, continuous, high quality radiograph, saves time and money, and decreases the number of times cores have to be handled. ?? 1979.

  1. Centric relation determinations: clinical and radiographic comparisons.

    PubMed

    Carwell, M L; McFall, W T

    1981-07-01

    This study investigated variations in occlusal prematurities and condylar positions using different methods of determining centric relation. Thirty patients were randomly placed into three groups of 10. In Group I a clinical analysis of occlusal patterns using bilateral mandibular manipulation (BMM) was compared to results with a chin point (CPM) method. Group II compared CPM to an anterior guidance jig (CPJ) method. Group III compared BMM to CPJ. Standardized transcranial oblique radiographs were taken of each temporomandibular joint using CPM and BMM on 10 patients. Condylar position was determined with tracing evaluations and direct measurements of the radiographs. Clinical results indicated that the initial point of contact was located most accurately with CPJ. Both initial contact points and secondary points were disclosed with CPM. The BMM disclosed the most tooth contacts. Contacts were most prevalent on the premolars. Radiographic analyses of condylar positions were inconclusive.

  2. Postmortem abdominal radiographic findings in feline cadavers.

    PubMed

    Heng, Hock Gan; Teoh, Wen Tian; Sheikh-Omar, Abdul Rahman

    2008-01-01

    Postmortem radiographic examinations of animals are commonly performed in judicial investigations to rule out gunshot and fractures. However, there was no available data on radiographic postmortem changes of animals. Forty-one sets of abdominal radiographs of feline cadavers made within 12 h of death were evaluated for postmortem changes. Intravascular gas was detected in 11 of 41 (27%) cadavers. The most common site of intravascular gas was the liver. Intravascular gas was also present in the aorta, femoral artery, celiac and cranial mesenteric arteries, and caudal superficial epigastric artery. Intrasplenic gas was detected in two cadavers. Only two cadavers had distended small intestine. One cadaver had pneumatosis coli. The changes detected were most likely due to putrefaction.

  3. Outcome after pin fixation of supracondylar humerus fractures in children: postoperative radiographic examinations are unnecessary.

    PubMed

    Tuomilehto, Noora; Kivisaari, Reetta; Sommarhem, Antti; Nietosvaara, Aarno Y

    2017-02-01

    Background and purpose - The quality of pin fixation of displaced supracondylar humerus fractures in children has not been assessed, and the clinical value of radiographic examinations after pin fixation is unclear. We evaluated pin configuration, quality of osteosynthesis, and outcome in 264 supracondylar fractures. The clinical significance of postoperative radiographs was analyzed. Patients and methods - 252 Gartland-III and 12 flexion-type supracondylar humerus fractures were pin-fixed in the periods 2002-2006 and 2012-2014. During 2012-2014, staff were intructed that postoperative radiographs should not be taken. Quality of reduction was assessed by measuring Baumann and lateral capitellohumeral angles (LCHA) and also by recording the crossing point of the anterior humeral line (AHL) with bony capitellum. Rotatory alignment was registered as normal or abnormal. Pin configuration and quality of osteosynthesis were evaluated. The clinical significance of postoperative radiographs was analyzed. Results - Postoperatively, Baumann angle was normal in 66% of the fractures, AHL crossed the capitellum in 84%, and no malrotation was evident in 85% of the fractures. Crossed pins were used in 89% of the cases. 2 or more pins fixed both fracture fragments in 66%. Radiographic examinations were inadequate for assessment of LCHA in 13%, of Bauman angle in 8%, of AHL in 2%, of rotation in 1%, and of pin fixation in 2% of the cases. Postoperative radiographs did not give useful information except in 1 patient who had corrective osteotomy. All 94 patients with follow-up (97%) who were treated during 2012-2014 were satisfied with the outcome. Interpretation - Despite pin fixation being deemed unsatisfactory in one-third of the cases, significant malunion was rare. Postoperative radiography did not alter management or outcome.

  4. Outcome after pin fixation of supracondylar humerus fractures in children: postoperative radiographic examinations are unnecessary

    PubMed Central

    Tuomilehto, Noora; Kivisaari, Reetta; Sommarhem, Antti; Nietosvaara, Aarno Y

    2017-01-01

    Background and purpose — The quality of pin fixation of displaced supracondylar humerus fractures in children has not been assessed, and the clinical value of radiographic examinations after pin fixation is unclear. We evaluated pin configuration, quality of osteosynthesis, and outcome in 264 supracondylar fractures. The clinical significance of postoperative radiographs was analyzed. Patients and methods — 252 Gartland-III and 12 flexion-type supracondylar humerus fractures were pin-fixed in the periods 2002–2006 and 2012–2014. During 2012–2014, staff were intructed that postoperative radiographs should not be taken. Quality of reduction was assessed by measuring Baumann and lateral capitellohumeral angles (LCHA) and also by recording the crossing point of the anterior humeral line (AHL) with bony capitellum. Rotatory alignment was registered as normal or abnormal. Pin configuration and quality of osteosynthesis were evaluated. The clinical significance of postoperative radiographs was analyzed. Results — Postoperatively, Baumann angle was normal in 66% of the fractures, AHL crossed the capitellum in 84%, and no malrotation was evident in 85% of the fractures. Crossed pins were used in 89% of the cases. 2 or more pins fixed both fracture fragments in 66%. Radiographic examinations were inadequate for assessment of LCHA in 13%, of Bauman angle in 8%, of AHL in 2%, of rotation in 1%, and of pin fixation in 2% of the cases. Postoperative radiographs did not give useful information except in 1 patient who had corrective osteotomy. All 94 patients with follow-up (97%) who were treated during 2012–2014 were satisfied with the outcome. Interpretation — Despite pin fixation being deemed unsatisfactory in one-third of the cases, significant malunion was rare. Postoperative radiography did not alter management or outcome. PMID:27774833

  5. 20 CFR 718.102 - Chest roentgenograms (X-rays).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification...-rays as described in Appendix A. (b) A chest X-ray to establish the existence of pneumoconiosis...

  6. 20 CFR 718.102 - Chest roentgenograms (X-rays).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification...-rays as described in Appendix A. (b) A chest X-ray to establish the existence of pneumoconiosis...

  7. 46 CFR 97.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 97.37-47 Section 97.37-47... OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: “PORTABLE MAGAZINE...

  8. 46 CFR 78.47-70 - Portable magazine chests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Portable magazine chests. 78.47-70 Section 78.47-70... Fire and Emergency Equipment, Etc. § 78.47-70 Portable magazine chests. (a) Portable magazine chest shall be marked in letters of at least 3 inches high “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS...

  9. 46 CFR 169.743 - 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. 169.743 Section 169.743... Vessel Control, Miscellaneous Systems, and Equipment Markings § 169.743 Portable magazine chests. Portable magazine chests must be marked in letters at least 3 inches high: “PORTABLE MAGAZINE...

  10. 46 CFR 108.651 - Portable magazine chests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 108.651 Section 108.651... AND EQUIPMENT Equipment Markings and Instructions § 108.651 Portable magazine chests. Each portable magazine chest must be marked: “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS AND FIRE AWAY” in letters...

  11. Method of radiographic inspection of wooden members

    NASA Technical Reports Server (NTRS)

    Berry, Maggie L. (Inventor); Berry, Robert F., Jr. (Inventor)

    1990-01-01

    The invention is a method to be used for radiographic inspection of a wooden specimen for internal defects which includes the steps of introducing a radiopaque penetrant into any internal defects in the specimen through surface openings; passing a beam of radiation through a portion of the specimen to be inspected; and making a radiographic film image of the radiation passing through the specimen, with the radiopaque penetrant in the specimen absorbing the radiation passing through it, thereby enhancing the resulting image of the internal defects in the specimen.

  12. Chest pain with myocardial ischemia in a child: should we think about coronary slow flow phenomenon?

    PubMed

    Kocabaş, Abdullah; Kardelen, Fırat; Akçurin, Gayaz; Ertuğ, Halil

    2013-10-01

    The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed opacification of epicardial coronary arteries in the absence of stenotic lesion. Herein, we present a 13-year-old boy with recurrent chest pain who was diagnosed with acute ST-segment elevation myocardial infarction associated with CSFP, which has not been reported previously in the pediatric age group. Coronary angiography revealed only the presence of slow flow in the left anterior descending (LAD) coronary artery. Myocardial perfusion scintigraphy revealed a reversible perfusion defect in the LAD territory, which regressed partially at rest and showed complete improvement after dipyridamole infusion. All the symptoms, electrocardiogram abnormalities and cardiac markers returned to normal after dipyridamole treatment during the follow-up. We conclude that CSFP should be kept in mind in the differential diagnosis of chest pain with myocardial ischemia in the pediatric age group.

  13. Chest pain, dyspnoea and elevated D-dimer in a recent air traveller.

    PubMed

    Lima, Joaquim Santos; Sandler, Belinda; McWilliams, Eric

    2011-08-17

    A previously asymptomatic 69-year-old lady, who recently travelled on a 4 h flight, presented with acute left-sided pleuritic pain, dyspnoea and calf pain. Blood gases revealed hypoxaemia and D-dimer was significantly elevated. She also had low-grade fever, leukocytosis and a small left-sided pleural effusion on chest x-ray. The working diagnosis was pulmonary embolism and chest infection and she received low molecular weight heparin and antibiotics. A subsequent CT pulmonary angiogram ruled out pulmonary embolism but revealed an abnormal finding in the ascending aorta, suggestive of a penetrating aortic ulcer. Urgent transoesophageal echocardiography was consistent with an intramural haematoma and the patient underwent emergency aortic root replacement with imminent aortic rupture confirmed at surgery. This case highlights the fact that acute aortic syndromes may have atypical presentations and also emphasises the fact that D-dimer levels are elevated in aortic syndromes.

  14. Rare Case of Posterior Reversible Leukoencephalopathy Syndrome Secondary to Acute Chest Syndrome

    PubMed Central

    Klein, Daniel; El-Sherif, Yasir

    2016-01-01

    We present a case of 29/m with a history of sickle cell disease who presented to the emergency department with sudden onset of chest, trunk, extremity, and back pain, consistent in quality and severity with the patient's usual pain crises. Soon after admission to the medical unit for acute chest syndrome (ACS), the patient developed sudden onset of hypertension associated with left sided hemiplegia, lethargy, dysarthria, aphasia, and left sided facial droop. Neuroimaging revealed that on MRI Brain there was multifocal extensive signal abnormality and a small focal areas of hemorrhage compatible with posterior reversible leukoencephalopathy syndrome (PRES). Patient was treated with levetiracetam and phenytoin and improved soon afterwards, with resolution seen on follow-up MRI two months later. PMID:27957377

  15. Structurally abnormal human autosomes

    SciTech Connect

    1993-12-31

    Chapter 25, discusses structurally abnormal human autosomes. This discussion includes: structurally abnormal chromosomes, chromosomal polymorphisms, pericentric inversions, paracentric inversions, deletions or partial monosomies, cri du chat (cat cry) syndrome, ring chromosomes, insertions, duplication or pure partial trisomy and mosaicism. 71 refs., 8 figs.

  16. Morphological abnormalities among lampreys

    USGS Publications Warehouse

    Manion, Patrick J.

