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Sample records for chest radiographic findings

  1. 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.

  2. 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

  3. Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study.

    PubMed

    Worsley, D F; Alavi, A; Aronchick, J M; Chen, J T; Greenspan, R H; Ravin, C E

    1993-10-01

    To determine the sensitivity, specificity, and positive and negative predictive values of chest radiographic findings in patients suspected of having acute pulmonary embolism (PE). Chest radiographs of 1,063 patients with suspected PE were reviewed. PE was confirmed angiographically in 383 patients and excluded in 680 patients. The chest radiograph was interpreted as normal in only 12% of patients with PE. The most common chest radiographic finding in patients with PE was atelectasis and/or parenchymal areas of increased opacity; however, the prevalence was not significantly different from that in patients without PE. Oligemia (the Westermark sign), prominent central pulmonary artery (the Fleischner sign), pleural-based area of increased opacity (the Hampton hump), vascular redistribution, pleural effusion, elevated diaphragm, and enlarged hilum were also poor predictors of PE. Although chest radiographs are essential in the investigation of suspected PE, their main value is to exclude diagnoses that clinically mimic PE and to aid in the interpretation of the ventilation-perfusion scan.

  4. 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

  5. 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

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

    PubMed

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

    2017-06-15

    Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)-defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia). At admission, each case underwent a standardized assessment of clinical signs and pneumonia risk factors by trained health personnel, and a CXR was taken that was interpreted using the standardized WHO methodology. CXRs were categorized as abnormal (consolidation and/or other infiltrate), normal, or uninterpretable. CXRs were interpretable in 3587 (85%) cases, of which 1935 (54%) were abnormal (site range, 35%-64%). Cases with abnormal CXRs were more likely than those with normal CXRs to have hypoxemia (45% vs 26%), crackles (69% vs 62%), tachypnea (85% vs 80%), or fever (20% vs 16%) and less likely to have wheeze (30% vs 38%; all P < .05). CXR consolidation was associated with a higher case fatality ratio at 30-day follow-up (13.5%) compared to other infiltrate (4.7%) or normal (4.9%) CXRs. Clinically diagnosed pneumonia cases with abnormal CXRs were more likely to have signs typically associated with pneumonia. However, CXR-normal cases were common, and clinical signs considered indicative of pneumonia were present in substantial proportions of these cases. CXR-consolidation cases represent a group with an increased likelihood of death at 30 days post-discharge.

  7. 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

  8. 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.

  9. 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.

  10. 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

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

    PubMed Central

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

    2015-01-01

    Background Multicenter studies rely on data derived from different institutions. Forms can be designed to standardize the reporting process allowing reliable comparison of data. Objective The purpose of the report is to provide a standardized method, developed as a part of a multicenter study of vertically transmitted HIV, for assessing chest radiographic results. Materials and methods Eight hundred and five infants and children were studied at five centers; 3057 chest radiographs were scored. Data were entered using a forced-choice, graded response for 12 findings. Quality assurance measures and inter- rater agreement statistics are reported. Results The form used for reporting chest radiographic results is presented. Inter-rater agreement was moderate to high for most findings, with the best correlation reported for the presence of bronchovascular markings and/or reticular densities addressed as a composite question (kappa = 0.71). The presence of nodular densities (kappa = 0.56) and parenchymal consolidation (kappa = 0.57) had moderate agreement. Agreement for lung volume was low. Conclusion The current tool, developed for use in the pediatric population, is applicable to any study involving the assessment of pediatric chest radiographs for a large population, whether at one or many centers. PMID:9361051

  12. Segmentation of ribs in digital chest radiographs

    NASA Astrophysics Data System (ADS)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

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

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. Usefulness of Chest Radiographs for Scoliosis Screening: A Comparison with Thoraco-Lumbar Standing Radiographs

    PubMed Central

    Oh, Chang Hyun; Kim, Chan Gyu; Lee, Myoung Seok; Park, Hyeong-Chun; Park, Chong Oon

    2012-01-01

    Purpose The purposes of this study were to evaluate the usefulness and limitations of chest radiographs in scoliosis screening and to compare these results with those of thoraco-lumbar standing radiographs (TLSR). Materials and Methods During Korean conscription, 419 males were retrospectively examined using both chest radiographs and TLSR to confirm the scoliosis and Cobb angle at the Regional Military Manpower. We compared the types of spinal curves and Cobb angles as measured from different radiographs. Results In the pattern of spinal curves, the overall matching rate of chest radiographs using TLSR was about 58.2% (244 of 419 cases). Cobb angle differences between chest radiographs and TLSR with meaningful difference was observed in 156 cases (37.2%); a relatively high proportion (9.5%) of Cobb angle differences more than 10 degrees was also observed. The matching rate of both spinal curve types and Cobb angle accuracy between chest radiographs and TLSR was 27.9% (117 among 419 cases). Chest radiographs for scoliosis screening were observed with 93.94% of sensitivity and 61.67% of specificity in thoracic curves; however, less than 40% of sensitivity (38.27%, 20.00%, and 25.80%) and more than 95% of specificity (97.34%, 99.69%, and 98.45%) were observed in thoraco-lumbar, lumbar, and double major curves, respectively. Conclusion The accuracy of chest radiographs for scoliosis screening was low. The incidence of thoracic curve scoliosis was overestimated and lumbar curve scoliosis was easily missed by chest radiography. Scoliosis screening using chest radiography has limited values, nevertheless, it is useful method for detecting thoracic curve scoliosis. PMID:23074120

  19. Usefulness of chest radiographs in first asthma attacks

    SciTech Connect

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

    1983-08-11

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

  20. [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.

  1. 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.

  2. 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.

  3. 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.

  4. The necessity of routine post-thoracostomy tube chest radiographs in post-operative thoracic surgery patients.

    PubMed

    Whitehouse, M R; Patel, A; Morgan, J A

    2009-04-01

    Chest radiographs are routinely performed post-operatively in thoracic surgery patients, in particular after the removal of thoracostomy tubes. From observation of our practice, we hypothesised that chest radiographs did not need to be performed routinely post-operatively and after removal of thoracostomy tubes. To determine whether routine chest radiographs post-operatively and post-thoracostomy tube removal directly influenced patient management. A five month prospective study was carried out to analyse our current practice at the Thoracic Surgery Unit, Bristol Royal Infirmary, Bristol, U.K. Demographic and clinico-pathological data were collected during admission. In the cohort of 74 patients, 66 (89%) patients had post-operative chest radiographs. Only three (5%) patients who had a chest radiograph had change in their management. Twenty-five (34%) patients had a chest radiograph post-thoracostomy tube removal. Only one (4%) patient in this group who had a chest radiograph after thoracostomy tube removal had a change of management. Interestingly, the decision to change patient management was not made on the basis of the chest radiographs alone; the clinical situation was the main determinant. Patients that did not have a chest radiograph postoperatively (eight patients, 11%) and post-thoracostomy tube removal (49 patients, 66%) did not suffer any adverse sequelae. We feel our data support the hypothesis that it is not necessary to perform routine chest radiographs in thoracic surgery patients post-operatively and after post-operative thoracostomy tube removal. It would be better to monitor these patients clinically and only request chest radiographs on the basis of deterioration in recorded observations or clinical findings.

  5. Effective dose assessment for participants in the National Lung Screening Trial undergoing posteroanterior chest radiographic examinations.

    PubMed

    Kruger, Randell; Flynn, Michael J; Judy, Phillip F; Cagnon, Christopher H; Seibert, J Anthony

    2013-07-01

    The National Lung Screening Trial (NLST) is a multicenter randomized controlled trial comparing low-dose helical CT with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004, when 53,454 participants had been randomized at 33 screening sites. The objective of this study was to determine the effective radiation dose associated with individual chest radiographic screening examinations. A total of 73,733 chest radiographic examinations were performed with 92 chest imaging systems. The entrance skin air kerma (ESAK) of participants' chest radiographic examinations was estimated and used in this analysis. The effective dose per ESAK for each examination was determined with a Monte Carlo-based program. The examination effective dose was calculated as the product of the examination ESAK and the Monte Carlo estimate of the ratio of effective dose per ESAK. This study showed that the mean effective dose assessed from 66,157 postero-anterior chest examinations was 0.052 mSv. Additional findings were a median effective dose of 0.038 mSv, a 95th percentile value of 0.136 mSv, and a fifth percentile value of 0.013 mSv. The effective dose for participant NLST chest radiographic examinations was determined and is of specific interest in relation to that associated with the previously published NLST low-dose CT examinations conducted during the trial.

  6. 42 CFR 37.3 - Chest radiographs required for miners.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic Examinations § 37.3... miner who is employed in or at any of its coal mines and who was employed in coal mining prior to... operator of each coal mine of a period within which the operator may provide examinations to each miner...

  7. Localized Fisher vector representation for pathology detection in chest radiographs

    NASA Astrophysics Data System (ADS)

    Geva, Ofer; Lieberman, Sivan; Konen, Eli; Greenspan, Hayit

    2016-03-01

    In this work, we present a novel framework for automatic detection of abnormalities in chest radiographs. The representation model is based on the Fisher Vector encoding method. In the representation process, we encode each chest radiograph using a set of extracted local descriptors. These include localized texture features that address typical local texture abnormalities as well as spatial features. Using a Gaussian Mixture Model, a rich image descriptor is generated for each chest radiograph. An improved representation is obtained by selection of features that correspond to the relevant region of interest for each pathology. Categorization of the X-ray images is conducted using supervised learning and the SVM classifier. The proposed system was tested on a dataset of 636 chest radiographs taken from a real clinical environment. We measured the performance in terms of area (AUC) under the receiver operating characteristic (ROC) curve. Results show an AUC value of 0.878 for abnormal mediastinum detection, and AUC values of 0.827 and 0.817 for detection of right and left lung opacities, respectively. These results improve upon the state-of-the-art as compared with two alternative representation models.

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

    NASA Astrophysics Data System (ADS)

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

    2017-03-01

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

  9. 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...

  10. 42 CFR 37.60 - Submitting required chest radiograph classification and miner identification documents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF COAL MINERS Chest Radiographic Examinations Specifications for Interpretation, Classification, and Submission of Chest Radiographs § 37.60 Submitting required chest radiograph classification and miner... and miner identification documents. 37.60 Section 37.60 Public Health PUBLIC HEALTH SERVICE...

  11. Chest radiographs after removal of chest drains in neonates: clinical benefit or common practice?

    PubMed Central

    van den Boom, J; Battin, M

    2007-01-01

    Background Chest drain insertion is a common procedure in neonatal care. Routine radiography after removal of chest drains increases radiation exposure, handling and cost, but there are few data proving clinical benefit. Objectives To review current practice and determine the yield of routinely obtained chest radiographs (CXR). Methods A retrospective chart review of all infants undergoing removal of chest tubes in a single tertiary neonatal unit in New Zealand between January 1998 and July 2004 was performed. Results In total, 119 infants were identified, from the database, to have a chest drainage performed. In 19 cases, the procedure was needle aspiration or the drain was removed outside of our unit, hence these were excluded. The remaining 100 patients with 110 episodes of chest drain removal after 174 chest tube insertions were analysed. In asymptomatic infants, routine radiography showed some reaccumulation of air in nine of 35 cases of pneumothorax or of fluid in two of the five cases of pleural effusion, but chest tube reinsertion was not required. In the 12 clinically symptomatic infants, chest tubes were reinserted in five cases (four reaccumulations of pneumothorax and one pleural effusion), and one infant had symptomatic right upper lobe collapse. In the remaining infants, there were no abnormalities on CXR accounting for deterioration. Conclusions Given the low yield for routine radiography after chest drain removal, we suggest that close observation is likely to detect clinically relevant recurrence of pneumothorax. PMID:16769712

  12. 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

  13. 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.

  14. Quantitative Measurement Method for Possible Rib Fractures in Chest Radiographs

    PubMed Central

    Kim, Jaeil; Kim, Sungjun; Kim, Young Jae

    2013-01-01

    Objectives This paper proposes a measurement method to quantify the abnormal characteristics of the broken parts of ribs using local texture and shape features in chest radiographs. Methods Our measurement method comprises two steps: a measurement area assignment and sampling step using a spline curve and sampling lines orthogonal to the spline curve, and a fracture-ness measurement step with three measures, asymmetry and gray-level co-occurrence matrix based measures (contrast and homogeneity). They were designed to quantify the regional shape and texture features of ribs along the centerline. The discriminating ability of our method was evaluated through region of interest (ROI) analysis and rib fracture classification test using support vector machine. Results The statistically significant difference was found between the measured values from fracture and normal ROIs; asymmetry (p < 0.0001), contrast (p < 0.001), and homogeneity (p = 0.022). The rib fracture classifier, trained with the measured values in ROI analysis, detected every rib fracture from chest radiographs used for ROI analysis, but it also classified some unbroken parts of ribs as abnormal parts (8 to 17 line sets; length of each line set, 2.998 ± 2.652 mm; length of centerlines, 131.067 ± 29.460 mm). Conclusions Our measurement method, which includes a flexible measurement technique for the curved shape of ribs and the proposed shape and texture measures, could discriminate the suspicious regions of ribs for possible rib fractures in chest radiographs. PMID:24175118

  15. Pulmonary sarcoidosis with a diffuse ground glass pattern on the chest radiograph.

    PubMed Central

    Tazi, A.; Desfemmes-Baleyte, T.; Soler, P.; Valeyre, D.; Hance, A. J.; Battesti, J. P.

    1994-01-01

    BACKGROUND--Several chest radiographic abnormalities have been described in pulmonary sarcoidosis, but a diffuse ground glass pattern is extremely rare. METHODS--The chest radiographs of more than 1600 patients with sarcoidosis evaluated in our service between 1976 and 1991 were reviewed to determine the prevalence of this pattern on chest radiography at presentation, and to assess the clinical characteristics of these patients. RESULTS--Ten patients (0.6%) were identified with diffuse ground glass abnormalities on the chest radiography (eight men); all had associated hilar or mediastinal adenopathy. All patients were white and nine were smokers or former smokers. Nine patients were symptomatic and six had inspiratory crackles on physical examination. As a group these patients were remarkable for the frequency and severity of physiological abnormalities and the presence of various findings typically associated with "active" disease. Nine patients were followed for more than three years. All were treated with oral corticosteroids because of significant symptoms or physiological abnormalities, or both. Symptoms and radiological abnormalities disappeared or improved in all patients, but recurred in a high proportion when steroids were tapered or discontinued. By December 1992 only three patients had been withdrawn from treatment. CONCLUSIONS--A diffuse ground glass pattern on the chest radiograph is unusual in patients with sarcoidosis and may occur more commonly in white subjects and cigarette smokers. Its presence suggests the existence of active disease of recent onset likely to require long term treatment with corticosteroids. Images PMID:8091326

  16. 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...

  17. 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...

  18. 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...

  19. 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

  20. Comparison of "B" readers' interpretations of chest radiographs for asbestos related changes.

    PubMed

    Gitlin, Joseph N; Cook, Leroy L; Linton, Otha W; Garrett-Mayer, Elizabeth

    2004-08-01

    The purpose of this study was to determine if chest radiographic interpretations by physicians retained by attorneys representing persons alleging respiratory changes from occupational exposure to asbestos would be confirmed by independent consultant readers. For 551 chest radiographs read as positive for lung changes by initial "B" readers retained by plaintiffs' attorneys, 492 matching interpretative reports were made available to the authors. Six consultants in chest radiology, also B readers, agreed to re-interpret the radiographs independently without knowledge of their provenance. The film source, patient name, and other identifiers on each film were masked. The International Labor Office 1980 Classification of Chest Radiographs(ILO 80) was used with forms designed by the US National Institute of Occupational Safety and Health to record the consult-ants' findings. The results were compared with initial readings for film quality, complete negativity, parenchymal abnormalities,small opacities profusion, and pleural abnormalities using chi-square tests and kappa statistics.Results. Initial readers interpreted study radiographs as positive for parenchymal abnormalities (ILO small opacity profusion category of 1/0 or higher) in 95.9% of 492 cases. Six consultants classified the films as 1/0 or higher in 4.5% of 2,952 readings. Statistical tests of these and other comparable data from the study showed highly significant differences between the interpretations of the initial readers and the findings of the consultants. The magnitude of the differences between the interpretations by initial readers and the six consultants is too great to be attributed to interobserver variability. There is no support in the literature on x-ray studies of workers exposed to asbestos and other mineral dusts for the high level of positive findings recorded by the initial readers in this report.

  1. Quality assurance: a comparison study of radiographic exposure for neonatal chest radiographs at 4 academic hospitals.

    PubMed

    Cohen, Mervyn D; Markowitz, Richard; Hill, Jeanne; Huda, Walter; Babyn, Paul; Apgar, Bruce

    2012-06-01

    Little is known about exposure differences among hospitals. Large differences might identify outliers using excessive exposure. We used the newly described exposure index and deviation index to compare the difference in existing radiographic exposures for neonatal portable chest radiographs among four academic children's hospitals. For each hospital we determined the mean exposure index. We also set target exposure indices and then measured the deviation from this target. There was not a large difference in exposure index among sites. No site had an exposure index mean that was more than twice or less than half that of any other site. For all four sites combined, 92% of exposures had a deviation index within the range from -3 to +3. Thus exposures at each hospital were consistently within a reasonable narrow spectrum. Mean exposure index differences are caused by operational differences with mean values that varied by less than 50% among four hospitals. Ninety-two percent of all exposures were between half and double the target exposure. Although only one vendor's equipment was used, these data establish a practical reference range of exposures for neonatal portable radiographs that can be recommended to other hospitals for neonatal chest radiographs.

  2. Chest ultrasound findings in pulmonary tuberculosis.

    PubMed

    Agostinis, Paolo; Copetti, Roberto; Lapini, Laura; Badona Monteiro, Geraldo; N'Deque, Augusto; Baritussio, Aldo

    2017-10-01

    In resource-limited countries, the diagnosis of pulmonary tuberculosis (TB) is based on clinical findings, chest radiography and the demonstration of acid-fast bacilli in sputum. Few data are available on the use of ultrasound (US) to diagnose pulmonary TB. Chest US was performed in patients with lung TB from a rural African setting, to look for signs of the disease and to clarify the role US may have in the diagnosis of pulmonary TB. Sixty adult patients diagnosed with lung TB underwent chest US. All patients had abnormal findings. The most frequent was a subpleural nodule (SUN), which was mostly multiple and also found in radiologically normal areas. Other findings were lung consolidations, cavitations, miliary patterns made of miniature SUNs, and pleural and pericardial effusions. Chest US is a complementary tool in evaluating patients with suspected lung TB in resource-limited settings where the disease has high prevalence.

  3. 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.

  4. 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.

  5. 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.

  6. Organizing pneumonia: chest HRCT findings*

    PubMed Central

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

    2015-01-01

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

  7. 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.

  8. 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.

  9. 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.

  10. Acute Middle East Respiratory Syndrome Coronavirus: Temporal Lung Changes Observed on the Chest Radiographs of 55 Patients.

    PubMed

    Das, Karuna M; Lee, Edward Y; Al Jawder, Suhayla E; Enani, Mushira A; Singh, Rajvir; Skakni, Leila; Al-Nakshabandi, Nizar; AlDossari, Khalid; Larsson, Sven G

    2015-09-01

    The objective of our study was to describe lung changes on serial chest radiographs from patients infected with the acute Middle East respiratory syndrome corona-virus (MERS-CoV) and to compare the chest radiographic findings and final outcomes with those of health care workers (HCWs) infected with the same virus. Chest radiographic scores and comorbidities were also examined as indicators of a fatal outcome to determine their potential prognostic value. Chest radiographs of 33 patients and 22 HCWs infected with MERS-CoV were examined for radiologic features indicative of disease and for evidence of radiographic deterioration and progression. Chest radiographic scores were estimated after dividing each lung into three zones. The scores (1 [mild] to 4 [severe]) for all six zones per chest radiographic examination were summed to provide a cumulative chest radiographic score (range, 0-24). Serial radiographs were also examined to assess for radiographic deterioration and progression from type 1 (mild) to type 4 (severe) disease. Multivariate logistic regression analysis, Kaplan-Meier survival curve analysis, and the Mann-Whitney U test were used to compare data of deceased patients with those of individuals who recovered to identify prognostic radiographic features. Ground-glass opacity was the most common abnormality (66%) followed by consolidation (18%). Overall mortality was 35% (19/55). Mortality was higher in the patient group (55%, 18/33) than in the HCW group (5%, 1/22). The mean chest radiographic score for deceased patients was significantly higher than that for those who recovered (13 ± 2.6 [SD] vs 5.8 ± 5.6, respectively; p = 0.001); in addition, higher rates of pneumothorax (deceased patients vs patients who recovered, 47% vs 0%; p = 0.001), pleural effusion (63% vs 14%; p = 0.001), and type 4 radiographic progression (63% vs 6%; p = 0.001) were seen in the deceased patients compared with those who recovered. Univariate and logistic regression analyses

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

    PubMed

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

    2002-08-01

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

  12. 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.

  13. System for pathology categorization and retrieval in chest radiographs

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

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

    PubMed

    Naidoo, Mergan; Govind, Mayuri

    2016-03-30

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

  15. 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

  16. 42 CFR 37.41 - Chest radiograph specifications-film.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... specifications—film. (a) Miners must be disrobed from the waist up at the time the radiograph is given. The... which is at least 100 and does not exceed 300, that produces radiographs with spatial resolution...

  17. 42 CFR 37.41 - Chest radiograph specifications-film.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Miners must be disrobed from the waist up at the time the radiograph is given. The facility must provide... which is at least 100 and does not exceed 300, that produces radiographs with spatial resolution...

  18. 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.

  19. REDUCE-PCP study: radiographs in the emergency department utilization criteria evaluation-pediatric chest pain.

    PubMed

    Neff, Justin; Anderson, Melanie; Stephenson, Trent; Young, Joe; Hennes, Halim; Suter, Robert

    2012-05-01

    Many emergency physicians order chest x-rays (CXRs) for pediatric patients who present with a chief complaint of chest pain despite a paucity of research to support this testing, which exposes patients to radiation, cost, and delays. This study aimed to begin development of a decision making tool that will allow emergency physicians to selectively obtain CXR films in pediatric patients presenting with chest pain. We performed a retrospective cohort study of 400 consecutive pediatric patients with a chief complaint of chest pain and reviewed charts to determine how many received a CXR and which clinical characteristics were present in all patients. Chest radiograph findings were graded for significance as follows: (1) no or minor clinical significance: normal result in the CXR film without effect on the immediate evaluation of a patient; (2) moderate clinical significance: only impact on plan for follow-up; and (3) major clinical significance: result in the CXR film directly affects immediate management. We then evaluated each chart for historical or examination findings that might identify criteria associated with positive radiographic findings to propose a set of criteria that could lead to the development of a decision rule that allows a reduced utilization while having a high sensitivity for clinically significant positive findings on CXR film. Of the 400 pediatric patients reviewed, 63.5% (n = 254) received a CXR in the emergency department (ED). Of those receiving a CXR, only 8.26% (n = 21) had a finding that affected either ED management or follow-up planning. The criteria that would have identified all patients with positive results in the CXR films were abnormal vital signs, shortness of breath, palpitations, presence of comorbidities, abnormal or unilateral breath sounds, history of trauma, murmur, or cough. This pilot study demonstrates the potential for a decision rule to eliminate both cost and radiation exposure by using defined criteria to determine

  20. A novel online Variance Based Instance Selection (VBIS) method for efficient atypicality detection in chest radiographs

    NASA Astrophysics Data System (ADS)

    Alzubaidi, Mohammad; Balasubramanian, Vineeth; Patel, Ameet; Panchanathan, Sethuraman; Black, John A., Jr.

    2012-02-01

    Chest radiographs are complex, heterogeneous medical images that depict many different types of tissues, and many different types of abnormalities. A radiologist develops a sense of what visual textures are typical for each anatomic region within chest radiographs by viewing a large set of "normal" radiographs over a period of years. As a result, an expert radiologist is able to readily detect atypical features. In our previous research, we modeled this type of learning by (1) collecting a large set of "normal" chest radiographs, (2) extracting local textural and contour features from anatomical regions within these radiographs, in the form of high-dimensional feature vectors, (3) using a distance-based transductive machine learning method to learn what it typical for each anatomical region, and (4) computing atypicality scores for the anatomical regions in test radiographs. That research demonstrated that the transductive One-Nearest-Neighbor (1NN) method was effective for identifying atypical regions in chest radiographs. However, the large set of training instances (and the need to compute a distance to each of these instances in a high dimensional space) made the transductive method computationally expensive. This paper discusses a novel online Variance Based Instance Selection (VBIS) method for use with the Nearest Neighbor classifier, that (1) substantially reduced the computational cost of the transductive 1NN method, while maintaining a high level of effectiveness in identifying regions of chest radiographs with atypical content, and (2) allowed the incremental incorporation of training data from new informative chest radiographs as they are encountered in day-to-day clinical work.

  1. 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

  2. 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

  3. 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)

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

    PubMed Central

    Egbe, N O; Akpan, B E

    2015-01-01

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

  5. 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

  6. Unilateral hypertransparency on chest radiograph: the congenital Poland Syndrome.

    PubMed

    Tomos, Ioannis; Papaioannou, Andriana I; Vlami, Aikaterini; Apollonatou, Vasiliki; Manali, Effrosyni D; Papiris, Spyros A

    2016-01-01

    Unilateral hypertransparent hemithorax requires a particular diagnostic approach as it can be the result of diverse pulmonary diseases, including pneumothorax, large pulmonary embolus, unilateral large bullae, mucous plag, airway obstruction and contralateral pleural effusion. Congenital syndromes with chest wall abnormalities, are rare, but often underdiagnosed causes. Poland Syndrome consists of such a rare, congenital anomaly and is characterized by the absence of the pectoralis major muscle and upper limb ipsilateral abnormalities. We present a case of a patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) and a unilateral hypertransparency on chest radiology, attributed to the underlying Poland Syndrome.

  7. Relevance of an incidental chest finding

    PubMed Central

    Cortés-Télles, Arturo; Mendoza, Daniel

    2012-01-01

    Solitary pulmonary nodule represents 0.2% of incidental findings in routine chest X-ray images. One of the main diagnoses includes lung cancer in which small-cell subtype has a poor survival rate. Recently, a new classification has been proposed including the very limited disease stage (VLD stage) or T1-T2N0M0 with better survival rate, specifically in those patients who are treated with surgery. However, current recommendations postulate that surgery remains controversial as a first-line treatment in this stage. We present the case of a 46-year-old female referred to our hospital with a preoperative diagnosis of a solitary pulmonary nodule. On initial approach, a biopsy revealed a small cell lung cancer. She received multimodal therapy with surgery, chemotherapy, and prophylactic cranial irradiation and is currently alive without recurrence on a 2-year follow-up. PMID:22345914

  8. 42 CFR 37.3 - Chest radiographs required for miners.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic... provide to each miner who is employed in or at any of its underground coal mines and who was employed in... may provide examinations to each miner employed at its coal mine. The period must begin no sooner than...

  9. Toward the detection of abnormal chest radiographs the way radiologists do it

    NASA Astrophysics Data System (ADS)

    Alzubaidi, Mohammad; Patel, Ameet; Panchanathan, Sethuraman; Black, John A., Jr.

    2011-03-01

    Computer Aided Detection (CADe) and Computer Aided Diagnosis (CADx) are relatively recent areas of research that attempt to employ feature extraction, pattern recognition, and machine learning algorithms to aid radiologists in detecting and diagnosing abnormalities in medical images. However, these computational methods are based on the assumption that there are distinct classes of abnormalities, and that each class has some distinguishing features that set it apart from other classes. However, abnormalities in chest radiographs tend to be very heterogeneous. The literature suggests that thoracic (chest) radiologists develop their ability to detect abnormalities by developing a sense of what is normal, so that anything that is abnormal attracts their attention. This paper discusses an approach to CADe that is based on a technique called anomaly detection (which aims to detect outliers in data sets) for the purpose of detecting atypical regions in chest radiographs. However, in order to apply anomaly detection to chest radiographs, it is necessary to develop a basis for extracting features from corresponding anatomical locations in different chest radiographs. This paper proposes a method for doing this, and describes how it can be used to support CADe.

  10. The Association of Positive Chest Radiograph and Laboratory Parameters with Community Acquired Pneumonia in Children

    PubMed Central

    Lakhani, Dhairya; Muley, Prasad

    2013-01-01

    Context: This study was designed to compare the sensitivities of different investigations for the diagnosis of Community Acquired Pneumonia (CAP). A prospective study was carried out which compared the sensitivities of the chest radiographs, CRP, TLC, ESR and the blood cultures in sixty-six patients who were diagnosed with WHO defined CAP. Method and Material: The chest radiographs, serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total leucocyte count (TLC) and blood cultures were determined in sixty-six patients who were amongst the age group of one month to five years of age, who were diagnosed with WHO defined CAP. Statistical Analysis: It was carried out by calculating the proportion, mean, standard deviation (SD) and the sensitivity of the test/.able Results: The chest radiographs were found to be positive in 93.9% (n=62) patients, CRP was positive in 90.9% (n=60) patients, ESR was positive in 72.7% (n=42) patients, TLC was positive in 48.5% (n=38) patients and the blood cultures were positive in 6.1% (n=4) patients. Hence, the sensitivity of the chest radiograph, CRP, ESR, TLC and the blood culture in the diagnosis of CAP were 93.9%, 90.9%, 72.7%, 48.5% and 6.1%. Conclusion: In view of the high sensitivity of CRP, which is almost similar to that of chest X-Ray in detecting CAP, CRP can be used as an alternative test to the chest radiographs at peripheral centres, where X-ray machines are not available. PMID:24086859

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

    NASA Astrophysics Data System (ADS)

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

    2012-02-01

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

  12. [Effects of image post-processing parameters on digital radiography chest radiograph for the diagnosis of pneumoconiosis].

    PubMed

    Chen, Jun-Qiang; Jiang, Zhao-Qiang; Zhou, Bin; Zhu, Qiang; Liu, Bin; Zhang, Xing

    2012-01-01

    To explore the effects of image post-processing parameters on DR chest radiograph for the diagnosis of pneumoconiosis. Eighty three coal miners were examined with high-kV and DR chest radiographs at the same time. Image post-processing parameters (density, contrast and so on) were designed in a Philips Essenta DR machine were designed, then differences of image quality between high-kV and DR chest radiographs were compared. After regulating image and proceeding the parameters, the OD (optical density) values of high density areas in the upper-middle lung fields, subphrenic and direct exposure areas were 1.58 +/- 0.10, 0.23 +/- 0.02 and 2.80 +/- 0.21, respectively. The quality of chest films met the requirements of diagnostic criteria of pneumoconiosis. The rate of excellent chest films for DR chest radiograph was 95.18%, which was significantly higher than that (80.72%) for high-kV chest radiograph (P < 0.01). Appropriate parameters of image post-processing can make DR chest radiograph to meet the requirements of chest radiograph quality for the diagnosis of pneumoconiosis.

  13. 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.

  14. 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.

  15. 42 CFR 37.4 - Chest radiographic examinations conducted by the Secretary.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic... Study of Coal Workers' Pneumoconiosis (an epidemiological study of respiratory diseases in coal miners... the locality where the miner resides, at the mine, or at a medical facility easily accessible to a...

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

    NASA Astrophysics Data System (ADS)

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

    2012-03-01

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

  17. 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.

  18. Automatic screening for tuberculosis in chest radiographs: a survey.

    PubMed

    Jaeger, Stefan; Karargyris, Alexandros; Candemir, Sema; Siegelman, Jenifer; Folio, Les; Antani, Sameer; Thoma, George

    2013-04-01

    Tuberculosis (TB) is a major global health threat. An estimated one-third of the world's population has a history of TB infection, and millions of new infections are occurring every year. The advent of new powerful hardware and software techniques has triggered attempts to develop computer-aided diagnostic systems for TB detection in support of inexpensive mass screening in developing countries. In this paper, we describe the medical background of TB detection in chest X-rays and present a survey of the recent approaches using computer-aided detection. After a thorough research of the computer science literature for such systems or related methods, we were able to identify 16 papers, including our own, written between 1996 and early 2013. These papers show that TB screening is a challenging task and an open research problem. We report on the progress to date and describe experimental screening systems that have been developed.

  19. Local-global classifier fusion for screening chest radiographs

    NASA Astrophysics Data System (ADS)

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

    2017-03-01

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

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

    PubMed

    Alavijeh, Fatemeh Shahsavari; Mahdavi-Nasab, Homayoun

    2015-01-01

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

  1. 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

  2. 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.

  3. A novel semi-transductive learning framework for efficient atypicality detection in chest radiographs

    NASA Astrophysics Data System (ADS)

    Alzubaidi, Mohammad; Balasubramanian, Vineeth; Patel, Ameet; Panchanathan, Sethuraman; Black, John A., Jr.

    2012-03-01

    Inductive learning refers to machine learning algorithms that learn a model from a set of training data instances. Any test instance is then classified by comparing it to the learned model. When the set of training instances lend themselves well to modeling, the use of a model substantially reduces the computation cost of classification. However, some training data sets are complex, and do not lend themselves well to modeling. Transductive learning refers to machine learning algorithms that classify test instances by comparing them to all of the training instances, without creating an explicit model. This can produce better classification performance, but at a much higher computational cost. Medical images vary greatly across human populations, constituting a data set that does not lend itself well to modeling. Our previous work showed that the wide variations seen across training sets of "normal" chest radiographs make it difficult to successfully classify test radiographs with an inductive (modeling) approach, and that a transductive approach leads to much better performance in detecting atypical regions. The problem with the transductive approach is its high computational cost. This paper develops and demonstrates a novel semi-transductive framework that can address the unique challenges of atypicality detection in chest radiographs. The proposed framework combines the superior performance of transductive methods with the reduced computational cost of inductive methods. Our results show that the proposed semitransductive approach provides both effective and efficient detection of atypical regions within a set of chest radiographs previously labeled by Mayo Clinic expert thoracic radiologists.

  4. [The chest CT findings and pathologic findings of pulmonary tuberculosis].

    PubMed

    Ogata, Hideo

    2009-08-01

    The past research of the radiologic manifestations of pulmonary tuberculosis in Japan was based on morphological pathology of the untreated patient autopsy. I would like to show the chest CT scan of tuberculosis diseases with caseous granuloma at its exudative reaction, proliferative reaction, productive reaction, cirrhotic reaction until self cure. This progress reflects the normal cell mediated immunological responses. Also I would like to show the cavitation of granuloma, which results from liquefaction of caseous materials during the course and results in the formation of the source of infection. And finally I would like to show the morphological differences of acinous lesion, acino-nodular lesion and caseous lobular pneumonia. These differences reflect the amount of bacilli disseminated in the peripheral parts under the lobules. In this study, I do not show old age cases and HIV positive cases, who do not form typical granuloma due to the decreased cell mediated immnunity and whose X ray findings are atypical.

  5. [Effect of digital radiography processing parameters on digital chest radiograph for occupational exposed workers].

    PubMed

    Wang, Xiao-hua; Liu, Dong-sheng; Xuan, Xiao; Kang, Han; Yuan, Hui-shu

    2013-05-01

    To investigate the effect of different processing parameters of digital radiography (DR) on the image quality of digital chest radiograph in dust-exposed workers. One hundred and five dust-exposed workers underwent both high-KV radiography and DR to obtain chest radiographs; the image processing parameters were set by the conventional processing method for digital chest radiograph (method A) and the processing method based on the special requirements of occupational diseases (method B). With the high-KV chest radiograph as the reference, the image qualities at 10 anatomic sites of DR image were graded. The images acquired by DR and high-KV radiography were compared, and the DR images acquired by methods A and B were also compared. For method A, the scores at the 10 anatomic sites of DR image were mostly 0 and +1, accounting for over 88%, and the mean score was 0.23 ∼ 0.65, there was a significant difference between the mean score of DR image and the score of high-KV image (P < 0.001). For method B, the scores at the 10 anatomic sites of DR image were mostly 0, accounting for over 65%, and the mean score was -0.01∼ +0.02 except at the pleura and chest wall; there was no significant difference between the mean score of DR image and the score of high-KV image (P > 0.05). There were significant differences in the scores at the 10 anatomic sites between the DR images acquired by methods A and B (P < 0.01). The DR images acquired based on different processing parameters are different. The quality of DR image acquired by the processing method based on the special requirements of occupational diseases is similar to that of high-KV image at the anatomic sites.

  6. 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.

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

    SciTech Connect

    Musk, A.W.

    1982-01-01

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

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

    PubMed Central

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

    2012-01-01

    Objective To evaluate the effect of computer-aided detection (CAD) system on observer performance in the detection of malignant lung nodules on chest radiograph. Materials and Methods Two hundred chest radiographs (100 normal and 100 abnormal with malignant solitary lung nodules) were evaluated. With CT and histological confirmation serving as a reference, the mean nodule size was 15.4 mm (range, 7-20 mm). Five chest radiologists and five radiology residents independently interpreted both the original radiographs and CAD output images using the sequential testing method. The performances of the observers for the detection of malignant nodules with and without CAD were compared using the jackknife free-response receiver operating characteristic analysis. Results Fifty-nine nodules were detected by the CAD system with a false positive rate of 1.9 nodules per case. The detection of malignant lung nodules significantly increased from 0.90 to 0.92 for a group of observers, excluding one first-year resident (p = 0.04). When lowering the confidence score was not allowed, the average figure of merit also increased from 0.90 to 0.91 (p = 0.04) for all observers after a CAD review. On average, the sensitivities with and without CAD were 87% and 84%, respectively; the false positive rates per case with and without CAD were 0.19 and 0.17, respectively. The number of additional malignancies detected following true positive CAD marks ranged from zero to seven for the various observers. Conclusion The CAD system may help improve observer performance in detecting malignant lung nodules on chest radiographs and contribute to a decrease in missed lung cancer. PMID:22977323

  9. 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.

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

    PubMed

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

    2013-07-01

    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. 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. 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 Az 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. The authors conclude that removal of foreign objects from chest radiographs is feasible and beneficial for automated image analysis.

  11. The chest radiograph in critically ill surgical patients is inaccurate in predicting ventilator-associated pneumonia.