    1967-01-01

    The experimental control of the sea lamprey (Petromyzon marinus) in the Great Lakes has required the collection of thousands of lampreys. Representatives of each life stage of the four species of the Lake Superior basin were examined for structural abnormalities. The most common aberration was the presence of additional tails. The accessory tails were always postanal and smaller than the normal tail. The point of origin varied; the extra tails occurred on dorsal, ventral, or lateral surfaces. Some of the extra tails were misshaped and curled, but others were normal in shape and pigment pattern. Other abnormalities in larval sea lampreys were malformed or twisted tails and bodies. The cause of the structural abnormalities is unknown. The presence of extra caudal fins could be genetically controlled, or be due to partial amputation or injury followed by abnormal regeneration. Few if any lampreys with structural abnormalities live to sexual maturity.

  17. Lateral cephalometric radiograph versus lateral nasopharyngeal radiograph for quantitative evaluation of nasopharyngeal airway space

    PubMed Central

    Pereira, Suelen Cristina da Costa; Beltrão, Rejane Targino Soares; Janson, Guilherme; Garib, Daniela Gamba

    2014-01-01

    Objective This study compared lateral radiographs of the nasopharynx (LN) and lateral cephalometric radiographs (LC) used to assess nasopharyngeal airway space in children. Material and Methods One examiner measured the nasopharyngeal space of 15 oral breathing patients aged between 5 and 11 years old by using LN and LC. Both assessments were made twice with a 15-day interval in between. Intergroup comparison was performed with t-tests (P < 0.05). Results Comparison between LN and LC measurements showed no significant differences. Conclusion Lateral cephalometric radiograph is an acceptable method used to assess nasopharyngeal airway space. PMID:25279526

  18. Proportionality between chest wall resistance and elastance.

    PubMed

    Barnas, G M; Stamenović, D; Fredberg, J J

    1991-02-01

    Fredberg and Stamenovic (J. Appl. Physiol. 67: 2408-2419, 1989) demonstrated a relatively robust phenomenological relationship between resistance (R) and elastance (E) of lung tissue during external forcing. The relationship can be expressed as omega R = eta E, where omega = 2 pi times forcing frequency and eta is hysteresivity; they found eta to be remarkably invariant under a wide range of circumstances. From data gathered in previous experiments, we have tested the adequacy and utility of this phenomenological description for the chest wall (eta w) and its major compartments, the rib cage (eta rc), diaphragm-abdomen (eta d-a), and belly wall (eta bw+). For forcing frequencies and tidal volumes within the normal range of breathing, we found that eta w remained in a relatively narrow range (0.27-0.37) and that neither eta w nor the compartmental eta's changed much with frequency or tidal volume. Compared with eta w, eta rc tended to be slightly low, whereas eta d-a tended to be slightly higher than eta w. However, at higher frequencies (greater than 1 Hz) all eta's increased appreciably with frequency. During various static nonrespiratory maneuvers involving use of respiratory muscles, eta w increased up to twofold. We conclude that in the normal ranges of breathing frequency and tidal volume 1) elastic and dissipative processes within the chest wall appear to be coupled, 2) eta's of the various component parts of the chest wall are well matched, 3) respiratory muscle contraction increases the ratio of cyclic dissipative losses to energy storage, and 4) R of the relaxed chest wall can be estimated from E.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. A new screening pathway for identifying asymptomatic patients using dental panoramic radiographs

    NASA Astrophysics Data System (ADS)

    Hayashi, Tatsuro; Matsumoto, Takuya; Sawagashira, Tsuyoshi; Tagami, Motoki; Katsumata, Akitoshi; Hayashi, Yoshinori; Muramatsu, Chisako; Zhou, Xiangrong; Iida, Yukihiro; Matsuoka, Masato; Katagi, Kiyoji; Fujita, Hiroshi

    2012-03-01

    To identify asymptomatic patients is the challenging task and the essential first step in diagnosis. Findings of dental panoramic radiographs include not only dental conditions but also radiographic signs that are suggestive of possible systemic diseases such as osteoporosis, arteriosclerosis, and maxillary sinusitis. Detection of such signs on panoramic radiographs has a potential to provide supplemental benefits for patients. However, it is not easy for general dental practitioners to pay careful attention to such signs. We addressed the development of a computer-aided detection (CAD) system that detects radiographic signs of pathology on panoramic images, and the design of the framework of new screening pathway by cooperation of dentists and our CAD system. The performance evaluation of our CAD system showed the sensitivity and specificity in the identification of osteoporotic patients were 92.6 % and 100 %, respectively, and those of the maxillary sinus abnormality were 89.6 % and 73.6 %, respectively. The detection rate of carotid artery calcifications that suggests the need for further medical evaluation was approximately 93.6 % with 4.4 false-positives per image. To validate the utility of the new screening pathway, preliminary clinical trials by using our CAD system were conducted. To date, 223 panoramic images were processed and 4 asymptomatic patients with suspected osteoporosis, 7 asymptomatic patients with suspected calcifications, and 40 asymptomatic patients with suspected maxillary sinusitis were detected in our initial trial. It was suggested that our new screening pathway could be useful to identify asymptomatic patients with systemic diseases.

  20. A comparative analysis of the interpretations of lumbar spinal radiographs by chiropractors and medical doctors.

    PubMed

    Frymoyer, J W; Phillips, R B; Newberg, A H; MacPherson, B V

    1986-12-01

    Ninety-nine anteroposterior and lateral lumbar radiographs taken of men, 18 to 55 years of age, were randomly selected from participants in a population survey of low-back pain. Thirty-one (31%) had never had low-back pain; 44 (44%) had or were having mild low-back pain; and 24 (24%) had or were having severe low-back pain. Three chiropractors assessed 56 radiographic variables, which included determinations of disc space height, vertebral malalignments and subluxations, spondylosis, postural disturbances, relationships among pelvis and spine and other congenital or acquired abnormalities. Interobserver reliability measurements showed that 6 of the 56 variables analyzed produced a high interobserver reliability. Sixteen additional variables showed a fair interobserver reliability. Comparison of the observations made by the chiropractors and a radiologist showed minimal agreement except for disc space height assessments at L3-4 and L4-5. Few of the radiographic variables discriminated between the current or prior history of low-back and leg complaints, although a few variables (most notably disc space narrowing) were statistically associated with back or leg complaints (P = .025). The conclusion was reached that spinal radiographs, whether analyzed by measurements, by a radiologist, or by chiropractors, have minimal value in determining the presence or absence of low-back complaints and, in particular, have no value in epidemiologic studies.

  1. Advances in chest drain management in thoracic disease

    PubMed Central

    George, Robert S.

    2016-01-01

    An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. In thoracic surgery the post-operative use of the conventional underwater seal chest drainage system fulfills these requirements, however they allow great variability amongst practices. In addition they do not offer accurate data and they are often inconvenient to both patients and hospital staff. This article aims to simplify the myths surrounding the management of chest drains following chest surgery, review current experience and explore the advantages of modern digital chest drain systems and address their disease-specific use. PMID:26941971

  2. Surface Chest Motion Decomposition for Cardiovascular Monitoring

    PubMed Central

    Shafiq, Ghufran; Veluvolu, Kalyana C.

    2014-01-01

    Surface chest motion can be easily monitored with a wide variety of sensors such as pressure belts, fiber Bragg gratings and inertial sensors, etc. The current applications of these sensors are mainly restricted to respiratory motion monitoring/analysis due to the technical challenges involved in separation of the cardiac motion from the dominant respiratory motion. The contribution of heart to the surface chest motion is relatively very small as compared to the respiratory motion. Further, the heart motion spectrally overlaps with the respiratory harmonics and their separation becomes even more challenging. In this paper, we approach this source separation problem with independent component analysis (ICA) framework. ICA with reference (ICA-R) yields only desired component with improved separation, but the method is highly sensitive to the reference generation. Several reference generation approaches are developed to solve the problem. Experimental validation of these proposed approaches is performed with chest displacement data and ECG obtained from healthy subjects under normal breathing and post-exercise conditions. The extracted component morphologically matches well with the collected ECG. Results show that the proposed methods perform better than conventional band pass filtering. PMID:24865183

  3. Detecting objects in radiographs for homeland security

    NASA Astrophysics Data System (ADS)

    Prasad, Lakshman; Snyder, Hans

    2005-05-01

    We present a general scheme for segmenting a radiographic image into polygons that correspond to visual features. This decomposition provides a vectorized representation that is a high-level description of the image. The polygons correspond to objects or object parts present in the image. This characterization of radiographs allows the direct application of several shape recognition algorithms to identify objects. In this paper we describe the use of constrained Delaunay triangulations as a uniform foundational tool to achieve multiple visual tasks, namely image segmentation, shape decomposition, and parts-based shape matching. Shape decomposition yields parts that serve as tokens representing local shape characteristics. Parts-based shape matching enables the recognition of objects in the presence of occlusions, which commonly occur in radiographs. The polygonal representation of image features affords the efficient design and application of sophisticated geometric filtering methods to detect large-scale structural properties of objects in images. Finally, the representation of radiographs via polygons results in significant reduction of image file sizes and permits the scalable graphical representation of images, along with annotations of detected objects, in the SVG (scalable vector graphics) format that is proposed by the world wide web consortium (W3C). This is a textual representation that can be compressed and encrypted for efficient and secure transmission of information over wireless channels and on the Internet. In particular, our methods described here provide an algorithmic framework for developing image analysis tools for screening cargo at ports of entry for homeland security.

  4. Identifying murder victims with endodontic radiographs.

    PubMed

    Silva, Rhonan Ferreira; Franco, Ademir; Mendes, Solon Diego Santos Carvalho; Picoli, Fernando Fortes; Nunes, Fernando Gomes; Estrela, Carlos

    2016-01-01

    Endodontics is a special branch of dentistry constantly guided by imaging examinations. From a forensic scope, endodontics plays a valuable role providing solid antemortem (AM) radiographic evidence for comparison with postmortem findings in human identifications. This study illustrates the interface between endodontics and forensic odontology describing three cases of human identification based on radiographic endodontic records. From 2009 to 2012, three unknown male victims of murder were examined in a local Brazilian medico-legal institute to retrieve identity and potential cause of death. Specifically, when asked for AM data, a relative of the three victims provided periapical radiographs of endodontic treatments. Based on that, forensic dentists reproduced the same imaging acquisition techniques obtaining similar periapical radiographs, enabling a comparative dental identification. All the victims were positively identified based on patterns of dental morphology and treatment intervention. This study draws the attention of general and forensic dentists highlight the importance of properly recording dental treatments and searching for evidence in AM endodontic data, respectively.

  5. Identifying murder victims with endodontic radiographs

    PubMed Central

    Silva, Rhonan Ferreira; Franco, Ademir; Mendes, Solon Diego Santos Carvalho; Picoli, Fernando Fortes; Nunes, Fernando Gomes; Estrela, Carlos

    2016-01-01

    Endodontics is a special branch of dentistry constantly guided by imaging examinations. From a forensic scope, endodontics plays a valuable role providing solid antemortem (AM) radiographic evidence for comparison with postmortem findings in human identifications. This study illustrates the interface between endodontics and forensic odontology describing three cases of human identification based on radiographic endodontic records. From 2009 to 2012, three unknown male victims of murder were examined in a local Brazilian medico-legal institute to retrieve identity and potential cause of death. Specifically, when asked for AM data, a relative of the three victims provided periapical radiographs of endodontic treatments. Based on that, forensic dentists reproduced the same imaging acquisition techniques obtaining similar periapical radiographs, enabling a comparative dental identification. All the victims were positively identified based on patterns of dental morphology and treatment intervention. This study draws the attention of general and forensic dentists highlight the importance of properly recording dental treatments and searching for evidence in AM endodontic data, respectively. PMID:28123272

  6. Radiographic applications of spatial frequency multiplexing

    NASA Technical Reports Server (NTRS)

    Macovski, A.