    PubMed

    Butler, K L; Sinclair, K E; Henderson, V J; McKinney, G; Mesidor, D A; Katon-Benitez, I; Weaver, W L

    1999-09-01

    Chest radiographs (CXRs) are frequently obtained in surgical intensive care unit (SICU) patients when a diagnosis of ventilator-associated pneumonia (VAP) is suspected. The purpose of this study was to determine if the interpretation of the CXR correlated with a diagnosis of VAP in SICU patients. Prospective evaluation of 20 SICU patients clinically suspected of VAP was performed from July 1997 through December 1998. All patients required mechanical ventilation for at least 48 hours, and antibiotic use was discontinued 24 hours before entry into the study. Bronchoscopy with protected specimen brush (PSB) sampling of secretions from the right and left lung was performed. A positive PSB was present if quantitative analysis yielded > or = 10(4) colony-forming units/mL of bacteria. VAP was diagnosed if either the right or left PSB was positive and ruled-out if both the right and left PSB yielded < 10(4) colony-forming units/mL. Twelve of 20 patients (60%) were diagnosed to have VAP by PSB criteria. Eight of 20 patients (40%) had CXRs interpreted as negative for infiltrates; four patients had VAP by PSB criteria. There were four patients with focal infiltrates; two patients had VAP. The remaining eight patients had radiographs interpreted as bilateral infiltrates (one) or pulmonary edema (seven); of these, six patients (75%) had VAP. The sensitivity of the CXR in determining the presence of VAP was 25 per cent, the specificity was 75 per cent, and the accuracy was 0.45. The CXR does not improve the clinician's ability to diagnose VAP: a normal CXR does not exclude the presence of VAP and the finding of a focal infiltrate does not confirm the diagnosis of VAP.

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

    NASA Astrophysics Data System (ADS)

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

    2017-03-01

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

  13. Bayesian latent class estimation of the incidence of chest radiograph-confirmed pneumonia in rural Thailand.

    PubMed

    Lu, Y; Baggett, H C; Rhodes, J; Thamthitiwat, S; Joseph, L; Gregory, C J

    2016-10-01

    Pneumonia is a leading cause of mortality and morbidity worldwide with radiographically confirmed pneumonia a key disease burden indicator. This is usually determined by a radiology panel which is assumed to be the best available standard; however, this assumption may introduce bias into pneumonia incidence estimates. To improve estimates of radiographic pneumonia incidence, we applied Bayesian latent class modelling (BLCM) to a large database of hospitalized patients with acute lower respiratory tract illness in Sa Kaeo and Nakhon Phanom provinces, Thailand from 2005 to 2010 with chest radiographs read by both a radiology panel and a clinician. We compared these estimates to those from conventional analysis. For children aged <5 years, estimated radiographically confirmed pneumonia incidence by BLCM was 2394/100 000 person-years (95% credible interval 2185-2574) vs. 1736/100 000 person-years (95% confidence interval 1706-1766) from conventional analysis. For persons aged ⩾5 years, estimated radiographically confirmed pneumonia incidence was similar between BLCM and conventional analysis (235 vs. 215/100 000 person-years). BLCM suggests the incidence of radiographically confirmed pneumonia in young children is substantially larger than estimated from the conventional approach using radiology panels as the reference standard.

  14. 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.

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

    SciTech Connect

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

    2012-11-15

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

  16. Impact of specific training in detecting osteoporotic vertebral fractures on routine chest radiographs.

    PubMed

    Gruber, M; Dinges, J; Müller, D; Baum, T; Rummeny, E J; Bauer, J

    2013-11-01

    Vertebral fractures are the most common complication of osteoporosis. Routine chest radiographs are a potential screening method, but a significant under-reporting has been described previously. The purpose of this study was to evaluate the effect of a specific training on the detection rate of vertebral fractures of a radiology resident. 936 routine lateral chest radiographs of postmenopausal women were evaluated by a radiology resident (R1) during clinical routine. After the evaluation of 470 radiographs (pre-training group), R1 underwent a specific training based on the teaching initiative of the IOF/ESSR. Afterwards the remaining 466 radiographs were evaluated (post-training group). As a standard of reference, all radiographs were reviewed by two radiologists in consensus (R2 + 3). A semi-quantitative method (spinal fracture index, SFI) was used to assess vertebral fractures. Kappa-values as statistical measure of agreement between R1 and R2 + 3 for the detection of vertebral fractures (Genant Severity > 0) increased from κ = 0.311 (95 % CI: 0.217 - 0.405; "fair agreement") in the pre-training group to κ = 0,882 (95 % CI: 0,835 - 0,929; "almost perfect agreement") in the post-training group. Similar results were observed for severe fractures (Genant Severity > 1). Especially fractures with Genant Severity 1 were not detected by R1 before training. A brief training is essential to increase the awareness of radiologists to correctly report osteoporotic vertebral fractures and may help to initiate appropriate therapy in patients with vertebral fractures. © Georg Thieme Verlag KG Stuttgart · New York.

  17. 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.

  18. 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.

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

    PubMed

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

    2017-09-01

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

  20. The vanishing lung: an important cause of hyperlucency on chest radiograph.

    PubMed

    Faruqi, S; Varma, R

    2013-01-01

    Giant bullous emphysema is an uncommon condition characterised by large asymmetric bullae with upper lobe predominance. This condition is most frequent in young male smokers. Patients usually present with progressive breathlessness which is secondary to enlargement of the bullae leading to compression of the lung parenchyma. Large asymmetrical bullae may appear as a unilateral hyperlucency on a plain chest radiograph, and may mimic the appearances of pneumothorax. A computed tomography scan is needed to delineate the lung pathology. We describe two cases with this condition that presented acutely and discuss the management of bullous emphysema.

  1. 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.

  2. 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.

  3. Chest ultrasound findings in pulmonary alveolar microlithiasis.

    PubMed

    Rea, Gaetano; Sperandeo, Marco; Sorrentino, Nunzia; Stanziola, Anna Agnese; D'Amato, Maria; Bocchino, Marialuisa

    2015-10-01

    Pulmonary alveolar microlithiasis (PAM) is a rare disorder of unknown etiology affecting people at any age. It is characterized by multiple and microscopic calcium deposits diffusely localized within the alveoli. Thorax high-resolution computed tomography is considered the gold standard for PAM imaging. Herein we report for the first time the use of trans-thoracic ultrasound (TUS) examination in a young severely obese PAM female patient, diagnosed at the age of 10, and referred to our clinic for re-staging purposes at the age of 36. Unlike expected, no reverberation or additional artifacts were appreciated on TUS examination despite the severity of the interstitial/alveolar involvement seen on conventional CT imaging. To date, no ring-down or comet-tail artifacts were detected. The only TUS finding was an increased thickness and irregular profile, more evident in the dorsal lower lung regions, of the hyper-echoic pleural line. TUS has recently aroused increasing interest among clinicians and radiologists as a useful noninvasive diagnostic tool for studying pleuro-pulmonary diseases, including interstitial lung diseases (ILDs). The peculiarity of our case is represented by the discrepancy between TUS and CT findings. Further efforts to address the usefulness and US patterns in diffuse ILDs, with the inclusion of rare disorders, are needed.

  4. Investigation of misfiled cases in the PACS environment and a solution to prevent filing errors for chest radiographs.

    PubMed

    Morishita, Junji; Watanabe, Hideyuki; Katsuragawa, Shigehiko; Oda, Nobuhiro; Sukenobu, Yoshiharu; Okazaki, Hiroko; Nakata, Hajime; Doi, Kunio

    2005-01-01

    The aim of the study was to survey misfiled cases in a picture archiving and communication system environment at two hospitals and to demonstrate the potential usefulness of an automated patient recognition method for posteroanterior chest radiographs based on a template-matching technique designed to prevent filing errors. We surveyed misfiled cases obtained from different modalities in one hospital for 25 months, and misfiled cases of chest radiographs in another hospital for 17 months. For investigating the usefulness of an automated patient recognition and identification method for chest radiographs, a prospective study has been completed in clinical settings at the latter hospital. The total numbers of misfiled cases for different modalities in one hospital and for chest radiographs in another hospital were 327 and 22, respectively. The misfiled cases in the two hospitals were mainly the result of human errors (eg, incorrect manual entries of patient information, incorrect usage of identification cards in which an identification card for the previous patient was used for the next patient's image acquisition). The prospective study indicated the usefulness of the computerized method for discovering misfiled cases with a high performance (ie, an 86.4% correct warning rate for different patients and 1.5% incorrect warning rate for the same patients). We confirmed the occurrence of misfiled cases in the two hospitals. The automated patient recognition and identification method for chest radiographs would be useful in preventing wrong images from being stored in the picture archiving and communication system environment.

  5. 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.

  6. Automated characterization of perceptual quality of clinical chest radiographs: validation and calibration to observer preference.

    PubMed

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

    2014-11-01

    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. 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. The observer study

  7. Irreversible JPEG compression of digital chest radiographs for primary interpretation: assessment of visually lossless threshold.

    PubMed

    Slone, Richard M; Muka, Edward; Pilgram, Thomas K

    2003-08-01

    To determine if digital chest images could be compressed in a primary interpretation context without perceived loss of fidelity (below the visually lossless threshold) at transilluminated film or cathode ray tube (CRT) display. One hundred forty-four posteroanterior radiographs were obtained with a digital chest radiography system. At both film and CRT display, an identified original image was presented side by side with a replicate, which was either an unaltered image or an image that had been Joint Photographic Experts Group (JPEG) compressed to 10:1, 20:1, or 50:1 and reconstructed. Each of the 10 readers indicated whether the replicate was "indistinguishable from the original" or "degraded" at clinical reading distance and at close inspection. The readers' ability to detect compressed images was examined for patterns; 95% CIs were used for statistical testing. With transilluminated film at clinical reading distance, readers were as likely to rate originals (48 [20%] of 240 readings) as degraded as they were to rate 20:1 replicates (106 [22%] of 480 readings) as degraded, but they frequently identified 50:1 replicates (283 [59%] of 480 readings) as degraded. At close inspection, 20:1 replicates (163 [34%] of 480 readings) were often identified as degraded, but 10:1 replicates (19 [8%] of 240 readings) were not identified as degraded more often than originals (17 [7%] of 240 readings). With CRT display, the results were nearly identical. At reading distance for primary interpretation, full-size digital chest radiographs that have been JPEG compressed to 10:1 or 20:1 and reconstructed are visually lossless at film or CRT display. Images compressed to 10:1 remain visually lossless at close inspection. Copyright RSNA, 2003.

  8. The development and evaluation of a computerized diagnosis scheme for pneumoconiosis on digital chest radiographs.

    PubMed

    Zhu, Biyun; Luo, Wei; Li, Baoping; Chen, Budong; Yang, Qiuying; Xu, Yan; Wu, Xiaohua; Chen, Hui; Zhang, Kuan

    2014-10-02

    To diagnose pneumoconiosis using a computer-aided diagnosis system based on digital chest radiographs. Lung fields were first extracted by combining the traditional Otsu-threshold method with a morphological reconstruction on digital radiographs (DRs), and then subdivided into six non-overlapping regions (region (a-f)). Twenty-two wavelet-based energy texture features were calculated exclusively from each region and selected using a decision tree algorithm. A support vector machine (SVM) with a linear kernel was trained using samples with texture features to classify an individual region of a healthy subject or a pneumoconiosis patient. The final classification results were obtained by integrating these individual classifiers with the weighted voting method. All models were developed on a dataset of 85 healthy controls and 40 stage I or II pneumoconiosis patients and validated by using the bootstrap resampling with replacement method. The areas under receiver operating characteristic curves (AUCs) of regions (c) and (f) were 0.688 and 0.563, which were worse than those of the other four regions. Region (c) and (f) were both excluded from the individual classifiers that were going to be assembled further. When built on the selected texture features, each individual SVM showed a higher diagnostic performance for the training set and the test set. The classification performance after an ensemble was 0.997 and 0.961 of the AUC value for the training and test sets, respectively. The final results were 0.974 ± 0.018 for AUC value and 0.929 ± 0.018 for accuracy. The integrated SVM model built on the selected feature set showed the highest diagnostic performance among all individual SVM models. The model has good potential in diagnosing pneumoconiosis based on digital chest radiographs.

  9. Utility of Postoperative Radiographs for Pediatric Scoliosis: Association Between History and Physical Examination Findings and Radiographic Findings.

    PubMed

    Shau, David N; Bible, Jesse E; Gadomski, Stephen P; Samade, Richard; Armaghani, Sheyan; Mencio, Gregory A; Devin, Clinton J

    2014-07-02

    Postoperative radiographs are routinely obtained following surgery for the correction of scoliosis in pediatric patients. The purpose of this study was to comprehensively evaluate the utility of obtaining routine postoperative radiographs in the management of these patients. A total of 1969 clinic notes and corresponding radiographs regarding 451 consecutive patients with scoliosis (age range, ten to eighteen years) who had surgical correction over a ten-year period at a single institution were retrospectively reviewed. Curve etiology, preoperative curve characteristics, and surgical procedures performed were recorded. All postoperative clinic notes and radiographs were reviewed for abnormalities and changes in treatment course. It was then determined whether clinical signs and symptoms and/or abnormal radiographic findings led to a change in treatment course, which was defined as a therapeutic intervention or further diagnostic testing. Of the 451 patients in this study (average age [and standard deviation], 14.7 ± 2.4 years), 72.5% had adolescent idiopathic scoliosis, 23.3% had neuromuscular scoliosis, and 4.2% had other underlying causes of scoliosis. A change in treatment course occurred in the cases of forty-two patients, all of whom had symptomatic findings on postoperative history and physical examination and only fifteen of whom had supportive abnormal findings on postoperative radiographs. Curve etiology and surgical procedures performed had no impact on radiographic utility. A significant increase in utility was seen for radiographs obtained at visits one year or more following surgery compared with those obtained at visits less than one year following surgery (1.7% compared with 0.3%, p = 0.001). The overall sensitivity, specificity, positive predictive value, and negative predictive value of routine postoperative radiographs in guiding treatment course were 35.7%, 98.1%, 28.8%, and 98.6%, respectively. Routine radiographs provide low utility in guiding

  10. Intramammary Findings on CT of the Chest – a Review of Normal Anatomy and Possible Findings

    PubMed Central

    Gossner, Johannes

    2016-01-01

    Summary Computed tomography (CT) is a frequently performed examination in women of all ages. In all thoracic CT examinations of the chest at least parts of the breasts are included. Therefore incidental breast pathology may be observed. It has been suggested that one out of 250 women undergoing chest CT will show a malignant incidental breast lesion. Given the high number of performed chest CT examinations, this contributes to a significant number of malignancies. In this review, after a brief discussion of the value of computed tomography in breast imaging, normal and pathologic findings are discussed to create awareness of this potential “black box” on chest CT. PMID:28058068

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

    SciTech Connect

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

    1984-02-01

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

  12. Subjective evaluation of image enhancements in improving the visibility of pathology in chest radiographs

    NASA Astrophysics Data System (ADS)

    Plessis, Brigitte; Goldberg, Morris; Belanger, Garry; Hickey, Nancy M.

    1991-06-01

    In this paper we report on an experiment to compare the relevance of various image enhancement methods for improving the visibility of pathologies on digitized chest radiographs. The five pathologies tested in our trial are pulmonary nodules, air bronchograms, paratracheal abnormalities, pneumothoraces, interstitial lung diseases. The first three are examples of situations where focus is put on shape, borders and content of the pathology, the next is an example of situations where the visualization of a subtle line is required and the last one is an example of diffuse disease where the perceivability of details is important. Eight image enhancements were tested and included both pixel based gray-level transformation such as, windowing, statistical differencing, polynomial transform, histogram equalization, histogram hyperbolization, and spatial enhancement such as, unsharp masking with different masks and a Sobel detector. For each pathology we recommend two or three acceptable transformations.

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

    SciTech Connect

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

    1986-06-01

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

  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. 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

  17. Accurate segmentation of lung fields on chest radiographs using deep convolutional networks

    NASA Astrophysics Data System (ADS)

    Arbabshirani, Mohammad R.; Dallal, Ahmed H.; Agarwal, Chirag; Patel, Aalpan; Moore, Gregory

    2017-02-01

    Accurate segmentation of lung fields on chest radiographs is the primary step for computer-aided detection of various conditions such as lung cancer and tuberculosis. The size, shape and texture of lung fields are key parameters for chest X-ray (CXR) based lung disease diagnosis in which the lung field segmentation is a significant primary step. Although many methods have been proposed for this problem, lung field segmentation remains as a challenge. In recent years, deep learning has shown state of the art performance in many visual tasks such as object detection, image classification and semantic image segmentation. In this study, we propose a deep convolutional neural network (CNN) framework for segmentation of lung fields. The algorithm was developed and tested on 167 clinical posterior-anterior (PA) CXR images collected retrospectively from picture archiving and communication system (PACS) of Geisinger Health System. The proposed multi-scale network is composed of five convolutional and two fully connected layers. The framework achieved IOU (intersection over union) of 0.96 on the testing dataset as compared to manual segmentation. The suggested framework outperforms state of the art registration-based segmentation by a significant margin. To our knowledge, this is the first deep learning based study of lung field segmentation on CXR images developed on a heterogeneous clinical dataset. The results suggest that convolutional neural networks could be employed reliably for lung field segmentation.

  18. 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.

  19. 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

  20. CHAOS: Prenatal imaging findings with post mortem contrast radiographic correlation.

    PubMed

    Gupta, Kanika; Venkatesan, Bhuvaneswari; Manoharan, Kiruba Shankar; Rajalakshmi, Vaithianathan; Menon, Maya

    2016-08-01

    Congenital high airway obstruction syndrome is a rare fetal anomaly with characteristic constellation of prenatal findings on ultrasound and MRI. The typical triad of imaging features are enlarged and echogenic lungs, flattening or inversion of diaphragm and fetal hydrops. Early prenatal recognition of congenital high airway obstruction syndrome by ultrasound and/or MRI is mandatory for the appropriate perinatal management. We report a case of a male fetus with typical imaging findings of congenital high airway obstruction syndrome on ultrasound and MRI at 19 weeks of gestation. The role of contrast radiographs of fetal airways, including retrograde laryngogram, in confirming the postnatal diagnosis of this fetal condition is demonstrated. The prenatal imaging findings were correlated with contrast radiographs of upper airways, sonography of aborted fetus and fetal autopsy findings.

  1. CHAOS: Prenatal imaging findings with post mortem contrast radiographic correlation

    PubMed Central

    Gupta, Kanika; Venkatesan, Bhuvaneswari; Manoharan, Kiruba Shankar; Rajalakshmi, Vaithianathan; Menon, Maya

    2016-01-01

    Congenital high airway obstruction syndrome is a rare fetal anomaly with characteristic constellation of prenatal findings on ultrasound and MRI. The typical triad of imaging features are enlarged and echogenic lungs, flattening or inversion of diaphragm and fetal hydrops. Early prenatal recognition of congenital high airway obstruction syndrome by ultrasound and/or MRI is mandatory for the appropriate perinatal management. We report a case of a male fetus with typical imaging findings of congenital high airway obstruction syndrome on ultrasound and MRI at 19 weeks of gestation. The role of contrast radiographs of fetal airways, including retrograde laryngogram, in confirming the postnatal diagnosis of this fetal condition is demonstrated. The prenatal imaging findings were correlated with contrast radiographs of upper airways, sonography of aborted fetus and fetal autopsy findings. PMID:27761192

  2. Suppression of the contrast of ribs in chest radiographs by means of massive training artificial neural network

    NASA Astrophysics Data System (ADS)

    Suzuki, Kenji; Abe, Hiroyuki; Li, Feng; Doi, Kunio

    2004-05-01

    We developed a method for suppression of the contrast of ribs in chest radiographs by means of a massive training artificial neural network (MTANN). The MTANN is a trainable highly nonlinear filter that can be trained by using input chest radiographs and the corresponding teacher images. We used either the soft-tissue image or the bone image obtained by use of a dual-energy subtraction technique as the teacher image for suppression of ribs in chest radiographs. When the soft-tissue images were used as the teacher images, the MTANN directly produced a "soft-tissue-image-like" image where the contrast of ribs was suppressed. When the bone images were used as the teacher images, the MTANN was able to produce a "bone-image-like" image, and then was subtracted from the corresponding chest radiograph to produce a bone-subtracted image where ribs are suppressed. Thus, the two kinds of rib-suppressed images, i.e., the soft-tissue-image-like image and the bone-subtracted image, could be produced by use of the MTANNs trained with two different teacher images. We applied each of the two trained MTANNs to non-training chest radiographs to investigate the difference between the processed images. The results showed that the contrast of ribs in chest radiographs almost disappeared, and was reduced to less than 10% in both processed images. The contrast of ribs was reduced slightly better in the soft-tissue-image-like images than in the bone-subtracted images, whereas soft-tissue opacities such as lung vessels and nodules were maintained better in the bone-subtracted images. Therefore, the use of the bone images as the teacher images for training the MTANN has produced better rib-suppressed images where soft-tissue opacities were substantially maintained. A method for rib suppression using the MTANN would be useful for radiologists as well as CAD schemes in detection of lung diseases such as nodules in chest radiographs.

  3. False-positive reduction in computer-aided diagnostic scheme for detecting nodules in chest radiographs by means of massive training artificial neural network.

    PubMed

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

    2005-02-01

    We developed a technique that uses a multiple massive-training artificial neural network (multi-MTANN) to reduce the number of false-positive results in a computer-aided diagnostic (CAD) scheme for detecting nodules in chest radiographs. Our database consisted of 91 solitary pulmonary nodules, including 64 malignant nodules and 27 benign nodules, in 91 chest radiographs. With our current CAD scheme based on a difference-image technique and linear discriminant analysis, we achieved a sensitivity of 82.4%, with 4.5 false positives per image. We developed the multi-MTANN for further reduction of the false positive rate. An MTANN is a highly nonlinear filter that can be trained with input images and corresponding teaching images. To reduce the effects of background levels in chest radiographs, we applied a background-trend-correction technique, followed by contrast normalization, to the input images for the MTANN. For enhancement of nodules, the teaching image was designed to contain the distribution for a "likelihood of being a nodule." Six MTANNs in the multi-MTANN were trained by using typical nodules and six different types of non-nodules (false positives). Use of the trained multi-MTANN eliminated 68.3% of false-positive findings with a reduction of one true-positive result. The false-positive rate of our original CAD scheme was improved from 4.5 to 1.4 false positives per image, at an overall sensitivity of 81.3%. Use of a multi-MTANN substantially reduced the false-positive rate of our CAD scheme for lung nodule detection on chest radiographs, while maintaining a level of sensitivity.

  4. 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

  5. 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.

  6. 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.

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2012-09-01

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

  9. 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

  10. 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.

  11. 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.

  12. Prediction of Anthracofibrosis Based on Clinico-Radiographic Findings

    PubMed Central

    Park, Tae Yun; Heo, Eun Young; Chung, Hee Soon; Jin, Kwang Nam

    2017-01-01

    Purpose Because anthracofibrosis (AF) is associated with tuberculosis (TB), detection of AF is clinically relevant in Korea, a TB endemic region. We thus sought to develop and validate a predictive model for AF using clinical radiographic data. Materials and Methods Between January 1, 2008 and March 31, 2014, 3849 adult patients who underwent bronchoscopies were retrospectively included from an observational registry. We dichotomized patients based on the presence (n=167) or absence (n=242) of AF. After analyzing their clinico-radiographic characteristics, a logistic prediction model was developed. An area under the curve (AUC) was drawn using the weighted score in logistic regression model. To evaluate the degree of overfitting of the predictive model, a 5-fold cross-validation procedure was performed. Results In multivariate logistic regression, clinical findings such as age >70 years, female gender, active TB, and computed tomography findings including atelectasis, stenosis, bronchial wall thickening, enlarged and calcified lymph nodes were significant diagnostic predictors for AF. The weighed score had an AUC of 0.939 [95% confidence interval (CI)=0.911–0.960], similar to the AUC obtained from internal validation (AUC=0.926, 95% CI=0.896–0.949). Conclusion The prediction model may be helpful for predicting AF based only on clinical and radiographic findings. However, further external validation is necessary. PMID:28120566

  13. 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

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

    PubMed

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

    2015-12-29

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

  15. Assessment of Cardiac Device Position on Supine Chest Radiograph in the ICU: Introduction and Applicability of the Aortic Valve Location Ratio.

    PubMed

    Ouweneel, Dagmar M; Sjauw, Krischan D; Wiegerinck, Esther M A; Hirsch, Alexander; Baan, Jan; de Mol, Bas A J M; Lagrand, Wim K; Planken, R Nils; Henriques, José P S

    2016-10-01

    The use of intracardiac assist devices is expanding, and correct position of these devices is required for optimal functioning. The aortic valve is an important landmark for positioning of those devices. It would be of great value if the device position could be easily monitored on plain supine chest radiograph in the ICU. We introduce a ratio-based tool for determination of the aortic valve location on plain supine chest radiograph images, which can be used to evaluate intracardiac device position. Retrospective observational study. Large academic medical center. Patients admitted to the ICU and supported by an intracardiac assist device. We developed a ratio to determine the aortic valve location on supine chest radiograph images. This ratio is used to assess the position of a cardiac assist device and is compared with echocardiographic findings. Supine anterior-posterior chest radiographs of patients with an aortic valve prosthesis (n = 473) were analyzed to determine the location of the aortic valve. We calculated several ratios with the potential to determine the position of the aortic valve. The aortic valve location ratio, defined as the distance between the carina and the aortic valve, divided by the thoracic width, was found to be the best performing ratio. The aortic valve location ratio determines the location of the aortic valve caudal to the carina, at a distance of 0.25 ± 0.05 times the thoracic width for male patients and 0.28 ± 0.05 times the thoracic width for female patients. The aortic valve location ratio was validated using CT images of patients with angina pectoris without known valvular disease (n = 95). There was a good correlation between cardiac device position (Impella) assessed with the aortic valve location ratio and with echocardiography (n = 53). The aortic valve location ratio enables accurate and reproducible localization of the aortic valve on supine chest radiograph. This tool is easily applicable and can be used for

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

    PubMed

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

    2016-07-01

    Susuk, or charm needles, are small, metallic needles inserted under the skin, considered to enhance beauty, health and luck. This hidden secret of inserting susuk is a traditional superstitious ritual, widely practiced among women of Southeast Asia. Here, we present an interesting case of incidental radiographic finding of the concealed art of susuk, which was exposed on a panoramic radiograph taken on a routine basis as a part of diagnostic work up at our centre. An orthopantomogram revealed bilateral metallic foreign bodies in the maxillo-facial region. Anamnestic data affirmed the practice of the body art of susuk. The charm needles were present in the orofacial region without the patient experiencing any pathological signs or symptoms. © The Author(s) 2015.

  17. 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

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

    PubMed

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

    2015-01-01

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

  19. 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

  20. 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.

  1. Automatic tissue characterization of air trapping in chest radiographs using deep neural networks.

    PubMed

    Mansoor, Awais; Perez, Geovanny; Nino, Gustavo; Linguraru, Marius George

    2016-08-01

    Significant progress has been made in recent years for computer-aided diagnosis of abnormal pulmonary textures from computed tomography (CT) images. Similar initiatives in chest radiographs (CXR), the common modality for pulmonary diagnosis, are much less developed. CXR are fast, cost effective and low-radiation solution to diagnosis over CT. However, the subtlety of textures in CXR makes them hard to discern even by trained eye. We explore the performance of deep learning abnormal tissue characterization from CXR. Prior studies have used CT imaging to characterize air trapping in subjects with pulmonary disease; however, the use of CT in children is not recommended mainly due to concerns pertaining to radiation dosage. In this work, we present a stacked autoencoder (SAE) deep learning architecture for automated tissue characterization of air-trapping from CXR. To our best knowledge this is the first study applying deep learning framework for the specific problem on 51 CXRs, an F-score of ≈ 76.5% and a strong correlation with the expert visual scoring (R=0.93, p =<; 0.01) demonstrate the potential of the proposed method to characterization of air trapping.

  2. 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.

  3. 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.

  4. A segmental analysis of thoracic shape in chest radiographs of children. Changes related to spinal level, age, sex, side and significance for lung growth and scoliosis.

    PubMed Central

    Grivas, T B; Burwell, R G; Purdue, M; Webb, J K; Moulton, A

    1991-01-01

    Thoracic ratios (TRs) were measured segmentally (T1-12) in the chest radiographs of 412 children aged 0-17 years attending hospital with minimal disorder or diseases (boys 193, girls 219). A new method for measuring TRs was used which calculates the width of the left hemithorax, the right hemithorax and the total thorax relative to T1-T12 distance. The data were analysed in 3 age groups--infancy, childhood and puberty, after the classification of Karlberg (1989). The findings are as follows. 1. The chest broadens from T1 to about T10-11. 2. Between infancy and childhood, relative to its length the chest narrows from above downwards and particularly in the lower chest (T5-12 average diminution, boys 9.5%, girls 9.8%). In the upper chest, the narrowing is more marked in girls than boys (T1-4 average diminution, boys 5.1%, girls 8.2%). 3. Between childhood and puberty, the girl's but not the boy's chest narrows further in its lower half (below T6 average diminution 3.3%). At T6 and above there is no detectable change in the relative width of the chest in either boys or girls. 4. The relative narrowing of the chest during growth appears to result from several mechanisms: (1) elevation of upper rib-vertebra angles (above 90 degrees); (2) drooping of lower rib-vertebra angles (below 90 degrees); and (3) linear rib growth being impaired relative to thoracic spinal growth in the lower ribcage (T6-12) of girls between childhood and puberty (Grivas et al. 1991 d). 5. The hypothesis is suggested that the relative narrowing of the lower chest with increasing age reduces the rotational inertia of the thorax in gait. There is a greater need for such reduction in girls because of the greater rotational inertia generated by the mass of their larger pelves. This hypothesis provides a mechanical explanation for the proportionate change in the girl's lung in the later stages of growth (Simon et al. 1972). 6. Developmentally, the left hemithorax is ahead of the right hemithorax in

  5. 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

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

    PubMed Central

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

    2017-01-01

    Abstract Background. Chest radiographs (CXRs) are a valuable diagnostic tool in epidemiologic studies of pneumonia. The World Health Organization (WHO) methodology for the interpretation of pediatric CXRs has not been evaluated beyond its intended application as an endpoint measure for bacterial vaccine trials. Methods. The Pneumonia Etiology Research for Child Health (PERCH) study enrolled children aged 1–59 months hospitalized with WHO-defined severe and very severe pneumonia from 7 low- and middle-income countries. An interpretation process categorized each CXR into 1 of 5 conclusions: consolidation, other infiltrate, both consolidation and other infiltrate, normal, or uninterpretable. Two members of a 14-person reading panel, who had undertaken training and standardization in CXR interpretation, interpreted each CXR. Two members of an arbitration panel provided additional independent reviews of CXRs with discordant interpretations at the primary reading, blinded to previous reports. Further discordance was resolved with consensus discussion. Results. A total of 4172 CXRs were obtained from 4232 cases. Observed agreement for detecting consolidation (with or without other infiltrate) between primary readers was 78% (κ = 0.50) and between arbitrators was 84% (κ = 0.61); agreement for primary readers and arbitrators across 5 conclusion categories was 43.5% (κ = 0.25) and 48.5% (κ = 0.32), respectively. Disagreement was most frequent between conclusions of other infiltrate and normal for both the reading panel and the arbitration panel (32% and 30% of discordant CXRs, respectively). Conclusions. Agreement was similar to that of previous evaluations using the WHO methodology for detecting consolidation, but poor for other infiltrates despite attempts at a rigorous standardization process. PMID:28575359

  7. The relation of exposure to asbestos and smoking habit with pulmonary function tests and chest radiograph.

    PubMed

    Dave, S K; Ghodasara, N B; Mohanrao, N; Patel, G C; Patel, B D

    1997-01-01

    Environmental cum medical study was conducted in asbestos cement factory. The environment was evaluated for asbestos fiber by the methods recommended by BIS. Total 355 exposed and 312 suitably matched control workers were investigated by spirometer, Wright's peak flow meter and full sized postero-anterior chest radiograph. The levels of asbestos fiber were 2 to 3 times higher than TLV i.e. 2 f/ml in pipe cutting dept., crude fiber grinding inlet count was more than the ACGIH recommended limit i.e. 5 mpccf of air in pipe cutting dept. and silica mill. In the rest of the department, fiber level as well as dust particle count were below prescribed limit. The comparison of mean values of PFT parameters of workers with 16-20 years exposure history with control one was showing statistically significant decline in mean values of FVC only suggesting restrictive type of PFT impairment in this group of workers. But in workers with more than 20 years exposure, the mean values of all the parameters studied were reduced as compared to control one suggesting combined type of PFT impairment. When the mean values of PFT parameters of exposed smokers were compared with exposed non-smokers there was statistically no significant difference. This can be due to marginal contribution of smoking habit in impairment of PFT parameters of exposed smokers. The percentages of workers with parenchymal and pleural changes due to asbestos exposure were nearly two times more in more than 20 years exposure groups as compared to 11-20 years exposure groups. The parenchymal and pleural changes due to asbestos exposure were more common in exposed smokers as compared exposed non-smokers. However the detailed analysis revealed that if smoking contributes to the development of interstitial fibrosis, the contribution is a marginal one in comparison to the effect of asbestos dust exposure.

  8. 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

  9. 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

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

    PubMed

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

    2006-12-01

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

  11. 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

  12. CT radiographic findings: atrio-esophageal fistula after transcatheter percutaneous ablation of atrial fibrillation.

    PubMed

    Malamis, Angelo P; Kirshenbaum, Kevin J; Nadimpalli, Surya

    2007-05-01

    Radio-frequency catheter ablation (RFCA) is an ever increasing modality for treating refractory atrial fibrillation. Radiologists should not only be able to interpret and convey anatomic variations of pulmonary veins and left atrium to referring electrophysiologists, but also should be aware of all the post-RFCA complications and their radiographic findings including this rare, but often fatal complication. This report describes a fatal atrio-esophageal fistula (AEF) involving a normal variant single left common pulmonary vein after transcatheter ablation. A 59-year-old man who presented to the Emergency Department (ED) with altered mental status previously complaining of fatigue and malaise. The patient underwent a total of 2 uneventful circumferential percutaneous pulmonary vein ablations for atrial fibrillation. The most recent was performed 5 weeks before admission to ED. Within hours of initial evaluation, the patient quickly deteriorated owing to overwhelming sepsis requiring both inotropic and ventilatory support. Transthoracic echocardiography within ED showed no evidence of valvular vegetation or gas bubbles in the left atrium. Computed tomography (CT) of the chest with intravenous contrast revealed findings compatible with AEF. Head CT was negative for ischemic changes or emboli. Patient underwent emergent cardiac and esophageal surgery at which point the patient later died on the operating table. Patients who present with signs and symptoms of endocarditis, and particularly with new neurologic symptom after RFCA should be promptly evaluated for AEF. In our case, radiographic findings in correlation with clinical history and high suspicion strongly suggested this rare, often fatal complication. During review of the chest CT, particular vigilance should be made to the left pulmonary vein/posterior left atrium junction at which site fistulous tracts tend to occur. Prompt diagnosis necessitates emergent cardiac and esophageal surgery to prevent rapid

  13. Hematologic neoplasms: interpreting lung findings in chest computed tomography.

    PubMed

    Calvillo Batllés, P; Carreres Polo, J; Sanz Caballer, J; Salavert Lletí, M; Compte Torrero, L

    2015-01-01

    Lung disease is very common in patients with hematologic neoplasms and varies in function of the underlying disease and its treatment. Lung involvement is associated with high morbidity and mortality, so it requires early appropriate treatment. Chest computed tomography (CT) and the analysis of biologic specimens are the first line diagnostic tools in these patients, and sometimes invasive methods are necessary. Interpreting the images requires an analysis of the clinical context, which is often complex. Starting from the knowledge about the differential diagnosis of lung findings that radiologists acquire during training, this article aims to explain the key clinical and radiological aspects that make it possible to orient the diagnosis correctly and to understand the current role of CT in the treatment strategy for this group of patients. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  14. [Welders' siderosis: a retrospective cohort study on welder's pneumoconiosis patients with small round opacities on chest radiograph].

    PubMed

    Mao, Ling; Shi, Jin; Chen, Zidan; Zhang, Jingbo

    2014-11-01

    To study the radiographycal changes and prognosis of welders' pneumoconiosis patients diagnosed within the last few years. Occupational hygienics data (including years on welding work, welding materials exposed to and work environment), symptoms, lung function test results and follow-up data of 136 welders' pneumoconiosis patients were collected retrospectively. The follow-up lasted up till June 30, 2014, with follow-up interval being one year. Chest radiographs were read/reviewed together by 3 senior experts experienced in pneumoconiosis diagnosing and shape and size of small opacity, overall profusion, affected lung zones and pneumoconiosis stages were all logged. Of all 136 pneumoconiosis cases, five were of stage II and 131 were stage I, and they had been engaged in welding work for 9.2±6.34 years. All patients were present with slight symptoms including coughing, chest distress and dyspnea, while their lung function remained normal. Small round opacities were found on chest radiographs of 88.9% of the 136 cases. Years of follow-up on 131 cases of stage I Welder's pneumoconiosis showed that irregular small opacities remained fundamentally unchanged, while small round opacities tended to gradually lessen instead of coalescence. Two years after primary diagnosing, the total affected lung zones of follow-up objects were noticed to start lessening, and reduced by 0.02 per patient among the 48 follow-up subjects. Of the 48 cases followed up up to six years after primary diagnosing, the affected lung zone number was reduced by 0.54 per patient while 4 cases (8%) went down to below stage I. As of the 36 patients followed up 10 years after after primary diagnosis, the number of affected lung areas decreased by 1.14, and 22% (8 cases) appeared less than stage I on chest radiograph. It seemed that the so-called welders' pneumoconiosis featuring small round opacities tended to get improved over time, which suggested the diagnosis of siderosis.

  15. Using Standardized Interpretation of Chest Radiographs to Identify Adults with Bacterial Pneumonia--Guatemala, 2007-2012.

    PubMed

    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

    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. 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. 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. 'Endpoint consolidation' was associated with 'any bacterial infection

  16. 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.

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

    NASA Astrophysics Data System (ADS)

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

    1984-08-01

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

  18. Risk and significance of chest radiograph and pulmonary function abnormalities in an elderly cohort of former nuclear weapons workers.