    1981-01-01

    The application of spacial frequency encoding techniques which allow different regions of the X-ray spectrum to be encoded on conventional radiographs was studied. Clinical considerations were reviewed, as were experimental studies involving the encoding and decoding of X-ray images at different energies and the subsequent processing of the data to produce images of specific materials in the body.

  7. TECHNICAL TRAINING FOR INDUSTRIAL RADIOGRAPHERS. FINAL REPORT.

    ERIC Educational Resources Information Center

    BEARDEN, H.D.

    TO OFFSET THE PROBLEM OF A SHORTAGE OF QUALIFIED TECHNICIANS TO SERVE AS RADIOGRAPHERS IN INDUSTRY, 19 STUDENTS WERE TRAINED IN TWO CLASSES, THE FIRST CONSISTING OF 19, AND THE SECOND OF EIGHTEEN 30-HOUR WEEKS. ORGANIZED FORMAL OR LECTURE-TYPE INSTRUCTION WAS PRESENTED IN SOME SUBJECT AREAS, BUT THE MAJOR EMPHASIS WAS ON LABORATORY EXPERIENCES…

  8. Digital radiographic systems detect boiler tube cracks

    SciTech Connect

    Walker, S.

    2008-06-15

    Boiler water wall leaks have been a major cause of steam plant forced outages. But conventional nondestructive evaluation techniques have a poor track record of detecting corrosion fatigue cracking on the inside surface of the cold side of waterwall tubing. EPRI is performing field trials of a prototype direct-digital radiographic system that promises to be a game changer. 8 figs.

  9. The Design of Radiographic Enhancement Systems.

    DTIC Science & Technology

    1986-09-01

    reco Inc., 547 St. Thomas, Longueuil , Quebec, Canada J4H 3A7 9 S. I",, . % . . ,. . - . % % .,, . -.- . . . .d- . - ,. , - - .,, - ,. - ..- , .S...34: the IED safe. Samples of original and enhanced radiographs made with the P-1700 scanner are shown in Figures 5 and 6. The improvement in image

  10. Panoramic radiographic demonstration of bilateral tonsilloliths.

    PubMed

    Guevara, Carlo; Mandel, Louis

    2011-04-01

    Calcifications can develop within the crypts of the palatine tonsil. During routine dental panoramic radiography, these tonsillar calcifications, or tonsilloliths, may be visualized superimposed upon the mandibular ramus. Their anatomic location and radiographic appearance are such that confusion with parotid sialolithiasis may occur. This report defines the symptomatology and differential diagnosis of these tonsilloliths.

  11. Survey of Radiographic Requirements and Techniques.

    ERIC Educational Resources Information Center

    Farman, Allan G.; Shawkat, Abdul H.

    1981-01-01

    A survey of dental schools revealed little standardization of student requirements for dental radiography in the United States. There was a high degree of variability as to what constituted a full radiographic survey, which has implications concerning the maximum limits to patient exposure to radiation. (Author/MLW)

  12. Pulp size in molars: underestimation on radiographs.

    PubMed

    Chandler, N P; Ford, T R Pitt; Monteith, B D

    2004-08-01

    The aim was to determine whether radiographs provide a clinically useful indication of pulp size in diseased/restored human first molar teeth, and to investigate accessibility of pulp tissue for diagnostic testing using laser Doppler flowmetry (LDF). Extracted teeth of known age were collected. Restorative materials were removed and teeth with evidence of pulp exposures excluded. Fifty-six teeth were radiographed from buccal and mesial aspects, and then their crowns were sectioned axiobuccolingually and photographed. Images were digitally scanned and measurements made of the total pulp area (above a line across the most superior part of the pulpal floor) and the pulp area in the clinical crown (superior to a line between the amelocemental junctions). The pulp width at the cervix and the highest point of the pulp were also recorded. Data were analysed using Pearson correlations. Pulp areas within the clinical crowns were significantly larger than indicated by radiographs, by 23% in the case of the clinically attainable buccal view (P < 0.05). Pulps may be more accessible to flowmeter testing than they appear. Absence of pulp tissues in the crown was recorded in equal numbers of teeth on radiographs and sections, but with agreement for only one tooth. Sixteen per cent of the teeth had no pulp area in the clinical crown when sectioned, but might still be suitable for testing using LDF.

  13. Radiographic evaluation and assessment of paragangliomas.

    PubMed

    Lustrin, E S; Palestro, C; Vaheesan, K

    2001-10-01

    Radiographic imaging plays an important role in the diagnosis and treatment of paragangliomas. Diagnosis and treatment should be performed as a team effort, with all the involved disciplines working together to provide the best possible individualized work-up and treatment plan for the patient.

  14. Radiographic Differentiation of Advanced Fibrocystic Lung Diseases.

    PubMed

    Akira, Masanori

    2017-03-01

    The concept of end-stage lung disease suggests a final common pathway for most diffuse parenchymal lung diseases. In accordance with this concept, end-stage disease is characterized radiographically and pathologically by the presence of extensive honeycombing. However, sequential computed tomographic (CT) scans obtained from patients with chronic diffuse lung disease evolve over time to show various advanced lung disease patterns other than honeycombing. In addition, several radiographically distinct honeycomb patterns, including microcystic, macrocystic, mixed, and combined emphysema and honeycombing, differentiate one advanced lung disease from another. For example, usual interstitial pneumonia (IP) usually shows mixed microcystic and macrocystic honeycombing. In contrast, CT images of long-standing fibrotic nonspecific IP typically show only small, scattered foci of honeycombing; instead, most enlarged airspaces observed in the advanced stage of this disease represent dilatation of bronchioles. In desquamative IP and pulmonary Langerhans cell histiocytosis, focal opacities typically evolve into emphysema-like lesions seen on CT imaging. In combined pulmonary fibrosis and emphysema and sarcoidosis, the cysts tend to be larger than those observed in usual IP. Sequential CT scans in other chronic, diffuse lung diseases also show various distinctive changes. This article highlights radiographic patterns of lung destruction that belie a single common pathway to end-stage lung disease. Recognition of distinct radiographic patterns of lung destruction can help differentiate diffuse parenchymal lung diseases, even in advanced stages of disease evolution.

  15. Natural course of treated pulmonary embolism. Evaluation by perfusion lung scintigraphy, gas exchange, and chest roentgenogram.

    PubMed

    Prediletto, R; Paoletti, P; Fornai, E; Perissinotto, A; Petruzzelli, S; Formichi, B; Ruschi, S; Palla, A; Giannella-Neto, A; Giuntini, C

    1990-03-01

    Perfusion lung scintigrams, pulmonary gas exchange data, and chest roentgenograms were obtained in 33 patients during acute embolism and over the following six months in order to assess their clinical usefulness in monitoring the effect of therapy. To this purpose, the measurement of pulmonary gas exchange and the presence of chest x-ray findings were compared with perfusion lung scintigraphic abnormalities both at diagnosis and after 7, 30, and 180 days during treatment. More than 50 percent of the pulmonary arterial tree was obstructed at diagnosis, and a large part of perfusion recovery was complete within the first month. All of the gas exchange parameters were abnormal at diagnosis, and the rate of their improvement was related to that of perfusion recovery. Interestingly, PaO2st (ie, PaO2 corrected for hyperventilation) and VE tended to return to normal during the first month as a consequence of the progressive recovery of perfusion, whereas oxygen and carbon dioxide gradients and physiologic dead space showed the persistence of some abnormalities six months after diagnosis. Significant correlations were observed between the number of ULSs evaluated on the perfusion lung scintigram (and considered an index of the severity of pulmonary embolization) and all of the gas exchange parameters at diagnosis (correlation coefficients averaged from 0.41 to 0.73) and after 7 and 30 days. The enlargement of the right descending pulmonary artery and particularly the "sausage" sign and the Westermark sign were significantly associated with a higher degree of gas exchange impairment and with a more severe embolization. In conclusion, this study demonstrates that perfusion lung scintigraphy has a primary role in monitoring the recovery of patients with pulmonary embolism under treatment. Moreover, the chest roentgenogram may help in this purpose. A second major result is that the simple measurement of some gas exchange parameters may allow the assessment of functional

  16. 10 CFR Appendix A to Part 34 - Radiographer Certification

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INDUSTRIAL RADIOGRAPHIC OPERATIONS Pt. 34, App. A Appendix A to Part 34—Radiographer Certification I... Agreement State requirements; 2. Written in a multiple-choice format; 3. Have test items drawn from...

  17. Reliability of Panoramic Radiographs in the Localization of Mandibular Foramen

    PubMed Central

    Patil, Karthikeya; Guledgud, Mahima V

    2015-01-01

    Objective The present study evaluated the reliability and accuracy of panoramic radiographs in the localization of mandibular foramen. Materials and Methods Twenty five Indian dry human adult mandibles constituted the study material. Ten measurements were carried on each of them to evaluate the location of mandibular foramen with respect to adjacent anatomic landmarks. Panoramic radiographs were then made of the mandibles. Same distances were measured on the traced images of the radiographs. Paired t-test and Pearson’s correlation test were applied to evaluate the accuracy and reliability of panoramic radiographs in localization of mandibular foramen. Results The mean distances measured on dry mandibles and panoramic radiographs showed statistically significant difference (p<0.05). There was strong positive correlation between the measurements on dry mandible and panoramic radiographs. Conclusion The panoramic radiographs can serve as a guide in locating the anterosuperior point of mandibular foramen on panoramic radiographs. PMID:26155559

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

    PubMed Central

    Hwang, Eun Gu; Lee, Yunjung

    2016-01-01

    Simple radiography is the best diagnostic tool for rib fractures caused by chest trauma, but it has some limitations. Thus, other tools are also being used. The aims of this study were to investigate the effectiveness of ultrasonography (US) for identifying rib fractures and to identify influencing factors of its effectiveness. Between October 2003 and August 2007, 201 patients with blunt chest trauma were available to undergo chest radiographic and US examinations for diagnosis of rib fractures. The two modalities were compared in terms of effectiveness based on simple radiographic readings and US examination results. We also investigated the factors that influenced the effectiveness of US examination. Rib fractures were detected on radiography in 69 patients (34.3%) but not in 132 patients. Rib fractures were diagnosed by using US examination in 160 patients (84.6%). Of the 132 patients who showed no rib fractures on radiography, 92 showed rib fractures on US. Among the 69 patients of rib fracture detected on radiography, 33 had additional rib fractures detected on US. Of the patients, 76 (37.8%) had identical radiographic and US results, and 125 (62.2%) had fractures detected on US that were previously undetected on radiography or additional fractures detected on US. Age, duration until US examination, and fracture location were not significant influencing factors. However, in the group without detected fractures on radiography, US showed a more significant effectiveness than in the group with detected fractures on radiography (P=0.003). US examination could detect unnoticed rib fractures on simple radiography. US examination is especially more effective in the group without detected fractures on radiography. More attention should be paid to patients with chest trauma who have no detected fractures on radiography. PMID:28119889

  19. Utility of ambulatory 24-hour esophageal pH and motility monitoring in noncardiac chest pain: report of 90 patients and review of the literature.

    PubMed

    Lacima, Gloria; Grande, Luis; Pera, Manuel; Francino, Antonio; Ros, Emilio

    2003-05-01

    It is unclear whether prolonged motility monitoring improves the diagnostic yield of standard esophageal tests in patients with noncardiac chest pain. Our aim was to assess the diagnostic value of ambulatory 24-hr pH and pressure monitoring in patients with noncardiac chest pain. Stationary manometry, edrophonium testing, and ambulatory pH and motility studies were performed in 90 consecutive patients with recurrent chest pain and normal coronary angiograms. Normality limits of ambulatory 24-hr motility were established in 30 healthy controls. The diagnoses of specific esophageal motility disorders (nutcracker esophagus and diffuse esophageal spasm) by stationary and ambulatory manometry were discordant in 48% of the patients. Edrophonium testing was positive in 9 patients, but correlated poorly with esophageal diagnoses. During ambulatory studies, 144 chest pain events occurred in 42 patients, and 72 (50%) were related to esophageal dysfunction. Strict temporal associations of events with esophageal dysfunction in relation to ambulatory 24-hr pH/motility scores permitted four patient categorizations: true positives (event-related and abnormal tests), N = 15; true negatives (event-unrelated and abnormal tests), N = 10; reduced esophageal pain threshold (event-related and normal tests), N = 4; and indeterminate origin (event-unrelated and normal tests), N = 13. Overall, 19 patients (21%) had a probable esophageal cause for chest pain (14 esophageal motility disorder, 4 acid reflux, 1 both). In conclusion, ambulatory manometry increases the diagnostic yield of standard esophageal testing in noncardiac chest pain, but the gain is small. Causes of chest pain other than high esophageal pressures and acid reflux must still be sought in most patients with chest pain of unknown origin after a negative cardiac work-up.

  20. "Jeopardy" in Abnormal Psychology.

    ERIC Educational Resources Information Center

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  1. Chest pain in the emergency room-an interesting case presentation.

    PubMed

    Turner, Michael C

    2016-12-01

    A 61-year-old woman presented to the emergency room with atypical chest pain, non-diagnostic electrocardiogram, and an initial troponin level that was normal. A coronary computed tomography angio (CCTA) was performed, and on initial review, it appeared to be normal. Subsequent review including evaluation of functional data from the retrospective scan identified a distal left anterior descending occlusion and an apical wall-motion abnormality with no other evidence of heart disease. This case illustrates the complementary contribution of anatomic and functional data and serves to remind us that on rare occasions, what looks "normal" is not always normal.

  2. Dynamic Chest Image Analysis: Evaluation of Model-Based Pulmonary Perfusion Analysis With Pyramid Images

    DTIC Science & Technology

    2007-11-02

    Image Analysis aims to develop model-based computer analysis and visualization methods for showing focal and general abnormalities of lung ventilation and perfusion based on a sequence of digital chest fluoroscopy frames collected with the Dynamic Pulmonary Imaging technique 18,5,17,6. We have proposed and evaluated a multiresolutional method with an explicit ventilation model based on pyramid images for ventilation analysis. We have further extended the method for ventilation analysis to pulmonary perfusion. This paper focuses on the clinical evaluation of our method for

  3. Use of indium 111-labeled white blood cell scan in the diagnosis of cytomegalovirus pneumonia in a renal transplant recipient with a normal chest roentgenogram

    SciTech Connect

    Chinsky, K.; Goodenberger, D.M. )

    1991-03-01

    Opportunistic infections are common in patients after renal transplantation. This report describes a case of cytomegalovirus pneumonia in a renal transplant recipient with a normal chest roentgenogram and normal arterial oxygenation. An abnormal 111In-white blood cell scan led to the discovery of a pulmonary source of his recurrent fevers.

  4. A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD

    SciTech Connect

    Båth, Magnus Svalkvist, Angelica; Söderman, Christina

    2014-10-15

    Purpose: The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. Methods: DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. Results: A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. Conclusions: A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis.

  5. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic ECG/respirator synchronizer. 892.1970... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic ECG/respirator synchronizer. (a) Identification. A radiographic ECG/respirator synchronizer is a device intended to be used...

  6. 21 CFR 892.1640 - Radiographic film marking system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic film marking system. 892.1640 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1640 Radiographic film marking system. (a) Identification. A radiographic film marking system is a device intended for medical purposes...

  7. 21 CFR 892.1850 - Radiographic film cassette.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic film cassette. 892.1850 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1850 Radiographic film cassette. (a) Identification. A radiographic film cassette is a device intended for use during diagnostic x-ray procedures...

  8. 21 CFR 892.1860 - Radiographic film/cassette changer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic film/cassette changer. 892.1860... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1860 Radiographic film/cassette changer. (a) Identification. A radiographic film/cassette changer is a device intended to be used during...

  9. 21 CFR 892.1890 - Radiographic film illuminator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic film illuminator. 892.1890 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1890 Radiographic film illuminator. (a) Identification. A radiographic film illuminator is a device containing a visible light source covered with...

  10. 21 CFR 892.1860 - Radiographic film/cassette changer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film/cassette changer. 892.1860... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1860 Radiographic film/cassette changer. (a) Identification. A radiographic film/cassette changer is a device intended to be used during...

  11. 21 CFR 892.1860 - Radiographic film/cassette changer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic film/cassette changer. 892.1860... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1860 Radiographic film/cassette changer. (a) Identification. A radiographic film/cassette changer is a device intended to be used during...

  12. 21 CFR 892.1640 - Radiographic film marking system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic film marking system. 892.1640 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1640 Radiographic film marking system. (a) Identification. A radiographic film marking system is a device intended for medical purposes...

  13. 21 CFR 892.1890 - Radiographic film illuminator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic film illuminator. 892.1890 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1890 Radiographic film illuminator. (a) Identification. A radiographic film illuminator is a device containing a visible light source covered with...

  14. 21 CFR 892.1900 - Automatic radiographic film processor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Automatic radiographic film processor. 892.1900... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1900 Automatic radiographic film processor. (a) Identification. An automatic radiographic film processor is a device intended to be used...

  15. 21 CFR 892.1850 - Radiographic film cassette.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic film cassette. 892.1850 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1850 Radiographic film cassette. (a) Identification. A radiographic film cassette is a device intended for use during diagnostic x-ray procedures...

  16. 21 CFR 892.1860 - Radiographic film/cassette changer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic film/cassette changer. 892.1860... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1860 Radiographic film/cassette changer. (a) Identification. A radiographic film/cassette changer is a device intended to be used during...

  17. 21 CFR 892.1640 - Radiographic film marking system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic film marking system. 892.1640 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1640 Radiographic film marking system. (a) Identification. A radiographic film marking system is a device intended for medical purposes...

  18. 21 CFR 892.1890 - Radiographic film illuminator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic film illuminator. 892.1890 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1890 Radiographic film illuminator. (a) Identification. A radiographic film illuminator is a device containing a visible light source covered with...

  19. 21 CFR 892.1900 - Automatic radiographic film processor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Automatic radiographic film processor. 892.1900... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1900 Automatic radiographic film processor. (a) Identification. An automatic radiographic film processor is a device intended to be used...

  20. 21 CFR 892.1890 - Radiographic film illuminator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic film illuminator. 892.1890 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1890 Radiographic film illuminator. (a) Identification. A radiographic film illuminator is a device containing a visible light source covered with...

  1. 21 CFR 892.1850 - Radiographic film cassette.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic film cassette. 892.1850 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1850 Radiographic film cassette. (a) Identification. A radiographic film cassette is a device intended for use during diagnostic x-ray procedures...

  2. 21 CFR 892.1850 - Radiographic film cassette.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film cassette. 892.1850 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1850 Radiographic film cassette. (a) Identification. A radiographic film cassette is a device intended for use during diagnostic x-ray procedures...

  3. 21 CFR 892.1900 - Automatic radiographic film processor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Automatic radiographic film processor. 892.1900... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1900 Automatic radiographic film processor. (a) Identification. An automatic radiographic film processor is a device intended to be used...

  4. 21 CFR 892.1900 - Automatic radiographic film processor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Automatic radiographic film processor. 892.1900... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1900 Automatic radiographic film processor. (a) Identification. An automatic radiographic film processor is a device intended to be used...

  5. 21 CFR 892.1860 - Radiographic film/cassette changer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic film/cassette changer. 892.1860... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1860 Radiographic film/cassette changer. (a) Identification. A radiographic film/cassette changer is a device intended to be used during...

  6. 21 CFR 892.1890 - Radiographic film illuminator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film illuminator. 892.1890 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1890 Radiographic film illuminator. (a) Identification. A radiographic film illuminator is a device containing a visible light source covered with...

  7. 21 CFR 892.1850 - Radiographic film cassette.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic film cassette. 892.1850 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1850 Radiographic film cassette. (a) Identification. A radiographic film cassette is a device intended for use during diagnostic x-ray procedures...

  8. 21 CFR 892.1900 - Automatic radiographic film processor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automatic radiographic film processor. 892.1900... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1900 Automatic radiographic film processor. (a) Identification. An automatic radiographic film processor is a device intended to be used...

  9. 21 CFR 892.1640 - Radiographic film marking system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic film marking system. 892.1640 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1640 Radiographic film marking system. (a) Identification. A radiographic film marking system is a device intended for medical purposes...

  10. 21 CFR 892.1640 - Radiographic film marking system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic film marking system. 892.1640 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1640 Radiographic film marking system. (a) Identification. A radiographic film marking system is a device intended for medical purposes...

  11. Laser reflectance imaging of human chest for localization of internal organs.

    PubMed

    Pandian, P S; Kumaravel, M; Singh, Megha

    2010-05-01

    The normalized backscattered intensity (NBI) profiles at various locations of human thorax by multiprobe laser reflectometer are obtained. These data after digitization, interpolation, and filtering are color-coded and displayed as images on the outline of the human thorax. For optical characterization of tissues in terms of their parameters, scattering and absorption coefficients and the anisotropy parameter (g) are obtained by matching the measured NBI profile with that as obtained by Monte Carlo simulation procedure. Corresponding to the variation of the NBI over the various regions, the optical parameters show their respective changes. The maximum absorption and minimum scattering coefficients are observed at the areola, clavicle, sternum, scapula, and vertebral column. The minimum absorption and maximum scattering coefficients are observed at the pectoralis major of chest and rectus abdominis of abdomen regions, as compared to the other regions, attributed to their tissue compositional variations. To visualize the various tissues in lower regions of the thorax, the color-coded scheme of the NBI variation, as measured by the third fiber, is further expanded. By this procedure, the outlines of the heart and lungs, as detected through intercostals regions, are observed, which is in good agreement with that as determined by the chest radiograph of the same subject taken in PA position. Similarly the lower sections of the liver and stomach, due to their distinct optical parameters, are also observed.

  12. Homogeneous Canine Chest Phantom Construction: A Tool for Image Quality Optimization.

    PubMed

    Pavan, Ana Luiza Menegatti; Rosa, Maria Eugênia Dela; Giacomini, Guilherme; Bacchim Neto, Fernando Antonio; Yamashita, Seizo; Vulcano, Luiz Carlos; Duarte, Sergio Barbosa; Miranda, José Ricardo de Arruda; de Pina, Diana Rodrigues

    2016-01-01

    Digital radiographic imaging is increasing in veterinary practice. The use of radiation demands responsibility to maintain high image quality. Low doses are necessary because workers are requested to restrain the animal. Optimizing digital systems is necessary to avoid unnecessary exposure, causing the phenomenon known as dose creep. Homogeneous phantoms are widely used to optimize image quality and dose. We developed an automatic computational methodology to classify and quantify tissues (i.e., lung tissue, adipose tissue, muscle tissue, and bone) in canine chest computed tomography exams. The thickness of each tissue was converted to simulator materials (i.e., Lucite, aluminum, and air). Dogs were separated into groups of 20 animals each according to weight. Mean weights were 6.5 ± 2.0 kg, 15.0 ± 5.0 kg, 32.0 ± 5.5 kg, and 50.0 ± 12.0 kg, for the small, medium, large, and giant groups, respectively. The one-way analysis of variance revealed significant differences in all simulator material thicknesses (p < 0.05) quantified between groups. As a result, four phantoms were constructed for dorsoventral and lateral views. In conclusion, the present methodology allows the development of phantoms of the canine chest and possibly other body regions and/or animals. The proposed phantom is a practical tool that may be employed in future work to optimize veterinary X-ray procedures.