    PubMed

    Mikulski, Marek A; Hartley, Patrick G; Sprince, Nancy L; Sanderson, Wayne T; Lourens, Spencer; Worden, Nicole E; Wang, Kai; Fuortes, Laurence J

    2011-09-01

    To estimate prevalence and risk factors for International Labour Organization radiographic abnormalities, and assess relationship of these abnormalities with spirometry results in former Department of Energy nuclear weapons workers. Participants were offered chest x-ray (CXR) and lung function testing. Three occupational medicine physicians read CXRs. Forty-five (5.9%) of 757 screened workers were found to have isolated parenchymal abnormalities on CXR and this rate is higher than that in many Department of Energy studies. Parenchymal and pleural and isolated pleural abnormalities were found in 19 (2.5%) and 37 (4.9%) workers, respectively, and these rates are lower than those in other Department of Energy studies to date. Lung function impairment was associated with radiographic abnormalities. This study found an elevated rate of parenchymal abnormalities compared to other DoE populations but the effect of age or other causes could not be ruled out. (C)2011The American College of Occupational and Environmental Medicine

  19. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2017-02-01

    Single image super-resolution (SR) method can generate a high-resolution (HR) image from a low-resolution (LR) image by enhancing image resolution. In medical imaging, HR images are expected to have a potential to provide a more accurate diagnosis with the practical application of HR displays. In recent years, the super-resolution convolutional neural network (SRCNN), which is one of the state-of-the-art deep learning based SR methods, has proposed in computer vision. In this study, we applied and evaluated the SRCNN scheme to improve the image quality of magnified images in chest radiographs. For evaluation, a total of 247 chest X-rays were sampled from the JSRT database. The 247 chest X-rays were divided into 93 training cases with non-nodules and 152 test cases with lung nodules. The SRCNN was trained using the training dataset. With the trained SRCNN, the HR image was reconstructed from the LR one. We compared the image quality of the SRCNN and conventional image interpolation methods, nearest neighbor, bilinear and bicubic interpolations. For quantitative evaluation, we measured two image quality metrics, peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). In the SRCNN scheme, PSNR and SSIM were significantly higher than those of three interpolation methods (p<0.001). Visual assessment confirmed that the SRCNN produced much sharper edge than conventional interpolation methods without any obvious artifacts. These preliminary results indicate that the SRCNN scheme significantly outperforms conventional interpolation algorithms for enhancing image resolution and that the use of the SRCNN can yield substantial improvement of the image quality of magnified images in chest radiographs.

  1. Paleopathological findings in radiographs of ancient and modern Greek skulls.

    PubMed

    Papagrigorakis, Manolis J; Karamesinis, Kostas G; Daliouris, Kostas P; Kousoulis, Antonis A; Synodinos, Philippos N; Hatziantoniou, Michail D

    2012-12-01

    The skull, when portrayed radiologically, can be a useful tool in detecting signs of systemic diseases and results of pathological growth mechanisms. The aim of this study was therefore to examine, compare, and classify findings in cranial configuration of pathological origin, in modern and ancient skulls. The material consists of 240 modern and 141 ancient dry skulls. Three radiographs for each skull (lateral, anteroposterior, basilar) provide enough evidence for differential diagnoses. Cases of osteoporosis are among the interesting pathological findings. A prevalence of female modern skulls in those determined as osteoporotic skulls is noted. Special interest is placed on the area of the sella turcica and many variations, regarding the shape and texture, are recognized both in ancient and modern skulls. Malignancies and important causes of cranial destruction are identified in both skull collections. Diploid thickening and osteolytic areas appear commonly among ancient remains. Moreover, from the ancient skull collection, one case possibly recognizable as fibrous dysplasia is noted while another case with an unusual exostosis gives rise to many questions. Interpreted with caution, the results of the present study, which can serve as an approach of paleopathology and paleoradiology, indicate similarity trends in cranial configuration of pathologic origin in modern and ancient people. Radiography and cephalometry were the main diagnostic tools used to gather evidence and are evaluated as a quite appropriate method to examine anthropological material and assess the internal structure of skeletal remains since they are non-destructive techniques.

  2. Establishing the Cardiothoracic Ratio Using Chest Radiographs in an Indigenous Ghanaian Population: A Simple Tool for Cardiomegaly Screening.

    PubMed

    Mensah, Y B; Mensah, K; Asiamah, S; Gbadamosi, H; Idun, E A; Brakohiapa, W; Oddoye, A

    2015-09-01

    Cardiothoracic ratio is a simple and cheap tool in the estimation of heart size. It is a useful index of cardiac size evaluation, and a value of 50% is generally considered to indicate the upper limit of normal. This study is to ascertain the normal mean value in cardiothoracic ratio of Ghanaians using chest radiography to serve as baseline for screening for cardiomegaly. Standard postero-anterior radiographs of the -clients/patients were used in the study. The cardiothoracic ratio (CTR) was obtained by dividing the transverse cardiac diameter [sum of the horizontal distances from the right and left lateral-most margins of the heart to the midline (spinous processes of the vertebral bodies)] by the maximum internal thoracic diameter. Systematic sampling with appropriate inclusion and exclusion criteria were used to obtain a sample size of 1989. The mean transverse cardiac diameter and cardiothoracic ratio increased with age. The transverse thoracic diameter increased with age until the sixth decade when it reduced with age. The mean CTR increased gradually with age with females having greater values than males. The mean CTR of the study population were 0.459, 0.467 and 0.452 for the general population, females and males respectively. This study has been able to establish 0.459 as the mean CTR values for Ghanaians. It has also shown the relationship between age and clients/patient's cardiothoracic ratio which compares favourably with findings of a similar study in Nigeria, a neighbouring country in the West African sub region with similar ethnic and social structure.

  3. 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…

  4. Diagnostic accuracy of computer-aided detection of pulmonary tuberculosis in chest radiographs: a validation study from sub-Saharan Africa.

    PubMed

    Breuninger, Marianne; van Ginneken, Bram; Philipsen, Rick H H M; Mhimbira, Francis; Hella, Jerry J; Lwilla, Fred; van den Hombergh, Jan; Ross, Amanda; Jugheli, Levan; Wagner, Dirk; Reither, Klaus

    2014-01-01

    Chest radiography to diagnose and screen for pulmonary tuberculosis has limitations, especially due to inter-reader variability. Automating the interpretation has the potential to overcome this drawback and to deliver objective and reproducible results. The CAD4TB software is a computer-aided detection system that has shown promising preliminary findings. Evaluation studies in different settings are needed to assess diagnostic accuracy and practicability of use. CAD4TB was evaluated on chest radiographs of patients with symptoms suggestive of pulmonary tuberculosis enrolled in two cohort studies in Tanzania. All patients were characterized by sputum smear microscopy and culture including subsequent antigen or molecular confirmation of Mycobacterium tuberculosis (M.tb) to determine the reference standard. Chest radiographs were read by the software and two human readers, one expert reader and one clinical officer. The sensitivity and specificity of CAD4TB was depicted using receiver operating characteristic (ROC) curves, the area under the curve calculated and the performance of the software compared to the results of human readers. Of 861 study participants, 194 (23%) were culture-positive for M.tb. The area under the ROC curve of CAD4TB for the detection of culture-positive pulmonary tuberculosis was 0.84 (95% CI 0.80-0.88). CAD4TB was significantly more accurate for the discrimination of smear-positive cases against non TB patients than for smear-negative cases (p-value<0.01). It differentiated better between TB cases and non TB patients among HIV-negative compared to HIV-positive individuals (p<0.01). CAD4TB significantly outperformed the clinical officer, but did not reach the accuracy of the expert reader (p = 0.02), for a tuberculosis specific reading threshold. CAD4TB accurately distinguished between the chest radiographs of culture-positive TB cases and controls. Further studies on cost-effectiveness, operational and ethical aspects should determine its

  5. 42 CFR 37.42 - Chest radiograph specifications-digital radiography systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... radiograph specifications—digital radiography systems. (a) Miners must be disrobed from the waist up at the... maximum pixel pitch of 200µm, with a minimum bit depth of 10. Spatial resolution must be at least 2.5 line...

  6. Mediastinal evaluation utilizing the reverse Trendelenburg radiograph.

    PubMed

    Barker, D E; Crabtree, J D; White, J E; Somberg, L B; Burns, R P

    1999-05-01

    When thoracic aortic rupture is suspected, a 45-degree reverse Trendelenburg (RT) anteroposterior (AP) chest radiograph should place the mediastinal structures in a more appropriate position and allow a more accurate evaluation than a supine AP radiograph. One hundred ninety-one consecutive hemodynamically stable adult patients with major blunt thoracic trauma were initially evaluated for mediastinal abnormalities associated with aortic disruption by both supine AP chest radiograph and an AP chest radiograph with the patient in 45-degree RT position. One hundred four patients underwent contrast aortography based on mediastinal abnormalities detected on the supine AP chest radiograph. Twenty of these patients had abnormal aortograms demonstrating traumatic aortic disruption confirmed at surgery. Supine and RT chest radiographs were retrospectively compared in a blinded fashion to evaluate their specificity and positive predictive value for detection of traumatic thoracic aortic rupture. If RT chest radiographic findings had been used to determine the need for further assessment, 29 angiograms (26%) would have been eliminated, specificity would have increased from 52 per cent to 69 per cent, and positive predictive value would have increased from 19 per cent to 27 per cent. Both supine and RT chest radiographs demonstrated mediastinal widening in all 20 patients with abnormal aortograms, with no missed thoracic aortic disruptions (100% sensitivity). This study indicated that the RT chest radiograph may be used instead of the standard supine radiograph as the initial screen for mediastinal evaluation, maintaining a high sensitivity and eliminating the cost and morbidity of many unnecessary aortograms.

  7. 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

  8. Traumatic pericarditis in cattle: clinical, radiographic and ultrasonographic findings.

    PubMed

    Braun, U

    2009-11-01

    Pericarditis is an inflammation of the pericardium with accumulation of serous or fibrinous inflammatory products. In cattle, it is almost always attributable to a reticular foreign body that has penetrated the reticular wall, diaphragm and pericardial sac. The lead signs of pericarditis are tachycardia, muffled heart sounds, asynchronous abnormal heart sounds, distension of the jugular veins and submandibular, brisket and ventral abdominal oedema. The glutaraldehyde test is an important diagnostic tool because it is positive in >90% of affected cattle. Other common laboratory findings are leukocytosis and hyperfibrinogenaemia (indicating inflammation), and elevation of liver enzyme activity (reflecting hepatic congestion). Radiographs of the thorax and reticulum often show a foreign body cranial to the reticulum. In the majority of cases, massive fibrinopurulent adhesions obscure the cardiophrenic angle, cardiac silhouette and ventral diaphragm. Ultrasonography is the method of choice for diagnosis and characterisation of pericardial effusion. Echogenic deposits and strands of fibrin are seen on the epicardium, and the ventricles are compressed by the effusion. Severe pleural effusion is usually evident. In cattle with distension of the jugular veins and tachycardia, the differential diagnosis includes right-sided cardiac insufficiency attributable to other causes. Distension of the jugular veins without signs of right-sided cardiac insufficiency may occur with obstruction or compression of the cranial vena cava. The prognosis is poor, and pericardiocentesis or pericardiotomy are inadequate methods of treatment. Thus, prompt and humane euthanasia is indicated for cattle with traumatic reticuloperitonitis. Because a definitive diagnosis of traumatic reticuloperitonitis is not always possible based on clinical signs alone, radiography and ultrasonography of the thorax and reticulum are indicated in doubtful cases.

  9. 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.

  10. 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.

  11. 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...

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

    SciTech Connect

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

    1982-06-01

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

  13. Radiographic findings of femoroacetabular impingement in National Football League Combine athletes undergoing radiographs for previous hip or groin pain.

    PubMed

    Nepple, Jeffrey J; Brophy, Robert H; Matava, Matthew J; Wright, Rick W; Clohisy, John C

    2012-10-01

    The purpose of this study was to investigate the prevalence of radiographic findings of femoroacetabular impingement (FAI) in elite football players with a history of hip pain or groin injury who underwent radiographs. We performed a retrospective review of athletes undergoing hip radiography at the National Football League Combine from 2007 to 2009. Radiographs were obtained in athletes with a history of hip pain or injury. Anteroposterior pelvis and frog-lateral radiographs were obtained in 123 hips (107 players) that met our inclusion criteria. Radiographic indicators of cam-type FAI (alpha angle, head-neck offset ratio) and pincer-type FAI (acetabular retroversion, center-edge angle, acetabular inclination) were recorded. Findings were correlated with clinical factors (previous groin/hip pain, position, race, and body mass index). The most common previous injuries included groin strain (n = 57) and sports hernia/abdominal strain (n = 21). Markers of cam- and/or pincer-type FAI were present in 94.3% of hips (116 of 123). Radiographic evidence of combined cam- and pincer-type FAI was the most common (61.8%, 76 hips), whereas isolated cam-type FAI (9.8%, 12 hips) and pincer-type FAI (22.8%, 28 hips) were less common. The most common deformities included acetabular retroversion (71.5%) and an abnormal alpha angle (61.8%). A body mass index greater than 35 was associated with the presence of global overcoverage (46.2% v 17.3%, P = .025). Radiographic indicators of FAI are very common among athletes evaluated at the National Football League Scouting Combine subjected to radiographic examination for the clinical suspicion of hip disease. Elite football athletes with significant or recurrent pain about the hip should be evaluated clinically and radiographically for FAI, because pain from FAI may be falsely attributed to or may be present in addition to other disorders. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America

  14. Difference of achalasia subtypes based on clinical symptoms, radiographic findings, and stasis scores.

    PubMed

    Meillier, A; Midani, D; Caroline, D; Saadi, M; Parkman, H; Schey, R

    2017-05-31

    Three subtypes of achalasia have been defined through high-resolution esophageal manometry: subtype i shows no pressurization with swallows, subtype ii has increased isobaric panesophageal pressure, and subtype iii has distal esophageal spastic non-isobaric contractions. Studies describing the subtypes based on radiographic findings, clinical symptoms, and stasis scores are limited. To determine the differences in clinical symptoms, radiographic findings, and stasis scores for the 3 achalasia subtypes. Patients undergoing high-resolution esophageal manometry received a questionnaire about current symptoms and previous treatments. The questions included the presence of symptoms and their severity. Barium swallow tests were performed before the high-resolution esophageal manometry study to evaluate the maximum esophageal diameter. Stasis scores were calculated using the transit patterns on high-resolution esophageal manometry. One hundred and eight patients with high-resolution esophageal manometry diagnosis of achalasia (n=8, subtype i; n=84, subtype ii; n=16, subtype iii) within the time frame of 1/2012-6/2015 were included in the study. Sex distribution was similar between the subtypes. Patient age was younger for subtype i (38±16 years), compared with subtypes ii (55±17 years) and iii (63±17 years) (P=.03). Esophageal symptoms did not differ between subtypes regarding the severity of nausea, chest pain, coughing, and heartburn, except for increased vomiting severity in subtype i (2.8±1.4 vs. 1.4±1.4 vs. 1.2±1.2, P<.01). A significant radiographic difference in esophageal dilation was seen between subtypes ii and iii (35.1±14.4 vs. 24.0±7.2mm, P=.023). Stasis scores did not significantly differ between the subtypes. Achalasia subtypes had similar clinical symptoms, except for increased vomiting severity in subtype i. The maximum esophageal diameter in subtype ii was significantly greater than in subtype iii. Esophageal stasis scores were similar. Thus

  15. 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%.

  16. 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.

  17. 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.

  18. [Radiographic diagnosis of abdominal diseases in foals and ponys. II. Pathologic findings in 60 cases].

    PubMed

    Gerhards, H; Klein, H J; Offeney, F

    1990-08-01

    A diagnostic approach based on clinical and radiographic examinations for evaluation of young foals and small ponies with acute abdominal discomfort is presented. Standing right to left lateral abdominal radiographs were taken of 54 foals and 6 ponies using a previously described technique. Interpretation of the radiographs was in conjunction with all clinical and laboratory findings and patient management. Using this approach, the site and cause of acute abdominal discomfort could be diagnosed accurately in 55 of 60 (91%) patients as confirmed by clinical, surgical or necropsy findings. Typical radiographs and photographs taken at surgery or at necropsy are presented. Typical radiographic findings, their interpretation and possible underlying gastrointestinal diseases are listed. The incorporation of standing lateral abdominal radiography in the clinical evaluation of foals and ponies with acute abdominal diseases gives findings of high diagnostic significance and should contribute to clinical decision-making. Abdominal radiography can replace data from rectal palpation in foals and ponies.

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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.

  4. Application of artificial neural networks for reduction of false-positive detections in digital chest radiographs.

    PubMed

    Lin, J S; Ligomenides, P A; Freedman, M T; Mun, S K

    1993-01-01

    A methodology based on the fuzzy set theory and the convolution neural network (CNN) architecture is proposed to tackle the problem of reducing false-positive rate in automatic lung nodule detection. The CNN which simulates human visual mechanism was trained by a supervised back-propagation algorithm based on fuzzy membership functions. The training and testing database consists of image blocks (each 32 x 32 pixels) of suspected lung nodule areas (nodule candidates) which were generated from our pre-scanning program [1]. A linguistic label was assigned to each nodule candidate of the training set, then the label was converted to a membership value through a pre-defined membership function and used as teaching signal (desired outputs) during the network learning. Before the nodule candidate was fed to the network input, it was pre-processed to reduce the complex background noise and the contrast discrepancy resulted from film development. During the network testing phase, a defuzzification process was applied to decipher the trained network's output triggered by the nodule candidate in the testing set. Finally, a Receiver Operating Characteristic (ROC) analysis was used to evaluate the CNN's performance based on the defuzzified output of the testing database. Preliminary results showed an average Az (the performance index) of 0.84 which is equivalent to 0.80 true-positive detection (sensitivity) with an average 2-3 false-positive detections per chest image.

  5. Application of artificial neural networks for reduction of false-positive detections in digital chest radiographs.

    PubMed Central

    Lin, J. S.; Ligomenides, P. A.; Freedman, M. T.; Mun, S. K.

    1993-01-01

    A methodology based on the fuzzy set theory and the convolution neural network (CNN) architecture is proposed to tackle the problem of reducing false-positive rate in automatic lung nodule detection. The CNN which simulates human visual mechanism was trained by a supervised back-propagation algorithm based on fuzzy membership functions. The training and testing database consists of image blocks (each 32 x 32 pixels) of suspected lung nodule areas (nodule candidates) which were generated from our pre-scanning program [1]. A linguistic label was assigned to each nodule candidate of the training set, then the label was converted to a membership value through a pre-defined membership function and used as teaching signal (desired outputs) during the network learning. Before the nodule candidate was fed to the network input, it was pre-processed to reduce the complex background noise and the contrast discrepancy resulted from film development. During the network testing phase, a defuzzification process was applied to decipher the trained network's output triggered by the nodule candidate in the testing set. Finally, a Receiver Operating Characteristic (ROC) analysis was used to evaluate the CNN's performance based on the defuzzified output of the testing database. Preliminary results showed an average Az (the performance index) of 0.84 which is equivalent to 0.80 true-positive detection (sensitivity) with an average 2-3 false-positive detections per chest image. PMID:8130511

  6. Evaluation of a new phosphor plate technology for neonatal portable chest radiographs.

    PubMed

    Cohen, Mervyn; Corea, Donald; Wanner, Matthew; Karmazyn, Boaz; Gunderman, Richard; Applegate, Kimberly; Jennings, Samuel G

    2011-02-01

    The aim of this study was to evaluate a new thick-needle phosphor plate for computed radiography. Two studies were performed. Patients acted as their own controls. In the first study, old powder and new needle phosphor plate technologies were compared. Twenty infants were identified who had undergone chest x-rays with both systems within 3 days of each other. Exposure factors were constant. In the second study, standard and reduced exposure techniques (tube current-time product reduced by 20%) using the needle phosphor technology were compared. Twenty babies who had been imaged with both standard and reduced exposures within 3 days of each other were evaluated. There was a significant preference for images obtained with the new needle phosphor technology compared with the older powder technology (P < .01). Using the new needle phosphor plates, a dose reduction of 20% could be achieved without a significant detectable difference between the high-dose and low-dose images (P < .19). For the study comparing old and new phosphor plate technology at fixed exposure, images were better with the new technology. Using the new plate technology, dose can be decreased by ≥20%. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. Radiographic findings in the jaws of clinically edentulous old people living at home in Helsinki, Finland.

    PubMed

    Soikkonen, K; Ainamo, A; Wolf, J; Xie, Q; Tilvis, R; Valvanne, J; Erkinjuntti, T

    1994-08-01

    In the present survey the radiographic findings in the jaws of 124 clinically edentulous old people living at home in Helsinki, Finland, were studied, using panoramic radiography supplemented by intraoral radiographs. Only 9% of the subjects had root remains. Impacted teeth were found in 4%, radiolucent lesions in 3%, and radiopaque findings in 13%. Deviations from normal condylar structure were found in 17% and mucosal thickenings in the maxillary sinuses in 7%. The mental foramen was situated at the top of the residual ridge in 42% of the subjects. Topically situated mental foramen and condylar changes were commoner in women. The radiographic oral health status of the population studied was good.

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

    PubMed

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

    2014-01-01

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

  10. Prevalence of Pathologic Findings in Panoramic Radiographs: Calcified Carotid Artery Atheroma

    PubMed Central

    Gonçalves, Jéssica Rodrigues da Silva Noll; Yamada, Juliana Laís Yoshie; Berrocal, Cristina; Westphalen, Fernando Henrique; Franco, Ademir

    2016-01-01

    Objectives To assess the prevalence of images suggestive of calcified carotid artery atheromas (ISCCAA) in panoramic radiographs of patients under dental treatment. Materials and methods The sample consisted of 8.338 panoramic radiographs from female (n=5.049) and male (n=3.289) patients under dental treatment between 4 and 94 years of age. The panoramic radiographs were evaluated searching for ISCCAA. The obtained findings were statistically associated with sex and age. Results ISCCAA were found in 579 radiographs (6.9%). No statistically significant differences were observed between females and males (p>0.05). ISCCAA were more prevalent in patients having a mean age of 50 (p<0.05). Conclusion The potential cases of ISCCAA that were assessed on panoramic radiographs are of utmost clinical significance because they can ensure early and correct diagnosis. PMID:27847396

  11. 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...

  12. The impact of an early-morning radiologist work shift on the timeliness of communicating urgent imaging findings on portable chest radiography.

    PubMed

    Kaewlai, Rathachai; Greene, Reginald E; Asrani, Ashwin V; Abujudeh, Hani H

    2010-09-01

    The aim of this study was to assess the potential impact of staggered radiologist work shifts on the timeliness of communicating urgent imaging findings that are detected on portable overnight chest radiography of hospitalized patients. The authors conducted a retrospective study that compared the interval between the acquisition and communication of urgent findings on portable overnight critical care chest radiography detected by an early-morning shift for radiologists (3 am to 11 am) with historical experience with a standard daytime shift (8 am to 5 pm) in the detection and communication of urgent findings in a similar patient population a year earlier. During a 4-month period, 6,448 portable chest radiographic studies were interpreted on the early-morning radiologist shift. Urgent findings requiring immediate communication were detected in 308 (4.8%) studies. The early-morning shift of radiologists, on average, communicated these findings 2 hours earlier compared with the historical control group (P < .001). Staggered radiologist work shifts that include an early-morning shift can improve the timeliness of reporting urgent findings on overnight portable chest radiography of hospitalized patients. Published by Elsevier Inc.

  13. Autoimmune Pancreatitis: A Case of Atypical Radiographic Findings

    PubMed Central

    Karimi, Shawhin; Bharill, Parth

    2016-01-01

    Autoimmune pancreatitis (AIP) is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD). AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids. PMID:27920645

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

    PubMed Central

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

    2015-01-01

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

  15. Adynamic ileus after caesarean section mimicking intestinal obstruction: findings on abdominal radiographs.

    PubMed

    Kammen, B F; Levine, M S; Rubesin, S E; Laufer, I

    2000-09-01

    The purpose of this study was to determine the spectrum of findings and the frequency of apparent distal colonic obstruction on abdominal radiographs in women with obstructive symptoms following Caesarean section. A search of radiology files yielded 21 patients who had abdominal radiographs because of obstructive symptoms during the early post-operative period. The radiographs were reviewed retrospectively to characterize the bowel gas patterns in these patients. Medical records were also reviewed to determine the treatment and patient course. Abdominal radiographs showed findings suggestive of distal colonic obstruction in 15 patients (71%), small bowel obstruction in 2 (10%), adynamic ileus in 3 (14%) and a normal bowel gas pattern in 1 (5%). In all 15 patients with apparent distal colonic obstruction, there was minimal or no gas in the rectosigmoid, with an associated pelvic mass representing the enlarged post-partum uterus, which compressed the rectosigmoid and prevented it from filling with gas. All 21 patients had rapid clinical or radiographic improvement on conservative management, indicating a transient post-operative ileus. Radiologists should be aware of the limitations of abdominal plain radiographs following Caesarean section so that a post-operative ileus is not mistaken for a distal colonic obstruction and conservative measures can be undertaken to decompress the bowel until the ileus resolves.

  16. Pediatric atlanto-occipital dissociation: radiographic findings and clinical outcome

    PubMed Central

    du Plessis, Jean-Pierre; Dix-Peek, Stewart; Hoffman, Eduard Bernard; Wieselthaler, Nicky; Dunn, Robert Neil

    2012-01-01

    Study design: Retrospective diagnostic feasibility study and clinical review. Objectives: To evaluate the feasibility of making an initial atlanto-occipital dissociation (AOD) diagnosis from four radiological measurements of the craniocervical relationship on lateral cervical spine x-rays and to assess the AOD patients' clinical outcomes relative to their magnetic resonance imaging (MRI) findings. Methods: The Powers ratio, Wackenheim line, basion-dens distance (BDD), and the C1/2:C2/3 interspinous ratio were measured in 58 pediatric controls and ten MRI-confirmed patients with AOD. The ability to identify the required anatomical landmarks and make the measurements was noted and sensitivity and specificity calculated. The correspondence between the clinical presentation and outcomes for patients with AOD and their MRI features was investigated. Results: Clear landmarks for measuring interspinous ratio and Wackenheim line were confirmed by all x-rays. The BDD was measureable in 90% and the Powers ratio could be calculated in only possible in 59%. The interspinous ratio and BDD offered high sensitivities and specificity. Although the Wackenheim line was consistantly measured, it conferred a low sensitivity but reasonable specificity. The Powers ratio offered high specificity with low sensitivity. On MRI, all patients with AOD had apical ligament disruption, with a high rate of interspinous ligamentous injury (8/9); prevertebral swelling (7/9); retroclival hematoma (6/9); and tectorial membrane injury (4/9). The only MRI feature associated with poor outcome was that of altered cord signal. Both patients who died had cord signal changes on T1- and T2-weighted images. The third patient with cord signal change was limited to T2 changes with a normal T1. He had a C5-L3 sensory deficit that resolved. The degree of tectorial membrane injury did not appear to influence outcome. Conclusions: The BDD and interspinous ratio offer the best measures for initial x

  17. 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.

  18. Bone Disease in the Common Marmoset: Radiographic and Histological Findings.

    PubMed

    Olson, E J; Shaw, G C; Hutchinson, E K; Schultz-Darken, N; Bolton, I D; Parker, J B; Morrison, J M; Baxter, V K; Pate, K A Metcalf; Mankowski, J L; Carlson, C S

    2015-09-01

    The common marmoset (Callithrix jacchus) is a New World primate that is used in biomedical research due to its small size and relative ease of handling compared with larger primates. Although bone disease in common marmosets is well recognized, there are very few detailed descriptions in the literature that cover the range of lesions seen in these animals. For all animals used to model human disease, it is important to be aware of background lesions that may affect the interpretation of study findings. This retrospective study details bone diseases encountered in marmoset breeding colonies at 2 different institutions. Affected marmosets at Johns Hopkins University had lesions compatible with diagnoses of rickets, fibrous osteodystrophy and osteopenia. Affected marmosets at the Wisconsin National Primate Research Center exhibited severe lesions of osteoclastic bone resorption and remodeling that had an unusual distribution and were not easily categorized into a known disease entity. The purpose of this report is to document these naturally occurring skeletal lesions of common marmosets and suggest an approach to evaluating skeletal disease in prospective studies of these animals that will allow the most accurate diagnoses.

  19. 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

  20. Time-series analysis of lung texture on bone-suppressed dynamic chest radiograph for the evaluation of pulmonary function: a preliminary study

    NASA Astrophysics Data System (ADS)

    Tanaka, Rie; Matsuda, Hiroaki; Sanada, Shigeru

    2017-03-01

    The density of lung tissue changes as demonstrated on imagery is dependent on the relative increases and decreases in the volume of air and lung vessels per unit volume of lung. Therefore, a time-series analysis of lung texture can be used to evaluate relative pulmonary function. This study was performed to assess a time-series analysis of lung texture on dynamic chest radiographs during respiration, and to demonstrate its usefulness in the diagnosis of pulmonary impairments. Sequential chest radiographs of 30 patients were obtained using a dynamic flat-panel detector (FPD; 100 kV, 0.2 mAs/pulse, 15 frames/s, SID = 2.0 m; Prototype, Konica Minolta). Imaging was performed during respiration, and 210 images were obtained over 14 seconds. Commercial bone suppression image-processing software (Clear Read Bone Suppression; Riverain Technologies, Miamisburg, Ohio, USA) was applied to the sequential chest radiographs to create corresponding bone suppression images. Average pixel values, standard deviation (SD), kurtosis, and skewness were calculated based on a density histogram analysis in lung regions. Regions of interest (ROIs) were manually located in the lungs, and the same ROIs were traced by the template matching technique during respiration. Average pixel value effectively differentiated regions with ventilatory defects and normal lung tissue. The average pixel values in normal areas changed dynamically in synchronization with the respiratory phase, whereas those in regions of ventilatory defects indicated reduced variations in pixel value. There were no significant differences between ventilatory defects and normal lung tissue in the other parameters. We confirmed that time-series analysis of lung texture was useful for the evaluation of pulmonary function in dynamic chest radiography during respiration. Pulmonary impairments were detected as reduced changes in pixel value. This technique is a simple, cost-effective diagnostic tool for the evaluation of regional

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

    PubMed

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

    2016-10-01

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

  2. Chondrosarcoma of the maxilla: panoramic radiographic and computed tomographic with multiplanar reconstruction findings.

    PubMed

    Hayt, M W; Becker, L; Katz, D S

    1998-03-01

    Chondrosarcomas are extremely rare tumors of which approximately 10% are found in the maxillofacial region. In this report, we present the imaging findings of a maxillary chondrosarcoma on a panoramic radiograph of the jaws and computed tomography with multiplanar reconstructions. We recommend the latter as an excellent way to image evolving or suspected lesions of the maxilla, particularly for surgical treatment planning.

  3. Lethal injuries following building collapse: comparison between autopsy and radiographic findings.

    PubMed

    Guglielmi, G; Sica, G; Palumbo, L; D'Errico, S; Pomara, C; Fineschi, V; Scaglione, M

    2011-09-01

    The aim of this study was to evaluate the impact of conventional radiology on the assessment of causes of death of human beings after a building collapse and to establish whether the radiographic approach is useful and justifiable. Eight victims of a building collapse were subjected to autopsy, toxicology and radiographic examinations of the entire body. The autopsy findings, classified into three groups according to the New Injury Severity Score (NISS), were compared with radiographic findings. The death of the three individuals in group 1 was ascribed to mechanical asphyxia. Costal fractures, pneumothorax and subcutaneous emphysema were detected in one case only. The three individuals in group 2 died of mechanical asphyxia associated with cerebral injuries in all cases, abdominal injuries in two and cardiac injuries in one. Plain films showed skull fracture in one case, air within the cardiac chambers in another and diaphragmatic injuries in the third. The two individuals in group 3 died of injuries not compatible with life at the cardiac and abdominal level in both cases and at the cerebral level in one. Radiography showed multiple fractures of the cranium associated with diaphragmatic injuries in one case only. No significant pleuropulmonary radiographic findings were detected in any of the eight victims. Paralytic ileus, identified in all patients, is not strictly correlated to abdominal injuries. Skeletal injuries were all confirmed at conventional radiography. Conventional radiography allows for the overall assessment of skeletal injuries. Radiographic findings provide limited information about the causes of death, whereas findings related to the concomitant causes of death are more frequent. Conventional radiography should be considered inadequate, especially if the potential of the modern software tools available on current computed tomography and magnetic resonance images is considered.

  4. Radiographic Findings in Patients with Medication-Related Osteonecrosis of the Jaw

    PubMed Central

    Barros, Carolina Arrabal; Curra, Cláudia; Fernandes, Luciana Maria Paes da Silva Ramos; Franzolin, Solange de Oliveira Braga; Júnior, Joel Santiago Ferreira; De Antoni, Carlos César; Curi, Marcos Martins

    2017-01-01

    A retrospective study was conducted of the records and panoramic radiographs of 35 patients treated with bisphosphonates (BP) and diagnosed with MRONJ. Panoramic radiography was used for evaluation, by two examiners, the following findings were subject of search: osteolysis (OT), cortical bone erosion (EC), bone sclerosis focal (FS) and diffuse (DS), bone sequestration (BS), thickening of lamina dura (TD), prominence of the inferior alveolar nerve canal (IAN), persisting alveolar sockets (SK), and the presence of a pathological fracture (PF). Medical information and staging were also recorded in order to correlate with radiographic findings. Bone sclerosis was the most frequent alteration, followed by OT and TD. The mandible was more affected than the maxilla. There was no significant difference between genders or significant correlation between the number of injuries with age and duration of BP usage. Considering the association between the radiographic findings and MRONJ staging, EC was predominant in stage 3 and DS in stage 2. IAN and PF demonstrated greater association with stage 3. In conclusion, the higher the clinical staging, the greater the severity of the bone alteration. Panoramic radiographic examination is a useful screening tool in patients submitted to antiresorptive therapy. PMID:28352284

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

    PubMed

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

    2016-07-01

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

  6. 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.

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

    PubMed

    Cortés Campos, A; Martínez Rodríguez, M

    2014-01-01

    Atelectasis is an important indicator of potentially severe underlying disease that must be diagnosed as early as possible. One of the most common mechanisms is the reabsorption of air distal to respiratory tract obstruction. The chest x-ray is an excellent tool to diagnose atelectasis, and it is especially useful for ruling out central bronchial obstructions (e.g., from endobronchial tumors). If the signs of volume loss are not recognized correctly, the diagnosis and treatment can be delayed. This article describes the main findings of lobar atelectasis on chest x-rays and their correlations with CT findings, including the classic signs described in the literature and other, less known and sometimes subtle signs. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

  8. Radiographic evaluation of nasal septal deviation from computed tomography correlates poorly with physical exam findings.

    PubMed

    Sedaghat, Ahmad R; Kieff, David A; Bergmark, Regan W; Cunnane, Mary E; Busaba, Nicolas Y

    2015-03-01

    Performance of septoplasty is dependent on objective evidence of nasal septal deviation. Although physical examination including anterior rhinoscopy and endoscopic examination is the gold standard for evaluation of septal deviation, third-party payors' reviews of septoplasty claims are often made on computed tomography (CT) findings. However, the correlation between radiographic evaluation of septal deviation with physical examination findings is unknown. Retrospective, blinded, independent evaluation of septal deviation in 39 consecutive patients from physical examination, including anterior rhinoscopy and endoscopic examination, by an otolaryngologist and radiographic evaluation of sinus CT scan by a neuroradiologist. Four distinct septal locations (nasal valve, cartilaginous, inferior/maxillary crest and osseous septum) were evaluated on a 4-point scale representing (1) 0% to 25%, (2) >25% to 50%, (3) >50% to 75%, and (4) >75% obstruction. Correlation between physical examination and radiographic evaluations was made by Pearson's correlation and quantitative agreement assessed by Krippendorf's alpha. Statistically significant correlation was detected between physical examination including nasal endoscopy and radiographic assessment of septal deviation only at the osseous septum (p = 0.007, r = 0.425) with low quantitative agreement (α = 0.290). No significant correlation was detected at the cartilaginous septum (p = 0.286, r = 0.175), inferior septum (p = 0.117, r = 0.255), or nasal valve (p = 0.174, r = 0.222). Quantitative agreement at the nasal valve suggested a bias in CT to underestimate physical exam findings (α = -0.490). CT is a poor substitute for physical examination, the gold standard, in assessment of septal deviation. Clinical decisions about pursuit of septoplasty or third-party payors' decisions to approve septoplasty should not be made on radiographic evidence. © 2014 ARS-AAOA, LLC.

  9. Radiographic, computed tomographic, and ultrasonographic findings with migrating intrathoracic grass awns in dogs and cats.

    PubMed

    Schultz, Ryan M; Zwingenberger, Allison

    2008-01-01

    The purpose of this study was to describe the clinical, radiographic, and computed tomographic findings in dogs and cats with migrating intrathoracic grass awns. Thirty-five dogs and five cats with visual confirmation of a grass awn following surgery, endoscopy or necropsy, and histology were assessed. The medical records and all diagnostic imaging studies were reviewed retrospectively. Labrador Retrievers or English Pointers < 5 years of age, with a history of coughing and hyperthermia, were the most common presentations. Seventeen animals had an inflammatory leukogram of which 14 had a left shift or toxic neutrophils. Radiographs were performed in 38 animals and computed tomography (CT) in 14. Thoracic radiographs were characterized by focal pulmonary interstitial to alveolar opacities (n = 26) that occurred most commonly in the caudal (n = 19) or accessory lobes (n = 8). Additional findings included pneumothorax (n = 9), pleural effusion (n = 8), and pleural thickening (n = 7). Pulmonary opacities identified on radiographs correlated to areas of pneumonia and foreign body location. CT findings included focal interstitial to alveolar pulmonary opacities (n = 12) most commonly in the right caudal lung lobe (n = 9), pleural thickening (n = 11), mildly enlarged intrathoracic lymph nodes (n = 10), soft tissue tracking (n = 7) with enhancing margins (n = 4), pneumothorax (n = 6), pleural effusion (n = 4), and foreign body visualization (n = 4). Histologic diagnoses included pulmonary and mediastinal granulomas or abscesses, bronchopneumonia, and pleuritis. Migrating intrathoracic grass awns should be considered as a differential diagnosis in coughing, febrile animals with focal interstitial to alveolar pulmonary opacities, pleural effusion, pleural thickening, and/or pneumothorax on radiographs or CT.