  13. Homogeneous Canine Chest Phantom Construction: A Tool for Image Quality Optimization

    PubMed Central

    2016-01-01

    Digital radiographic imaging is increasing in veterinary practice. The use of radiation demands responsibility to maintain high image quality. Low doses are necessary because workers are requested to restrain the animal. Optimizing digital systems is necessary to avoid unnecessary exposure, causing the phenomenon known as dose creep. Homogeneous phantoms are widely used to optimize image quality and dose. We developed an automatic computational methodology to classify and quantify tissues (i.e., lung tissue, adipose tissue, muscle tissue, and bone) in canine chest computed tomography exams. The thickness of each tissue was converted to simulator materials (i.e., Lucite, aluminum, and air). Dogs were separated into groups of 20 animals each according to weight. Mean weights were 6.5 ± 2.0 kg, 15.0 ± 5.0 kg, 32.0 ± 5.5 kg, and 50.0 ± 12.0 kg, for the small, medium, large, and giant groups, respectively. The one-way analysis of variance revealed significant differences in all simulator material thicknesses (p < 0.05) quantified between groups. As a result, four phantoms were constructed for dorsoventral and lateral views. In conclusion, the present methodology allows the development of phantoms of the canine chest and possibly other body regions and/or animals. The proposed phantom is a practical tool that may be employed in future work to optimize veterinary X-ray procedures. PMID:27101001

  14. [Reproducibility of dynamic chest radiography with a flat-panel detector - respiratory changes in pixel value].

    PubMed

    Kawashima, Hiroki; Tanaka, Rie; Sanada, Shigeru

    2009-06-20

    Dynamic chest radiography using a flat panel detector (FPD) with a large field of view is expected to be a useful pulmonary functional evaluation method based on the respiratory changes in pixel value. For clinical use as a follow-up and therapeutic evaluation tool, the system must have a high degree of reproducibility in measurements of pixel values. The present study was performed to investigate the reproducibility of respiratory changes in pixel values. Dynamic chest radiographs of five normal subjects and one patient were obtained. Imaging was performed twice in each subject. The slope (X-ray translucency variation) was then calculated from the changes in pixel value from distance lung apex-diaphragm, and the slopes of two sequences were compared. The results showed there were no significant differences in changes in pixel value between the two sequences in all normal subject (5 males, p>0.05). The results indicated that the present method has reproducibility for measuring pulmonary function and also has potential as a tool for follow-up and therapeutic evaluation.

  15. 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.

  16. Chest CT Features of North American Paragonimiasis

    PubMed Central

    Henry, Travis S.; Lane, Michael A.; Weil, Gary J.; Bailey, Thomas C.; Bhalla, Sanjeev

    2013-01-01

    OBJECTIVE The purpose of this study was to characterize the chest CT findings of North American paragonimiasis due to Paragonimus kellicotti in the largest (to our knowledge) case series reported to date and to compare the findings with those reported for paragonimiasis infections in other regions. MATERIALS AND METHODS A retrospective review was performed of chest CT examinations of eight patients with North American paragonimiasis treated at our institution between 2006 and 2010. Findings were characterized by site of involvement, including lungs and pleura, heart and pericardium, lymph nodes, and upper abdomen. RESULTS The most common chest CT findings in this case series were pleural effusions and internal mammary and cardiophrenic lymphadenopathy. Pulmonary parenchymal findings included peripheral lung nodules of 1–3.5 cm in size with surrounding ground-glass opacity; many nodules had a linear track to the pleural surface that may correspond to the worm’s burrow tunnel. Pericardial involvement (5/8 patients) and omental inflammation (5/7 patients), which are uncommon in Asian paragonimiasis, were common in this series. CONCLUSION Pleural and pulmonary features of North American paragonimiasis are generally similar to those reported from Asia. The presence of a track between a pulmonary nodule and the pleura may help distinguish paragonimiasis from mimickers, including chronic eosinophilic pneumonia, tuberculosis, fungal infection, or malignancy. Pericarditis, lymphadenopathy, and omental inflammation were more common in our series than in reports on paragonimiasis from other regions. These differences may be related to the infecting parasite species or to the fact that radiologic examinations in the present series were performed relatively early in the course of infection. PMID:22528896

  17. Acute Chest Pain: Emergency Evaluation and Management

    PubMed Central

    Walker, David M. C.

    1982-01-01

    Since cardiovascular and pulmonary disorders have significant morbidity and mortality, triage of patients who complain of chest pain is paramount. The less sophisticated the triage system, the more important the protocol should be to have these patients evaluated immediately. History and physical are still the most important diagnostic tools; information should be gathered from all available sources. Advanced cardiac life support training is most useful. Eight diagnostic classifications are described, together with the distinctions of onset, duration, location, radiation, precipitating and relieving factors, character and associated symptoms. The protocol for initial management is outlined, emphasizing coincident management wherever possible. Imagesp2005-a PMID:21286539

  18. Image processing of digital chest ionograms.

    PubMed

    Yarwood, J R; Moores, B M

    1988-10-01

    A number of image-processing techniques have been applied to a digital ionographic chest image in order to evaluate their possible effects on this type of image. In order to quantify any effect, a simulated lesion was superimposed on the image at a variety of locations representing different types of structural detail. Visualization of these lesions was evaluated by a number of observers both pre- and post-processing operations. The operations employed included grey-scale transformations, histogram operations, edge-enhancement and smoothing functions. The resulting effects of these operations on the visualization of the simulated lesions are discussed.

  19. Pitfalls and variants in pediatric chest imaging.

    PubMed

    García Asensio, D; Fernández Martín, M

    2016-05-01

    Most pitfalls in the interpretation of pediatric chest imaging are closely related with the technique used and the characteristics of pediatric patients. To obtain a quality image that will enable the correct diagnosis, it is very important to use an appropriate technique. It is important to know how technical factors influence the image and to be aware of the possible artifacts that can result from poor patient cooperation. Moreover, radiologists need to be familiar with the normal anatomy in children, with the classic radiologic findings, and with the anatomic and developmental variants to avoid misinterpreting normal findings as pathological.

  20. Normal and abnormal US findings at the mastectomy site.

    PubMed

    Kim, Sun Mi; Park, Jeong Mi

    2004-01-01

    Evaluation of a mastectomy site is more effective with ultrasonography (US) than with either mammography or chest computed tomography because abnormalities are usually small and close to the skin surface. US does not involve the use of ionizing radiation and has a multiplanar scanning capability. The technique is readily available and inexpensive, and it allows real-time monitoring of needle tip placement during biopsy of a lesion. Normal US anatomy of the chest wall after mastectomy usually consists of four layers: skin, subcutaneous fat, pectoral muscles, and rib and intercostal muscle. The axilla is changed in appearance after lymph node dissection, but it remains the same in patients who have undergone simple mastectomy. US can accurately depict benign and malignant conditions in the mastectomy site, including fluid collection, fibrosis, local recurrent tumor, and metastatic lymphadenopathy, and can enable accurate diagnosis based on findings at fine needle aspiration biopsy.

  1. Iterative Reconstruction of Coded Source Neutron Radiographs

    SciTech Connect

    Santos-Villalobos, Hector J; Bingham, Philip R; Gregor, Jens

    2012-01-01

    Use of a coded source facilitates high-resolution neutron imaging but requires that the radiographic data be deconvolved. In this paper, we compare direct deconvolution with two different iterative algorithms, namely, one based on direct deconvolution embedded in an MLE-like framework and one based on a geometric model of the neutron beam and a least squares formulation of the inverse imaging problem.

  2. Video enhancement of dental radiographic films

    SciTech Connect

    Van Dis, M.L.; Beck, F.M.; Miles, D.A. )

    1989-08-01

    A prototype video image display system, a real-time analog enhancer (RAE), was compared to conventional viewing conditions with the use of nonscreen dental films. When medium optical density films were evaluated, there was no significant difference in the number of radiographic details detected. Conventional viewing conditions allowed perception of more details when dark films were evaluated; however, the RAE unit allowed the perception of more details when light films were viewed.

  3. Clinical and radiographic maxillofacial features of pycnodysostosis

    PubMed Central

    Alves, Nilton; Cantín, Mario

    2014-01-01

    The aim of this study was to review of the literature to determine the radiographic and clinical maxillofacial features of pycnodysostosis emphasizing the main aspects of interest to the dentist in order to make them fit for the proper treatment of this population. It is important to make the diagnosis as early as possible in order to plan the treatment more suitable to provide a better life’s quality to the patients. The most frequent clinical maxillofacial features were: grooved palate, midfacial hypoplasia, mandibular hypoplasia and enamel hypoplasia. The most common radiographic maxillofacial features were: obtuse mandibular angle, frontal/parietal/occiptal bossing, open fontanels and sutures, multiple impacted teeth. The earlier diagnostic of pycnodysostosis has a fundamental role in general health of the patients. We consider that is very important that the dentist know recognize the radiographic and clinical maxillofacial features of pycnodysostosis, which allows correct treatment planning avoiding risks and ensuring better life’s quality to the patients. PMID:24753741

  4. The forensic radiographer: a new member in the medicolegal team.

    PubMed

    Schneider, Benjamin; Chevallier, Christine; Dominguez, Alejandro; Bruguier, Christine; Elandoy, Cristèle; Mangin, Patrice; Grabherr, Silke

    2012-03-01

    Multidetector computed tomography is becoming more widespread in forensic medicine. In most services, autopsy assistants perform the radiological examination. We introduced professional radiographers into the legal medicine service and hypothesized they would also be able to take over duties currently reserved for other specialists. The aims of this study were to evaluate if radiographers could be trained as "forensic radiographers" by (1) integrating graduated medical radiographers into the legal medicine service, (2) investigating the advantages of this collaboration, and (3) defining the duties of the forensic radiographers.The study was performed prospectively on a group of 8 recruited radiographers who underwent a testing period with special training. They learned the basics of medicolegal case treatment, the autonomous execution of postmortem computed tomography angiography, and postprocessing of data. Seven of 8 radiographers finished the training and were integrated into our service. Although all radiographers were able to fulfill the duties demanded after the training period, some radiographers could not enter or complete the program because they were unable to work with dead bodies.Our study presents the advantages of integrating radiographers into the medicolegal team and proposes how to train the forensic radiographers. In addition, the duties and responsibilities of these new specialists are defined.