  10. Is the chest x-ray an appropriate screening exam for ER patients with AMS?

    PubMed

    Birkemeier, Krista L; Nipper, Michael L; Williams, Jonathan M

    2008-11-01

    Emergency department patients with altered mental status (AMS) regularly undergo a routine chest radiograph at our institution. While there are many causes of chest pathology seen on the chest radiograph that may cause an altered mental status, it is not clear that a routine chest radiograph for these patients affects management. The goal of this study is to determine if a chest radiograph is an appropriate screening examination for AMS. This is a retrospective review of 100 consecutive patients who underwent head computed tomography for altered mental status in the emergency department and had a chest radiograph during the same visit. Of 100 patients undergoing a routine chest radiograph for AMS, 17 had findings which altered patient care, 15 of those had signs/symptoms which clearly indicated that a chest radiograph was needed, and the other two had leukocytosis. The routine performance of a chest radiograph in the setting of a patient presenting to the emergency department with altered mental status affected medical management in 17%, a modest benefit. The positive predictive value of a chest x-ray in these patients may be improved if certain symptomatologies are present.

  11. [Radiographic findings of pulmonary nontuberculous mycobacteriosis other than Mycobacterium avium complex].

    PubMed

    Kurashima, Atsuyuki

    2009-08-01

    Almost all nontuberculous mycobacteria (NTM) cause opportunistic infection. Therefore, the radiographic findings of NTM have a tendency of nonspecific patterns modifying the predisposing conditions or diseases and we could not extract species specific radiographic characterizations in that situations. In this review, the NTM cases without predisposing conditions or diseases are submitted essentially. Mycobacterium kansasii cases show more or less the same patterns with TB cases. Mycobacterium fortuitum case shows nonspecific consolidations. Mycobacterium xenopi case shows solitary cavity in the upper lobe area. Mycobacterium gordonae case shows the same cavitary pattern. Mycobacterium abscessus case shows widely scattered tree-in-bud appearance foci. Weak virulence NTM like as Mycobacterium xenopi or Mycobacterium gordonae may form solitary cavity without predisposing conditions. The pattern of bronchial wall thickening seems to be one of the specific findings with NTM pulmonary infection.

  12. Melorheostosis involving the cervical and upper thoracic spine: radiographic, CT, and MR imaging findings.

    PubMed

    Motimaya, A M; Meyers, S P

    2006-01-01

    Melorheostosis, an uncommon mesenchymal dysplasia, rarely affects the axial skeleton. We describe the imaging findings of melorheostosis involving the cervical and upper thoracic spine. Radiographs and CT showed unilateral well-marginated undulating zones of cortical hyperostosis involving multiple vertebrae that were contiguous with a coalescent ossified right paravertebral mass. MR imaging showed zones of signal intensity void on all pulse sequences without contrast enhancement. Conservative management was elected because of lack of interval clinical and imaging changes for 8 years.

  13. A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors

    PubMed Central

    El Khateeb, Sara M.; Abu-Hammad, Osama; Fadel, Hani; Dar-Odeh, Najla

    2017-01-01

    Aims and Objectives: To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings. Materials and Methods: The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings. Results: A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05). Conclusions: A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend. PMID:28316945

  14. 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

  15. Talocalcaneal coalition: A focus on radiographic findings and sites of bridging

    PubMed Central

    Lee, Soon Hyuck; Park, Hyung Jun; Yeo, Eui Dong; Lee, Young Koo

    2016-01-01

    Background: Verifying the exact location of talocalcaneal (TC) coalition is important for surgery, but the complicated anatomy of the subtalar joint makes it difficult to visualize on radiographs. No study has used computed tomography (CT) or magnetic resonance imaging (MRI) to verify the radiological characteristics of TC coalition or those of different facet coalitions. Therefore, this study verified the radiological findings used to identify TC coalitions and those of different facet coalitions using CT and MRI. Materials and Methods: Plain with/without weight bearing anteroposterior and lateral radiographs, CT, and MRI of 43 feet in 39 patients with TC coalitions were reviewed retrospectively. CT or MRI was used to verify the location of the TC coalition. Secondary signs for the presence of a coalition in the anteroposterior and lateral plain radiographs, including talar beak, humpback sign, duck-face sign, and typical or deformed C-sign, were evaluated. Three independent observers evaluated the radiographs twice at 6-week intervals to determine intraobserver reliability. They examined the radiographs for the secondary signs, listed above, and coalition involved facets. Results: The average rates from both assessments were as follows: Middle facet 5%, middle and posterior facets 27%, and posterior facet 68%. The deformed C-sign is more prevalent in posterior facet coalitions. The posterior facet has the highest prevalence of involvement in TC coalitions, and the deformed C-sign and duck-face sign have high correlations with TC coalitions in the posterior subtalar facet. Conclusion: A posterior facet is the most prevalent for TC coalition, and the C-sign is useful for determining all types of TC coalition. PMID:27904223

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

    PubMed

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

    1994-05-01

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

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

    PubMed

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

    2003-10-01

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

  18. Do sanitary ceramic workers have a worse presentation of chest radiographs or pulmonary function tests than other ceramic workers?

    PubMed

    Tsao, Yu-Chung; Liu, Su-Hsun; Tzeng, I-Shiang; Hsieh, Tsung-Han; Chen, Jau-Yuan; Luo, Jiin-Chyuan John

    2017-03-01

    Silicosis remains the most prevalent occupational disease worldwide. There have been no specific studies focusing on the association between exposure settings at work and the clinical severity in silicosis patients. In this study, we describe and compare the clinical characteristics and silicosis-associated exposure history at work among workers from several types of ceramic production facilities in Taiwan. We reviewed the medical records of 221 patients who were first diagnosed with silicosis at the Occupational Medicine Clinic of Northern Taiwan in 2012. For each patient, we collected data on demographic characteristics, smoking habits, working history, duration of exposure, and years on the first relevant job. We also retrieved clinical reports of the pulmonary function test and the baseline chest radiography used for silicosis staging. As compared to other ceramic workers, sanitary ceramic workers had a worse X-ray type (p=0.044), more advanced age (p<0.001), longer working duration (p=0.029), and a higher proportion of starting the first relevant job prior to the year 1975 (p=0.003). However, after adjusting for age, work duration, and an initial occupational exposure prior to 1975, sanitary ceramic workers showed a comparable risk for worse X-ray findings to other ceramic workers (adjusted odds ratio=1.18, p=0.704). Results of multivariable regression models on individual lung function parameter also suggested comparably impaired lung function tests between sanitary and other ceramic workers (p>0.05). In this study, we found that sanitary ceramic workers were at a similar risk to other ceramic workers for moderate to severe silicosis when older age and longer working duration were accounted for. Copyright © 2016. Published by Elsevier B.V.

  19. Aortic valve calcification - a commonly observed but frequently ignored finding during CT scanning of the chest.

    PubMed

    Raju, Prashanth; Sallomi, David; George, Bindu; Patel, Hitesh; Patel, Nikhil; Lloyd, Guy

    2012-06-01

    To describe the frequency and severity of Aortic valve calcification (AVC) in an unselected cohort of patients undergoing chest CT scanning and to assess the frequency with which AVC was being reported in the radiology reports. Consecutive CT scan images of the chest and the radiological reports (December 2009 to May 2010) were reviewed at the district general hospital (DGH). AVC on CT scan was visually graded on a scale ranging from 0 to IV (0 = no calcification, IV = severe calcification). Total of 416 (232 male; 184 female) CT chest scans [Contrast enhanced 302 (72%), unenhanced 114 (28%)] were reviewed. Mean age was 70.55 ± 11.48 years. AVC in CT scans was identified in 95 of the 416 patients (22.83%). AVC classification was as follows: Grade I: 60 (63.15%), Grade II: 22 (23.15%), Grade III: 9 (9.47%), Grade IV: 4 (4.21%). Only one CT report mentioned AVC. Only 31 of 95 AVC had Transthoracic echocardiogram (TTE). The interval time between CT scan and TTE was variable.   Aortic valve calcification in CT chest scans is a common finding and studies have shown that it is strongly related to the presence and severity of aortic valve disease. As CT scans are considered as a valuable additional screening tool for detection of aortic stenosis, AVC should always be commented upon in the radiology reports. Furthermore, patients with at least Grade III and IV AVC should be sent for TTE. © 2012 Blackwell Publishing Ltd.

  20. Active case finding for pulmonary tuberculosis using mobile digital chest radiography: an observational study.

    PubMed

    Story, A; Aldridge, R W; Abubakar, I; Stagg, H R; Lipman, M; Watson, J M; Hayward, A C

    2012-11-01

    Mobile digital chest radiography (CXR) is used routinely to screen for pulmonary tuberculosis (PTB) in London among homeless populations, persons accessing drug treatment services and prisoners. 1) To establish the sensitivity and specificity of mobile digital CXR, and 2) to test the hypothesis that actively identified cases have reduced odds of sputum smear positivity vs. those presenting passively to health care services from the same populations. Sensitivity and specificity were calculated using a gold standard comparator of culture-confirmed cases of PTB reported to the national surveillance system within 90 days of screening. Logistic regression was used to determine whether actively detected cases had reduced odds of smear positivity compared to passively detected cases after adjustment for confounding. The intervention had a sensitivity of 81.8% (95%CI 64.5-93.0) and a specificity of 99.2% (95%CI 99.1-99.3). After adjusting for confounding, there was evidence that cases identified through screening were less likely to be smear-positive than passively identified cases (OR 0.34, 95%CI 0.14-0.85; likelihood ratio test P = 0.022). Digital CXR achieves a high level of sensitivity and specificity in an operational setting; targeted mobile radiographic screening can reduce the risk of onward transmission by identifying cases before they become infectious.

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

    PubMed Central

    Gopinath, Vellore Kannan; Anwar, Khurshid

    2014-01-01

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

  2. Pathological findings in a sample of Mexican pediatric patients. Clinical and radiographic survey.

    PubMed

    Ledesma-Montes, C; Salcido-García, J F; Hernández-Flores, F; Garcés-Ortíz, M

    2012-05-01

    The findings of a clinical-radiological review of 467 children attending the Oral Diagnosis Clinic of the Facultad de Odontología, UNAM, Mexico, are presented. All patients were clinically reviewed, clinical history was taken, and an orthopantomogram obtained by last year dentistry students. Patients and radiographs were then reviewed by the panel and all alterations in teeth, soft tissues and bone were recorded. Clinical and/or radiographic alterations were found in 132 (28.26%) children. The main alterations were developmental (75%) and inflammatory/infectious and traumatic (6.06% each). The most common entities were: supernumeraries (30.77%); hypodontia (29.7%); osteosclerotic lesions and microdontia (4.4% each). The data on the frequency of alterations in the pediatric population attending at our institution reinforce the importance of this kind of study in efforts to improve the quality of stomatologic services in the pediatric population.

  3. Pre-radiographic MRI findings are associated with onset of knee symptoms: the most study

    PubMed Central

    Javaid, M. K.; Lynch, J. A.; Tolstykh, I.; Guermazi, A.; Roemer, F.; Aliabadi, P.; McCulloch, C.; Curtis, J.; Felson, D.; Lane, N. E.; Torner, J.; Nevitt, M.

    2010-01-01

    Summary Objective Magnetic resonance imaging (MRI) has greater sensitivity to detect osteoarthritis (OA) damage than radiographs but it is uncertain which MRI findings in early OA are clinically important. We examined MRI abnormalities detected in knees without radiographic OA and their association with incident knee symptoms. Method Participants from the Multicenter Osteoarthritis Study (MOST) without frequent knee symptoms (FKS) at baseline were eligible if they also lacked radiographic features of OA at baseline. At 15 months, knees that developed FKS were defined as cases while control knees were drawn from those that remained without FKS. Baseline MRIs were scored at each subregion for cartilage lesions (CARTs); osteophytes (OST); bone marrow lesions (BML) and cysts. We compared cases and controls using marginal logistic regression models, adjusting for age, gender, race, body mass index (BMI), previous injury and clinic site. Results 36 case knees and 128 control knees were analyzed. MRI damage was common in both cases and controls. The presence of a severe CART (P = 0.03), BML (P = 0.02) or OST (P = 0.02) in the whole knee joint was more common in cases while subchondral cysts did not differ significantly between cases and controls (P > 0.1). Case status at 15 months was predicted by baseline damage at only two locations; a BML in the lateral patella (P = 0.047) and at the tibial subspinous subregions (P = 0.01). Conclusion In knees without significant symptoms or radiographic features of OA, MRI lesions of OA in only a few specific locations preceded onset of clinical symptoms and suggest that changes in bone play a role in the early development of knee pain. Confirmation of these findings in other prospective studies of knee OA is warranted. PMID:19919856

  4. Desmoplastic Fibroma of Bone in a Toe: Radiographic and MRI Findings

    PubMed Central

    Kim, Seon Jeong; Kim, Ji Yeon; Ryu, Ji Hwa; Choo, Hye Jung; Lee, Sun Joo; Lee, In Sook; Suh, Kyung Jin

    2013-01-01

    Desmoplastic fibroma is a rare benign primary bone tumor that is histologically similar to the soft tissue desmoid tumor. It most often involves the mandible, large long bone or iliac bone. Desmoplastic fibroma in a toe has been extremely rarely reported. Authors report a rare case of desmoplastic fibroma of bone occurring in the distal phalanx of a foot, with descriptions of the radiographic and MRI findings, correlation of the radiologic and pathologic findings, and discussion on the differential diagnosis of the tumor. PMID:24265574

  5. 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.

  6. Diagnostic value of abdominal free air detection on a plain chest radiograph in the early postoperative period: a prospective study in 648 consecutive patients who have undergone abdominal surgery.

    PubMed

    Milone, Marco; Di Minno, Matteo Nicola Dario; Bifulco, Giuseppe; Maietta, Paola; Sosa Fernandez, Loredana Maria; Musella, Mario; Iaccarino, Vittorio; Buccelli, Claudio; Nappi, Carmine; Milone, Francesco

    2013-09-01

    To the best of our knowledge, this is the first study to evaluate the predictive value of free air (on a plain radiograph) for bowel perforation in a large prospective cohort of surgical patients. All consecutive patients undergoing abdominal surgery between January 2011 and June 2012 were screened for this study. We performed an upright chest radiograph on the second and third postoperative day. Thereafter, additional radiographic evaluations were performed every 2 days until the disappearance of abdominal free air. Of the 648 subjects enrolled in our study, free abdominal air was found in 65 subjects on the first radiographic evaluation (2 days after surgery), 51 on the second (3 days after surgery), three on the third (5 days after surgery), and none on the fourth (7 days after surgery). The presence of free abdominal air was associated with an increased risk of gastrointestinal perforation. The presence of free air was associated with a hazard ratio (HR) of 21.54 (95% CI 9.66-48.01, p<0.001) and a HR of 23.87 (95% CI 10.68-53.34, p<0.001) at 2 and 3 days after surgery, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 70, 93, 33, and 98%, respectively, at 2 days after surgery, and similar results were confirmed at 3 days after surgery. We believe that the presence of free air at 3 days after surgery should not be considered a common finding. Here, we demonstrate that the detection of free air has a remarkable predictive value for gastrointestinal perforation, which has been overestimated in previous experience.

  7. Dental radiographic findings in cats with chronic gingivostomatitis (2002-2012).

    PubMed

    Farcas, Nicodin; Lommer, Milinda J; Kass, Philip H; Verstraete, Frank J M

    2014-02-01

    To compare dental radiographic findings in cats with and without feline chronic gingivostomatitis (FCGS). Retrospective case-control study. 101 cats with FCGS (cases) and 101 cats with other oral diseases (controls). Controls were age- and treatment date-matched with cases. Conventional full-mouth dental radiographic views were evaluated for distribution, pattern, and severity of alveolar bone loss (periodontitis), tooth resorption, buccal bone expansion, tooth fractures, and retained roots. All cases and 77 (76%) controls had periodontitis; differences in extent and severity of periodontitis were significant, with semigeneralized or generalized and moderate or severe periodontitis in 78 (77%) and 93 (92%) cases, respectively, and 28 (28%) and 38 (38%) controls, respectively. The pattern of alveolar bone loss in cases was dominated by horizontal bone loss, with a nonsignificant increase in vertical bone loss, compared with that of controls. Cases were more likely than controls to have external inflammatory root resorption (49 [49%] vs 25 [25%]) and retained roots (57 [56%] vs 28 [28%]). Fewer dental fractures occurred in cases (14 [14%]) than in controls (35 [35%]). There were no differences between cases and controls in breed, sex, or presence of feline resorptive lesions or buccal bone expansion. Results suggested that FCGS was associated with more widely distributed and severe periodontitis, with a higher prevalence of external inflammatory root resorption and retained roots than other oral diseases. Full-mouth radiographic views are indicated for cats with FCGS to diagnose the extent of associated periodontitis, reveal external inflammatory root resorption, and identify retained roots.

  8. Clinical, radiographic, and magnetic resonance imaging findings of gastrocnemius musculotendinopathy in various dog breeds.

    PubMed

    Kaiser, Susanne M; Harms, Oliver; Konar, Martin; Staudacher, Anne; Langer, Anna; Thiel, Cetina; Kramer, Martin; Schaub, Sebastian; von Pückler, Kerstin H

    2016-11-23

    To describe clinical, radiographic, and magnetic resonance imaging (MRI) findings in 16 dogs diagnosed with gastrocnemius musculotendinopathy. Retrospective evaluation of medical records, radiographs, and MRI results, as well as follow-up completed by telephone questionnaire. Most dogs had chronic hindlimb lameness with no history of trauma or athletic activities. Clinical examination revealed signs of pain on palpation without stifle joint instability. Seven dogs had radiographic signs of osteophyte formation on the lateral fabella. Magnetic resonance imaging revealed T2 hyperintensity and uptake of contrast agent in the region of the origin of the gastrocnemius muscle. Changes were found in the lateral and medial heads of the gastrocnemius. Conservative treatment resulted in return to full function in 11 dogs. Two dogs showed partial restoration of normal function, one dog showed no improvement. Two dogs were lost to follow-up. Gastrocnemius musculotendinopathy is a potential cause of chronic hindlimb lameness in medium to large breed dogs. A history of athletic activity must not necessarily be present. Magnetic resonance imaging shows signal changes and uptake of contrast agent in the region of the origin of the gastrocnemius muscle. A combination of T1 pre- and post-contrast administration and T2 weighted sequences completed by a fat-suppressed sequence in the sagittal plane are well-suited for diagnosis. Conservative treatment generally results in return to normal function.

  9. Active Case Finding of Tuberculosis: Randomized Evaluation of Simple and Infotainment Chest Camps.

    PubMed

    Khan, Muhammad Amir; Anil, Shirin; Ahmed, Maqsood; Athar, Ali; Ghafoor, Abdul; Brouwer, Miranda

    In Pakistan, many tuberculosis (TB) cases are not reported to the national surveillance system. An active case finding strategy in the form of conventional (simple) or innovative (infotainment) chest camps can contribute to diagnosing these missed cases. To compare the yield in terms of TB patients detected at a simple chest camp (SCC) versus an infotainment chest camp (ICC) in rural areas. A cluster randomized controlled trial with 2 parallel arms was conducted in 4 districts of Pakistan from June 2012 to May 2013. Rural neighborhoods (n = 318) were randomly allocated in a ratio of 1:3 to receive either SCC or ICC. Incidence of TB (all forms and sputum smear positive [SS+]) and number needed to screen (NNS) to diagnose 1 TB case were calculated. Cluster analysis was done according to intention to treat and risk ratio (RR), and 95% confidence intervals (CIs) were calculated. A total of 3086 participants were tested at the SCC and 9029 at the ICC, of whom 38.5% were female. Mean age was 37.4 ± 15.9 years. Incidences of previously undiagnosed TB (all forms) for SCC and ICC were 23.6 (95% CI 20.04-27.4) and 22.1 (95% CI 20.3-24.1) per 100,000 population (P = .42), SS+ TB 22.5 (95% CI 19.3-26.1) and 21.6 (95% CI 19.8-23.6) (P = .67), respectively. NNS to diagnose 1 TB case were 260 (95% CI 234.3-289.6) and 258 (95% CI 233.3-287.9) for SCC and ICC, respectively (P = .9). RRs for all forms of TB and SS+ TB in SCC compared to ICC were 0.94 (95% CI 0.73-1.19) and 0.95 (95% CI 0.74-1.22) and P values were .58 and .71, respectively. Both types of chest camps are equally effective in active case finding of previously undiagnosed TB cases in rural areas in 2 provinces in Pakistan. Copyright © 2016. Published by Elsevier Inc.

  10. Clinical evolution and radiographic findings of feline heartworm infection in asymptomatic cats.

    PubMed

    Venco, L; Genchi, C; Genchi, M; Grandi, G; Kramer, L H

    2008-12-10

    Clinical manifestations of heartworm disease in cats are variable; most cats seem to tolerate the infection well for extended periods. Heartworm-infected cats may undergo spontaneous self-cure due to the natural death of parasites without any symptomatology, or they may suddenly show dramatic and acute symptoms. Sudden death in apparently healthy cats is not a rare event. Thoracic radiographs are important tool for the diagnosis of cardiopulmonary disease. However, thoracic abnormalities are often absent or transient and highly variable in heartworm-infected cats. Findings, such as enlargement of the peripheral branches of the pulmonary arteries, with a varying degree of pulmonary parenchymal disease and hyperinflation, are the most typical features consistent with infection. A field study was performed for cats referred to the Veterinary Hospital Città di Pavia from January 1998 to December 2001 for routine health examinations and procedures to evaluate the clinical evolution and radiographic findings of feline heartworm infection. Thirty-four asymptomatic cats diagnosed with feline heartworm infection by antibody and antigen tests together with an echocardiogram that allowed worm visualization were included in the follow-up study. Cats were routinely examined every 3 months from the time of heartworm diagnosis until the outcome (self-cure or death). Self-cure was defined as no positive serology for heartworm antigens and no visualization of worms by echocardiography. A final examination for antibodies was carried after 12 months as a final confirmation of self-cure. Twenty-eight cats (82.4%) self-cured; including 21 that showed no clinical signs of infection throughout the study. Six cats died. The most common clinical features observed were acute respiratory symptoms and sudden death. Infection lasted over 3 years in the majority of the cats enrolled in the study. Thoracic radiograph appearance was variable, and the most commonly observed findings were focal

  11. 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.

  12. Multifocal Eosinophilic Granuloma of Jaws and Skull with Classical and Unusual Radiographic/Imaging Findings

    PubMed Central

    Venkata, Suman; Shaik, Sameulla; Kodadala, Amrutha; Kakarla, Prashanti

    2017-01-01

    Eosinophilic granuloma is basically a disorder of reticuloendothelial system and is one of the variants of langerhans cell histiocytosis. Multifocal eosinophilic granuloma affecting jaws and skull is relatively a rare disorder. We hereby report a case of multifocal eosinophilic granuloma involving mandible, maxilla and several skull bones. The present case has mixture of classical floating teeth appearance and an unusual radiographic/imaging finding of periosteal remodeling, which is rarely seen in adult patients of eosinophilic granuloma and pseudo-multilocular appearance in anterior mandibular region in coronal sections and moth-eaten appearance of skull was appreciated in axial slices of Computed Tomography (CT). PMID:28274065

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

    PubMed

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

    2017-10-01

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

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

    SciTech Connect

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

    1981-01-01

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

  15. Correlation between clinical characteristics and chest computed tomography findings of pulmonary cryptococcosis.

    PubMed

    Yamakawa, Hideaki; Yoshida, Masahiro; Yabe, Masami; Baba, Emiri; Okuda, Keitaro; Fujimoto, Shota; Katagi, Hiroaki; Ishikawa, Takeo; Takagi, Masamichi; Kuwano, Kazuyoshi

    2015-01-01

    The aim of this study was to review HIV-negative patients with pulmonary cryptococcosis to analyze the correlations between clinical characteristics and chest computed tomography (CT) findings. We retrospectively analyzed medical records of 16 HIV-negative patients with pulmonary cryptococcosis diagnosed at our institution, and clinical characteristics of the patients with nodules or masses without ground-glass attenuation (GGA)/consolidation type were compared with those of patients with inclusive GGA or consolidation type. Host status was immunocompromised (81.2%) in most of the patients, and 6 (37.5%) were asymptomatic. The most frequent radiologic abnormalities on chest CT scans were one or more nodules (87.5%), GGA (37.5%), and consolidations (18.8%). Most lesions were located in the lower lung. Levels of hemoglobin and platelets were significantly lower in patients with inclusive GGA or consolidation type. Although the differences were not significant, patients with inclusive GGA or consolidation type tended to have a C-reactive protein level of ≥1.0 mg/dL. If a patient with anemia and thrombocytopenia shows GGA or consolidation in the lung, pulmonary cryptococcosis should be given careful consideration.

  16. Correlation between Clinical Characteristics and Chest Computed Tomography Findings of Pulmonary Cryptococcosis

    PubMed Central

    Yoshida, Masahiro; Yabe, Masami; Baba, Emiri; Okuda, Keitaro; Fujimoto, Shota; Katagi, Hiroaki; Takagi, Masamichi; Kuwano, Kazuyoshi

    2015-01-01

    Objective. The aim of this study was to review HIV-negative patients with pulmonary cryptococcosis to analyze the correlations between clinical characteristics and chest computed tomography (CT) findings. Methods. We retrospectively analyzed medical records of 16 HIV-negative patients with pulmonary cryptococcosis diagnosed at our institution, and clinical characteristics of the patients with nodules or masses without ground-glass attenuation (GGA)/consolidation type were compared with those of patients with inclusive GGA or consolidation type. Results. Host status was immunocompromised (81.2%) in most of the patients, and 6 (37.5%) were asymptomatic. The most frequent radiologic abnormalities on chest CT scans were one or more nodules (87.5%), GGA (37.5%), and consolidations (18.8%). Most lesions were located in the lower lung. Levels of hemoglobin and platelets were significantly lower in patients with inclusive GGA or consolidation type. Although the differences were not significant, patients with inclusive GGA or consolidation type tended to have a C-reactive protein level of ≥1.0 mg/dL. Conclusion. If a patient with anemia and thrombocytopenia shows GGA or consolidation in the lung, pulmonary cryptococcosis should be given careful consideration. PMID:25767722

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

    PubMed

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

    2008-03-01

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

  18. Trends in pleural radiographic findings in the Navy Asbestos Medical Surveillance Program (1990-1999).

    PubMed

    Muller, John G; Bohnker, Bruce K; Philippi, Alan F; Litow, Francesca K; Rudolph, Garry; Hernandez, Jose E

    2005-05-01

    The U.S. Navy Asbestos Medical Surveillance Program is a comprehensive effort to decrease exposure to asbestos, a known health hazard. This study was part of a programmatic review of the Asbestos Medical Surveillance Program database, which included 233,353 radiographic examinations from 1990 to 1999. The initial review focused on incidental findings recorded by B-readers for 23,460 radiographs. Abnormalities reported included bullae (0.68%), cancer (0.56%), cardiac size/ shape abnormalities (1.36%), emphysema (0.74%), subpleural fat (2.62%), fractured ribs (1.24%), hilar adenopathy (0.13%), ill-defined diaphragm (0.46%), ill-defined heart border (0.29%), Kerley lines (0.06%), pleural thickening (2.35%), and tuberculosis (0.27%). The rates by age cohort for pleural abnormalities decreased significantly (30-39 years, chi2 for trend = 23.49, df = 1; 40-49 years, chi2 for trend = 176.21; 50-59 years, chi2 for trend = 401.87), but findings were not significantly different for those > or =60 years of age. This suggests that sequential age cohorts in the program are developing fewer pleural abnormalities; pleural abnormalities have historically been associated with asbestos exposure.

  19. Endorectal MRI for risk classification of localized prostate cancer: Radiographic findings and influence on treatment decisions.

    PubMed

    Liauw, Stanley L; Kropp, Lauren M; Dess, Robert T; Oto, Aytekin

    2016-09-01

    To report the results of endorectal coil magnetic resonance imaging (eMRI) in patients with localized prostate cancer, and how these images influenced radiotherapeutic management. A total of 122 men with localized adenocarcinoma of the prostate referred to radiation oncology underwent 3-T eMRI between 2010 and 2014, to evaluate candidacy for active surveillance (n = 26) and brachytherapy as monotherapy (n = 47), or to further risk stratify intermediate-risk (n = 29) or high-risk (n = 20) men before external beam radiation therapy. By National Comprehensive Cancer Network classification, men had low-risk (28%), intermediate-risk (55%), or high-risk (17%) disease. Multiparametric MRI sequences included T2-weighted, diffusion-weighted imaging, and dynamic contrast-enhanced imaging. Radiographic extracapsular extension, seminal vesicle invasion (rSVI), and pelvic lymph node involvement (LNI) were graded as negative, indeterminate, or positive. A dominant nodule was defined as a nodule≥1.5cm. Changes in management were identified comparing pre-MRI and post-MRI plan of care. The rates of radiographic extracapsular extension, radiographic seminal vesicle invasion, lymph node involvement, and dominant nodule were 39%, 7%, 12%, and 28%, respectively. The eMRI identified measurable disease in most patients with an increasing burden of disease (sextants involved, median nodule size) according to risk category (P<0.01). Changes in management after eMRI occurred in 18%, including 9%, 18%, and 33% of men with low-risk, intermediate-risk, or high-risk disease (P = 0.08), and 12%, 17%, and 22% of men who were candidates for active surveillance, brachytherapy as monotherapy, or external beam radiation therapy (P = 0.48), respectively. The eMRI influenced management in a risk-dependent fashion. Further study is required to determine the clinical importance of eMRI findings and to determine whether changes in management can lead to improved clinical outcome. Copyright © 2016

  20. Desmoid Tumor of the Chest Wall Mimicking Recurrent Breast Cancer: Multimodality Imaging Findings

    PubMed Central

    Choi, Kyeong A; An, Yeong Yi

    2016-01-01

    Desmoid tumor of breast is a rare benign, locally aggressive tumor with a high recurrence rate. It has been associated with scar from previous breast surgery or trauma. Especially in breast cancer patients with previous operation history, it may simulate recurrent breast cancer clinically and radiologically. We presented multimodality imaging findings (ultrasound, computed tomography, magnetic resonance imaging and positron emission tomography/computed tomography) of chest wall desmoid tumor mimicking recurrent breast cancer in a 38-year-old patient with a history of left modified mastectomy. The desmoid tumor is a rare benign tumor that should be considered in the differential diagnosis of malignant local tumor recurrence after breast cancer operation. Biopsy was required for accurate diagnosis and wide local excision was its appropriate surgical management. PMID:27895871

  1. Are magnetic resonance imaging or radiographic findings correlated with clinical prognosis in spinal cord neuropathy?

    PubMed Central

    Neshat Halati, Fatemeh; Vajhi, Alireza; Molazem, Mohammad; Dehghan, Mohammad Mehdi; Ansari, Fereshteh

    2016-01-01

    Dogs presented to the Small Animal Hospital of Veterinary Medicine, University of Tehran were included in the present study if spinal or intervertebral disc involvement was suspected. Clinical signs were recorded as well as general information of the patient such as age, breed and sex. Sixty dogs were examined radiographically and two standard orthogonal lateral and ventrodorsal projections were taken from the suspected region. Then magnetic resonance imaging (MRI) was performed for all patients. Agreement between MRI and radiographic findings, comparison of sex and breed with diagnostic imaging grades, comparison between diagnostic imaging grades and mean age, recovery rate after surgery or medical treatment, effects of diagnostic imaging severity grades on surgical or medical referrals were evaluated statistically. There were no significant association between age, sex and breed and frequency of the intervertebral disk disease. Intervertebral disc involvements between L2-L3 and T13-L1 were estimated as the most frequent sites of involvements. Sensitivity and specificity of radiography were evaluated 90.0% and 46.0%, respectively, by considering the MRI as a gold standard modality. There was a significant association between severity of disease in the MRI with referral to surgery and medical treatment. The recovery rate after surgery was significantly higher than medical treatment. These results can be used as a foundation for other studies with more focuses on details of injury and larger group of patients. PMID:27872724

  2. A health survey of granite workers in Finland: radiographic findings, respiratory function, hearing, electric sensory thresholds of the fingers and subjective symptoms.

    PubMed

    Ahlman, K; Backman, A L; Partanen, T

    1975-06-01

    Results from a health survey of 777 granite workers, exposed to quartz dust, noise and/or machine vibration, and 122 unexposed "controls" are reported. The survey included chest X-rays, pulmonary function tests, a hearing examination, the determination of the electric sensory thresholds of the fingers, and questionnaires on the subjective symptoms of the respiratory system and upper limbs. The exposed workers' radiographic findings (except for a 2.6 % rate of silicosis), respiratory functions, and sensory thresholds did not differ significantly from those of the controls. Granite drillers had a high prevalence of hearing defects. Respiratory symptoms were common among drillers and sandblasters, and subjective symptoms of the upper limbs due to vibration occurred among the granite dressing workers who used pneumatic hammers. Both primary and secondary measures of prevention are strongly recommended for the granite industry, primarlily for quartz dust exposure and its health effects.

  3. 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

  4. [Radiographic findings in raptors affected with a mycosis of the respiratory tract].

    PubMed

    Vorbrüggen, S; Bailey, T; Krautwald-Junghanns, M-E

    2013-01-01

    Summary of typical radiographic signs in birds of prey with aspergillosis compared to signs previously established in parrots. Evaluation of radiographs of 110 falcons (Falco spp.) with aspergillosis confirmed by endoscopy. Compared to parrots primarily subtle radiographic signs were detected in falcons (especially inhomogeneously increased radiodensities of the airsacs/lungs). Two typical signs for diseased falcons consisted of the poor delineation of the cardiac silhouette and the line-shaped increased radiodensity of the caudal lung border. Radiographic diagnosis of the lung is limited due to the strong flight musculature. The varying results between avian species can be explained by the different radiographic anatomy, husbandry conditions and x-ray technique (digital versus analog). A pet bird-experienced practitioner should be aware of specific radiographic signs in birds of prey suspected of having aspergillosis.

  5. 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

  6. 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

  7. Cervical spine in patients with diastrophic dysplasia--radiographic findings in 122 patients.

    PubMed

    Remes, Ville M; Marttinen, Eino J; Poussa, Mikko S; Helenius, Ilkka J; Peltonen, Jari I

    2002-09-01

    In previous studies, typical radiological findings in the cervical spine of patients with diastrophic dysplasia (DD) have been kyphosis, displacement of the vertebrae, spina bifida occulta (SBO), anterior hypoplasia of vertebrae C3-5, and hyperplasia and dysmorphism of the odontoid process. To make a radiological analysis of the cervical spine in patients with DD. The study comprised 122 patients (50 males, 72 females), with an average age of 19 years (range newborn-63 years). Follow-up was available on 62 patients (51%), for an average duration of 11 years. Cervical spine alignment was measured according to Cobb's method. The height (H) and depth (D) of the vertebral body and sagittal diameter (S) of the spinal canal were measured. H/D and S/D ratios were then calculated from the measurements. The shape of the vertebrae was assessed. Displacement and movement of cervical vertebrae in neutral and bending radiographs were measured. RESULTS. The average lordosis in the last radiograph was 17(degrees) (range 4 degrees -55(degrees)). Five (4%) patients had a cervical kyphosis with an average of 92(degrees) (range 10-165(degrees)) on their last radiograph. The H/D ratio increased slowly during growth and showed significant correlation with age. There was no growth spurt at puberty. The S/D ratio was fairly stable until 7-8 years of age, when it started to decline slowly. The percentage of vertebrae with a flat vertebral body and narrow spinal canal value tended to increase with age. Vertebral hypoplasia and displacement between vertebrae were most common in the mid-cervical region and resolved spontaneously with age. Degenerative changes seemed to increase with age and were already visible during the second decade of life. SBO was noted in 79% of patients. The most common alignment in the cervical spine is lordosis in adulthood. The vertebral bodies are flattened and the spinal canal is narrowed. Vertebral body hypoplasia and displacement usually resolve spontaneously

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

    PubMed

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

    2016-01-01

    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. 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). 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. 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.

  9. 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

  10. 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

  11. Effect of Preoperative Stress Radiographic Findings on Radiographic and Clinical Outcomes of the Modified Broström Procedure for Chronic Ankle Instability.

    PubMed

    Jeong, Bi O; Kim, Tae Yong; Song, Wook Jae

    2016-01-01

    The purpose of the present study is to evaluate whether findings of instability on preoperative stress radiographs of patients with chronic ankle instability affects the radiographic and clinical outcomes after a modified Broström procedure. A total of 45 consecutive patients (45 ankles) who had undergone the modified Broström procedure for unilateral ankle joint instability and were followed up for ≥2 years were selected. The patients were classified into 2 groups according to the results of the preoperative stress radiographs: 1 group with positive findings (35 [77.8%] patients; stress-positive group) and 1 group with negative findings (10 [22.2%] patients; stress-negative group). The radiographic and clinical outcomes were compared between the 2 groups. The mean preoperative talar tilt measured on the stress radiograph was 14.4° ± 4.2° and 4.8° ± 2.6° in the stress-positive and stress-negative groups, respectively, a statistically significant difference. Postoperative talar tilt improved in both groups, with a mean final talar tilt of 5.4° ± 3.4° in the stress-positive group (p < .001) and 3.0° ± 1.5° in the stress-negative group (p = .038). The average American Orthopaedic Foot and Ankle Society ankle-hindfoot score in the stress-positive and stress-negative groups improved from 65.1 ± 14.6 to 90.0 ± 6.3 (p < .001) and 72.5 ± 9.3 to 92.6 ± 7.8 (p = .007), respectively. The mean postoperative satisfaction rate was 83.9 ± 11.9 and 85.0 ± 11.8 in the 2 groups. No statistically significant differences were seen in the preoperative and postoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot scores or in postoperative satisfaction rates between the 2 groups.

  12. Computed chest tomography in an animal model for decompression sickness: radiologic, physiologic, and pathologic findings.