  5. Usefulness of low dose chest CT for initial evaluation of blunt chest trauma

    PubMed Central

    Kim, Sung Jung; Bista, Anjali Basnyat; Min, Young Gi; Kim, Eun Young; Park, Kyung Joo; Kang, Doo Kyoung; Sun, Joo Sung

    2017-01-01

    Abstract We aimed to compare the diagnostic performance and inter-observer consistency between low dose chest CT (LDCT) and standard dose chest CT (SDCT) in the patients with blunt chest trauma. A total of 69 patients who met criteria indicative of blunt chest trauma (77% of male; age range, 16–85) were enrolled. All patients underwent LDCT without intravenous (IV) contrast and SDCT with IV contrast using parameters as following: LDCT, 40 mAs with automatic tube current modulation (ATCM) and 100 kVp (BMI <25, n = 51) or 120 kVp (BMI>25, n = 18); SDCT, 180 mAs with ATCM and 120 kVp. Transverse, coronal, sagittal images were reconstructed with 3-mm slice thickness without gap and provided for evaluation of 3 observers. Reference standard images (transverse, coronal, sagittal) were reconstructed using SDCT data with 1-mm slice thickness without gap. Reference standard was established by 2 experienced thoracic radiologists by consensus. Three observers independently evaluated each data set of LDCT and SDCT. Multiple-reader receiver operating characteristic analysis for comparing areas under the ROC curves demonstrated that there was no significant difference of diagnostic performance between LDCT and SDCT for the diagnosis of pulmonary injury, skeletal trauma, mediastinal injury, and chest wall injury (P > 0.05). The intraclass correlation coefficient was measured for inter-observer consistency and revealed that there was good inter-observer consistency in each examination of LDCT and SDCT for evaluation of blunt chest injury (0.8601–1.000). Aortic and upper abdominal injury could not be appropriately compared as LDCT was performed without using contrast materials and this was limitation of this study. The effective radiation dose of LDCT (average DLP = 1.52 mSv⋅mGy−1 cm−1) was significantly lower than those of SDCT (7.21 mSv mGy−1 cm−1). There is a great potential benefit to use of LDCT for initial evaluation of blunt chest trauma

  6. Radiographic and Tomographic Analysis in Patients with Stickler Syndrome Type I

    PubMed Central

    Al Kaissi, Ali; Chehida, Farid Ben; Ganger, Rudolf; Kenis, Vladimir; Zandieh, Shahin; Hofstaetter, Jochen G; Klaushofer, Klaus; Grill, Franz

    2013-01-01

    Objective: To further investigate the underlying pathology of axial and appendicular skeletal abnormalities such as painful spine stiffness, gait abnormalities, early onset osteoarthritis and patellar instability in patients with Stickler syndrome type I. Radiographic and tomographic analyses were organized. Methods: From a series of Stickler syndrome patients followed from early life to late childhood. Ten patients (6 boys and four girls of different ethnic origins were consistent with the diagnosis of Stickler syndrome type I ). Phenotypic characterization was the baseline tool applied for all patients and genotypic correlation was performed on four families Results: A constellation of axial abnormalities namely; anterolateral ossification of the anterior longitudinal spinal ligament with subsequent fusion of two cervical vertebrae, early onset Forestier disease (progressive spinal hyperostosis with subsequent vertebral fusion on top of bridging osteophytes and “Bamboo-like spine” resembling ankylosing spondylitis) and severe premature spine degeneration were evident. Appendicular abnormalities in connection with generalized epiphyseal dysplasia were the underlying aetiology in patients with Intoeing gait and femoral anteversion, early onset severe osteoarthritis of the weight bearing joint. Remarkable trochleo-patellar dysplasia secondary to severe osteoarthritis causing effectively the development of patellar instability was additional pathology. Mutation of COL2A1 has been confirmed as the causative gene for Stickler syndrome type I Conclusion: We concluded that conventional radiographs and the molecular determination of a COL2A1 in patients with (Stickler syndrome type I) are insufficient tools to explain the reasons behind the tremendous magnitude of axial and appendicular skeletal abnormalities. We were able to modify the criteria of the clinical phenotype as designated by Rose et al in accordance with the novel axial and appendicular criteria as

  7. Computer Assisted Diagnosis of Chest Pain. Preliminary Manual

    DTIC Science & Technology

    1984-04-27

    addition, chest pain has been reported to be one of the most frequent causes of medical evacuation from submarines. The Naval Submarine Medical...having potentially fatal outcomes. In addition, chest pain has been reported to be one of the most frequent causes of medical evacuation from submarines...serious causes of acute chest pain . The 5 illnesses which are considered by the conputer are MY0CARD1AL INFARCTION, ANGINA, NON-SPECIFIC CNEST PAIN

  8. Esophageal hypersensitivity in noncardiac chest pain.

    PubMed

    Min, Yang Won; Rhee, Poong-Lyul

    2016-09-01

    Noncardiac chest pain (NCCP) is an often-encountered clinical problem. Although many patients suffer from persistent or recurrent chest pain, treatment remains a challenge owing to its various possible etiologies. Gastroesophageal reflux disease (GERD) is the most common cause of NCCP. In GERD-related NCCP, proton pump inhibitor treatment appears to be effective. However, the pathophysiology remains to be fully elucidated in NCCP patients without GERD. Treatment for non-GERD-related NCCP has been aimed at esophageal motility disorders and visceral hypersensitivity. As there is growing evidence that esophageal visceral hypersensitivity plays a role in NCCP, pain modulators have become the mainstay of therapy in patients with non-GERD-related NCCP. However, there is an unmet need for the treatment of esophageal hypersensitivity in NCCP due to modest evidence for the benefit of pain modulators, including antidepressants, in non-GERD-related NCCP. Recent studies have demonstrated that esophageal mast cell infiltration and impaired mucosal integrity are related to visceral hypersensitivity in patients with NCCP. Thus, esophageal mast cell stabilization and restoration of esophageal mucosal integrity could be considered potential therapeutic targets in selected NCCP patients with hypersensitivity. However, further observations are necessary to shed light on esophageal hypersensitivity in NCCP.

  9. Interaction of asbestos, age, and cigarette smoking in producing radiographic evidence of diffuse pulmonary fibrosis

    SciTech Connect

    Kilburn, K.H.; Lilis, R.; Anderson, H.A.; Miller, A.; Warshaw, R.H.

    1986-03-01

    The study of 3,472 chest x-rays from four populations with different levels of exposure to asbestos and with different cigarette smoking histories shows that smoking in the general population does not produce pulmonary fibrosis recognizable on chest radiography. In the general population of Michigan, the prevalence of a radiographic pattern of fibrosis was 0.5 percent in men and 0.0 percent in women. In a Long Beach, California census tract population, the prevalences were 3.7 percent for men and 0.6 percent for women. Similarly, cigarette smoking does not enhance fibrosis when the exposure to asbestos has been as light as that in households of shipyard workers. Asbestosis was recognized in 6.6 percent of 137 shipyard workers' wives who have never smoked and 7.6 percent of 132 who had ever smoked. Cigarette smoking and asbestos appear to be synergistic in those occupationally exposed to asbestos (as insulators), since 7.2 percent of 97 nonsmokers and 20.5 percent of 316 ever-smokers showed fibrosis. This apparent synergy was also found in shipyard workers up to age 70 with 31 percent of nonsmokers and 43.3 percent of ever-smokers having fibrosis. There were increases of approximately 10 percent in the prevalence of fibrosis in cigarette smokers and nonsmokers for each decade after age 40.

  10. Detection of pulmonary nodule growth with dose reduced chest tomosynthesis: a human observer study using simulated nodules

    NASA Astrophysics Data System (ADS)

    Söderman, Christina; Johnsson, Ã. se; Vikgren, Jenny; Rossi Norrlund, Rauni; Molnar, David; Mirzai, Maral; Svalkvist, Angelica; Mânsson, Lars Gunnar; Bâth, Magnus

    2016-03-01

    Chest tomosynthesis may be a suitable alternative to computed tomography for the clinical task of follow up of pulmonary nodules. The aim of the present study was to investigate the detection of pulmonary nodule growth suggestive of malignancy using chest tomosynthesis. Previous studies have indicated remained levels of detection of pulmonary nodules at dose levels corresponding to that of a conventional lateral radiograph, approximately 0.04 mSv, which motivated to perform the present study this dose level. Pairs of chest tomosynthesis image sets, where the image sets in each pair were acquired of the same patient at two separate occasions, were included in the study. Simulated nodules with original diameters of approximately 8 mm were inserted in the pairs of image sets, simulating situations where the nodule had remained stable in size or increased isotropically in size between the two different imaging occasions. Four different categories of nodule growth were included, corresponding to a volume increase of approximately 21 %, 68 %, 108 % and 250 %. All nodules were centered in the depth direction in the tomosynthesis images. All images were subjected to a simulated dose reduction, resulting in images corresponding to an effective dose of 0.04 mSv. Four observers were given the task of rating their confidence that the nodule was stable in size or not on a five-level rating scale. This was done both before any size measurements were made of the nodule as well as after measurements were performed. Using Receiver operating characteristic analysis, the rating data for the nodules that were stable in size was compared to the rating data for the nodules simulated to have increased in size. Statistically significant differences between the rating distributions for the stable nodules and all of the four nodule growth categories were found. For the three largest nodule growths, nearly perfect detection of nodule growth was seen. In conclusion, the present study

  11. Drug induced chest pain—rare but important

    PubMed Central

    Davey, P.; Lalloo, D.

    2000-01-01

    Pericarditis, usually viral in origin, is an infrequent cause of chest pain. Pericarditis due to drug allergy is even less frequent and is thus rarely considered in the differential diagnosis. A case is reported of a woman who presented with severe chest pain, caused by minocycline induced pericarditis. Such allergy may be more common than reported. It is suggested that drug induced pericarditis should be included in the differential diagnosis of acute chest pain.


Keywords: chest pain; pericarditis; minocycline; drug allergy PMID:10878205

  12. 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

  13. 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.

  14. Measuring chest circumference change during respiration with an electromagnetic biosensor.

    PubMed

    Padasdao, Bryson; Shahhaidar, Ehsaneh; Boric-Lubecke, Olga

    2013-01-01

    In this paper, an off-the-shelf DC motor is modified into a chest belt and used to successfully measure circumference change on a mechanical chest model, while simultaneously harvesting significant power. Chest circumference change can provide information on tidal volume, which is vital in assessing lung function. The chest circumference change is calculated from the motor's voltage output. Calculated values are within 0.95mm of measured circumference changes, with a standard deviation of 0.37mm. The wearable motor can also harvest at least 29.4µW during normal breathing.

  15. Thoracic Trauma: Which Chest Tube When and Where?

    PubMed

    Molnar, Tamas F

    2017-02-01

    Clinical suspicion of hemo/pneumothorax: when in doubt, drain the chest. Stable chest trauma with hemo/pneumothorax: drain and wait. Unstable patient with dislocated trachea must be approached with drain in hand and scalpel ready. Massive hemo/pneumothorax may be controlled by drainage alone. The surgeon should not hesitate to open the chest if too much blood drains over a short period. The chest drainage procedure does not end with the last stitch; the second half of the match is still ahead. The drained patient is in need of physiotherapy and proper pain relief with an extended pleural space: control the suction system.

  16. Clinical relevance of abnormal scintigraphic findings of adult equine ribs.

    PubMed

    Dahlberg, Jessica A; Ross, Michael W; Martin, Benson B; Davidson, Elizabeth J; Leitch, Midge

    2011-01-01

    Horses with cranial rib abnormalities may exhibit severe acute lameness and may have unusual gait deficits characterized by forelimb abduction during protraction at the walk. Horses with caudal rib abnormalities may resent being saddled and ridden. In a retrospective evaluation of 20 horses with a documented rib lesion, 25 sites of increased radiopharmaceutical uptake were found in one or more ribs. Thirteen (52%) scintigraphic lesions involved the first rib; four were located immediately dorsal to the sternal articulation, eight were near the costochondral junction and one was at the costovertebral junction. Six (24%) scintigraphic rib lesions involved ribs 2-8; one was located immediately dorsal to the sternal articulation, three were at the costovertebral junction and two were near the costochondral junction. Six (24%) scintigraphic rib lesions involved the mid-portion (five) or costovertebral junction (one) of ribs 9-18. The 20 horses were divided into three groups based on the clinical relevance of the scintigraphic findings. Group 1 (n=3) horses had clinical signs attributed to a rib abnormality; Group 2 (n=6) horses had a rib abnormality that was a plausible explanation for clinical signs; Group 3 (n=11) horses had clinical signs that could not be attributed to a rib abnormality. For horses with cranial rib abnormalities, a modified lateral scintigraphic image with the ipsilateral limb pulled caudally and a left (right) 45° caudal-right (left) radiograph facilitated the diagnosis.