    PubMed

    Reuter, M; Tetzlaff, K; Brasch, F; Gerriets, T; Weiher, M; Struck, N; Hirt, S; Hansen, J; Müller, K M; Heller, M

    2000-01-01

    This study was conducted to investigate the early pulmonary effects of acute decompression in an animal model for human decompression sickness by CT and light microscopy. Ten test pigs were exposed to severe decompression stress in a chamber dive. Three pigs were kept at ambient pressure to serve as controls. Decompression stress was monitored by measurement of pulmonary artery pressure and arterial and venous Doppler recording of bubbles of inert gas. Chest CT was performed pre- and postdive and in addition the inflated lungs were examined after resection. Each lung was investigated by light microscopy. Hemodynamic data and bubble recordings reflected severe decompression stress in the ten test pigs. Computed tomography revealed large quantities of ectopic gas, predominantly intravascular, in three of ten pigs. These findings corresponded to maximum bubble counts in the Doppler study. The remaining test pigs showed lower bubble grades and no ectopic gas by CT. Sporadic interstitial edema was demonstrated in all animals--both test and control pigs--by CT of resected lungs and on histologic examination. A severe compression-decompression schedule can liberate large volumes of inert gas which are detectable by CT. Despite this severe decompression stress, which led to venous microembolism, CT and light microscopy did not demonstrate changes in lung structure related to the experimental dive. Increased extravascular lung water found in all animals may be due to infusion therapy.

  13. Chest CT findings in patients with dysphagia and aspiration: a systematic review.

    PubMed

    Scheeren, Betina; Gomes, Erissandra; Alves, Giordano; Marchiori, Edson; Hochhegger, Bruno

    2017-07-31

    The objective of this systematic review was to characterize chest CT findings in patients with dysphagia and pulmonary aspiration, identifying the characteristics and the methods used. The studies were selected from among those indexed in the Brazilian Virtual Library of Health, LILACS, Indice Bibliográfico Español de Ciencias de la Salud, Medline, Cochrane Library, SciELO, and PubMed databases. The search was carried out between June and July of 2016. Five articles were included and reviewed, all of them carried out in the last five years, published in English, and coming from different countries. The sample size in the selected studies ranged from 43 to 56 patients, with a predominance of adult and elderly subjects. The tomographic findings in patients with dysphagia-related aspiration were varied, including bronchiectasis, bronchial wall thickening, pulmonary nodules, consolidations, pleural effusion, ground-glass attenuation, atelectasis, septal thickening, fibrosis, and air trapping. Evidence suggests that chest CT findings in patients with aspiration are diverse. In this review, it was not possible to establish a consensus that could characterize a pattern of pulmonary aspiration in patients with dysphagia, further studies of the topic being needed. RESUMO O objetivo deste estudo foi realizar uma revisão sistemática dos achados de TC de tórax que caracterizem aspiração pulmonar em pacientes com disfagia, identificando as características e os métodos utilizados. Para a seleção dos estudos, foram utilizadas as bases de dados da Biblioteca Virtual em Saúde, LILACS, Indice Bibliográfico Español de Ciencias de la Salud, Medline, Biblioteca Cochrane, SciELO e PubMed. A busca foi realizada no período entre junho e julho de 2016. Foram incluídos e revisados cinco artigos, todos realizados nos últimos cinco anos, publicados em língua inglesa e oriundos de diferentes países. O tamanho da amostra nos estudos selecionados variou de 43 a 56 pacientes

  14. Correlation of radiographic and manometric findings in patients with ineffective esophageal motility.

    PubMed

    Shakespear, J S; Blom, D; Huprich, J E; Peters, J H

    2004-03-01

    Ineffective esophageal motility disorder (IEM) is a new, manometrically defined, esophageal motility disorder, associated with severe gastroesophageal reflux disease (GERD), GERD-associated respiratory symptoms, delayed acid clearance, and mucosal injury. Videoesophagram is an important, inexpensive, and widely available tool in the diagnostic evaluation of patients with esophageal pathologies. The efficacy of videoesophagography has not been rigorously examined in patients with IEM. The aim of this study was to determine the diagnostic value of videoesophagography in patients with IEM. The radiographic and manometric findings of 202 consecutive patients presenting with foregut symptoms were evaluated. IEM was defined by strict manometric criteria. All other named motility disorders such as achalasia were excluded. Videoesophagography was performed according to a standard protocol. Of patients in this cohort, 16% (33/202) had IEM by manometric criteria. Of IEM patients, 55% (18/33) had an abnormal videoesophagram, while in 45% (15/33) this test was read as normal. Only 11% (15/137) of patients with a normal videoesophagram were found to have IEM. Sensitivity of videoesophagram was 54.6%, specificity 72.2%, positive predictive value only 27.7%, and negative predictive value 89.1% in the diagnosis of IEM. These data show that videoesophagram is relatively insensitive in detecting patients with IEM and should not be considered a valid diagnostic test for this disorder. We conclude that esophageal manometry is an indispensable diagnostic modality in the workup of a patient with suspected of IEM.

  15. Long term radiographic findings of breast brachytherapy: Implications of surgical volume.

    PubMed

    Wallace, Audrey S; Tchatalbachev, Vladislav; Nelson, Jay; Wang, Zhenyu; Dale, Paul; Biedermann, Gregory B

    2017-08-01

    Little is known about long-term radiographic findings after treatment with accelerated partial breast irradiation (APBI). Univariate and multivariate analysis of factors leading to formation and resolution of seroma were performed in patients treated with lumpectomy and APBI. Post-treatment images of 129 patients were reviewed by one radiologist. Median surgical excision volume was 108.9 cc (range 20.5-681.9). Primary mode of imaging was mammogram. Median time from end of RT to first and last surveillance image was 6 and 54 months, respectively. Median number of images was 7 (range 3-12). Seroma was identified in 98 (76%) patients, with median maximum diameter of 3.9 cm. Forty (41%) patients experienced resolution of seroma, at a median time of 29 months (range 6-74). On univariate analysis, surgical excision volume was associated with seroma formation, and tumor stage and margin re-excision were significant on univariate and multivariate analysis. No factors were associated with seroma resolution. Seroma formation after APBI resolves around 2.5 years for many patients, but persists for others possibly due to primary tumor and surgical excision volumes. With revised criteria on the definition of positive margins, smaller volumes may lead to decreased risk of seroma formation for future patients. © 2017 Wiley Periodicals, Inc.

  16. Spontaneous Crenosoma vulpis infection in 10 dogs: laboratory, radiographic and endoscopic findings.

    PubMed

    Unterer, S; Deplazes, P; Arnold, P; Flückiger, M; Reusch, C E; Glaus, T M

    2002-04-01

    Crenosoma (C.) vulpis infection was diagnosed in 10 dogs aged between 0.5 and 12 years (median 4 years) during a 4-year period. The predominant clinical sign in all dogs was coughing which lasted from 1 day to > 4 months. Hematological abnormalities included eosinophilia in 5/9 dogs, basophilia in 3/9 dogs, and mild monocytosis in 6/9 dogs. Thoracic radiographs (n = 9) were normal in 1 dog, showed a mild bronchial or interstitial pattern in 4 dogs, and moderate to marked changes (bronchial-interstitial to alveolar) in 4 dogs. Endoscopic findings (n = 9) varied from mild erythematous bronchitis (n = 3) to marked bronchitis with accumulation of large amounts of mucus (n = 2), irregular nodular mucosal surface (n = 2), accumulation of pus (n = 1), and bronchial hemorrhage (n = 1). Adult worms were observed in 2 dogs. Bronchial lavage cytology revealed inflammation with predominance of eosinophils in 7/10 dogs, eosinophils and neutrophils in 2/10 dogs, and neutrophils in 1/10 dogs. C. vulpis larvae were identified in the BAL of 5/10 dogs. Fecal examinations with the Baermann technique was the most sensitive method and positive in all 10 dogs. C. vulpis infection has to be considered in the differential diagnosis in dogs of all ages presenting with acute or chronic cough.

  17. Deficiency of interleukin-1-receptor antagonist syndrome: a rare auto-inflammatory condition that mimics multiple classic radiographic findings.

    PubMed

    Thacker, Paul G; Binkovitz, Larry A; Thomas, Kristen B

    2012-04-01

    Deficiency of interleukin-1-receptor antagonist (DIRA) syndrome is a newly identified inflammatory disease of the skeleton and appendicular soft tissues presenting in early infancy that has yet to be reported in the radiology literature. The radiological manifestations of DIRA syndrome include multifocal osteitis of the ribs and long bones, heterotopic ossification and periarticular soft-tissue swelling. Thus, the pediatric radiologist should be made aware of this novel disease because its radiographic findings can mimic multiple other disease entities. With knowledge of the unique clinical presentation of DIRA syndrome and its multiple radiographic manifestations, the pediatric radiologist may be the first to suggest the correct diagnosis.

  18. Specific Radiological Findings of Traumatic Gastrointestinal Tract Injuries in Patients With Blunt Chest and Abdominal Trauma.

    PubMed

    Kokabi, Nima; Harmouche, Elie; Xing, Minzhi; Shuaib, Waqas; Mittal, Pardeep K; Wilson, Kenneth; Johnson, Jamlik-Omari; Nicolaou, Savvas; Khosa, Faisal

    2015-05-01

    Gastrointestinal hollow viscus injury after blunt chest and abdominal trauma is uncommon and complicates 0.6%-1.2% of all cases of trauma. Early recognition of such injuries significantly decreases morbidity and mortality. Since physical examination is not accurate in detecting such injuries, contrast-enhanced computed tomography has been the mainstay for diagnosis in many emergency departments. This pictorial essay aims to review the incidence, mechanisms, and signs of gastrointestinal hollow viscus injuries in the setting of blunt chest and abdominal trauma.

  19. 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.

  20. Radiographic Findings of Distressed Venous Stents and Inferior Vena Cava Filters: Clinical Implications.

    PubMed

    Chick, Jeffrey Forris Beecham; Abramowitz, Steven D; Osher, Matthew L; Khaja, Minhaj S; Cooper, Kyle J; Saad, Wael E; Williams, David M

    2017-08-31

    The objective of our study was to describe an association between the radiographic appearance of distressed intravascular implants and venous stenosis or occlusion and to determine the success of reparative endovascular procedures. Seventy-eight patients with distressed stents or inferior vena cava (IVC) filters characterized by pursing (short-axis contracture), straightening, longitudinal contraction (long-axis contracture), or fracture were identified from retrospective review of a venous registry for the period from February 2004 to October 2016. Patients originally presented with superior vena cava (SVC) syndrome (n = 25), arm swelling (n = 16), iliocaval thrombosis (n = 21), and lower extremity deep venous thrombosis (n = 16), and stents were initially placed in 65 and filters in 13. Implants were located in the IVC (n = 24), subclavian vein (n = 16), brachiocephalic vein (n = 15), common iliac vein (n = 10), multiple veins (n = 4), axillary vein (n = 4), common femoral vein (n = 3), SVC (n = 1), and internal jugular vein (n = 1). Implants included Wallstents in 63 patients; Smart stents in two patients; and Celect Platinum, Denali, Greenfield, and Trapease IVC filters in two, three, two, and six patients, respectively. Venographic indication, distress type, time from initial normal placement to identification of distress, venographic finding (patent, mild stenosis, high-grade stenosis, or occlusion), treatment, revascularization outcome, and complications were recorded. The mean time to distress was 23 months. Fifty-two (67%) patients underwent venography for symptoms and 26 (33%) for surveillance. Forty-five (58%) implants were pursed; 19 (24%), straightened; nine (12%), contracted; and five (6%), fractured. Venography depicted 48 (62%) high-grade stenoses, 19 (24%) complete occlusions, and six (8%) mild stenoses. Of the 73 patients who underwent an intervention, 29 (40%) underwent angioplasty, 15 (21%) underwent angioplasty and stenting, 15 (21%) underwent

  1. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report.

    PubMed

    Kim, Jeong-Hee; Song, Byeong-Chul; Kim, Sun-Ho; Park, Yang-Soon

    2011-09-01

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  2. Correlation of chest computed tomography findings with dyspnea and lung functions in post-tubercular sequelae

    PubMed Central

    Panda, Ananya; Bhalla, Ashu Seith; Sharma, Raju; Mohan, Anant; Sreenivas, Vishnu; Kalaimannan, Umasankar; Upadhyay, Ashish Dutt

    2016-01-01

    Aims: To study the correlation between dyspnea, radiological findings, and pulmonary function tests (PFTs) in patients with sequelae of pulmonary tuberculosis (TB). Materials and Methods: Clinical history, chest computed tomography (CT), and PFT of patients with post-TB sequelae were recorded. Dyspnea was graded according to the Modified Medical Research Council (mMRC) scale. CT scans were analyzed for fibrosis, cavitation, bronchiectasis, consolidation, nodules, and aspergilloma. Semi-quantitative analysis was done for these abnormalities. Scores were added to obtain a total morphological score (TMS). The lungs were also divided into three zones and scores added to obtain the total lung score (TLS). Spirometry was done for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC. Results: Dyspnea was present in 58/101 patients. A total of 22/58 patients had mMRC Grade 1, and 17/58 patients had Grades 2 and 3 dyspnea each. There was a significant difference in median fibrosis, bronchiectasis, nodules (P < 0.01) scores, TMS, and TLS (P < 0.0001) between dyspnea and nondyspnea groups. Significant correlations were obtained between grades of dyspnea and fibrosis (r = 0.34, P = 0.006), bronchiectasis (r = 0.35, P = 0.004), nodule (r = 0.24, P = 0.016) scores, TMS (r = 0.398, P = 0.000), and TLS (r = 0.35, P = 0.0003). PFTs were impaired in 78/101 (77.2%) patients. Restrictive defect was most common in 39.6% followed by mixed in 34.7%. There was a negative but statistically insignificant trend between PFT and fibrosis, bronchiectasis, nodule scores, TMS, and TLS. However, there were significant differences in median fibrosis, cavitation, and bronchiectasis scores in patients with normal, mild to moderate, and severe respiratory defects. No difference was seen in TMS and TLS according to the severity of the respiratory defect. Conclusion: Both fibrosis and bronchiectasis correlated with dyspnea and with PFT. However, this correlation was not

  3. Correlation of Histopathologic Features with Demographic, Gross and Radiographic Findings in Giant Cell Granulomas of the Jaws

    PubMed Central

    Aghbali, Amirala; Sina, Mahmood; Vahid Pakdel, Seyyed Mahdi; Emamverdizadeh, Parya; Kouhsoltani, Maryam; Mahmoudi, Seyyed Mostafa; Janani, Maryam

    2013-01-01

    Background and aims. The correlation between morphology of giant cells in peripheral granulomas of the jaws and the aggressive behavior of the lesion is unknown. This study investigated the correlation between the histopathologic features with demographic, gross and radiographic findings in giant cell granulomas. Materials and methods. In this analytical study, data from 23 cases of central giant cell granuloma (CGCG) and 42 cases of peripheral giant cell granuloma (PGCG) were analyzed, focusing on age, gender, location, and gross and radiographic features. For each patient, microscopic slides were assessed in terms of histologic features of giant cells and stroma. Results. No significant differences were found in the mean number of nuclei or the size of nuclei and giant cell distribution patterns between the jaws and genders in both lesions (P >0.05). Correlation between the mean number of nuclei and age was positively significant and correlation between the size of nuclei and age was negatively significant (P < 0.05). In addition, correlation between the mean number and size of nuclei and the size of the lesion was significant (P < 0.05). Correlation between stroma and aggressiveness of CGCGs was not statistically significant. Correlation between histopathologic features and radiographic findings was not statistically significant (P > 0.05). Conclusion. There were correlations between the mean number of nuclei per giant cell and the size of the lesion and age, and between the size of nuclei and size of the lesion. No relation was observed between histopathologic and radiographic features. PMID:24578821

  4. Clinical and radiographic dental findings in X linked hypohidrotic ectodermal dysplasia.

    PubMed Central

    Crawford, P J; Aldred, M J; Clarke, A

    1991-01-01

    X linked hypohidrotic ectodermal dysplasia was studied in the dentition of both affected males and carrier females. Hypodontia was more severe in males than females and there were differences in the pattern of tooth absence between the sexes. Abnormal crown form, with the maximum diameter of the teeth being apically displaced, was noted particularly in the anterior teeth. Taurodontism was commonly seen radiographically. Images PMID:2051453

  5. Sports participation and radiographic findings of adolescents treated nonoperatively for displaced clavicle fractures.

    PubMed

    Robinson, Luke; Gargoum, Riyad; Auer, Ron; Nyland, John; Chan, Gilbert

    2015-07-01

    There is a relative paucity of high-level evidence that guides the treatment of displaced midshaft clavicle fractures in adolescents. Some use overhead sports or significant shortening as relative indications for surgical treatment, while others rarely consider operative intervention for these patients. The purpose of this study is to determine the effect of overhead sports participation and fracture shortening on subjective and objective outcomes after nonoperative treatment of displaced midshaft clavicle fractures in those aged 10-17 years. Using a radiographic database, adolescents with displaced clavicle fractures were identified and contacted over the phone. These subjects were invited to take part in the study in return for compensation. Radiographic measurements of dedicated clavicle films around the time of injury were performed, and a custom survey aimed at elucidating participation in overhead or contact sports was given. The Nottingham Clavicle Score (NCS) and the Constant Shoulder Score were obtained for each patient to provide both subjective and objective outcome data. Statistical Package for Social Science (SPSS) software (version 22, IBM) was used to compare radiographic and sports data to the outcome measures. Gender, age at the time of fracture, time since fracture, relative and absolute radiographic shortening, and hand dominance were all not significantly correlated with subjective or objective outcomes. Five patients (23%) reported not feeling happy with the appearance of their shoulder at the beach or at the pool. This group had statistically lower NCS results. Eleven of 22 participated in ≥6 months per year of overhead or contact sports; they did not have worse subjective or objective outcomes. Fracture shortening and sports participation do not have a significant impact in adolescents on outcomes after displaced midshaft clavicle fracture. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Finding the fifth intercostal space for chest drain insertion: guidelines and ultrasound.

    PubMed

    Bowness, J S; Nicholls, K; Kilgour, P M; Ferris, J; Whiten, S; Parkin, I; Mooney, J; Driscoll, P

    2015-12-01

    International guidelines exist for chest drain insertion and recommend identifying the fifth intercostal space or above, around the midaxillary line. In a recent study, applying these guidelines in cadavers risked insertion in the 6th intercostal space or below in 80% of cases. However, there are limitations of cadaveric studies and this investigation uses ultrasound to determine the intercostal space identified when applying these guidelines in healthy adult volunteers. On each side of the chest wall in 31 volunteers, the position for drain insertion was identified using the European Trauma Course method, Advanced Trauma Life Support (ATLS) method, British Thoracic Society's 'safe triangle' and the 'traditional' method of palpation. Ultrasound imaging was used to determine the relationship of the skin marks with the underlying intercostal spaces. Five methods were assessed on 60 sides. In contrast to the cadaveric study, 94% of skin marks lay over a safe intercostal space. However, the range of intercostal spaces found spanned the second to the seventh space. In 44% of women, the inferior boundary of the 'safe triangle' and the ATLS guidelines located the sixth intercostal space or below. Current guidelines often identify a safe site for chest drain insertion, although the same site is not reproducibly found. In addition, women appear to be at risk of subdiaphragmatic drain insertion when the nipple is used to identify the fifth intercostal space. Real-time ultrasonography can be used to confirm the intercostal space during this procedure, although a safe guideline is still needed for circumstances in which ultrasound is not possible. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. 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

  8. Computer-aided diagnosis as a second reader: spectrum of findings in CT studies of the chest interpreted as normal.

    PubMed

    Peldschus, Kersten; Herzog, Peter; Wood, Susan A; Cheema, Jugesh I; Costello, Philip; Schoepf, U Joseph

    2005-09-01

    To assess the performance of an automated computer-aided detection (CAD) system as a second reader on chest CT studies interpreted as normal at routine clinical interpretation. Chest CT studies were processed using a prototype CAD system for automated detection of lung lesions. Three experienced radiologists analyzed each CAD finding and confirmed or dismissed the marked image features as lung lesions. Noncalcified, focal lung lesions were classified according to size as being of high (> or = 10 mm), intermediate (5 to 9 mm), or low (< or = 4 mm) significance. Two sub-specialized academic tertiary referral centers in the United States and Germany. Chest CT studies were performed in 100 patients, with results initially reported as normal at clinical double reading. Indications for chest CT were suspected pulmonary embolism (PE) [n = 33], lung cancer screening in a high-risk population (n = 28), or follow-up for a cancer history (n = 39). Reevaluation of all chest CT studies for focal lung lesions with the CAD system as a second reader. Prevalence and spectrum of lung lesions missed at routine clinical interpretation but found by the CAD system. In 33% (33 of 100 patients), CAD detected significant lung lesions that were not previously reported. Fifty-three significant lesions were detected (mean, 1.6 lesions per case), of which 5 lesions (9.4%) were of high significance, 21 lesions (39.6%) were of intermediate significance, and 27 lesions (50.9%) were of low significance. In the PE group, the lung cancer screening group, and the group with a cancer history, four patients (12.1%), six patients (21.4%), and nine patients (23.1%), respectively, had focal lung lesions of high and/or intermediate significance. The false-positive rate of the CAD system was an average of 1.25 per case (range, 0 to 11). Significant lung lesions are frequently missed at routine clinical interpretation of chest CT studies but may be detected if CAD is used as an additional reader.

  9. Reliability of Assessing Hand Osteoarthritis on Digital Photographs and Associations With Radiographic and Clinical Findings

    PubMed Central

    Marshall, Michelle; Jonsson, Helgi; Helgadottir, Gudrun P; Nicholls, Elaine; van der Windt, Danielle; Myers, Helen; Dziedzic, Krysia

    2014-01-01

    Objective To investigate the reliability and construct validity of an atlas for grading hand osteoarthritis (OA) on photographs in a separate younger community-dwelling population than the development cohort. Methods Participants were community-dwelling adults (ages ≥50 years) in North Staffordshire, UK with hand pain or hand problems in the last year who attended a research clinic. High-quality photographs were taken in a standardized position. A photographic atlas was used to score hand joints (second and third distal interphalangeal [DIP], second and third proximal interphalangeal [PIP], and first carpometacarpal [CMC] joints) and joint groups (DIP, PIP, and CMC joints) for OA on a 0–3 scale. Hand radiographs were graded for OA using the Kellgren/Lawrence (K/L) grading system. Clinical features (nodes, bony enlargement, and deformity) were determined by physical examination. Associations of photographic hand OA grades with radiographic OA and clinical features were determined to assess construct validity. Results In total, 558 participants (mean age 64 years, 62% women) were included in the analyses. Reliability for scoring OA on the photographs was good (mean intrarater intraclass correlation coefficient [ICC] 0.77 and mean interrater ICC 0.71). At the joint level, photographic hand OA grade was positively associated with radiographic OA grade (Spearman's ρ = 0.19–0.57, P < 0.001) and the number of clinical features (Spearman's ρ = 0.36–0.59, P < 0.001). At the person level, individuals with higher global photographic OA scores had higher summed K/L scores and higher percentages meeting the American College of Rheumatology clinical hand OA criteria. Conclusion This photographic scoring system was reliable and a good indicator of hand OA in a separate younger community-dwelling population than the development cohort. This method of data collection offers researchers a feasible alternative to physical examination and radiography. PMID:26259552

  10. A comparison of MRI, radiographic and clinical findings of the position of the TMJ articular disc following open treatment of condylar neck fractures.

    PubMed

    Schneider, Alexander; Zahnert, Diana; Klengel, Steffen; Loukota, Richard; Eckelt, Uwe

    2007-10-01

    We examined the position and function of the articular disc after open treatment of condylar fractures by comparing magnetic resonance images (MRI) and radiographs with clinical data. MRI and radiographs were taken after treatment of 28 patients with 33 fractures of the mandibular condyles. In all cases, the disc was located in the fossa after open reduction and internal fixation (ORIF). The MRI, radiographic and clinical findings did not correlate, and damage to the temporomandibular joint (TMJ) could be seen more clearly on MRI than on clinical or radiographic examination. Damage to soft tissues seen on MRI after treatment was more pronounced in dislocated than in displaced fractures.

  11. Cough in Ambulatory Immunocompromised Adults: CHEST Expert Panel Report.

    PubMed

    Rosen, Mark J; Ireland, Belinda; Narasimhan, Mangala; French, Cynthia; Irwin, Richard S

    2017-08-19

    Cough is a common symptom prompting patients to seek medical care. Like patients in the general population, patients with compromised immune systems also seek care for cough. However, it is unclear whether the causes of cough in immunocompromised patients who are deemed unlikely to have a life-threating condition and a normal or unchanged chest radiograph are similar to those in persons with cough and normal immune systems. We conducted a systematic review to answer the question: What are the most common causes of cough in ambulatory immunodeficient adults with normal chest radiographs? Studies of patients ≥ 18 years of age with immune deficiency, cough of any duration, and normal or unchanged chest radiographs were included and assessed for relevance and quality. Based on the systematic review, suggestions were developed and voted on using the American College of Chest Physicians (CHEST) methodology framework. The results of the systematic review revealed no high-quality evidence to guide the clinician in determining the likely causes of cough specifically in immunocompromised ambulatory patients with normal chest radiographs. Based on a systematic review, we found no evidence to assess whether or not the proper initial evaluation of cough in immunocompromised patients is different from that in immunocompetent persons. A consensus of the panel suggested that the initial diagnostic algorithm should be similar to that for immunocompetent persons but that the context of the type and severity of the immune defect, geographic location, and social determinants be considered. The major modifications to the 2006 CHEST Cough Guidelines are the suggestions that tuberculosis should be part of the initial evaluation of patients with cough and HIV infection who reside in regions with a high prevalence of TB, regardless of the radiographic findings, and that specific causes and immune defects be considered in all patients in whom the initial evaluation is unrevealing

  12. [Recommendations for reporting benign asbestos-related findings in chest X-ray and CT to the accident insurances].

    PubMed

    Kraus, T; Borsch-Galetke, E; Elliehausen, H J; Frank, K; Hering, K G; Hieckel, H G; Hofmann-Preiss, K; Jacques, W; Jeremie, U; Kotschy-Lang, N; Mannes, E; Otten, H; Raab, W; Raithel, H J; Schneider, W D; Tuengerthal, S

    2009-12-01

    Asbestos-related diseases still play an important role in occupational medicine. The detection of benign asbestos-related diseases is one condition for the compensation of asbestos-related lung cancer in Germany. Due to the increasing use of computed tomography, asbestos-related diseases are more frequently detected in the early stages. The present article proposes recommendations for the findings which have to be reported as suspicious for being asbestos-related based on a) chest X-rays and b) computed tomography using the International Classification System for Occupational and Environmental Respiratory Diseases (ICOERD).

  13. Clinical and radiographic findings in multiple epiphyseal dysplasia caused by MATN3 mutations: description of 12 patients.

    PubMed

    Mäkitie, Outi; Mortier, Geert R; Czarny-Ratajczak, Malwina; Wright, Michael J; Suri, Mohnish; Rogala, Piotr; Freund, Margarida; Jackson, Gail C; Jakkula, Eveliina; Ala-Kokko, Leena; Briggs, Michael D; Cole, William G

    2004-03-15

    Multiple epiphyseal dysplasia (MED) is characterized by pain and stiffness in joints and delayed and irregular ossification of epiphyses. Causative mutations have been recognized in six different genes. We have identified disease-causing mutations in the gene encoding matrilin-3, an extracellular matrix protein, in seven families with autosomal dominant MED. Review of the clinical and radiographic features in 12 of the affected family members shows a uniform pattern of skeletal anomalies in all patients with considerable degree of variability in severity, both between and within families. The characteristic clinical findings are onset of symptoms in early childhood with predominance of knee and hip related complaints, normal stature, and early-onset osteoarthritis. Radiographs show small and irregular epiphyses and mild metaphyseal irregularities and striations, especially at the knees and hips and mild spinal changes. Despite overlap, both clinically and radiographically, with other forms of MED, the described features may help to differentiate this particular form from other entities within the MED spectrum.

  14. COMPARISON BETWEEN THORACIC RADIOGRAPHIC FINDINGS AND POSTMORTEM DIAGNOSIS OF THORACIC DISEASES IN DYSPNEIC COMPANION RATS (RATTUS NORVEGICUS).

    PubMed

    Fouriez-Lablée, Virginie; Vergneau-Grosset, Claire; Kass, Philip H; Zwingenberger, Allison L

    2017-03-01

    Companion rats are often presented to veterinarians for respiratory difficulties. Dyspnea in rats is most commonly due to infectious pneumonia, and thoracic neoplasia can go undiagnosed ante mortem due to a mistaken interpretation of pneumonia. In domestic carnivores, pulmonary nodular patterns have been shown to correlate with lung neoplastic diseases and infectious diseases. The main objective of this retrospective case series study was to determine whether certain radiographic criteria could be correlated with the presence of thoracic infectious disease and neoplastic disease in companion rats. A secondary objective was to determine whether the patient's sex and age were different between rats diagnosed with infectious versus neoplastic disease. Medical records and thoracic radiographs of dyspneic companion rats presented to the University of California at Davis, William R. Pritchard Veterinary Medical Teaching Hospital during the time period from January 2000 to December 2014 were reviewed. Rats with postmortem confirmation of thoracic lesions were included in the study. Thoracic radiographs were evaluated for positioning, lesion distribution, lung lobe involved, pulmonary pattern, mediastinal and pleural lesions by three observers blinded to diagnosis. Thirty rats were included in the study, including 23 rats with an infectious disease and seven with neoplasia. Mediastinal lesions were significantly more prevalent in the group diagnosed with thoracic neoplasia (P = 0.031), in particular cranially (P = 0.048). Although there was an overlap between the two groups, findings indicated that the presence of cranial mediastinal lesions may be helpful for differentiating neoplastic from infectious disease in rats. © 2016 American College of Veterinary Radiology.

  15. A Pediatric Case of Reversible Cerebral Vasoconstriction Syndrome With Similar Radiographic Findings to Posterior Reversible Encephalopathy Syndrome.

    PubMed

    Kamide, Tomoya; Tsutsui, Taishi; Misaki, Kouichi; Sano, Hiroki; Mohri, Masanao; Uchiyama, Naoyuki; Nakada, Mitsutoshi

    2017-06-01

    Reversible cerebral vasoconstriction syndrome occurs predominantly in middle-aged women. Only nine pediatric patients with this syndrome have been reported. We present a ten-year-old boy with reversible cerebral vasoconstriction syndrome with radiographic findings similar to those of posterior reversible encephalopathy syndrome (PRES). He presented with a thunderclap headache without a neurological deficit. Brain magnetic resonance angiography (MRA) revealed multifocal narrowing of the cerebral arteries, whereas magnetic resonance imaging (MRI) with diffusion-weighted imaging and fluid-attenuated inversion recovery demonstrated hyperintense lesions in the occipital lobes and the left cerebellum. The patient's symptoms resolved spontaneously after a few hours with no recurrence. MRA on the second day showed a complete normalization of the affected arteries, and MRI after one month demonstrated improvement in the abnormal findings, leading to a diagnosis of RCVS with radiographic findings similar to those of PRES. This child's findings suggests that, RCVS, with or without PRES, may occur in children who present with a thunderclap headache. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Intracardiac (superior vena cava/right atrial) ECGs using saline solution as the conductive medium for the proper positioning of the Shiley hemodialysis catheter: is it not time to forego [correction of forgo] the postinsertion chest radiograph?

    PubMed

    Madias, John E

    2003-12-01

    Hemodialysis (HD) is often administered in critical care areas to patients with chronic renal failure as a continuation of the HD they are receiving on an ambulatory basis, and to patients who develop such a need for the first time or may require HD only transiently. The double-lumen Shiley central venous catheter (SCVC), inserted via the brachiocephalic veins, is often employed for HD, and it is customary to obtain a chest radiograph to ensure proper positioning of the tip of the SCVC within the superior vena cava (SVC) or high right atrium (RA). This practice is implemented to evaluate for complications stemming from the insertion of the SCVC and subsequent mishaps due to low positioning of the tip of the catheter in the RA or right ventricle. Intracardiac ECGs obtained via a saline solution-filled SCVC as the conductive medium can be easily recorded serially and periprocedurally to ensure proper positioning of the tip of the SCVC in the SVC or high RA based on the evaluation of the appearance and amplitude of atrial depolarization, thus rendering chest radiographs redundant.

  17. Foreign Bodies on Lateral Neck Radiographs in Adults: Imaging Findings and Common Pitfalls.

    PubMed

    Castán Senar, Alba; Dinu, Laura E; Artigas, José M; Larrosa, Raquel; Navarro, Ylenia; Angulo, Elena

    2017-01-01

    Foreign-body (FB) ingestion is less common in adults than in children, but still occurs. Diagnostic management of patients with suspected FB ingestion in emergency departments depends on FB type and location, both of which are related to the patient profile. In adults, fish and chicken bones are the most common FB types, and the oropharynx and cricopharyngeal muscle are the most common locations. Once accidentally swallowed, an FB may become lodged in the oropharynx, and in such cases indirect or fiberoptic laryngoscopy is the first clinical management option. For FBs that have passed beyond this location, radiologic study is recommended, including anteroposterior and lateral neck radiographs (LNRs) using the soft-tissue technique. This is a quick and simple imaging method that in emergency departments achieves detection rates of 70%-80% in assessing FBs in the hypopharynx and upper cervical esophagus. Careful initial evaluation using LNRs can determine the presence and nature of an FB, which helps with predicting the location and risk assessment, making further imaging-including computed tomography-unnecessary. Prevertebral soft-tissue swelling is a nonspecific indirect sign, which in the appropriate clinical context raises suspicion of a radiolucent FB or related complications. LNRs can sometimes be difficult to interpret due to the presence of multiple overlapping soft-tissue structures and variable patterns of laryngeal cartilage calcification in adults. Adequate performance in interpreting LNRs along with familiarity with the full diagnostic process in these patients will enable radiologists to use the right imaging technique for the right patient, as described in the clinical algorithm proposed by the authors. (©)RSNA, 2017.

  18. 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

  19. 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

  20. Acute chest pain in emergency room. Preliminary findings with 40-64-slice CT ECG-gated of the whole chest.

    PubMed

    Coche, E

    2007-01-01

    ECG-gated MDCT of the entire chest represents the latest technical advance in the diagnostic work-up of atypical chest pain. The authors report their preliminary experience with the use of 40 and 64-slice CT in the emergency room and recommend to study only patients with moderate likelihood of coronary artery disease. ECG-gated MDCT of the entire chest will be preferentially performed on 64-slice MDCT rather than 40-slice MDCT because it enable to reduce the scan time (18 seconds versus 28 seconds acquisition time), the volume of contrast medium (82 mL + 15 mL versus 97 mL + 15 mL of highly concentrated contrast agent for a patient of 70 kgs) and radiation exposure (17 mSv versus 19 mSv). Approximately 1500 to 2000 of images are produced and need to be analysed on a dedicated workstation by a radiologist expert in cardiac and thoracic disorders. At the present time, only a few studies exist in the literature showing some promising results but further large clinical studies are needed before to implement such sophisticated protocol in emergency room.

  1. The diagnostic accuracy of chest ultrasound for CT-detected radiographic consolidation in hospitalised adults with acute respiratory failure: a systematic review.

    PubMed

    Hew, Mark; Corcoran, John P; Harriss, Elinor K; Rahman, Najib M; Mallett, Susan

    2015-05-19

    (1) Summarise chest ultrasound accuracy to diagnose radiological consolidation, referenced to chest CT in patients with acute respiratory failure (ARF). (2) Directly compared ultrasound with chest X-ray. Hospitalised patients. Studies were eligible if adult participants in respiratory failure underwent chest ultrasound to diagnose consolidation referenced to CT. Exclusion: (1) not primary study, (2) not respiratory failure, (3) not chest ultrasound, (4) not consolidation, (5) translation unobtainable, (6) unable to extract data, (7) unable to obtain paper. 4 studies comprising 224 participants met inclusion. As planned, paired forest plots display 95% CIs of sensitivity and specificity for ultrasound and chest X-ray. Sensitivity and specificity from each study are plotted in receiver operator characteristics space. Meta-analysis was planned if studies were sufficiently homogeneous and numerous (≥4). Although this numerical requirement was met, meta-analysis was prevented by heterogeneous units of analysis between studies. All studies were in intensive care, with either a high risk of selection bias or high applicability concerns. Studies had unclear or high risk of bias related to use of ultrasound. Only 1 study clearly performed ultrasound within 24 h of respiratory failure diagnosis. Ultrasound sensitivity ranged from 0.91 (95% CI 0.81 to 0.97) to 1.00 (95% CI 0.95 to 1.00). Specificity ranged from 0.78 (95% CI 0.52 to 0.94) to 1.00 (0.99 to 1.00). In two studies, chest X-ray had lower sensitivity than ultrasound, but there were insufficient patients to compare specificity. Four small studies suggest ultrasound is highly sensitive and specific for consolidation in ARF, but high risk of bias and concerns about applicability in all studies may have inflated diagnostic accuracy. Further robustly designed studies are needed to define the role of ultrasound in this setting. http://www.crd.york.ac.uk/PROSPERO/ (CRD42013006472). Published by the BMJ Publishing Group

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

    SciTech Connect

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

    1987-01-01

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

  3. Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings.

    PubMed

    Kutluay Köklü, Harika; Cankal, Dilek A; Bozkaya, Süleyman; Ergün, Gülfem; Bar, Emre

    2013-02-01

    Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions.

  4. Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings

    PubMed Central

    Çankal, Dilek A.; Bozkaya, Süleyman; Ergün, Gülfem; Bar??, Emre

    2013-01-01

    Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions. PMID:24455053

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

    PubMed Central

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

    2015-01-01

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

  6. Pulmonary infection caused by Mycobacterium kansasii: findings on computed tomography of the chest*

    PubMed Central

    Mogami, Roberto; Goldenberg, Telma; de Marca, Patricia Gomes Cytrangulo; Mello, Fernanda Carvalho de Queiroz; Lopes, Agnaldo José

    2016-01-01

    Objective To describe the main tomography findings in patients diagnosed with pulmonary infection caused by Mycobacterium kansasii. Materials and Methods Retrospective study of computed tomography scans of 19 patients with pulmonary infection by M. kansasii. Results Of the 19 patients evaluated, 10 (52.6%) were male and 9 (47.4%) were female. The mean age of the patients was 58 years (range, 33-76 years). Computed tomography findings were as follows: architectural distortion, in 17 patients (89.5%); reticular opacities and bronchiectasis, in 16 (84.2%); cavities, in 14 (73.7%); centrilobular nodules, in 13 (68.4%); small consolidations, in 10 (52.6%); atelectasis and large consolidations, in 9 (47.4%); subpleural blebs and emphysema, in 6 (31.6%); and adenopathy, in 1 (5.3%). Conclusion There was a predominance of cavities, as well as of involvement of the small and large airways. The airway disease was characterized by bronchiectasis and bronchiolitis presenting as centrilobular nodules. PMID:27777472

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

    PubMed

    Brauer, Carsten; Hennig-Pauka, Isabel; Hoeltig, Doris; Buettner, Falk F R; Beyerbach, Martin; Gasse, Hagen; Gerlach, Gerald-F; Waldmann, Karl-H

    2012-04-30

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

  8. Fetal Musculoskeletal Malformations with a Poor Outcome: Ultrasonographic, Pathologic, and Radiographic Findings

    PubMed Central

    Lee, Soo-Hyun; Song, Mi Jin; Min, Jee-Yeon; Han, Byoung Hee; Lee, Young Ho; Cho, Byung Jae; Kim, Seung Hyup

    2002-01-01

    The early and accurate antenatal diagnosis of fetal musculoskeletal malfomations with a poor outcome has important implications for the management of a pregnancy. Careful ultrasonographic examination of a fetus helps detect such anomalies, and a number of characteristic features may suggest possible differential diagnoses. During the last five years, we have encountered 39 cases of such anomalies, and the typical prenatal ultrasonographic and pathologic findings of a number of those are described in this article. PMID:12087201

  9. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics.