  17. Role of Quantitative Wall Motion Analysis in Patients with Acute Chest Pain at Emergency Department

    PubMed Central

    Kim, Kyung-Hee; Park, Jin-Sik

    2017-01-01

    Background Evaluation of acute chest pain in emergency department (ED), using limited resource and time, is still very difficult despite recent development of many diagnostic tools. In this study, we tried to determine the applicability of new semi-automated cardiac function analysis tool, velocity vector imaging (VVI), in the evaluation of the patients with acute chest pain in ED. Methods We prospectively enrolled 48 patients, who visited ED with acute chest pain, and store images to analyze VVI from July 2005 to July 2007. Results In 677 of 768 segments (88%), the analysis by VVI was feasible among 48 patients. Peak systolic radial velocity (Vpeak) and strain significantly decreased according to visual regional wall motion abnormality (Vpeak, 3.50 ± 1.34 cm/s for normal vs. 3.46 ± 1.52 cm/s for hypokinesia, 2.51 ± 1.26 for akinesia, p < 0.01; peak systolic radial strain -31.74 ± 9.15% fornormal, -24.33 ± 6.28% for hypokinesia, -20.30 ± 7.78% for akinesia, p < 0.01). However, the velocity vectors at the time of mitral valve opening (MVO) were directed outward in the visually normal myocardium, inward velocity vectors were revealed in the visually akinetic area (VMVO, -0.85 ± 1.65 cm/s for normal vs. 0.10 ± 1.46 cm/s for akinesia, p < 0.001). At coronary angiography, VMVO clearly increased in the ischemic area (VMVO, -0.88+1.56 cm/s for normal vs. 0.70 + 2.04 cm/s for ischemic area, p < 0.01). Conclusion Regional wall motion assessment using VVI showed could be used to detect significant ischemia in the patient with acute chest pain at ED.

  18. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

    PubMed Central

    Ferreira, Eleci Vaz; Gazzana, Marcelo Basso; Sarmento, Muriel Bossle; Guazzelli, Pedro Arends; Hoffmeister, Mariana Costa; Guerra, Vinicius André; Seligman, Renato; Knorst, Marli Maria

    2016-01-01

    Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients. PMID:26982039

  19. Value of tomographic thallium-201 imaging in patients with chest pain following coronary artery bypass grafting

    SciTech Connect

    Starling, M.R.; Walsh, R.A.; Dehmer, G.J.; Lasher, J.C.; Blumhardt, R.

    1987-02-01

    To determine whether thallium-201 washout profile analysis can detect regional myocardial ischemia caused by coronary artery bypass graft occlusion or progression of disease in nonbypassed coronary arteries, 19 consecutive patients with chest pain following bypass grafting were evaluated with coronary arteriography and thallium-201 scintigraphy. Twenty of the 55 coronary artery regions were perfused by an occluded bypass graft or a significantly stenosed (greater than or equal to 70% diameter narrowing) nonbypassed coronary artery, while 35 coronary regions were perfused by patent bypass grafts or insignificantly diseased coronary arteries. The tomographic thallium-201 washout profile results correlated with the bypass graft and coronary arteriographic findings. The sensitivity of tomographic thallium-201 washout profile abnormalities for arteriographic abnormalities was 75%, while the specificity was 86%. The authors conclude that tomographic thallium-201 washout profile analysis may be very useful in the evaluation of patients with chest pain following coronary artery bypass grafting by detecting regional myocardial ischemia caused by occlusion of specific bypass grafts or progression of disease in nonbypassed coronary arteries.

  20. Effects of chest resistance exercise and chest expansion exercise on stroke patients’ respiratory function and trunk control ability

    PubMed Central

    Song, Gui bin; Park, Eun cho

    2015-01-01

    [Purpose] The purpose of this study was to examine the efficiency of chest resistance and chest expansion exercises for improving respiratory function and trunk control ability in patients with stroke. [Subjects] Forty patients with stroke were randomly allocated into a chest resistance exercise group (CREG, n = 20) and a chest expansion exercise group (CEEG, n = 20). [Methods] CREG patients underwent chest resistance exercises, and diaphragmatic resistance exercises by way of the proprioceptive neuromuscular facilitation. CEEG patients underwent respiratory exercises with chest expansion in various positions. Both groups received 30 minutes of training per day, five times per week, for eight weeks. [Results] Both the CERG and CEEG groups showed significant changes in FVC, FEV1, and TIS after the intervention. TIS was significantly increased in the CREG compared to the CEEG after the intervention. [Conclusion] Both chest resistance and chest expansion exercises were effective for improving respiratory function and trunk control ability in stroke patients; however, chest resistance exercise is more efficient for increasing trunk control ability. PMID:26180292

  1. [The relativity of abnormity].

    PubMed

    Nilson, Annika

    2006-01-01

    In the late 19th century and in the beginning of the 20th century, mental diseases and abnormal behavior was considered to be a great danger to culture and society. "Degeneration" was the buzzword of the time, used and misused by artists and scientists alike. At the same time, some scientists saw abnormity as the key to unlock the mysteries of the ordinary mind. Naturalistic curiosity left Pandoras box open when religion declined in Darwins wake. Two swedish scientists, the physician Bror Gadelius (1862-1938) and his friend the philosopher Axel Herrlin (1870-1937), inspired by the French psychologist Theodule Ribots (1839-1916) "psychology without a soul", denied all fixed demarcation lines between abnormity and normality. All humans are natures creatures ruled by physiological laws, not ruled by God or convention. Even ordinary morality was considered to be an utterly backward explanation and guideline for complex human behavior. Different forms of therapy, not various kinds of penalties for wicked and disturbing behavior, are the now the solution for lots of people, "normal" as well as "abnormal". Psychiatry is expanding.

  2. Abnormalities of gonadal differentiation.

    PubMed

    Berkovitz, G D; Seeherunvong, T

    1998-04-01

    Gonadal differentiation involves a complex interplay of developmental pathways. The sex determining region Y (SRY) gene plays a key role in testis determination, but its interaction with other genes is less well understood. Abnormalities of gonadal differentiation result in a range of clinical problems. 46,XY complete gonadal dysgenesis is defined by an absence of testis determination. Subjects have female external genitalia and come to clinical attention because of delayed puberty. Individuals with 46,XY partial gonadal dysgenesis usually present in the newborn period for the valuation of ambiguous genitalia. Gonadal histology always shows an abnormality of seminiferous tubule formation. A diagnosis of 46,XY true hermaphroditism is made if the gonads contain well-formed testicular and ovarian elements. Despite the pivotal role of the SRY gene in testis development, mutations of SRY are unusual in subjects with a 46,XY karyotype and abnormal gonadal development. 46,XX maleness is defined by testis determination in an individual with a 46,XX karyotype. Most affected individuals have a phenotype similar to that of Klinefelter syndrome. In contrast, subjects with 46,XX true hermaphroditism usually present with ambiguous genitalia. The majority of subjects with 46,XX maleness have Y sequences including SRY in genomic DNA. However, only rare subjects with 46,XX true hermaphroditism have translocated sequences encoding SRY. Mosaicism and chimaerism involving the Y chromosome can also be associated with abnormal gonadal development. However, the vast majority of subjects with 45,X/46,XY mosaicism have normal testes and normal male external genitalia.

  3. A radiographic survey of public school building maintenance and custodial employees

    SciTech Connect

    Anderson, H.A.; Hanrahan, L.P.; Higgins, D.N.; Sarow, P.G. )

    1992-10-01

    Analyses of radiographs from a cohort of 457 school maintenance and custodial workers (90 had no employment other than at a school) demonstrated an increased prevalence of abnormalities consistent with asbestos-caused disease. Pleural abnormalities predominated (24 of 29). The abnormalities could not be explained by occupational asbestos exposures which may have occurred prior to school employment. Abnormality prevalence ranged from 1.7% among those with less than 10 years to 37% among those with 30 or more years of public school employment. Laborers and skilled tradesmen with more than 20 years of school employment had a higher prevalence of abnormality (40 and 28%) than the building engineers (14%). In order to ensure that future asbestos exposure and disease risk is minimized in buildings constructed with asbestos-containing materials (ACM), implementation of asbestos hazard identification and abatement must include a rigorous operations and maintenance program. Control of asbestos from in-plane ACM is a public health priority. 23 refs., 2 figs., 2 tabs.

  4. Effective dose to patients from chest examinations with tomosynthesis.

    PubMed

    Båth, Magnus; Svalkvist, Angelica; von Wrangel, Alexa; Rismyhr-Olsson, Heidi; Cederblad, Ake

    2010-01-01

    Chest tomosynthesis, which refers to the principle of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest, is an imaging technique recently introduced to health care. The main purpose of the present work was to determine the average effective dose to patients from clinical use of chest tomosynthesis. Exposure data for two chest radiography laboratories with tomosynthesis option (Definium 8000 with VolumeRAD option, GE Healthcare, Chalfont St. Giles, UK) were registered for 20 patients with a weight between 60 and 80 kg (average weight of 70.2 kg). The recorded data were used in the Monte Carlo program PCXMC 2.0 (STUK-Radiation and Nuclear Safety Authority, Helsinki, Finland) to determine the average effective dose for each projection. The effective dose for the chest tomosynthesis examination, including a scout view and the tomosynthesis acquisition, was finally obtained by adding the effective doses from all projections. Using the weighting factors given in ICRP 103, the average effective dose for the examination was found to be 0.13 mSv, whereas the average effective dose for the conventional two-view chest radiography examination was 0.05 mSv. A conversion factor of 0.26 mSv Gy(-1) cm(-2) was found suitable for determining the effective dose from a VolumeRAD chest tomosynthesis examination from the total registered kerma-area product. In conclusion, the effective dose to a standard-sized patient (170 cm/70 kg) from a VolumeRAD chest tomosynthesis examination is ~2 % of an average chest CT and only two to three times the effective dose from the conventional two-view chest radiography examination.

  5. The time of onset of abnormal calcification in spondylometaepiphyseal dysplasia, short limb-abnormal calcification type.

    PubMed

    Tüysüz, Beyhan; Gazioğlu, Nurperi; Ungür, Savaş; Aji, Dolly Yafet; Türkmen, Seval

    2009-01-01

    A 1-month-old boy with shortness of extremities on prenatal US was referred to our department with a provisional diagnosis of achondroplasia. His height was normal but he had short extremities and platyspondyly, premature carpal epiphyses on both hands, and short tubular bones with irregular metaphyses on radiographs. Re-evaluation of the patient at the age of 1 year revealed very short height and premature calcification of the costal cartilages and epiphyses. Spondylometaepiphyseal dysplasia (SMED), short limb-abnormal calcification type was diagnosed. This condition is a very rare autosomal recessively inherited disorder, and most of the patients die in early childhood due to neurological involvement. At the age of 2 years and 5 months, a CT scan showed narrowing of the cervical spinal canal. One month later he died suddenly because of spinal cord injury. In conclusion early diagnosis is very important because the recurrence risk is high and patients may die due to early neurological complications. The time of onset of abnormal calcifications, a diagnostic finding of the disease, is at the age of around 1 year in most patients. When abnormal calcifications are not yet present, but radiological changes associated with SMED are present, this rare disease must be considered.