    PubMed

    Jaffe, Tracy; Thompson, William M

    2015-06-01

    Large-bowel obstruction is an abdominal emergency with high morbidity and mortality rates if left untreated. Although abdominal radiography is usually the initial imaging study performed in patients suspected of having large-bowel obstruction, it may not be sufficient to distinguish obstruction from other causes of colonic dilatation. Computed tomography is the imaging method of choice as it can establish the diagnosis and cause of large-bowel obstruction. A contrast agent enema may be used to confirm or exclude large-bowel obstruction. In this review, the imaging findings in multiple causes of large-bowel obstruction are illustrated and compared with acute colonic pseudo-obstruction.

  10. [Confusing injury findings in a suicidal gunshot fired to the chest from a carbine with a sawed-off barrel].

    PubMed

    Perdekamp, Markus Grosse; Bohnert, Michael; Braunwarth, Roland; Pollak, Stefan

    2006-01-01

    The stellate bullet entrance wound is one of the facultative features of a contact shot. For the formation of a star-shaped wound two factors are of special importance: first, an extensive bony support underlying the skin in the entrance region, and second, a strong propellant charge of the cartridge fired. Contact shots to the precordial region usually do not cause stellate entrance wounds, even if high-powered rifle ammunition is used. In the reported case, an injury pattern was observed that was not in line with normal findings and seemed confusing at first. Following a suicidal gunshot to the chest from a sawed-off carbine 98a (cal. 8 x 57 Js), a 4.5 cm wide, gaping bullet entrance wound with radiating tears was found. Instead of the usual pocket, the anterior thoracic wall showed a fist-sized area of destruction with extensive undermining of the subcutis. Not far from the entrance hole, a rib fragment had become displaced retrogradely thus perforating the skin from the inside out. The unusual pattern of findings could be explained by the fact that the barrel had been sawed off: as a result of this manipulation, a considerable part of the propellant charge had been converted outside the barrel, i.e. in the initial section of the bullet path.

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

    PubMed

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

    2014-01-01

    Lung ultrasound is superior to lung auscultation and supine chest radiography for many respiratory conditions in human patients. Ultrasound diagnoses are based on easily learned patterns of sonographic findings and artifacts in standardized images. By applying the wet lung (ultrasound lung rockets or B-lines, representing interstitial edema) versus dry lung (A-lines with a glide sign) concept many respiratory conditions can be diagnosed or excluded. The ultrasound probe can be used as a visual stethoscope for the evaluation of human lungs because dry artifacts (A-lines with a glide sign) predominate over wet artifacts (ultrasound lung rockets or B-lines). However, the frequency and number of wet lung ultrasound artifacts in dogs with radiographically normal lungs is unknown. Thus, the primary objective was to determine the baseline frequency and number of ultrasound lung rockets in dogs without clinical signs of respiratory disease and with radiographically normal lung findings using an 8-view novel regionally based lung ultrasound examination called Vet BLUE. Frequency of ultrasound lung rockets were statistically compared based on signalment, body condition score, investigator, and reasons for radiography. Ten left-sided heart failure dogs were similarly enrolled. Overall frequency of ultrasound lung rockets was 11% (95% confidence interval, 6-19%) in dogs without respiratory disease versus 100% (95% confidence interval, 74-100%) in those with left-sided heart failure. The low frequency and number of ultrasound lung rockets observed in dogs without respiratory disease and with radiographically normal lungs suggests that Vet BLUE will be clinically useful for the identification of canine respiratory conditions. © 2014 American College of Veterinary Radiology.

  12. The efficacy of X-rays after chest tube removal.

    PubMed

    Palesty, J A; McKelvey, A A; Dudrick, S J

    2000-01-01

    The insertion and subsequent removal of chest tubes are frequently performed procedures. We hypothesize that routine chest radiographs obtained after chest tube removal to confirm the absence of any post-procedure complications have little impact on clinical management. A 5-year retrospective study of 73 patients with tube thoracotomies was performed in a level II trauma center's intensive care unit. Patients were identified from billing records for chest tube placement. Medical records and official chest x-ray film reports, both before and after removal, were reviewed, and demographic data were collected. Of the 73 patients examined, only 8 had postprocedure reports that differed from the preprocedure reports. Two of these 8 patients required reinsertion of a chest tube to treat the recurrence of a significant pneumothorax. However, the decision to reinsert the chest tube was based on the patient's clinical appearance rather than on the x-ray findings. Chest radiography following the removal of chest tubes should not be a routinely performed procedure, but should preferably be based on the good clinical judgement and discrimination of the surgeon.

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

    PubMed

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

    2015-11-01

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

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

    PubMed

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

    2013-01-01

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

  15. Assessment of medial coronoid disease in 180 canine lame elbow joints: a sensitivity and specificity comparison of radiographic, computed tomographic and arthroscopic findings.

    PubMed

    Villamonte-Chevalier, A; van Bree, H; Broeckx, Bjg; Dingemanse, W; Soler, M; Van Ryssen, B; Gielen, I

    2015-09-25

    Diagnostic imaging is essential to assess the lame patient; lesions of the elbow joint have traditionally been evaluated radiographically, however computed tomography (CT) has been suggested as a useful technique to diagnose various elbow pathologies. The primary objective of this study was to determine the sensitivity and specificity of CT to assess medial coronoid disease (MCD), using arthroscopy as gold standard. The secondary objective was to ascertain the radiographic sensitivity and specificity for MCD compared with CT. For this study 180 elbow joints were assessed, of which 141 had been examined with radiography, CT and arthroscopy; and 39 joints, had radiographic and CT assessment. Sensitivity and specificity were calculated for CT and radiographic findings using available statistical software. Sensitivity and specificity of CT using arthroscopy as gold standard resulted in high values for sensitivity (100 %) and specificity (93 %) for the assessment of MCD. For the radiographic evaluation, a sensitivity of 98 % and specificity of 64 - 69 % using CT as the technique of reference, were found. These results suggest that in case of doubt during radiographic assessment, CT could be used as a non-invasive technique to assess the presence of MCD. Based on the high sensitivity and specificity obtained in this study it has been considered that CT, rather than arthroscopy, is the preferred noninvasive technique to assess MCD lesions of the canine elbow joint.

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

    PubMed

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

    2004-08-01

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

  17. Ultrasound of the coracoclavicular ligaments in the acute phase of an acromioclavicular disjonction: Comparison of radiographic, ultrasound and MRI findings.

    PubMed

    Faruch Bilfeld, Marie; Lapègue, Franck; Chiavassa Gandois, Hélène; Bayol, Marie Aurélie; Bonnevialle, Nicolas; Sans, Nicolas

    2017-02-01

    Acromioclavicular joint injuries are typically diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. The purpose of this study was to describe how the ultrasound findings of acromioclavicular joint injury compare with radiography and MRI findings. Forty-seven patients with suspected unilateral acromioclavicular joint injury after acute trauma were enrolled in this prospective study. All patients underwent digital radiography, ultrasound and 3T MRI. A modified Rockwood classification was used to evaluate the coracoclavicular ligaments. The classifications of acromioclavicular joint injuries diagnosed with radiography, ultrasound and MRI were compared. MRI was used as the gold standard. The agreement between the ultrasound and MRI findings was very good, with a correlation coefficient of 0.83 (95 % CI: 0.72-0.90; p < 0.0001). Ultrasound detected coracoclavicular ligament injuries with a sensitivity of 88.9 %, specificity of 90.0 %, positive predictive value of 92.3 % and negative predictive value of 85.7 %. The agreement between the ultrasound and radiography findings was poor, with a correlation coefficient of 0.69 (95 % CI: 0.51-0.82; p < 0.0001). Ultrasound is an effective examination for the diagnostic work-up of lesions of the coracoclavicular ligaments in the acute phase of an acromioclavicular injury. • Ultrasound is appropriate for acute acromioclavicular trauma due to its accessibility. • Ultrasound contributes to the diagnostic work-up of acute lesions of the coracoclavicular ligaments. • Ultrasound is appropriate in patients likely to benefit from surgical treatment. • Ultrasound could be a supplement to standard radiography in acute acromioclavicular trauma.

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed Central

    Meillier, Andrew; Commodore, Marius

    2015-01-01

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

  20. A retrospective study of a modified 1-minute formocresol pulpotomy technique part 1: clinical and radiographic findings.

    PubMed

    Kurji, Zahra A; Sigal, Michael J; Andrews, Paul; Titley, Keith

    2011-01-01

    The purpose of this study was to assess the clinical and radiographic outcomes of a 1-minute application of full-strength Buckley's formocresol with concurrent hemostasis using the medicated cotton pledget in human primary teeth. Using a retrospective chart review, clinical and radiographic data were available for 557 primary molars in 320 patients. Descriptive statistics and survival analysis were used to assess outcomes. Overall clinical success, radiographic success, and cumulative 5-year survival rates were approximately 99%, 90%, and 87%, respectively. Internal root resorption (∼5%) and pulp canal obliteration (∼2%) were the most frequently observed radiographic failures. Thirty-nine teeth were extracted due to clinical and or radiographic failure. Mandibular molars were 6 times more prone to radiographic failure than maxillary molars. Success rates for the modified technique are comparable to techniques that use the 5-minute diluted or full-strength solutions reported in the literature. This 1-minute full-strength formocresol technique is an acceptable alternative to published traditional techniques.

  1. 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.

  2. Relationship between radiographic changes and symptoms or physical examination findings in subjects with symptomatic medial knee osteoarthritis: a three-year prospective study.

    PubMed

    Fukui, Naoshi; Yamane, Shoji; Ishida, Satoru; Tanaka, Konagi; Masuda, Riako; Tanaka, Nobuho; Katsuragawa, Yozo; Fukui, Sakiko

    2010-11-24

    Although osteoarthritis (OA) of the knee joints is the most common and debilitating joint disease in developed countries, the factors that determine the severity of symptoms are not yet understood well. Subjects with symptomatic medial knee OA were followed up prospectively to explore the relationship between radiographic changes and symptoms or physical examination findings. One-hundred six OA knees in 68 subjects (mean age 71.1 years; 85% women) were followed up at 6-month intervals over 36 months. At each visit, knee radiographs were obtained, symptoms were assessed by a validated questionnaire, and the result of physical examination was recorded systematically using a specific chart. Correlations between the change of radiographs and clinical data were investigated in a longitudinal manner. During the study period, the narrowing of joint space width (JSW) was observed in 34 joints (32%). Although those knees were clinically or radiographically indistinguishable at baseline from those without JSW narrowing, differences became apparent at later visits during the follow-up. The subjects with knees that underwent JSW narrowing had severer symptoms, and the symptoms tended to be worse for those with higher rates of narrowing. A significant correlation was not found between the severity of symptoms and the growth of osteophytes. For the knees that did not undergo radiographic progression, the range of motion improved during the follow-up period, possibly due to the reduction of knee pain. Such improvement was not observed with the knees that underwent JSW narrowing or osteophyte growth. The result of this study indicates that the symptoms of knee OA patients tend to be worse when JSW narrowing is underway. This finding may explain, at least partly, a known dissociation between the radiographic stage of OA and the severity of symptoms.

  3. 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.

  4. Canine prostatic disease--comparison of radiographic appearance with morphologic and microbiologic findings: 30 cases (1981-1985).

    PubMed

    Feeney, D A; Johnston, G R; Klausner, J S; Perman, V; Leininger, J R; Tomlinson, M J

    1987-04-15

    A retrospective analysis was made of radiographs from 24 clinically normal young adult male Beagles used in previously reported base-line research on the distal male urinary tract. The ventrodorsal and craniocaudal prostate gland dimensions were measured, as visualized on the lateral radiographic view, and expressed as a ratio of the distance between the cranial aspect of the public bone and the sacral promontory. In 17 of these 24 dogs, there was sufficient image clarity to permit confident measurement of prostatic dimensions. From these data, the largest acceptable prostatic dimension, as visualized on the lateral radiographic view, was 70% of the public-promontory distance. A retrospective analysis was made of 30 cases of canine prostatic disease, with the objective of identifying the radiographic (survey and distention retrograde urethrocystogram) appearance most often associated with the various spontaneous prostatic diseases. Prostatomegaly was not specific for the cause of prostatic disease, except if the apparent parenchymal dimensions were greater than or equal to 90% of the public-promontory distance wherein neoplasia, abscess, and paraprostatic cysts (readily differentiated from diffuse intraparenchymal disease by ultrasonography) were the principle considerations. Multifocal, irregularly shaped, parenchymal mineral densities were observed only in dogs with prostatic carcinoma (4/7 cases) or prostatitis (1 case of chronic prostatitis). Narrowing of the prostatic portion of the urethra was observed only in association with abscess, neoplasm, or noninflammatory nonneoplastic disease (possibly benign hypertrophy/hyperplasia), whereas widening of this part of the urethra was not observed.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Occupational burnout among radiographers, sonographers and radiologists in Australia and New Zealand: Findings from a national survey.

    PubMed

    Singh, Nabita; Knight, Kellie; Wright, Caroline; Baird, Marilyn; Akroyd, Duane; Adams, Robert D; Schneider, Michal E

    2017-06-01

    Evidence demonstrates that health care professionals are more prone to burnout than other professionals due to the emotionally taxing interactions they have with their patients on a daily basis. The aims of this study were to measure occupational burnout levels among sonographers, radiographers and radiologists and to examine predictors of burnout according to demographic characteristics. A cross-sectional online survey was administered in 2010 to radiographers, sonographers and radiologists who were members of the following professional bodies: Australian Institute of Radiography, Australian Sonographers Association and The Royal Australian and New Zealand College of Radiologists. The Maslach Burnout Inventory was used to measure burnout levels for each profession. Data were analysed using SPSS Ver 20 (IBM, Chicago, IL, USA) statistical software. A total of 613 radiographers, 121 sonographers and 35 radiologists participated in the survey. Radiographers, sonographers and radiologists had a high mean (±SD) burnout score for emotional exhaustion (39.9 ± 8.5, 42.2 ± 8.5 and 44.9 ± 7.1 respectively) and depersonalization (18.9 ± 5.5, 20.3 ± 5.8 and 20.6 ± 5.6) compared to MBI norms. Radiographers also had low personal achievement (30.8 ± 5.5) compared to MBI norms. Radiographers and sonographers who were male, worked >10 hours overtime and spent <10% of their time training students per week had significantly higher depersonalization scores (p < 0.05). Burnout levels among radiographers, sonographers and radiologists are high and likely to vary according to some demographic and work-related factors. Further research is needed to examine ways to alleviate burnout in these professions so that loss of experienced staff due to burnout can be minimized and quality of patient care can be maintained. © 2016 The Royal Australian and New Zealand College of Radiologists.

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

    PubMed Central

    2014-01-01

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

  7. 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.

  8. Comparison between Radiographic (2-dimensional and 3-dimensional) and Histologic Findings of Periapical Lesions Treated with Apical Surgery.

    PubMed

    Bornstein, Michael M; Bingisser, Andreas C; Reichart, Peter A; Sendi, Pedram; Bosshardt, Dieter D; von Arx, Thomas

    2015-06-01

    The aim of this study was to evaluate the concordance of 2- and 3-dimensional radiography and histopathology in the diagnosis of periapical lesions. Patients were consecutively enrolled in this study provided that preoperative periapical radiography (PR) and cone-beam computed tomographic imaging of the tooth to be treated with apical surgery were performed. The periapical lesional tissue was histologically analyzed by 2 blinded examiners. The final histologic diagnosis was compared with the radiographic assessments of 4 blinded observers. The initial study material included 62 teeth in the same number of patients. Four lesions had to be excluded during processing, resulting in a final number of 58 evaluated cases (31 women and 27 men, mean age = 55 years). The final histologic diagnosis of the periapical lesions included 55 granulomas (94.8%) and 3 cysts (5.2%). Histologic analysis of the tissue samples from the apical lesions exhibited an almost perfect agreement between the 2 experienced investigators with an overall agreement of 94.83% (kappa = 0.8011). Radiographic assessment overestimated cysts by 28.4% (cone-beam computed tomographic imaging) and 20.7% (periapical radiography), respectively. Comparing the correlation of the radiographic diagnosis of 4 observers with the final histologic diagnosis, 2-dimensional (kappa = 0.104) and 3-dimensional imaging (kappa = 0.111) provided only minimum agreement. To establish a final diagnosis of an apical radiolucency, the tissue specimen should be evaluated histologically and specified as a granuloma (with/without epithelium) or a cyst. Analysis of 2-dimensional and 3-dimensional radiographic images alike results only in a tentative diagnosis that should be confirmed with biopsy. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. Correlation of radiographic size and the presence of radiopaque lamina with histological findings in 70 periapical lesions.

    PubMed

    Carrillo, Celia; Penarrocha, Miguel; Ortega, Bárbara; Martí, Eva; Bagán, José Vicente; Vera, Francisco

    2008-08-01

    This study was conducted to relate the histological diagnosis of chronic inflammatory periapical lesions with the radiographic images of these lesions. A total of 70 biopsy specimens obtained during periapical surgery were stained with hematoxylin and eosin and examined under a microscope. Histological analysis established the diagnosis as granuloma, cyst, or scar tissue. The location of the lesion was recorded, as were the radiographic size (maximum and minimum diameter in mm and area in mm(2)) and the presence of radiopaque lamina around the lesion, using an image analyzing system. The distribution of the biopsy specimens was 65.7% granulomas, 25.7% scar tissue, and 8.6% cysts, 1 of which was a keratocyst. The largest lesions were cysts and epithelialized granulomas, with statistically significant differences. Radiopaque lamina was observed around 9 lesions; of these, only 2 were histologically diagnosed as cysts, with the rest as granulomas. Most of the apical lesions were granulomas. Cysts had the largest radiotransparent images; however, in the 70 cases studied, neither the radiographic size nor the presence of associated radiopaque lamina alone was sufficient to determine the type of lesion. Histological analysis is required.

  10. Initial radiographic findings of early gastric cancer detected in health check programs and human "dry dock" (multiphasic screening) collective health checks and treated by endoscopic mucosal resection.

    PubMed

    Arai, Junya; Yamada, Hironori; Maruyama, Masakazu

    2002-01-01

    The purpose of this study was to evaluate the capacity of detection (detectability), by radiographic examination, of minute gastric cancer that was indicated for endoscopic mucosal resection (EMR). Fifty-five lesions in 55 patients with minute gastric cancer were endoscopically resected between 1992 and 2000 at the Foundation for Detection of Early Gastric Carcinoma. Of these 55 patients, 33 patients underwent indirect (with image intensifier and 100-mm roll film) and/or direct radiographic examination of the upper gastrointestinal tract as the initial screening examination, and subsequent upper gastrointestinal endoscopy. The remaining 22 patients underwent upper gastrointestinal endoscopy as the initial screening examination. As the first step, radiographic (indirect and direct) images were reviewed, and the abnormalities which had eventually led to the detection of the minute early gastric cancer (EGC) were reconfirmed. Then, they were analyzed in terms of the reproducibility of abnormal findings which enabled the detection of such a minute EGC, and in terms of whether they could be treated by EMR. The size, morphology, and location of the radiographically detected lesions were analyzed. Seventeen lesions of EGC were detected in the group in which indirect radiography was initially performed. Of these 17 lesions, some abnormality corresponding to the site of the lesion was pointed out in 7 lesions (2 lesions of type IIa and 5 lesions of type IIc). On the other hand, the remaining 10 lesions (type IIa, 3; type IIc, 5; type IIa + IIc, 1; and type IIb, 1) were detected by endoscopy, which was carried out to confirm the other abnormalities in the indirect radiographic images. Sixteen lesions of EGC were detected in the group in which direct radiography was initially performed. Of these 16 lesions, some abnormality corresponding to the site of the lesion was pointed out in 8 lesions (4 lesions of type IIa and 4 lesions of type IIc). The remaining 8 lesions (3 lesions

  11. Repeat rates in digital chest radiography and strategies for improvement.

    PubMed

    Fintelmann, Florian; Pulli, Benjamin; Abedi-Tari, Faezeh; Trombley, Maureen; Shore, Mary-Theresa; Shepard, Jo-Anne; Rosenthal, Daniel I

    2012-05-01

    To determine the repeat rate (RR) of chest radiographs acquired with portable computed radiography (CR) and installed direct radiography (DR) and to develop and assess strategies designed to decrease the RR. The RR and reasons for repeated digital chest radiographs were documented over the course of 16 months while a task force of thoracic radiologists, technologist supervisors, technologists, and information technology specialists continued to examine the workflow for underlying causes. Interventions decreasing the RR were designed and implemented. The initial RR of digital chest radiographs was 3.6% (138/3818) for portable CR and 13.3% (476/3575) for installed DR systems. By combining RR measurement with workflow analysis, targets for technical and teaching interventions were identified. The interventions decreased the RR to 1.8% (81/4476) for portable CR and to 8.2% (306/3748) for installed DR. We found the RR of direct digital chest radiography to be significantly higher than that of computed chest radiography. We believe this is due to the ease with which repeat images can be obtained and discarded, and it suggests the need for ongoing surveillance of RR. We were able to demonstrate that strategies to lower the RR, which had been developed in the era of film-based imaging, can be adapted to the digital environment. On the basis of our findings, we encourage radiologists to assess their own departmental RRs for direct digital chest radiography and to consider similar interventions if necessary to achieve acceptable RRs for this modality.

  12. Low Yield of Chest Radiography in a Large Tuberculosis Screening Program1

    PubMed Central

    Pollock, Nira R.

    2010-01-01

    Purpose: To assess the frequency and spectrum of abnormalities on routine screening chest radiographs in the pre-employment evaluation of health care workers with positive tuberculin skin test (TST) results. Materials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the need for written informed patient consent. Chest radiographic reports of all 2586 asymptomatic individuals with positive TST results who underwent pre-employment evaluation between January 1, 2003, and December 31, 2007, were evaluated to determine the frequency of detection of evidence of active tuberculosis (TB) or latent TB infection (LTBI) and the spectrum of imaging findings. All chest radiographs interpreted as positive were reviewed by an experienced board-certified radiologist. If there was a discrepancy between the two readings, a second experienced radiologist served as an independent and final arbiter. Any follow-up chest radiographs or computed tomographic images that had been acquired by employee health services or by the employee’s private physician as a result of a suspected abnormality detected at initial screening were also evaluated. Results: Of the 159 (6.1%) chest radiographic examinations that yielded abnormal results, there were no findings that were consistent with active TB. There were 92 cases of calcified granulomas, calcified lymph nodes, or both; 25 cases of apical pleural thickening; 16 cases of fibrous scarring; and 31 cases of noncalcified nodules. All cases of fibrous scarring involved an area smaller than 2 cm2. All noncalcified nodules were 4 mm in diameter or smaller, with the exception of one primary lung malignancy and one necrotizing granuloma (negative for acid-fast bacilli) that grew Mycobacterium kansasii on culture. Conclusion: Universal chest radiography in a large pre-employment TB screening program was of low yield in the detection of active TB or increased LTBI reactivation risk, and it provided

  13. Association of tibialis posterior tendon pathology with other radiographic findings in the foot: a case-control study.

    PubMed

    Shibuya, Naohiro; Ramanujam, Crystal L; Garcia, Glenn M

    2008-01-01

    The purpose of this study was to analyze the prevalence of spring ligament pathology and other radiographic changes related to flatfoot deformity in the presence of different degrees of tibialis posterior tendon pathology. A total of 72 patients (24 with tibialis posterior tendon abnormality and 48 sex- and age-matched controls) were evaluated for tibialis posterior tendon pathology, spring ligament pathology, and plain pedal radiographic angles, including cuboid abduction, talar declination, calcaneal inclination, and Meary's angles. The patients with tibialis posterior tendon pathology were subdivided into either minor (Type I) or severe (Type II/III), according to the Conti classification of tibialis posterior tendon pathology on MRI. All the continuous data of radiographic angles were dichotomized into either a flatfoot group or normal/cavus foot group. Associations between these nominal variables were analyzed. There was no association between Type I tibialis posterior tendon pathology and spring ligament pathologies (OR = 0.8, 95% CI = 0.15-4.65). Conversely, every patient with Type II/III tibialis posterior tendon pathology had spring ligament abnormality. Type II/III group also showed statistically significant associations with both increased talar declination angle (OR = 10.4, 95% CI = 1.62-109.22) and Meary's angle (OR = 7.5, 95% CI = 1.35-51.12), while no such associations were found with Type I tibialis posterior tendon pathology (OR = 1.0, 95% CI = 0.18-6.18 with talar declination angle; OR = 3.9, 95% CI = 0.65-27.71 with Meary's angle). In this investigation, only advanced tibialis posterior tendon pathology was statistically significantly associated with adult-acquired flatfoot deformity and spring ligament pathology.

  14. Preoperative Radiographic and CT Findings Predicting Syndesmotic Injuries in Supination-External Rotation-Type Ankle Fractures.

    PubMed

    Choi, Young; Kwon, Soon-Sun; Chung, Chin Youb; Park, Moon Seok; Lee, Seung Yeol; Lee, Kyoung Min

    2014-07-16

    The Lauge-Hansen classification system does not provide sufficient data related to syndesmotic injuries in supination-external rotation (SER)-type ankle fractures. The aim of the present study was to investigate factors helpful for the preoperative detection of syndesmotic injuries in SER-type ankle fractures using radiographs and computed tomography (CT). A cohort of 191 consecutive patients (104 male and eighty-seven female patients with a mean age [and standard deviation] of 50.7 ± 16.4 years) with SER-type ankle fractures who had undergone operative treatment were included. Preoperative ankle radiographs and CT imaging scans were made for all patients, and clinical data, including age, sex, and mechanism of injury (high or low-energy trauma), were collected. Patients were divided into two groups: the stable syndesmotic group and the unstable syndesmotic group, with a positive intraoperative lateral stress test leading to syndesmotic screw fixation. Fracture height, fracture length, medial joint space, extent of fracture, and bone attenuation were measured on radiographs and CT images and were compared between the groups. Binary logistic regression analysis was performed to identify the factors that significantly contributed to unstable syndesmotic injuries. Receiver operating characteristic curves were calculated, and cutoff values were suggested to predict unstable syndesmotic injuries on preoperative imaging measurements. Of the 191 patents with a SER-type ankle fracture, thirty-eight (19.9%) had a concurrent unstable syndesmotic injury. Age, sex, mechanism of injury, fracture height, medial joint space, and bone attenuation were significantly different between the two groups. In the binary logistic analysis, fracture height, medial joint space, and bone attenuation were found to be significant factors contributing to unstable syndesmotic injuries. The cutoff values for predicting unstable syndesmotic injuries were a fracture height of >3 mm and a medial

  15. Estimation of salivary amylase and total proteins in leukemia patients and its correlation with clinical feature and radiographic finding.

    PubMed

    Ashok, L; Sujatha, G P; Hema, G

    2010-01-01

    Leukemia is a fatal disease. The oral manifestations of the leukemias occur early in the course of the disease and these oral features can at times act as a diagnostic indicator. Saliva has been used as a diagnostic aid in a number of systemic diseases. In our study, samples of unstimulated saliva of 30 leukemia patients who were not on chemotherapy were collected and analyzed for salivary amylase and total protein. The oral manifestations and radiographic changes (OPG) were recorded. The correlation between the oral manifestations and the salivary components (salivary amylase and total protein) was assessed for prognostic significance. In the present study when the mean values of salivary amylase (1280±754 U/ml) and total protein (647.2±320.7 mg%) were compared with that in control subjects. There was a statistically significant difference for amylase levels (P<.05). On intraoral examination the study subjects showed pallor, gingivitis, gingival enlargement, petechiae, and ecchymosis. On the OPG, the radiographic features included generalized rarefaction of bone (20%), thinning of lamina dura (3.4%), generalized alveolar crest bone resorption (30%), thinning of walls of alveolar crypts (6.7%), besides others, e.g., periapical abscess (10%). The saliva of leukemic patients demonstrated obvious changes in composition. A rise in salivary amylase and total protein levels was evident, with the increase in amylase levels being statistically significant.

  16. Evaluation of Patellar Position before and After Medial Opening Wedge High Tibial Osteotomy: Radiographic and Computed Tomography Findings

    PubMed Central

    Moghtadaei, Mehdi; Otoukesh, Babak; Bodduhi, Bahram; Ahmadi, Keyvan; Yeganeh, Ali

    2016-01-01

    Introduction: Genovarum is a common orthopedic problem. Its optimal prompt treatment is an issue of importance. Aim: This study was conducted to determine the radiographic changes in patella bone before and after open wedge high tibial osteotomy. Material and Methods: In this quasi-experimental study, 43 patients were enrolled and underwent open wedge high tibial osteotomy and the radiographic and CT-scan indices including Q-Angle, Congruence Angle, Insall-Salvati index, and TTTG were measured and compared before and after surgery. Results: The result revealed that all indices including Q-Angle, Congruence Angle, Insull-Salvati index, and TTTG were not significantly differed across the study (P > 0.05). There was no difference between DLFA values before and after the operation (P> 0.05), while MPTA values were significantly different before and after operation (p <0.001). Conclusions: Totally it may be concluded that imaging indices are not differed after open wedge high tibial osteotomy and monitoring for them is not necessary and they would have no prognostic role. PMID:27703292

  17. 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…

  18. 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…

  19. 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.

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

    PubMed Central

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

    2013-01-01

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

  1. Long-term follow-up results and radiographic findings of anterior surgery with Cloward trephination for cervical spondylotic myelopathy.

    PubMed

    Xu, Bao-Shan; Zhang, Zuo-Lun; Le Huec, Jean-Charles; Xia, Qun; Hu, Yong-Cheng

    2009-04-01

    Serial retrospective long-term follow-up study. To assess the long-term results of anterior surgery with Cloward trephination and iliac strut grafting for cervical spondylotic myelopathy. Anterior surgery remains the most common surgical option and generally gives good results, although early and late deterioration after initial postoperative improvement has been noted. Although anterior decompression with trephination is a variant of the Cloward technique, little information is available concerning the long-term results after this procedure. One hundred sixty-eight consecutive patients treated with this technique by the same author from the years 1978 to 1992 were followed serially. One hundred and seven patients were followed for over 10 years (mean: 14.1 y) (follow-up rate: 71.8%). Clinical results were evaluated according to the Japanese Orthopedic Association system and the results at different postoperative intervals were analyzed. Thirty-six patients returned for the final follow-up. Plain radiographs were taken in neutral and flexion-extension positions and computed tomography scans were taken at fused segments and unfused levels. The mean recovery rate was 56.8% at final follow-up. Deterioration of 2 Japanese Orthopedic Association points or more was experienced in 44 patients at various postoperative periods and was more frequent at over 10 years follow-up. Kyphosis of fused segments was noted frequently on the radiographies of the 36 patients with a mean of 7.8 degrees. A straight or misaligned cervical spine was found in 28 (77.8%) patients and these deformities were more serious in multilevel fusions. Stenosis of the canal at fused segments was found in 15 (41.7%) patients owing to osteogenesis resulting from inadequate decompression or pseudoarthrosis. At unfused levels, the incidence of spondylolisthesis, bony bridge, disc hernia, and thickening or bulging of the ligament flavum was 19.4%, 27.8%, 33.3%, 19.4%, respectively, and these abnormalities

  2. Clinical and Radiologic Predictive Factors of Rib Fractures in Outpatients With Chest Pain.

    PubMed

    Zhang, Liang; McMahon, Colm J; Shah, Samir; Wu, Jim S; Eisenberg, Ronald L; Kung, Justin W

    2017-05-30

    , rib fractures have a higher association with a history of minor trauma and age ≥40 in the adult population. Radiographic findings associated with rib fractures include pleural effusion. The frontal chest radiograph alone has low sensitivity in detecting rib fractures. The dedicated rib series detected a greater number of rib fractures. Although no patients required hospitalization, those with rib fractures were more likely to receive narcotic analgesia. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Dental and oral radiographic findings in first-year university students in 1982 and 2002 in Helsinki, Finland.

    PubMed

    Peltola, Jaakko Sakari; Ventä, Irja; Haahtela, Sauli; Lakoma, Ani; Ylipaavalniemi, Pekka; Turtola, Lauri

    2006-02-01

    This study is part of a larger research program, at the Finnish Student Health Service in Helsinki, in which changes in the dental and oral health of first-year university students (born in Helsinki) in the years 1982 and 2002 were compared. Panoramic radiographs were taken of 176 students in 1982, mean age 19.8 years (SD+/-0.7), and of 231 in 2002, mean age 20.2 (SD+/-0.7). DMFT index, caries and periapical changes, alveolar bone resorption, wisdom teeth, supernumerary, missing, and persisting deciduous teeth were evaluated from the radiographs. The chi-squared test and non-parametric tests were used to analyze the statistical significance of differences between the study groups and between genders. The DMFT index diminished from 11.0 (SD +/- 4.2) to 2.9 (SD +/- 3.3) (p < 0.0001). In 2002, 27.9% of the students had a DMFT index of zero (in 1982, 0%, p < 0.000). The mean number of endodontically treated teeth diminished from 0.1 to 0.03 (p < 0.05). The number of impacted wisdom teeth increased in males from mean 0.41 to 0.69 (p < 0.05). An improvement in dental health was obvious in the year 2002. The favorable change in DMFT index is a trend that has been going on for several decades in Finland, probably as a result of the use of fluorides and better education in dental hygiene. The change might also be connected with improved general health.

  4. Restorative treatment thresholds for interproximal primary caries based on radiographic images: findings from the Dental Practice-Based Research Network.

    PubMed

    Gordan, Valeria V; Garvan, Cynthia W; Heft, Marc W; Fellows, Jeffrey L; Qvist, Vibeke; Rindal, D Brad; Gilbert, Gregg H

    2009-01-01

    This study sought to quantify the depths of proximal caries lesions that lead dentists in regular clinical practice to intervene restoratively, based on hypothetical scenarios that present radiographic images and patient background information, and to identify characteristics associated with restorative intervention in lesions that have penetrated only the enamel surface. This study surveyed dentists from the Dental Practice-Based Research Network (DPBRN) who had reported doing at least some restorative dentistry (n = 901). Dentists were asked to indicate the depth at which they would restore a lesion, based on a series of radiographic images depicting interproximal caries at increasing lesion depths in a mandibular premolar; in addition, the dentists were questioned regarding two caries risk scenarios: one involving a patient with low caries risk and another involving a patient at higher risk. Logistic regression was used to analyze associations between the decision to intervene restoratively and specific dentist, practice, and patient characteristics. Of the 901 DPBRN practitioner-investigators, 500 (56%) completed the survey. For a high caries risk patient, 66% of respondents indicated that they would restore a proximal enamel lesion, while 24% would do so once the lesion had reached into the outer third of the dentin. For a low caries risk patient, 39% of respondents reported that they would restore an enamel lesion, and 54% would do so once the lesion had reached into the outer third of the dentin. In multivariate analyses that accounted for dentist and practice characteristics, dentists in large group practices were less likely to intervene surgically for enamel caries, regardless of patient's caries risk.

  5. A combined pulmonary-radiology workshop for visual evaluation of COPD: study design, chest CT findings and concordance with quantitative evaluation.

    PubMed

    Barr, R Graham; Berkowitz, Eugene A; Bigazzi, Francesca; Bode, Frederick; Bon, Jessica; Bowler, Russell P; Chiles, Caroline; Crapo, James D; Criner, Gerard J; Curtis, Jeffrey L; Dass, Chandra; Dirksen, Asger; Dransfield, Mark T; Edula, Goutham; Erikkson, Leif; Friedlander, Adam; Galperin-Aizenberg, Maya; Gefter, Warren B; Gierada, David S; Grenier, Philippe A; Goldin, Jonathan; Han, MeiLan K; Hanania, Nicola A; Hansel, Nadia N; Jacobson, Francine L; Kauczor, Hans-Ulrich; Kinnula, Vuokko L; Lipson, David A; Lynch, David A; MacNee, William; Make, Barry J; Mamary, A James; Mann, Howard; Marchetti, Nathaniel; Mascalchi, Mario; McLennan, Geoffrey; Murphy, James R; Naidich, David; Nath, Hrudaya; Newell, John D; Pistolesi, Massimo; Regan, Elizabeth A; Reilly, John J; Sandhaus, Robert; Schroeder, Joyce D; Sciurba, Frank; Shaker, Saher; Sharafkhaneh, Amir; Silverman, Edwin K; Steiner, Robert M; Strange, Charlton; Sverzellati, Nicola; Tashjian, Joseph H; van Beek, Edwin J R; Washington, Lacey; Washko, George R; Westney, Gloria; Wood, Susan A; Woodruff, Prescott G

    2012-04-01

    The purposes of this study were: to describe chest CT findings in normal non-smoking controls and cigarette smokers with and without COPD; to compare the prevalence of CT abnormalities with severity of COPD; and to evaluate concordance between visual and quantitative chest CT (QCT) scoring. Volumetric inspiratory and expiratory CT scans of 294 subjects, including normal non-smokers, smokers without COPD, and smokers with GOLD Stage I-IV COPD, were scored at a multi-reader workshop using a standardized worksheet. There were 58 observers (33 pulmonologists, 25 radiologists); each scan was scored by 9-11 observers. Interobserver agreement was calculated using kappa statistic. Median score of visual observations was compared with QCT measurements. Interobserver agreement was moderate for the presence or absence of emphysema and for the presence of panlobular emphysema; fair for the presence of centrilobular, paraseptal, and bullous emphysema subtypes and for the presence of bronchial wall thickening; and poor for gas trapping, centrilobular nodularity, mosaic attenuation, and bronchial dilation. Agreement was similar for radiologists and pulmonologists. The prevalence on CT readings of most abnormalities (e.g. emphysema, bronchial wall thickening, mosaic attenuation, expiratory gas trapping) increased significantly with greater COPD severity, while the prevalence of centrilobular nodularity decreased. Concordances between visual scoring and quantitative scoring of emphysema, gas trapping and airway wall thickening were 75%, 87% and 65%, respectively. Despite substantial inter-observer variation, visual assessment of chest CT scans in cigarette smokers provides information regarding lung disease severity; visual scoring may be complementary to quantitative evaluation.

  6. 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

  7. Chest pain

    MedlinePlus

    ... have a fever or a cough that produces yellow-green phlegm. You have chest pain that is severe and does not go away. You are having problems swallowing. Chest pain lasts longer than 3 to 5 days. What to Expect at Your Office Visit ...

  8. [Chest pain].

    PubMed

    Horn, Benedikt

    2015-01-01

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

  9. Association of Cartilage Defects, and other MR Findings with Pain and Function in Individuals with Mild-Moderate Radiographic Hip Osteoarthritis and Controls

    PubMed Central

    Kumar, Deepak; Wyatt, Cory R.; Lee, Sonia; Nardo, Lorenzo; Link, Thomas M; Majumdar, Sharmila; Souza, Richard B.

    2013-01-01

    Objective To evaluate the relationship of hip radiographic osteoarthritis (ROA) and MR findings of cartilage lesions, labral tears, bone marrow edema like lesions (BMEL) and subchondral cysts with self-reported and physical function. Design Eighty five subjects were classified as controls (n= 55, KL 0, 1) or having mild-moderate ROA (n = 30, KL 2, 3). T2-weighted MR images at 3-Tesla were graded for presence of cartilage lesions, labral tears, BMELs and subchondral cysts. Posterior wall sign, cross-over sign, center-edge angle and alpha angle were also recorded. Function was assessed using Hip Osteoarthritis Outcome Score (HOOS), Timed-Up and Go (TUG) test and Y-Balance Test (YBT). Analysis compared function between subjects with and without ROA and those with and without femoral or acetabular cartilage lesions, adjusted for age. Non-parametric correlations were used to assess the relationship between radiographic scores, MR scores and function. Results Subjects with acetabular cartilage lesions had worse HOOS (Difference = 5–10%, P = 0.036–0.004), but not TUG or YBT, scores. Acetabular cartilage lesions, BMELs and subchondral cysts were associated with worse HOOS scores (ρ= 0.23–0.37, P = 0.041–0.001). Differences in function between subjects with and without ROA or femoral cartilage lesions were not significant. Other radiologic findings were not associated with function. Conclusions Acetabular cartilage defects, but not femoral cartilage defects or ROA, were associated with greater self-reported pain and disability. BMELs and subchondral cysts were related to greater hip related self-reported pain and disability. None of the radiographic or MR features were related to physical function. PMID:23948977

  10. 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.

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

    PubMed

    Macaluso, P James; Lucena, Joaquín

    2014-08-01

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

  12. Comparison of chest CT findings in nontuberculous mycobacterial diseases vs. Mycobacterium tuberculosis lung disease in HIV-negative patients with cavities

    PubMed Central

    Kim, Cherry; Park, So Hee; Oh, Sang Young; Kim, Sung-Soo; Jo, Kyung-Wook; Shim, Tae Sun

    2017-01-01

    Objectives This article focuses on the differences between CT findings of HIV-negative patients who have cavities with nontuberculous mycobacteria (NTM) disease and those with Mycobacterium tuberculosis infections (TB). Methods We retrospectively reviewed 128 NTM disease patients (79 males and 49 females) with cavities in chest CT, matched for age and gender with 128 TB patients in the same period. Sputum cultures of all patients were positive for pathogens. Two independent chest radiologists evaluated the characteristics of the largest cavity and related factors. Results Interobserver agreement was excellent (κ value, 0.853–0.938). Cavity walls in NTM disease were significantly thinner (6.9±4 mm vs 10.9±6 mm, P<0.001) and more even (the ratio of thickness, 2.6±1 vs 3.7±2, P<0.001) than those in TB. The thickening of adjacent pleura next to the cavity was also significantly thicker in NTM than TB (P<0.001). However, in the multivariate analysis, thickening of adjacent pleura was the only significant factor among the representative cavity findings (Odds ratio [OR], 6.49; P<0.001). In addition, ill-defined tree-in-bud nodules (OR, 8.82; P<0.001), number of non-cavitary nodules (≥10mm) (OR, 0.72; P = 0.003), and bronchiectasis in the RUL (OR, 5.3; P = 0.002) were significantly associated ancillary findings with NTM disease in the multivariate analysis. Conclusions The major cavities in NTM disease generally have thinner and more even walls than those in TB. When cavities are associated with adjacent pleural thickening, ill-defined satellite tree-in-bud nodules, or fewer non-cavitary nodules ≥10 mm, these CT findings are highly suggestive of NTM disease rather than TB. PMID:28346488

  13. Radiographic thumb osteoarthritis: frequency, patterns and associations with pain and clinical assessment findings in a community-dwelling population

    PubMed Central

    van der Windt, Danielle; Nicholls, Elaine; Myers, Helen; Dziedzic, Krysia

    2011-01-01

    Objectives. The aim of this study was to investigate: (i) the frequency and patterns of radiographic OA (ROA) in the thumb joints; and (ii) associations between thumb ROA and the clinical characteristics of thumb OA in older adults with hand pain or problems. Methods. Participants were 592 community-dwelling older adults with hand pain or hand problems who attended a research clinic. Hand X-rays were taken and 32 joints were scored for the presence of ROA. The occurrence and pattern of ROA in the hand were examined. Univariable and multivariable associations of thumb pain and clinical assessments (nodes, deformity, enlargement, thenar muscle wasting, grind test, Kapandji index, Finkelstein’s test and thumb extension) with ROA were investigated. Results. The first CMC and thumb IP joints were the hand joints most frequently affected with ROA. The thumb (thumb IP, first MCP, first CMC, trapezioscaphoid) was the most commonly affected joint group (n = 412). Isolated thumb ROA occurred more frequently than in any other isolated joint group. Multivariable analyses showed that older age, thumb pain, thenar muscle wasting and presence of nodes, deformity or enlargement best determined the presence of thumb ROA. Conclusion. The first CMC and thumb IP joints were frequently affected with ROA. Prevalence estimates of ROA would be underestimated if these were not scored. One-third of the individuals with thumb ROA did not have involvement of the first CMC joint. The presence of thumb ROA was strongly associated with a combination of older age, thumb pain and clinical features of OA. PMID:21134961

  14. [Chest pain in pediatric emergency departments: a usually benign process].

    PubMed

    Gastesi Larrañaga, M; Fernández Landaluce, A; Mintegi Raso, S; Vázquez Ronco, M; Benito Fernández, J

    2003-09-01

    To describe the characteristics and management of the children aged less than 14 years presenting to the pediatric emergency department with chest pain. Retrospective review of all the patients who presented to the pediatric emergency department with chest pain from 15 January 2001 to 14 January 2002. Families received a follow-up telephone call inquiring about the patient's outcome. The Mann-Whitney U test was used for non-parametric data and the Chi-square test with Yates' correction and Fisher's exact test were used for categorical data. Statistical significance was set at p<0.05. In 2001, 161 children presented with chest pain, representing 0.34% of the total number of consultations. Less than half of these patients (48%) had associated symptoms. Physical examination revealed abnormalities in 63% of the patients (39.1%). The most common finding was pain on palpation of the chest wall. Additional diagnostic tests were performed in 129 patients (80%). These included 116 radiographs, 62 electrocardiograms and nine miscellaneous tests. Abnormalities were found in seven chest radiographs. Only one child was admitted to hospital with pneumonia. The most common discharge diagnoses were idiopathic and/or musculoskeletal chest pain in 139 patients, pain of respiratory origin in 14 patients, gastrointestinal disorders in one patient, cardiac problems in one patient and other morbid processes in nine patients. Children with associated symptoms were more likely to receive a diagnosis other than nonspecific chest pain (28% vs 3.2% in children without other symptoms; relative risk: 8.66). Outpatient treatment included analgesics in 105 patients (65.2%). Only two children (1.2%) returned for reevaluation and no important findings were detected. Telephone follow-up was carried out in 117 children (72.6%). The pain lasted for less than 24 hours in 52 patients (32.2%). Thirty percent of the patients missed at least one day of school because of chest pain. Chest pain is an

  15. 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 ...

  16. 99mTc-HDP pinhole SPECT findings of foot reflex sympathetic dystrophy: radiographic and MRI correlation and a speculation about subperiosteal bone resorption.

    PubMed Central

    Kim, Sung Hoon; Chung, Soo Kyo; Bahk, Yong-Whee; Chung, Yong An; Song, Kyung Sub

    2003-01-01

    Reflex sympathetic dystrophy (RSD) is a common rheumatic disorder manifesting painful swelling, discoloration, stiffening and atrophy of the skin. Radiographic alterations include small, spotty subperiosteal bone resorption (SBR) and diffuse porosis, and MR imaging shows bone and soft-tissue edema. The purposes of current investigation were to assess 99mTc HDP pinhole SPECT (pSPECT) findings of RSD, to correlate them with those of radiography and MRI and to speculate about causative mechanism of SBR which characterizes RSD. pSPECT was performed in five patients with RSD of the foot. pSPECT showed small, discrete, spotty hot areas in the subperiosteal zones of ankle bones in all five patients. Diffusely increased tracer uptake was seen in the retrocalcaneal surface where the calcaneal tendon inserts in two patients with atrophic RSD. pSPECT and radiographic correlation showed spotty hot areas, that reflect focally activated bone turnover, to closely match with SBR. Further correlation with MRI showed both spotty hot areas and SBR to coincide in location with the insertions of ligaments and tendons, onto which pulling strain is constantly exerted. In contrast, the disuse osteoporosis in unstrained bones did not show any more significantly increased tracer uptake than normal cancellous bones. PMID:14555825

  17. Chest X-Ray (Chest Radiography)

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z X-ray (Radiography) - Chest Chest x-ray uses a very ... limitations of Chest Radiography? What is a Chest X-ray (Chest Radiography)? The chest x-ray is the ...

  18. The mass miniature chest radiography programme in Cape Town, South Africa, 1948 - 1994: The impact of active tuberculosis case finding.

    PubMed

    Hermans, S M; Andrews, J R; Bekker, L-G; Wood, R

    2016-12-01

    Tuberculosis (TB) control programmes rely mainly on passive detection of symptomatic individuals. The resurgence of TB has rekindled interest in active case finding. Cape Town (South Africa) had a mass miniature radiography (MMR) screening programme from 1948 to 1994. To evaluate screening coverage, yield and secular trends in TB notifications during the MMR programme. We performed an ecological analysis of the MMR programme and TB notification data from the City of Cape Town Medical Officer of Health reports for 1948 - 1994. Between 1948 and 1962, MMR screening increased to 12% of the population per annum with yields of 14 cases per 1 000 X-rays performed, accounting for >20% of total annual TB notifications. Concurrent with increasing coverage (1948 - 1965), TB case notification decreased in the most heavily TB-burdened non-European population from 844/100 000 population to 415/100 000. After 1966, coverage declined and TB notifications that initially remained stable (1967 - 1978) subsequently increased to 525/100 000. MMR yields remained low in the European population but declined rapidly in the non-European population after 1966, coincidental with forced removals from District 6. An inverse relationship between screening coverage and TB notification rates was observed in the non-European adult population. Similar secular trends occurred in infants and young children who were not part of the MMR screening programme. MMR of a high-burdened population may have significantly contributed to TB control and was temporally associated with decreased transmission to infants and children. These historical findings emphasise the importance of re-exploring targeted active case finding strategies as part of population TB control.

  19. Contrast-enhanced ultrasound findings in a case of primary chest chondrosarcoma mimicking a porta hepatis mass.

    PubMed

    Liu, Jin-Ya; Zhou, Lu-Yao; Liang, Jin-Yu; Lu, Ming-De; Wang, Wei

    2015-04-01

    We report a case of a 32-year-old woman who presented with upper abdominal pain. The physical examination revealed a palpable hard mass with a well-demarcated lower margin. Laboratory tests indicated hepatitis B viral infection. Computed tomography scan with intravenous contrast depicted a huge well-demarcated heterogeneous mass at the porta hepatis with irregular peripheral rim enhancement. Contrast-enhanced ultrasound showed peripheral irregular hyper-enhancement in the artery phase and hypo-enhancement in the portal and late phases. The postoperative histopathologic examination confirmed the diagnosis of low-grade chondrosarcoma. This is the first report of contrast-enhanced ultrasound findings of chondrosarcoma. There is some differential diagnosis to be discussed.

  20. An unusual case of disseminated toxoplasmosis in a previously healthy pregnant patient: radiographic, CT, and MRI findings.

    PubMed

    Paruthikunnan, Samir; Shankar, Balasubramanyam; Kadavigere, Rajagopal; Prabhu, Mukhyaprana; Narayanan, Ramakrishna; Jain, Harshwardhan

    2014-11-01

    Toxoplasmosis is a ubiquitous protozoal infection that during pregnancy commonly affects the fetus severely, with maternal infection usually being mild self-limiting. Disseminated toxoplasmosis in a healthy pregnant woman has, to the best of our knowledge, not been reported before. We present a case of disseminated toxoplasmosis involving pulmonary, central nervous system, and lymph nodes in a pregnant woman and imaging findings on radiography, computed tomography, and magnetic resonance imaging.

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

    PubMed

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

    2013-09-01

    Medial coronoid disease (MCD) encompasses lesions of the entire medial coronoid process (MCP), both of the articular cartilage and the subchondral bone. To detect the earliest signs of MCD, radiography and computed tomography were used to monitor the development of MCD in 14 Labrador retrievers, from 6 to 7 weeks of age until euthanasia. The definitive diagnosis of MCD was based on necropsy and micro-computed tomography findings. The frequency of MCD in the dogs studied was 50%. Radiographic findings did not provide evidence of MCD, ulnar subtrochlear sclerosis or blunting of the cranial edge of the MCP. Computed tomography was more sensitive (30.8%) than radiography (0%) in detecting early MCD, with the earliest signs detectable at 14 weeks of age. A combination of the necropsy and micro-computed tomography findings of the MCP showed that MCD was manifested as a lesion of only the subchondral bone in dogs <18 weeks of age. In all dogs (affected and unaffected), there was close contact between the base of the MCP and the proximal radial head in the congruent joints. Computed tomography and micro-computed tomography findings indicated that the lesions of MCD probably originated at the base of the MCP. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Chest Diseases

    PubMed Central

    Balmes, John R.

    1992-01-01

    The Council on Scientific Affairs of the California Medical Association presents the following inventory of items of progress in chest diseases. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, or scholars to stay abreast of these items of progress in chest diseases that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another. The items of progress listed below were selected by the Advisory Panel to the Section on Chest Diseases of the California Medical Association, and the summaries were prepared under its direction. PMID:1441468

  3. 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.

  4. Safety of coronary CT angiography and functional testing for stable chest pain in the PROMISE trial: A randomized comparison of test complications, incidental findings, and radiation dose.

    PubMed

    Lu, Michael T; Douglas, Pamela S; Udelson, James E; Adami, Elizabeth; Ghoshhajra, Brian B; Picard, Michael H; Roberts, Rhonda; Lee, Kerry L; Einstein, Andrew J; Mark, Daniel B; Velazquez, Eric J; Carter, William; Ridner, Michael; Al-Khalidi, Hussein R; Hoffmann, Udo

    2017-08-15

    Coronary computed tomography angiography (CTA) and functional testing strategies for stable chest pain yield similar outcomes; one aspect that may guide test choice is safety. We compared test safety (test complications, incidental findings, and effective radiation dose) between CTA and functional testing as-tested in PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain). In the subgroup whose physicians intended nuclear stress over other functional tests if randomized to the functional arm, we compared radiation dose of CTA versus nuclear stress and identified characteristics associated with dose. Of 9470 patients, none had major and <1% had minor complications (CTA: 0.8% [37/4633] vs. functional: 0.6% [27/4837]). CTA identified more incidental findings (11.6% [539/4633] vs. 0.7% [34/4837], p < 0.001), most commonly pulmonary nodules (9.4%, 437/4633). CTA had similar 90-day cumulative radiation dose to functional testing. However, in the subgroup whose physicians intended nuclear stress (CTA 3147; nuclear 3203), CTA had lower median index test (8.8 vs. 12.6 mSv, p < 0.001) and 90-day cumulative (11.6 vs. 13.1 mSv, p < 0.001) dose, independent of patient characteristics. The lowest nuclear doses employed 1-day Tc-99m protocols (12.2 mSv). The lowest CTA doses were at sites performing ≥500 CTAs/year (6.9 mSv) and with advanced (latest available) CT scanners (5.5 mSv). Complications were negligibly rare for both CTA and functional testing. CTA detects more incidental findings. Compared to nuclear stress testing, CTA's lower radiation dose, independent of patient characteristics, makes it an attractive test choice. Radiation dose varies with imaging protocol, indicating opportunities to further reduce dose. (ClinicalTrials.gov number, NCT01174550). Copyright © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  5. 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

  6. Symptoms and radiographic findings in the proximal and distal ulnar stumps after the Sauvé-Kapandji procedure for treatment of chronic derangement of the distal radioulnar joint.

    PubMed

    Inagaki, Hironobu; Nakamura, Ryogo; Horii, Emiko; Nakao, Etsuhiro; Tatebe, Masahiro

    2006-01-01

    We analyzed correlations between symptoms and radiographic findings with respect to the proximal and distal ulnar stumps after the Sauvé-Kapandji procedure for treating chronic derangement of the distal radioulnar joint. A total of 26 patients were studied (13 men, 13 women) with a mean age of 46 years at examination. Clinical assessment included elicitation of postoperative symptoms related to the proximal and distal ulnar stumps. In the radiographic study the radioulnar distance in the neutral wrist position and the presence or absence of scalloping at the radius were determined from posteroanterior (PA) views. The total mobility distance of the proximal ulnar stump was measured on the PA and lateral views while the wrist moved from radial to ulnar deviation or from extension to flexion. Eleven patients complained of tenderness over the distal ulnar stump and 5 patients felt discomfort around the proximal ulnar stump during forearm rotation. The postoperative radioulnar distance in patients with tenderness was significantly smaller than in the group without tenderness. Scalloping at the radius was shown in 9 patients but it was not related to the radioulnar distance. The total mobility distance of the proximal ulnar stump on the PA view was significantly greater in patients with tenderness than in those without, and it also was significantly greater in patients with scalloping than in those without. The total mobility distance on the lateral view was significantly greater in the group with discomfort than in the group without discomfort. The radioulnar distance was related to tenderness over the distal ulnar stump but not to the scalloping. Tenderness and scalloping each were related to radioulnar instability of the proximal ulnar stump. Discomfort around the proximal ulnar stump was related to dorsovolar instability of the stump. Prognostic, Level IV.

  7. Prevalence of radiographic findings in individuals with chronic low back pain screened for a randomized controlled trial: secondary analysis and clinical implications

    PubMed Central

    Vining, Robert D.; Potocki, Eric; McLean, Ian; Seidman, Michael; Morgenthal, A. Paige; Boysen, James; Goertz, Christine

    2014-01-01

    Objective The purpose of this study is to measure the prevalence of graded disc degeneration, spondylolisthesis, transitional segmentation and the distribution of sacral slope in patients 21 to 65 years of age with chronic low back pain (CLBP). Methods This retrospective study analyzed 247 digital lumbar radiographic series obtained during a randomized controlled trial of chiropractic patients with CLBP. CLBP was defined as pain in the low back lasting 12 weeks or longer. Radiographic findings of disc degeneration, spondylolisthesis, and lumbosacral transitional segmentation were graded by 2 authors using established classification criteria. Sacral slope was measured with a digital tool contained within imaging software. Results Lumbosacral transitional segments graded I – IV (Castellvi classification) were present in 14% of cases. Lumbar disc degeneration was most prevalent at L3-4 (49%) followed by L4-5 (42%), L2-3 (41%), L5-S1 (37%), and L1-2 (29%). Isthmic spondylolisthesis was present in 5% of cases with L5 the most common location. Degenerative spondylolisthesis demonstrated a prevalence rate of 18%, most commonly occurring at L4. The prevalence of degenerative spondylolisthesis was 51% for females aged 50–59 and 24% for males in the same age range. Conclusions Moderate-severe disc degeneration, multi-level disc narrowing, and degenerative spondylolisthesis were common in individuals with CLBP over age 40. Isthmic spondylolisthesis was not more prevalent than what has been reported in other populations. Transitional segmentation was identified in a minority of participants with some of these exhibiting accessory joints or fusion. Mean sacral slope in individuals with CLBP was not substantially different from mean slopes reported in other populations. PMID:25455834

  8. 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 ...

  9. 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

  10. Diagnosing pulmonary edema: lung ultrasound versus chest radiography.

    PubMed

    Martindale, Jennifer L; Noble, Vicki E; Liteplo, Andrew

    2013-10-01

    Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. To evaluate the ability of residents to recognize pulmonary edema on lung ultrasound using chest radiographs as a comparison standard. This is a prospective, blinded, observational study of a convenience sample of resident physicians in the Departments of Emergency Medicine (EM), Internal Medicine (IM), and Radiology. Residents were given a tutorial on interpreting pulmonary edema on both chest radiograph and lung ultrasound. They were then shown both ultrasounds and chest radiographs from 20 patients who had presented to the emergency department with dyspnea, 10 with a primary diagnosis of pulmonary edema, and 10 with alternative diagnoses. Cohen's κ values were calculated to describe the strength of the correlation between resident and gold standard interpretations. Participants included 20 EM, 20 IM, and 20 Radiology residents. The overall agreement with gold standard interpretation of pulmonary edema on lung ultrasound (74%, κ = 0.51, 95% confidence interval 0.46-0.55) was superior to chest radiographs (58%, κ = 0.25, 95% confidence interval 0.20-0.30) (P < 0.0001). EM residents interpreted lung ultrasounds more accurately than IM residents. Radiology residents interpreted chest radiographs more accurately than did EM and IM residents. Residents were able to more accurately identify pulmonary edema with lung ultrasound than with chest radiograph. Physicians with minimal exposure to lung ultrasound may be able to correctly recognize pulmonary edema on lung ultrasound.

  11. Chest tomosynthesis: technical and clinical perspectives.

    PubMed

    Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

    2014-02-01

    The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Physiological interpretations of radiographic findings on malformations of small veins: seriality of cisterns, communications to systemic veins and relationship to muscles

    PubMed Central

    Morita, Nobuo; Terada, Tomoaki; Sato, Morio; Sonomura, Tetsuo

    2014-01-01

    Objectives To re-evaluate the fluoroscopic findings of venous malformation by cine mode cisternography. Methods Using direct injection cine-cisternography, we studied 49 venous malformation lesions in the head and neck of 30 patients who were scheduled to undergo ethanol sclerotherapy. The diameter of definitively measurable 46 lesions was 21.7 ± 10.5 mm (mean ± SD, range: 6.0–48.0 mm). The injection was continued until the draining veins were clearly observed. Outflow communications between cisterns and systemic veins were classified into Type 1, no visible drainage; Type 2, draining into a normal venous system; and Type 3, with abnormally ectatic draining veins. The topological relationships of the lesions to surrounding structures were addressed using computed tomography, magnetic resonance imaging or ultrasonogram. Treatment results were evaluated. Results The direct injection cine-cisternography showed the typical ‘bunch of grapes’ pattern, and revealed serial cisternal, followed by the appearance of outflow/draining veins in all lesions. There were no Type 1, 47 Type 2 and two Type 2 outflow pattern. Satellite lesions emerged via the communicating veins in six lesions. Of the all 49 lesions, 48 were located in or on the muscle fascia. Sclerotherapy was safely completed in all Type 2 lesions with satisfactory results, but for the Type 3 lesions treatment was limited to be partial to avoid complications. Conclusions The present study suggested that communications from venous malformation to the systemic vein are fluoroscopically confirmable. These radiographic findings were thought explainable in relation to developmental nature or facilitating process of venous malformation. PMID:23223003

  13. Physiological interpretations of radiographic findings on malformations of small veins: seriality of cisterns, communications to systemic veins and relationship to muscles.

    PubMed

    Kishi, Kazushi; Morita, Nobuo; Terada, Tomoaki; Sato, Morio; Sonomura, Tetsuo

    2014-02-01

    To re-evaluate the fluoroscopic findings of venous malformation by cine mode cisternography. Using direct injection cine-cisternography, we studied 49 venous malformation lesions in the head and neck of 30 patients who were scheduled to undergo ethanol sclerotherapy. The diameter of definitively measurable 46 lesions was 21.7 ± 10.5 mm (mean ± SD, range: 6.0-48.0 mm). The injection was continued until the draining veins were clearly observed. Outflow communications between cisterns and systemic veins were classified into Type 1, no visible drainage; Type 2, draining into a normal venous system; and Type 3, with abnormally ectatic draining veins. The topological relationships of the lesions to surrounding structures were addressed using computed tomography, magnetic resonance imaging or ultrasonogram. Treatment results were evaluated. The direct injection cine-cisternography showed the typical 'bunch of grapes' pattern, and revealed serial cisternal, followed by the appearance of outflow/draining veins in all lesions. There were no Type 1, 47 Type 2 and two Type 2 outflow pattern. Satellite lesions emerged via the communicating veins in six lesions. Of the all 49 lesions, 48 were located in or on the muscle fascia. Sclerotherapy was safely completed in all Type 2 lesions with satisfactory results, but for the Type 3 lesions treatment was limited to be partial to avoid complications. The present study suggested that communications from venous malformation to the systemic vein are fluoroscopically confirmable. These radiographic findings were thought explainable in relation to developmental nature or facilitating process of venous malformation.

  14. 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.

  15. 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.

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations § 37.8 Radiographic examination at miner's expense. Any miner who wishes to obtain an examination... 42 Public Health 1 2013-10-01 2013-10-01 false Radiographic examination at miner's expense. 37.8...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic... information and radiographs on miners will be released by NIOSH only with the written consent from the miner, or if the miner is deceased, written consent from the miner's widow or widower, next of kin, or legal...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SERVICES MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS... 42 Public Health 1 2013-10-01 2013-10-01 false Submitting required chest roentgenograms and miner... Chest Radiographs § 37.60 Submitting required chest roentgenograms and miner identification documents...

  19. 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, ...

  20. Chest X Ray?

    MedlinePlus

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

  1. Chest Injuries and Disorders

    MedlinePlus

    ... inside of the chest cavity. Chest injuries and disorders include Heart diseases Lung diseases and collapsed lung Pleural disorders Esophagus disorders Broken ribs Thoracic aortic aneurysms Disorders ...

  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. Validation of a clinical decision rule: chest X-ray in patients with chest pain and possible acute coronary syndrome.

    PubMed

    Goldschlager, Romi; Roth, Hedley; Solomon, Jarryd; Robson, Scott; Green, Jessica; Green, Sarah; Spanger, Manfred; Gunn, Robyn; Cameron, Peter

    2014-08-01

    Current literature suggests that a large proportion of chest X-rays (CXRs) performed in emergency department (ED) patients with chest pain and suspected acute coronary syndrome (ACS) are unnecessary. The Canadian ACS Guidelines aim to guide clinicians in the appropriate use of CXR within this patient population. This study determined the prevalence of clinically significant CXR abnormalities and assessed the utility of the guidelines in a population of ED patients with chest pain and suspected ACS. Included in the study were participants over the age of 18 who presented to an Australian metropolitan ED, over a 1-year period, with a primary complaint of chest pain and who had a CXR and troponin level ordered in the ED (N = 760). We retrospectively compared their radiographic findings with their recommendations for CXR according to the ACS Guidelines. We found that 12 % of the participants had a clinically significant chest X-ray. The guidelines had a sensitivity of 80 % (95 % CI 0.70-0.87) and specificity of 50 % (95 % CI 0.47-0.54). The positive predictive value was 18 % (95 % CI 0.15-0.22) with a 95 % negative predictive value (95 % CI 0.92-0.97). Had the ACS guidelines been applied to our patient population, the number of CXR performed would have been reduced by 47 %. This study suggests that the ACS Guidelines has the potential to reduce the numbers of unnecessary CXR performed in ED patients. However, this would come at the expense of missing a minority of significant CXR abnormalities.

  4. Head-to-head comparison of the diagnostic performance of coronary computed tomography angiography and dobutamine-stress echocardiography in the evaluation of acute chest pain with normal ECG findings and negative troponin tests: A prospective multicenter study.

    PubMed

    Durand, Eric; Bauer, Fabrice; Mansencal, Nicolas; Azarine, Arshid; Diebold, Benoit; Hagege, Albert; Perdrix, Ludivine; Gilard, Martine; Jobic, Yannick; Eltchaninoff, Hélène; Bensalah, Mourad; Dubourg, Benjamin; Caudron, Jérôme; Niarra, Ralph; Chatellier, Gilles; Dacher, Jean-Nicolas; Mousseaux, Elie

    2017-08-15

    To perform a head-to-head comparison of coronary CT angiography (CCTA) and dobutamine-stress echocardiography (DSE) in patients presenting recent chest pain when troponin and ECG are negative. Two hundred seventeen patients with recent chest pain, normal ECG findings, and negative troponin were prospectively included in this multicenter study and were scheduled for CCTA and DSE. Invasive coronary angiography (ICA), was performed in patients when either DSE or CCTA was considered positive or when both were non-contributive or in case of recurrent chest pain during 6month follow-up. The presence of coronary artery stenosis was defined as a luminal obstruction >50% diameter in any coronary segment at ICA. ICA was performed in 75 (34.6%) patients. Coronary artery stenosis was identified in 37 (17%) patients. For CCTA, the sensitivity was 96.9% (95% CI 83.4-99.9), specificity 48.3% (29.4-67.5), positive likelihood ratio 2.06 (95% CI 1.36-3.11), and negative likelihood ratio 0.07 (95% CI 0.01-0.52). The sensitivity of DSE was 51.6% (95% CI 33.1-69.9), specificity 46.7% (28.3-65.7), positive likelihood ratio 1.03 (95% CI 0.62-1.72), and negative likelihood ratio 1.10 (95% CI 0.63-1.93). The CCTA: DSE ratio of true-positive and false-positive rates was 1.70 (95% CI 1.65-1.75) and 1.00 (95% CI 0.91-1.09), respectively, when non-contributive CCTA and DSE were both considered positive. Only one missed acute coronary syndrome was observed at six months. CCTA has higher diagnostic performance than DSE in the evaluation of patients with recent chest pain, normal ECG findings, and negative troponine to exclude coronary artery disease. Copyright © 2017. Published by Elsevier B.V.

  5. Evaluation of patients diagnosed with acute blunt aortic injury and their bedside plain chest radiography in the emergency department: A retrospective study.

    PubMed

    Karbek Akarca, Funda; Korkmaz, Tanzer; Çınar, Celal; Çakal, Elif Dilek; Ersel, Murat

    2016-09-01

    The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury. Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented. Bedside plain chest radiograph images were interpreted by 2 emergency medicine specialists and 1 radiologist. Thirty patients, mean age 45.87±16.14 years (70% male), were enrolled. Most common trauma mechanism was motor vehicle accident (53.3%). Agreement rates between emergency medicine specialists and radiologist were found to be "excellent" and "substantial" in identifying mediastinal widening and multiple left sided rib fractures; and "fair" in identifying widened paraspinal line, and transthoracic vertebral fractures. Though not completely reliable, bedside plain chest radiographs and physical examination findings may be useful in detecting aortic injury during primary survey when the patient is unstable and cannot be sent for chest computerized tomography. Appropriate further imaging studies should be carried out as appropriate based on patient's hemodynamic status.

  6. GI Radiographic Tests

    MedlinePlus

    ... Topic / Radiographic Tests in GI Radiographic Tests in GI Basics Commonly Performed Radiographic Tests in Gastroenterology Gastroenterologists ... January 2009. Updated December 2012. Return to Top GI Health Centers Colorectal Cancer Hepatitis C Inflammatory Bowel ...

  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. Severity of chest disease in cystic fibrosis patients in relation to their genotypes.

    PubMed

    al-Jader, L N; Meredith, A L; Ryley, H C; Cheadle, J P; Maguire, S; Owen, G; Goodchild, M C; Harper, P S

    1992-12-01

    A detailed comparison of the severity of chest disease with mutational status was carried out by cross sectional study of 127 cystic fibrosis patients, aged 1 to 31 years, living in Wales. Lung disease was classified according to severity, depending on pulmonary function tests (carried out on 76 patients) and chest radiograph status; information was obtained also on age at diagnosis in relation to severity of chest disease and colonisation with Pseudomonas species. Genotypes were determined by analysis for the mutations delta F508, delta I507, G551D, R553X, G542X, R117H, R560T, 1717--IG > A, and 621 + 1G > T. CF patients homozygous positive and heterozygous for the delta F508 deletion showed a significant decline of lung function with age. Unlike other studies, we did not find patients homozygous positive for the delta F508 deletion to have poorer lung function compared with heterozygous patients. Patients with the genotype 621 + IG > T/delta F508 tended to have more severe chest disease than the delta F508 homozygous patients in the same age group. There was some evidence that four patients heterozygous for R117H have mild chest disease.

  9. Severity of chest disease in cystic fibrosis patients in relation to their genotypes.

    PubMed Central

    al-Jader, L N; Meredith, A L; Ryley, H C; Cheadle, J P; Maguire, S; Owen, G; Goodchild, M C; Harper, P S

    1992-01-01

    A detailed comparison of the severity of chest disease with mutational status was carried out by cross sectional study of 127 cystic fibrosis patients, aged 1 to 31 years, living in Wales. Lung disease was classified according to severity, depending on pulmonary function tests (carried out on 76 patients) and chest radiograph status; information was obtained also on age at diagnosis in relation to severity of chest disease and colonisation with Pseudomonas species. Genotypes were determined by analysis for the mutations delta F508, delta I507, G551D, R553X, G542X, R117H, R560T, 1717--IG > A, and 621 + 1G > T. CF patients homozygous positive and heterozygous for the delta F508 deletion showed a significant decline of lung function with age. Unlike other studies, we did not find patients homozygous positive for the delta F508 deletion to have poorer lung function compared with heterozygous patients. Patients with the genotype 621 + IG > T/delta F508 tended to have more severe chest disease than the delta F508 homozygous patients in the same age group. There was some evidence that four patients heterozygous for R117H have mild chest disease. PMID:1479603

  10. Digital Paper Prints as Replacement for LASER Films: A Study of Intra-Observer Agreement for Wrist Radiographic Findings in Rickets.

    PubMed

    Jain, Abhinav; Gupta, Priyanka; Anand, Surinder Pal Singh; Dang, Archana

    2016-08-01

    Replacement of conventional LASER films with digital paper prints as supplement to radiology reports may serve as an economical and environment friendly method. However, it is essential that such a change does not compromise patient's intended diagnostic outcome. The aim of this study was to assess the reliability and acceptability of digital paper prints for the radiographic images by the treating physicians and radiologists. This observational analytical study was done at a tertiary care hospital of New Delhi, India. A total of 58 consecutively ordered wrist radiographs of paediatric patients (6 months to 12 years of age) for ruling out rickets were retrieved from the PACS (Picture Archiving and Communication System). These 58 radiographs, out of which 21 (36.2%) had radiological evidence of rickets over PACS were printed on two different media i.e., LASER films and glossy photographic paper. An objective scoring for the severity of rickets was done on both LASER films and paper prints by six observers independently. Overall comfort level with paper prints was rated on a 1-5 point Likert scale. Data was analysed using STATA 14.0 (Stata Corp, College Station, TX). Intra-observer percentage agreement and value of Cohen's kappa for PACS vs. LASER films and PACS vs. paper prints was equal i.e., 98.3% and 0.97, respectively. Intra-observer agreement between LASER films and paper prints for all six observers was excellent, ranging from 0.92 to 1.00; percentage agreement ranging from 94.8% to 100%. Fracture of ulna/radius present in 4 sets of the X-rays was well demonstrated in both LASER films and paper prints. Comfort level with paper prints was rated as 5 out of 5 by all due to no requirement of any special illuminated view box and dark room. This study concludes that the use of paper prints may serve as a reliable alternative to LASER films to communicate the report of wrist radiographs for the treating physicians without any compromise over diagnostic information

  11. Digital Paper Prints as Replacement for LASER Films: A Study of Intra-Observer Agreement for Wrist Radiographic Findings in Rickets

    PubMed Central

    Jain, Abhinav; Anand, Surinder Pal Singh; Dang, Archana

    2016-01-01

    Introduction Replacement of conventional LASER films with digital paper prints as supplement to radiology reports may serve as an economical and environment friendly method. However, it is essential that such a change does not compromise patient’s intended diagnostic outcome. Aim The aim of this study was to assess the reliability and acceptability of digital paper prints for the radiographic images by the treating physicians and radiologists. Materials and Methods This observational analytical study was done at a tertiary care hospital of New Delhi, India. A total of 58 consecutively ordered wrist radiographs of paediatric patients (6 months to 12 years of age) for ruling out rickets were retrieved from the PACS (Picture Archiving and Communication System). These 58 radiographs, out of which 21 (36.2%) had radiological evidence of rickets over PACS were printed on two different media i.e., LASER films and glossy photographic paper. An objective scoring for the severity of rickets was done on both LASER films and paper prints by six observers independently. Overall comfort level with paper prints was rated on a 1-5 point Likert scale. Data was analysed using STATA 14.0 (Stata Corp, College Station, TX). Results Intra-observer percentage agreement and value of Cohen’s kappa for PACS vs. LASER films and PACS vs. paper prints was equal i.e., 98.3% and 0.97, respectively. Intra-observer agreement between LASER films and paper prints for all six observers was excellent, ranging from 0.92 to 1.00; percentage agreement ranging from 94.8% to 100%. Fracture of ulna/radius present in 4 sets of the X-rays was well demonstrated in both LASER films and paper prints. Comfort level with paper prints was rated as 5 out of 5 by all due to no requirement of any special illuminated view box and dark room. Conclusion This study concludes that the use of paper prints may serve as a reliable alternative to LASER films to communicate the report of wrist radiographs for the treating

  12. 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

  13. Two-Year Comparative Outcomes of MIS Lateral and MIS Transforaminal Interbody Fusion in the Treatment of Degenerative Spondylolisthesis: Part II: Radiographic Findings.