  6. An atypical cause of atypical chest pain

    PubMed Central

    Zaheen, Ahmad; Siemieniuk, Reed A; Gudgeon, Patrick

    2014-01-01

    The present report describes a case involving a 57-year-old HIV-positive man who presented with acute retrosternal chest pain accompanied by 24 h of fever. Septic arthritis of the manubriosternal joint was diagnosed based on magnetic resonance imaging findings in addition to Staphylococcus aureus bacteremia. To the authors’ knowledge, the present case is only the 12th reported case of manubriosternal septic arthritis, and the first in an HIV-positive patient. Early diagnosis and treatment can circumvent the need for surgical intervention. Based on the present case report and review of the literature, the authors summarize the epidemiology, appropriate imaging and suggestions for antibiotic therapy for this rare presentation. PMID:25371686

  7. Management of chest trauma in children.

    PubMed

    Tovar, Juan A; Vazquez, Juan J

    2013-06-01

    Chest trauma in children is caused by high-energy blows, due in general to traffic accidents, that involve several other body regions. They occur mainly in the first decade of life and can be penetrating but are more often non-penetrating. Rib fractures and lung contusions, sometimes associated with pneumothorax or haemothorax, are the more usual injuries, but tracheobronchial rupture, cardiac, oesophageal or diaphragmatic injuries may also occur. These injuries are treated with supportive respiratory and haemodynamic measures, drainage of air or blood from the pleural space and, at times, surgical repair of the injured organ(s). Ruptures of the airway may be difficult to treat and occasionally require suture, anastomosis or resection. Oesophageal injuries can be treated conservatively with antibiotics, drainage and parenteral nutrition. Diaphragmatic tears should be repaired operatively. Overall mortality ranges from 6 to 20%. Mortality is high but this is mainly due to the associated presence of extra-thoracic trauma, and particularly to head injuries.

  8. Necrobiotic xanthogranuloma of the chest wall.

    PubMed

    Smith, H Garth; Sargent, Larry A; Lundgrin, Daryl B

    2006-01-27

    Necrobiotic xanthogranuloma is a rare disease that usually presents with indurated yellow red nodules or plaques in the dermis or subdermal tissues. The pathogenesis of this disease is unknown and the limited number of cases has made long-term studies difficult. We report the case of a 61-year-old woman seen in our office for a 5 x 5-cm lesion of her chest wall. Biopsies established a diagnosis of necrobiotic xanthogranuloma. The patient received 4 months of intralesional steroid injections without change in the lesion. The patient was also treated with colchicine for several months without improvement. Therefore, the lesion was surgically excised and the area was reconstructed with local advancement skin flaps. The patient has been followed for 2 years with no evidence of recurrence.

  9. Comparing prediction models for radiographic exposures

    NASA Astrophysics Data System (ADS)

    Ching, W.; Robinson, J.; McEntee, M. F.

    2015-03-01

    During radiographic exposures the milliampere-seconds (mAs), kilovoltage peak (kVp) and source-to-image distance can be adjusted for variations in patient thicknesses. Several exposure adjustment systems have been developed to assist with this selection. This study compares the accuracy of four systems to predict the required mAs for pelvic radiographs taken on a direct digital radiography system (DDR). Sixty radiographs were obtained by adjusting mAs to compensate for varying combinations of source-to-image distance (SID), kVp and patient thicknesses. The 25% rule, the DuPont Bit System and the DigiBit system were compared to determine which of these three most accurately predicted the mAs required for an increase in patient thickness. Similarly, the 15% rule, the DuPont Bit System and the DigiBit system were compared for an increase in kVp. The exposure index (EI) was used as an indication of exposure to the DDR. For each exposure combination the mAs was adjusted until an EI of 1500+/-2% was achieved. The 25% rule was the most accurate at predicting the mAs required for an increase in patient thickness, with 53% of the mAs predictions correct. The DigiBit system was the most accurate at predicting mAs needed for changes in kVp, with 33% of predictions correct. This study demonstrated that the 25% rule and DigiBit system were the most accurate predictors of mAs required for an increase in patient thickness and kVp respectively. The DigiBit system worked well in both scenarios as it is a single exposure adjustment system that considers a variety of exposure factors.

  10. Inspecting Pipe Radiographically Through Asbestos Insulation

    NASA Technical Reports Server (NTRS)

    Gianettino, David P.

    1994-01-01

    Welds between sections of insulated steampipe located and inspected radiographically. Unless need to repair defective weld, one avoids cost, time, and hazard of removing asbestos insulation. Enables inspectors to locate and evaluate nondestructively any weld in pipe system, without shutting down steam. Hidden weld joints first located by use of low-power fluoroscope, moved along pipe while technician observes fluoroscopic image. Low-energy x rays from fluoroscope penetrate insulation but not pipe. Weld bead appears in silhouette on fluoroscope screen. Technician then accurately marks weld sites on insulation for later inspection.

  11. [Detection method for blurred regions in radiographs].

    PubMed

    Muroi, Tomoya; Lee, Yongbum; Tsai, Du-Yih; Tsurumaki, Masaki

    2014-03-01

    In this paper, we propose a detection method for blurred regions in radiographs. The method involves edge detection using a Sobel filter, manually determining the region of interest (ROI), feature calculation, and classification using a support vector machine. We applied our method to 14 phantom images (7 normal images, 7 blurred images) and 14 clinical images (12 normal images, 2 blurred images). As a result, the average classification accuracies of ROIs with blurring and ROIs without blurring were 98% and 90% for phantom images and clinical images, respectively.

  12. Chest pain and bilateral atrioventricular valve prolapse with normal coronary arteries in isolated corrected transposition of the great vessels. Clinical, angiographic and metabolic features.

    PubMed

    Cowley, M J; Coghlan, H C; Mantle, J A; Soto, B

    1977-09-01

    A man evaluated for disabling chest pain was found to have isolated anatomically corrected transposition of the great vessels. Angiography demonstrated right and left atrioventricular (A-V) valve prolapse and normal coronary arteries. Atrial pacing produced chest pain, ischemic electrocardiographic changes, abnormal myocardial lactate metabolism and marked elevation of the left ventricular end-diastolic pressure; all of these changes returned to normal on termination of pacing. The association of corrected transposition and bilateral A-V valve prolapse and the possible causes of myocardial ischemia in this patient are discussed.

  13. Effect of cigarette smoking on the detection of small radiographic opacities in inorganic dust diseases

    SciTech Connect

    Blanc, P.D.; Gamsu, G.

    1988-10-01

    Whether cigarette smoking can cause radiographic opacities indistinguishable from those due to pneumoconiosis remains controversial. The situation becomes clearer when one limits the abnormalities to those that can be standardized under the International Labour Office (ILO) classification system. The bulk of the evidence indicates that, using the ILO system, cigarette smoking alone is not associated with radiographic opacities that would be mistaken for pneumoconiosis with sufficient frequency to be of any practical importance. The effects of cigarette smoking, as a cofactor, in conjunction with occupational dust exposure depend on the type of dust. No relationship has been convincingly demonstrated for coal dust or silica. Only with asbestos exposure does there appear to be a significant cigarette smoking-associated increase in the frequency of irregular radiographic opacities. This increase does not appear to translate into a restrictive impairment in pulmonary function. The limited information available indicates that the features of asbestosis on high-resolution computed tomography are not similarly related to cigarette smoking. Additional research is needed to substantiate the relationship between smoking and occupational exposure to dust of many types, and also the possible imaging and pathophysiologic significance of their interactions. 47 references.

  14. Osteogenesis imperfecta type V: clinical and radiographic manifestations in mutation confirmed patients.

    PubMed

    Kim, Ok-Hwa; Jin, Dong-Kyu; Kosaki, Keisuke; Kim, Jung-Wook; Cho, Sung Yoon; Yoo, Won Joon; Choi, In Ho; Nishimura, Gen; Ikegawa, Shiro; Cho, Tae-Joon

    2013-08-01

    Osteogenesis imperfecta (OI) type V is a specific OI phenotype with interosseous membrane calcification of the forearm and hyperplastic callus formation as typical features. The causative gene mutation for OI type V has been recently discovered. The purpose of this report is to review the clinical and radiographic characteristics of mutation confirmed OI type V in detail. Sixteen (nine familial and seven sporadic) patients were enrolled in the study. Blue sclera and dentinogenesis imperfecta were not evident in any patient. However, hypodontia in the permanent teeth, ectopic eruption, and short roots in molars were additionally observed in 11 patients. Of the radiographic abnormalities, cortical thickening and bony excrescence of interosseous margin of the ulna was the most common finding, followed by overgrowth of the olecranon and/or coronoid process of the ulna. Slender ribs and sloping of the posterior ribs with or without fractures were also a consistent finding. Hyperplastic callus was detected in 75% of patients and was commonly encountered at the femur. Heterotopic ossification in the muscles and tendon insertion sites were noted in four patients, which resulted in bony ankylosis or contracture of joints. The current study confirms common clinical and radiographic findings of OI type V and reports additional phenotypic information. These observations provide clues to recognize OI type V more promptly and guide to direct targeted molecular study. © 2013 Wiley Periodicals, Inc.

  15. 46 CFR 194.10-20 - Magazine chest construction.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... lid shall have a minimum thickness of 1/8 inch. (b) Permanent sun shields shall be provided for sides... distance of 11/2 inches. Sun shields may be omitted when chests are installed “on deck protected,” shielded from direct exposure to the sun. (c) Chests shall be limited to a gross capacity of 100 cubic feet....

  16. 46 CFR 194.10-20 - Magazine chest construction.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... lid shall have a minimum thickness of 1/8 inch. (b) Permanent sun shields shall be provided for sides... distance of 11/2 inches. Sun shields may be omitted when chests are installed “on deck protected,” shielded from direct exposure to the sun. (c) Chests shall be limited to a gross capacity of 100 cubic feet....

  17. 46 CFR 194.10-20 - Magazine chest construction.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... lid shall have a minimum thickness of 1/8 inch. (b) Permanent sun shields shall be provided for sides... distance of 11/2 inches. Sun shields may be omitted when chests are installed “on deck protected,” shielded from direct exposure to the sun. (c) Chests shall be limited to a gross capacity of 100 cubic feet....

  18. 46 CFR 194.10-20 - Magazine chest construction.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... lid shall have a minimum thickness of 1/8 inch. (b) Permanent sun shields shall be provided for sides... distance of 11/2 inches. Sun shields may be omitted when chests are installed “on deck protected,” shielded from direct exposure to the sun. (c) Chests shall be limited to a gross capacity of 100 cubic feet....

  19. Penetrating cardiac injuries in blunt chest wall trauma.

    PubMed

    Kanchan, Tanuj; Menezes, Ritesh G; Sirohi, Parmendra

    2012-08-01

    The present photocase illustrates the possible mechanism of direct cardiac injuries from broken sharp jagged fractured ends of ribs in blunt force trauma to the chest in run over traffic mishaps. We propose that the projecting fractured ends of the ribs penetrate the underlying thoracic organs due to the transient phenomenon of deformation of chest cavity under pressure in run over traffic mishaps.

  20. Management of chest drainage tubes after lung surgery.

    PubMed

    Satoh, Yukitoshi

    2016-06-01

    Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient's characteristics, and the operative procedures that had been performed.