    PubMed

    Isaacs, Robert E; Sembrano, Jonathan N; Tohmeh, Antoine G

    2016-04-01

    Prospective, multicenter, institutional review board approved study with randomized and observational study arms. The purpose of this study was to compare radiographic outcomes between minimally invasive transforaminal (MIS TLIF) or MIS lateral interbody fusion (XLIF) in the treatment of patients with low-grade degenerative spondylolisthesis with stenosis through 2-year postoperative. Few reports exist comparing different MIS approaches directly in the treatment of similar pathology, as most studies report differences between MIS and open procedures. A total of 55 patients undergoing surgical treatment for degenerative spondylolisthesis with spinal stenosis at one or two contiguous levels between L1 and L5 were enrolled. Twenty-nine patients were treated with XLIF and 26 patients were treated with MIS TLIF. Disc height was significantly improved from preoperative at all postoperative time points in both groups, though the XLIF group experienced less subsidence and resultant loss of disc height than the MIS TLIF group by 24-month postoperative (P = 0.002). Postoperative change in central canal area was statistically greater in the MIS TLIF compared with the XLIF group (43.1 mmvs. 4.1 mm, P = 0.028). At several postoperative time points, foraminal height and area on the ipsilateral side and foraminal height on the contralateral side to the approach were significantly increased postoperatively in the XLIF group, and the magnitude of ipsilateral height increase was greater than in the MIS TLIF cohort (P < 0.05).Using fusion criteria of <3° range of motion and <3 mm translation on plain radiographs, 100% of patients in both groups were solidly fused at 24-month postoperative. Using computed tomography fusion criteria of presence of intervertebral bridging bone, 100% (32/32) of XLIF levels and 96% (25/26) of MIS TLIF levels were solidly bridged (P = 0.448). Different mechanisms of stenosis correction (direct vs. indirect) between the MIS TLIF and

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

    PubMed Central

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

    2015-01-01

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

  15. Ankle "sprains" during sport activities with normal radiographs: Incidence of associated bone and tendon injuries on MRI findings and its clinical impact.

    PubMed

    Yammine, Kaissar; Fathi, Yahia

    2011-12-01

    To evaluate, with magnetic resonance imaging (MRI), the occurrence of bone and tendon injuries and their impact on clinical management in athletes with ankle trauma during sports activities having normal radiographs and referred to the orthopedic department as "ankle sprains". This was a prospective study of 54 patients. Clinical examination and MR imaging were done in order to have an accurate diagnosis and the incidence of those injuries. Nearly half of the patients were found to have no ligament injury on MRI. Isolated bone bruises and isolated tendon injuries may share the same clinical signs with ankle sprains. MRI-based clinical management has been adjusted for each case; beside the Grade 3 ligament injuries and the rare, but difficult to diagnose osteochondral lesions of the talus, partial weight bearing or short-immobilization were offered as treatment modalities for the rest of the patients avoiding unnecessary long-term treatments and rehabilitation exercises. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. [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.

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

    PubMed

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

    2016-07-15

    Coronary computed tomography angiography (CCTA) appears comparable to standard care, including exercise stress testing (EST), in diagnosing acute coronary syndrome in emergency department (ED) patients with chest pain but may increase downstream testing. The objective of this study was to investigate rates of post-CCTA versus post-EST testing for (1) invasive angiography and (2) all combined cardiac testing. This was a retrospective cohort study performed at 2 urban Canadian EDs involving patients aged up to 65 years with chest pain but no objective ACS findings that were evaluated with CCTA or EST at the physician's discretion. The primary outcome was the proportion of patients who had 30-day invasive angiography in each group; secondary outcomes included all subsequent 30-day cardiac testing, including nuclear medicine scanning. From July 1, 2012, to June 30, 2014, we collected 1,700 patients: 521 CCTA and 1,179 EST. Demographics and risk factors were similar in both cohorts. In the following 30 days, 30 CCTA (5.8%) and 297 EST (25.2%) patients underwent any type of additional cardiac testing (difference 19.4%, 95% CI 16.0 to 22.6), whereas 12 CCTA (2.3%) and 20 EST patients (1.7%) underwent angiography (difference 0.6%, 95% CI -0.8% to 2.6%). No patients in either group died or had a myocardial infarction within 30 days. For ED patients with chest pain who underwent brief observation, CCTA and EST had similar 30-day angiography rates, but CCTA patients underwent significantly less overall cardiac investigations. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Chest x-ray

    MedlinePlus

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

  19. Sex specific impact of prodromal chest pain on pre-hospital delay time during an acute myocardial infarction: Findings from the multicenter MEDEA Study with 619 STEMI patients.

    PubMed

    von Eisenhart Rothe, A F; Albarqouni, L; Gärtner, C; Walz, L; Smenes, K; Ladwig, K-H

    2015-12-15

    Scarce evidence yields conflicting results regarding the effect of prodromal chest pain (PCP) on pre-hospital delay during an acute myocardial infarction (AMI). We aimed to assess the impact of PCP on delay. Data was collected on 619 ST-elevated MI patients from the multicenter Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. Patients with any PCP (which was subdivided into undefined PCP, possible and definite angina) within a year before AMI were identified using the Rose questionnaire, administered in bedside interviews. The influence of PCP and its subdivisions (all compared to no PCP) was assessed using logistic regression (with cut-offs of 2 h, 6 h, and a 4-category ordinal outcome). Any type of PCP was reported by men (50.6%) more than women (34.6%) (OR=1.9; 95% CI: 1.3 to 2.8; p=.001). The median delay of patients with PCP was not significantly different to delay in patients with no PCP (p=.327). Prolonged delay times were observed in women with PCPs of lesser degree of cardiac confirmation, while the opposite was observed in men. In women, possible angina was more strongly associated with delay <2 h (OR=6.8; 95% CI=2 to 23.8) than any PCP (OR=2.6; 95% CI=1.2 to 5.7). For men, PCPs of increasing cardiac confirmation are associated with prolonged delay. For women, PCPs of lesser cardiac confirmation are more likely to lead to prolonged delay. Future studies should investigate mediating factors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. The radiographic presentation of osteomyelitis in the foot.

    PubMed

    Christman, R A

    1990-07-01

    Numerous authors have described the radiographic findings associated with osteomyelitis. Knowledge of these findings and their presentation radiographically may make diagnosis of this pathology quite simple. The challenge comes not in diagnosing osteomyelitis based on gross radiographic evidence; by this time, the disease has significantly progressed. The challenge is to be able to recognize early, subtle changes, and, in conjunction with clinical findings, to diagnose and treat the disease before classic radiographic evidence is demonstrated.

  1. [History of chest percussion].

    PubMed

    Chrobák, L

    2001-01-01

    Although percussion of the abdomen was already known to the Greek physician Galenos (2nd century A. D.) who used it to distinguish between ascites and meteorism, the Viennese physician Leopold Auenbrugger (1722-1809) started to use, the percussion of the chest as a diagnostic tool. In 1761 he published his experience in a treatise called "New Method for Detecting Hidden Ailments of the Chest by Percussion of the Thorax" (Inventum novum ex percussione thoracis hummani ut signo abstruso interni pectoris morbos detergendi). However, this method was introduced into practice only 50 years later by Jean Nicolas Corvisart, who translated Auenbrugger's book in 1808 into French. The famous Vinnese internist of Czech origin Joseph Skoda (1805-1881) set the teaching about percussion and auscultation on a firm physical basis. Skoda confronted the physical findings with dissection materials in close cooperation with the renowned Vinnese pathologist Karl Rokitansky (1804-1878), who was born in Hradec Králové. The Medical School in Prague became famous for its excellent command of methods based on physical examination and surpassed even the Viennese School.

  2. Blunt chest trauma.

    PubMed

    Adegboye, V O; Ladipo, J K; Brimmo, I A; Adebo, A O

    2002-12-01

    A retrospective study was conducted at the cardiothoracic surgical unit of the University College Hospital, Ibadan on all consecutive, blunt chest injury patients treated between May 1975 and April 1999. The period of study was divided into 2 periods: May 1975-April 1987, May 1987-April 1999. The aim was to determine the pattern of injury, the management and complications of the injury among the treated. Blunt chest trauma patients were 69% (1331 patients) of all chest injury patients (1928 patients) treated. Mean age for the 2 periods was 38.3 +/- 15 years and 56.4 +/- 6.2 years, the male:female ratio was 4:1 and 2:1 respectively. The incidence of blunt chest trauma tripled in the second period. Blunt chest trauma was classified as involving bony chest wall or without the involvement of bony chest wall. Majority of the blunt chest injuries were minor chest wall injuries (68%, 905 patients), 7.6% (101 patients) had major but stable chest wall injuries, 10.8% (144 patients) had flail chest injuries. Thoracic injuries without fractures of bony chest wall occurred in 181 patients (13.6%). Seven hundred and eighty-seven patients (59.1%) had associated extra-thoracic injuries, in 426 patients (54.1%) two or more extra-thoracic systems were involved. While orthopaedic injury was the most frequent extra-thoracic injury (69.5%) associated with blunt chest trauma, craniospinal injury (31.9%) was more common injury among the patients with severe or life threatening chest trauma. The most common extra-thoracic operation was laparotomy (221 patients). Nine hundred and seventy patients (72.9%) had either closed thoracostomy drainage or clinical observation, 361 patients (27.1%) had major thoracic surgical intervention (emergent in 134 patients, late in 227 patients). Most of the severe lung contusion that needed ventilatory care (85 patients) featured among patients with bony chest wall injury, 15 were without chest wall injury. Majority of patients 63.2% (835 patients) had no

  3. Findings

    MedlinePlus

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

  4. [A case of cryptogenic organizing pneumonia showing reversed halo sign on computed tomography of the chest].

    PubMed

    Arai, Toru; Inoue, Yoshikazu; Ando, Seijitsu; Inoue, Koji; Tsuyuguchi, Kazunari; Suzuki, Katsuhiro; Hayashi, Seiji; Kitaichi, Masanori; Akira, Masanori; Sakatani, Mitsunori

    2007-08-01

    A 56-year-old female non-smoker complained of general fatigue and pyrexia. Laboratory examination revealed elevation of white blood cells (WBC) 10200/microl and C-reactive protein (CRP) 13.3mg/dl. Chest radiograph showed bilateral patchy and ring-shaped consolidations in both lungs. Chest computed tomography (CT) revealed multiple round ground glass opacities fringed with consolidation, namely the "reversed halo sign". Transbronchial lung biopsy specimens showed polypoid granulation tissue in terminal air spaces, consistent with an organizing pneumonia pattern. Clinical findings suggesting collagen vascular diseases and drug induced lung diseases were not recognized, thus cryptogenic organizing pneumonia (COP) was diagnosed. High dose methylprednisolone therapy improved her condition, and the ring-shaped opacities on chest CT resolved. She relapsed twice during approximately five years after the disease onset. Chest CT at the recurrences revealed subpleural patchy consolidations without formation of the "reversed halo sign". The sign was originally supposed to be specific for cryptogenic organizing pneumonia. However, other diseases like sarcoidosis and paracoccidioidomycosis have been reported to show this sign. The meaning of the "reversed halo sign" should be examined based on the accumulation of more cases.

  5. Satisfaction of Search in Chest Radiography 2015.

    PubMed

    Berbaum, Kevin S; Krupinski, Elizabeth A; Schartz, Kevin M; Caldwell, Robert T; Madsen, Mark T; Hur, Seung; Laroia, Archana T; Thompson, Brad H; Mullan, Brian F; Franken, Edmund A

    2015-11-01

    Two decades have passed since the publication of laboratory studies of satisfaction of search (SOS) in chest radiography. Those studies were performed using film. The current investigation tests for SOS effects in computed radiography of the chest. Sixty-four chest computed radiographs half demonstrating various "test" abnormalities were read twice by 20 radiologists, once with and once without the addition of a simulated pulmonary nodule. Receiver-operating characteristic detection accuracy and decision thresholds were analyzed to study the effects of adding the nodule on detecting the test abnormalities. Results of previous studies were reanalyzed using similar modern techniques. In the present study, adding nodules did not influence detection accuracy for the other abnormalities (P = .93), but did induce a reluctance to report them (P < .001). Adding nodules did not affect inspection time (P = .58) so the reluctance to report was not associated with reduced search. Reanalysis revealed a similar decision threshold shift that had not been recognized in the early studies of SOS in chest radiography (P < .01) in addition to reduced detection accuracy (P < .01). The nature of SOS in chest radiography has changed, but it is not clear why. SOS may be changing as a function of changes in radiology education and practice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1999-05-01

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

  8. Resolution of lung collapse in a preterm neonate following chest physiotherapy.

    PubMed

    Pandya, Yesha Subhashchandra; Shetye, Jaimala; Nanavati, Ruchi; Mehta, Amita

    2011-09-01

    Preterm neonates are prone to lung collapse because of many reasons. Chest physiotherapy can be used successfully in such cases with lung collapse in order to facilitate removal of secretions and re-expansion of the lung. With the help of a chest radiograph, improvement can be noted as in this case.

  9. Radiographic prevalence of scaphotrapeziotrapezoid osteoarthrosis.

    PubMed

    Scordino, Laura E; Bernstein, Jenna; Nakashian, Michael; McIntosh, Masai; Cote, Mark P; Rodner, Craig M; Wolf, Jennifer Moriatis; Wolf, Jennifer Moraitis

    2014-09-01

    To define the radiographic prevalence of scaphotrapeziotrapezoid (STT) osteoarthrosis (OA) in a cohort of patients presenting to a hand surgeon for any complaint. The secondary purpose was to evaluate coexisting thumb carpometacarpal (CMC) joint OA. Seven hundred radiographs were evaluated for presence and degree of STT and thumb CMC arthritic changes in consecutive patients presenting to a hand clinic for any chief complaint over the study period. OA was noted at the STT joint in 111 of the 700 (16%) radiographs reviewed. Increased age, female sex, presence of a scapholunate (SL) ligament gap greater than 3 mm, and presence of radiographic thumb CMC joint OA were all significantly correlated with presence of STT joint OA. However, logistical regression analysis demonstrated that only increasing age, presence of an SL ligament gap greater than 3 mm, and presence of thumb CMC joint OA were strong predictors of STT joint OA. STT joint OA is a common finding on hand radiographs of patients presenting to a hand clinic. Its prevalence increases with age, the presence of an SL ligament gap greater than 3 mm, and with the presence of CMC joint OA. Diagnostic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  10. 42 CFR 37.41 - Chest roentgenogram specifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Miners shall be disrobed from the waist up at the time the roentgenogram is given. The facility shall... least 100 and does not exceed 300, which produces roentgenograms with spatial resolution, contrast... Chest radiograph specifications—film. (a) Miners must be disrobed from the waist up at the time the...

  11. 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

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

    PubMed

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

    2017-01-01

    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). 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. 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. 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.

  13. Chest Wall Trauma.

    PubMed

    Majercik, Sarah; Pieracci, Fredric M

    2017-05-01

    Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. [Chest pain in adolescents].

    PubMed

    Raiola, G; Galati, M C; De Sanctis, V; Salerno, D; Arcuri, V M; Mussari, A

    2002-12-01

    In children and in adolescents, chest pain is relatively common and self-limiting. The close association between chest pain, cardiopathies and sudden death is the cause of intense anxiety in boys and their parents and even doctors. The most frequent causes of chest pain, the diagnosis and the eventual treatment are examined. Finally, the causes of chest pain due to drug abuse (in particular cocaine) and to CO poisoning are also examined. Good knowledge of the problem, an accurate anamnesis and a careful objective exam are useful to choose the most suitable treatment.

  15. 42 CFR 37.80 - Availability of records for radiographs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest.... (a) Medical information and radiographs on miners will be released by NIOSH only with the written consent from the miner, or if the miner is deceased, written consent from the miner's widow or widower...

  16. 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.

  17. Comparative analysis of chest tube thoracostomy and video-assisted thoracoscopic surgery in empyema and parapneumonic effusion associated with pneumonia in children.

    PubMed

    Aziz, Abdulhameed; Healey, Jeffrey M; Qureshi, Faisal; Kane, Timothy D; Kurland, Geoffrey; Green, Michael; Hackam, David J

    2008-06-01

    Controversy exists regarding the optimal management strategy for children having empyema or parapneumonic effusion as a complication of pneumonia. We hypothesized that video-assisted thoracoscopic surgery (VATS)-assisted drainage of pleural fluid and debridement of the pleural space is superior to a chest tube alone in the management of these patients. We further identified predictive factors-namely, presentation, radiographic findings, antibiotic usage, and pleural fluid features-that could predict the need for VATS rather than primary chest tube drainage. Forty-nine pediatric patients with pneumonia complicated by parapneumonic effusion or empyema treated at the Children's Hospital of Pittsburgh (1997-2003) were divided into three groups according to the therapy instituted: Primary chest tube, chest tube followed by VATS, or primary VATS. The groups were analyzed in terms of demographics and outcome, as judged by pleural fluid analysis and hospital resource utilization. Demographic and outcome data were compared among groups using one-way analysis of variance and the Student t-test. All groups were similar with respect to demographics and initial antibiotic usage. Patients undergoing primary VATS had a higher initial temperature, whereas radiographic findings of mediastinal shift and air bronchograms were more likely to be found in patients who underwent primary chest tube placement. Patients undergoing primary VATS demonstrated a significantly shorter total stay and lower hospital charges than the other groups. Forty percent of children started on chest tube therapy failed even with subsequent VATS, necessitating a significantly longer hospital course (18 +/- 3 vs. 11 +/- 0.8 days; p < 0.05) and higher hospital charges ($50,000 +/- 7,000 vs. $29,000 +/- 1000) than those having primary VATS. Patients treated by primary VATS had a shorter stay and lower hospital charges than patients treated by chest tube and antibiotic therapy alone. There were no demographic

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. Dental radiographic guidelines: a review.

    PubMed

    Kim, Irene H; Mupparapu, Muralidhar

    2009-05-01

    The 2004 American Dental Association (ADA)/US Food and Drug Administration (FDA) radiographic selection criteria and guidelines were reviewed and compared with the prior radiographic selection criteria and guidelines. The authors reviewed the publications from the US FDA, US Department of Health and Human Services, and National Council on Radiation Protection and Measurements. The positions outlined by the Canadian Dental Association and the European Commission were also reviewed and compared to US guidelines. The FDA guidelines were first published in 1987, and several changes have been made to them over the years. Recent literature reveals that the general compliance of these guidelines is very low, especially within dental schools in the United States and Canada. Little is known about the compliance outside of the dental school environment; however, it is expected to be low for various reasons. In 2007, the International Commission on Radiological Protection (ICRP) revised its estimates of tissue radiosensitivity, which resulted in effective doses of dental radiographs 32% to 422% higher than the 1990 ICRP guidelines. Flow charts summarizing the latest guidelines were developed to facilitate general compliance among practitioners. Based on the literature reviewed and the recent ICRP findings, it would be prudent for dental health care professionals to follow dental radiographic guidelines.

  3. 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

  4. 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.

  5. Applied pathology for radiographers

    SciTech Connect

    Laudicina, P.

    1987-01-01

    This book presents a basic text for the student of radiologic sciences. It includes most of the pathology recommended by the ASRT Curriculum Guide. Radiographic technique and positioning are examined when relevant to obtaining quality radiographs of specific disease conditions. Brief overviews of these conditions include background etiology, diagnosis, treatment and prognosis. Many illustrations are included to enhance understanding.

  6. 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.

  7. Chest Pain: First Aid

    MedlinePlus

    ... condition. Seek emergency medical assistance immediately. Pneumonia with pleurisy Frequent signs and symptoms of pneumonia are chest ... a breath or coughing. This condition is called pleurisy. One sign of pleurisy is that the pain ...

  8. 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 ...

  9. 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 ...

  10. Radiographic Findings Associated with Vascular Anomalies

    PubMed Central

    Masand, Prakash

    2014-01-01

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

  11. [Chest injuries (author's transl)].

    PubMed

    Elert, O; Satter, P

    1979-04-01

    The mortality rate of chest injuries sustained during work or in road accidents stands now at 15-20%. The considerable force of the impact in road accidents is, in 60-80% of the cases, responsible for chest injuries which involve not only the chest wall but also the lungs. The extent and course of the lung damage must be assessed by repeated X-ray examinations, blood gas analyses and clinical observations. The decision to intubate and apply artificial ventilation should be made at an early stage. Fracture of a single rib needs only pain killers. If a rib is broken in several places or if several ribs are fractured instability of the chest wall is apt to develop in 15-20% of the cases. It manifests itself in paradoxical breathing and ensuing increase in the dead space. These cases require prompt "internal pneumatic splinting" in the form of positive pressure respiration and intubation. In recent years surgical stabilization of the chest wall has regained favour. Plate osteosynthesis, screw-less rib plates, self-gripping steel plates and steel splints are being used (Brunner, Hofmeister, Koncz). Primary osteosynthetic stabilization of the chest wall is indicated only if artificial ventilation has proved inadequate and there are other reasons for performing a thoracotomy. In these circumstances surgical intervention ensures that prolonged artificial ventilation and its attendent risks and complications and the demands made on the nursing staff are reduced to a minimum.

  12. 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.

  13. Pleuritic Chest Pain: Sorting Through the Differential Diagnosis.

    PubMed

    Reamy, Brian V; Williams, Pamela M; Odom, Michael Ryan

    2017-09-01

    Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made. Validated clinical decision rules are available to help exclude coronary artery disease. Viruses are common causative agents of pleuritic chest pain. Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus are likely pathogens. Treatment is guided by the underlying diagnosis. Nonsteroidal anti-inflammatory drugs are appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain. In patients with persistent symptoms, persons who smoke, and those older than 50 years with pneumonia, it is important to document radiographic resolution with repeat chest radiography six weeks after initial treatment.

  14. Clinical findings among hard metal workers.

    PubMed Central

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

    1992-01-01

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

  15. [Chest pain evaluation project].

    PubMed

    Filippo, Ottani; Nicola, Binetti; Casagranda, Ivo; Cassin, Matteo; Cavazza, Mario; Grifoni, Stefano; Lenzi, Tiziano; Lorenzoni, Roberto; Sbrojavacca, Rodolfo; Tanzi, Pietro; Vergara, Giuseppe

    2009-01-01

    The evaluation of acute chest pain remains challenging, despite many insights and innovations over the past two decades. The percentage of patients presenting at the emergency department with acute chest pain who are subsequently admitted to the hospital appears to be increasing. Patients with acute coronary syndromes who are inadvertently discharged from the emergency department have an adverse short-term prognosis. However, the admission of a patient with chest pain who is at low risk for acute coronary syndrome can lead to unnecessary tests and procedures, with their burden of costs and complications. Therefore, with increasing economic pressures on health care, physicians and administrators are interested in improving the efficiency of care for patients with acute chest pain. Since the emergency department organization (i.e. the availability of an intensive observational area) and integration of care and treatment between emergency physicians and cardiologists greatly differ over the national territory, the purpose of the present position paper is two-fold: first, to review the evidence-based efficacy and utility of various diagnostic tools, and, second, to delineate the basic critical pathways (describing key steps for care and treatment) that need to be implemented in order to standardize and expedite the evaluation of chest pain patients, making their diagnosis and treatment as uniform as possible across the country.

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

    PubMed

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

    2016-12-01

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

  18. 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

  19. 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

  20. Chest Tomosynthesis: Technical Principles and Clinical Update

    PubMed Central

    Dobbins, James T.; McAdams, H. Page

    2009-01-01

    Digital tomosynthesis is a radiographic technique that can produce an arbitrary number of section images of a patient from a single pass of the x-ray tube. It utilizes a conventional x-ray tube, a flat-panel detector, a computer-controlled tube mover, and special reconstruction algorithms to produce section images. While it does not have the depth resolution of computed tomography (CT), tomosynthesis provides some of the tomographic benefits of CT but at lower cost and radiation dose than CT. Compared to conventional chest radiography, chest tomosynthesis results in improved visibility of normal structures such as vessels, airway and spine. By reducing visual clutter from overlying normal anatomy, it also enhances detection of small lung nodules. This review article outlines the components of a tomosynthesis system, discusses results regarding improved lung nodule detection from the recent literature, and presents examples of nodule detection from a clinical trial in human subjects. Possible implementation strategies for use in clinical chest imaging are discussed. PMID:19616909

  1. Restrictive chest wall disorders.

    PubMed

    Donath, Joseph; Miller, Albert

    2009-06-01

    Hypoventilation can be caused by diseases of the chest wall. Any anatomical or functional abnormality of the bony thorax increases dead space ventilation and the work of breathing, whether congenital or acquired, acute or chronic, and whether its cause is infectious, traumatic, environmental, iatrogenic, or unknown. In this article, we discuss these heterogeneous disorders from the viewpoint of the practicing nonpediatric pulmonary physician, only briefly touching on surgical, pediatric, rheumatologic, and other nonpulmonary ramifications. Emphasis is on the most common and the best researched forms of chest wall restriction, including kyphoscoliosis, fibrothorax, thoracoplasty, flail chest, and ankylosing spondylitis. Other diseases such as osteoporosis with its less well known pulmonary effects, and some rarely seen entities, are briefly discussed.

  2. 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

  3. Flail chest and pulmonary contusion.

    PubMed

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

    2008-01-01

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

  4. Chest neoplasms with infectious etiologies.

    PubMed

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

    2011-12-28

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

  5. 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.

  6. 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. ...

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. Chest radiography in dust-exposed miners: Promise and problems, potential and imperfections

    SciTech Connect

    Wagner, G.R.; Attfield, M.D.; Parker, J.E. )

    1993-01-01

    Since the early 1900s, it was recognized that many dust-exposed workers developed abnormal radiographs during life. Chest radiography remains the primary means of determining the presence and extent of dust-induced pneumoconiosis, although it is ineffective for detecting airways obstructions from mine dust exposure. This chapter reviews the uses and limitations of chest radiography in the study, surveillance, screening, clinical diagnosis, and disability determinations of occupational lung diseases in dust-exposed workers. 70 refs.

  12. Significant efficiency findings while controlling for the frequent confounders of CAI research in the PlanAlyzer project's computer-based, self-paced, case-based programs in anemia and chest pain diagnosis.

    PubMed

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

    1991-04-01

    Richard E. Clark in his widely published comprehensive studies and meta-analyses of the literature on computer assisted instruction (CAI) has decried the lack of carefully controlled research, challenging almost every study which shows the computer-based intervention to result in significant post-test proficiency gains over a non-computer-based intervention. We report on a randomized study in a medical school setting where the usual confounders found by Clark to plague most research, were carefully controlled. PlanAlyzer is a microcomputer-based, self-paced, case-based, event-driven system for medical education which was developed and used in carefully controlled trials in a second year medical school curriculum to test the hypothesis that students with access to the interactive programs could integrate their didactic knowledge more effectively and/or efficiently than with access only to traditional textual "nonintelligent" materials. PlanAlyzer presents cases, elicits and critiques a student's approach to the diagnosis of two common medical disorders: anemias and chest pain. PlanAlyzer uses text, hypertext, images and critiquing theory. Students were randomized, one half becoming the experimental group who received the interactive PlanAlyzer cases in anemia, the other half becoming the controls who received the exact same content material in a text format. Later in each year there was a crossover, the controls becoming the experimentals for a similar intervention with the cardiology PlanAlyzer cases. Preliminary results at the end of the first two full trials shows that the programs have achieved most of the proposed instructional objectives, plus some significant efficiency and economy gains. 96 faculty hours of classroom time were saved by using PlanAlyzer in their place, while maintaining high student achievement. In terms of student proficiency and efficiency, the 328 students in the trials over two years were able to accomplish the project's instructional

  13. 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

  14. [TUBERCULOSIS SCREENING BY CHEST RADIOGRAPHY AMONG INTERNATIONAL STUDENTS AT JAPANESE LANGUAGE SCHOOLS IN OSAKA CITY].

    PubMed

    Tsuda, Yuko; Matsumoto, Kenji; Komukai, Jun; Furukawa, Kanae; Saito, Kazumi; Shimouchi, Akira

    2015-10-01

    With a broader aim of controlling pulmonary tuberculosis (TB) among foreigners, here, we have reported the findings of chest radiography screening for TB among international students at Japanese language schools in Osaka city. Between April 2011 and December 2013, 4,529 international students from 19 Japanese language schools in Osaka city underwent chest radiography for TB screening. The chest radiographs were studied in reference to the student's sex, age, nationality, and date of entry to Japan as well as any health conditions present at the time of screening. We further analyzed the bacterial information and pulmonary TB classification based on chest radiography findings of students who were identified to be positive for TB. Information on the implementation of health education was also gathered. The results revealed that 52.5% of the students who underwent chest radiography came from China, 20.3 % from South Korea, and 16.3% from Vietnam. Of the students, 52.9% were male and 47.1% were female. The median age of students was 23 years (range: 14-70 years). The median number of days from the first date of entry to Japan up until the radiography screening was 63 days. Based on the chest radiography findings, 71 students (1.6%) were suspected to have TB; however, further detailed examination confirmed that 19 students (0.4%) had active TB. This percentage is significantly higher than the 0.1% TB identification rate among residents in Osaka city of the same time period (P<0.001), which was also determined by chest radiography. The median age of the 19 TB positive patients was 23 years. Among them, 14 (73.7%) were male. The median time from the date of entry to Japan to the date of the chest radiography screening was 137 days. For 16 of those students, the entry to Japan was within 1 year of the radiography. Of the 19 TB positive patients, 16 (84.2%) did not have respiratory symptoms, 15 (79.0%) had sputum smear negative results, and 17 (89.5%) had no cavity. Health

  15. A comparison of conventional and grid techniques for chest radiography in field surveys

    PubMed Central

    Washington, J. S.; Dick, J. A.; Jacobsen, M.; Prentice, W. M.

    1973-01-01

    Washington, J. S., Dick, J. A., Jacobsen, M., and Prentice, W. M. (1973).British Journal of Industrial Medicine,30, 365-374. A comparison of conventional and grid techniques for chest radiography in field surveys. The effect on the quality of chest radiographs using a reciprocating grid with a moderately high kilovoltage (96 to 105 kV) has been studied. A total of 1 710 mineworkers had two postero-anterior chest radiographs taken at the same visit to a linked pair of mobile ϰ-ray units. One film was taken with conventional exposure factors and the other with moderately high kilovoltage and a reciprocating grid. The grid was exchanged between the two units according to a randomized plan so that the first radiograph was not always taken with the same technique. The 3 420 films so produced were subsequently assessed for quality by five doctors experienced in reading chest films. The films were examined singly in random order and the reader did not know which technique had been used for a given film. Four of the readers recorded improved quality using the grid technique for films from men whose antero-posterior chest measurements exceeded 254 mm (10 in), but they preferred the conventional exposure technique for films from men whose chest measurements were less than 254 mm. Results from all film pairs where a difference in quality was recorded showed no overall advantage for either technique. PMID:4753720

  16. 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 ...

  17. 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.

  18. 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

  19. 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 ...

  20. Which Disposable Chest Electrode?

    PubMed Central

    Hubner, P. J. B.

    1969-01-01

    Chest electrodes are preferred to limb electrodes for cardiac monitoring, as limb movements are not restricted and produce less interference of the E.C.G. trace. Eight types of disposable chest electrodes were investigated to compare their performance, skin reactions, cost, ease of application, size, and skin–electrode impedance. Elema-Schonander electrodes were found to be the most efficient and the most expensive. In their application care was required to avoid severe skin reactions. Dracard electrodes were simple to attach, worked well without severe skin reactions, and were cheap. They are recommended for routine use. Smith and Nephew electrodes, a type of “multipoint electrodes” which do not require electrode jelly, frequently produced severe skin reactions, making them unsuitable for monitoring for periods exceeding 12 hours. PMID:5801347

  1. 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.

  2. Treatment of Morbidity with Atypical Chest Pain

    PubMed Central

    Cott, Arthur

    1987-01-01

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

  3. 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

  4. 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.

  5. 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

  6. Susuk - black magic exposed "white" by dental radiographs.

    PubMed

    F, Arishiya Thapasum; Mohammed, Faraz

    2014-07-01

    Susuk or charm needles are a facial cum body art widely practiced among women of Malaysia, Brunei, Singapore, Thailand and Indonesia. These are small, needle-shaped metallic talismans inserted subcutaneously in different parts of the body. The concealed art of susuk was "exposed" by routine radiographic examination in the oral and maxillofacial region. This paper reports two such cases of unusual incidental radiographic finding in dental radiographs which were taken on a routine basis as part of the diagnostic work up. This article will also primarily enlighten the importance of radiographs in detecting such charm needles as the wearer keeps the body art a "hidden secret" thereby avoiding misdiagnosis.

  7. Neutron radiographic viewing system

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The design, development and application of a neutron radiographic viewing system for use in nondestructive testing applications is considered. The system consists of a SEC vidicon camera, neutron image intensifier system, disc recorder, and TV readout. Neutron bombardment of the subject is recorded by an image converter and passed through an optical system into the SEC vidicon. The vidicon output may be stored, or processed for visual readout.

  8. Chest neoplasms with infectious etiologies

    PubMed Central

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

    2011-01-01

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

  9. 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).

  10. Large Format Radiographic Imaging

    SciTech Connect

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

    1999-08-01

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

  11. Pelvic radiograph in skeletal dysplasias: An approach

    PubMed Central

    Jana, Manisha; Nair, Nikhil; Gupta, Arun K; Kabra, Madhulika; Gupta, Neerja

    2017-01-01

    The bony pelvis is constituted by the ilium, ischium, pubis, and sacrum. The pelvic radiograph is an important component of the skeletal survey performed in suspected skeletal dysplasia. Most of the common skeletal dysplasias have either minor or major radiological abnormalities; hence, knowledge of the normal radiological appearance of bony pelvis is vital for recognizing the early signs of various skeletal dysplasias. This article discusses many common and some uncommon radiological findings on pelvic radiographs along with the specific dysplasia in which they are seen; common differential diagnostic considerations are also discussed. PMID:28744080

  12. [Utility of digital thoracotomy in chest trauma].

    PubMed

    Vélez, Sebastián E; Sarquis, Guillermo

    2006-01-01

    toracostomy in thoracic trauma is a good opportunity for the digital exploration of pleural cavity. To evaluate the utility of digital exploration during chest tube insertion in thoracic trauma. Hospital de Urgencias. Córdoba. patients with blunt and penetrating chest trauma by stab wound, who need chest tube insertion and treated by only one surgeon, were evaluated from July 10 to December 31st 2000. Previously to the thoracostomy with 24 french tube in 5th intercostal space, at the affected side, a digital exploration of pleural cavity was done, attempting to find intrathoracic injuries. in a six months period, 36 thoracostomy tubes were placed, due thoracic trauma (11 blunt trauma and 25 penetrating, by stab wound). Three patients had positive findings in the digital exploration, which forced to do another diagnostic or therapeutic procedures. digital thoracotomy is not considered a formal procedure, but as a part of a technique, in which, the previous exploration with the finger before chest tube insertion, allows to reach a diagnosis of the pleural space situation, to confirm suspicions, to modify a conduct, and to avoid greater morbidity to patients.

  13. 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.

  14. 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.

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

    PubMed

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

    2008-08-01

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

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. A rare cause of misdiagnosis in chest X-ray

    PubMed Central

    Ortiz-Mendoza, Carlos Manuel

    2016-01-01

    Chest X-ray is a usual tool for family physicians; however, unexpected findings in chest X-ray are a frequent challenge. We present a rare case of pulmonary hilar nodule misdiagnosis in a chest X-ray. An 84-year-old woman was sent with a diagnosis of a right pulmonary hilum nodule. She had a history of chronic obstructive pulmonary disease; so in a chest X-ray, her family physician discovered a “nodule” in her right lung hilum. Her physical exam was not relevant. In our hospital, a thoracic computed tomography (CT) scan verified the mass in the right pulmonary hilum; nevertheless, in a coronal CT scan, the “hilum lump” was the tortuous descending aorta that created an angle. This case illustrates how anatomical changes associated with vascular aging may cause this exceptional pitfall in chest X-ray. PMID:28217605

  1. 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

  2. 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.

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS Chest Radiographic.... The form must include: (1) The date of the last radiation safety inspection by an appropriate... have been corrected; and (4) The date of acquisition of the X-ray unit. To be acceptable, the radiation...

  4. 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.

  5. Coronary heart disease in primary care: accuracy of medical history and physical findings in patients with chest pain--a study protocol for a systematic review with individual patient data.

    PubMed

    Haasenritter, Jörg; Aerts, Marc; Bösner, Stefan; Buntinx, Frank; Burnand, Bernard; Herzig, Lilli; Knottnerus, J André; Minalu, Girma; Nilsson, Staffan; Renier, Walter; Sox, Carol; Sox, Harold; Donner-Banzhoff, Norbert

    2012-08-09

    Chest pain is a common complaint in primary care, with coronary heart disease (CHD) being the most concerning of many potential causes. Systematic reviews on the sensitivity and specificity of symptoms and signs summarize the evidence about which of them are most useful in making a diagnosis. Previous meta-analyses are dominated by studies of patients referred to specialists. Moreover, as the analysis is typically based on study-level data, the statistical analyses in these reviews are limited while meta-analyses based on individual patient data can provide additional information. Our patient-level meta-analysis has three unique aims. First, we strive to determine the diagnostic accuracy of symptoms and signs for myocardial ischemia in primary care. Second, we investigate associations between study- or patient-level characteristics and measures of diagnostic accuracy. Third, we aim to validate existing clinical prediction rules for diagnosing myocardial ischemia in primary care. This article describes the methods of our study and six prospective studies of primary care patients with chest pain. Later articles will describe the main results. We will conduct a systematic review and IPD meta-analysis of studies evaluating the diagnostic accuracy of symptoms and signs for diagnosing coronary heart disease in primary care. We will perform bivariate analyses to determine the sensitivity, specificity and likelihood ratios of individual symptoms and signs and multivariate analyses to explore the diagnostic value of an optimal combination of all symptoms and signs based on all data of all studies. We will validate existing clinical prediction rules from each of the included studies by calculating measures of diagnostic accuracy separately by study. Our study will face several methodological challenges. First, the number of studies will be limited. Second, the investigators of original studies defined some outcomes and predictors differently. Third, the studies did not

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

    PubMed Central

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

    1991-01-01

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

  7. [Do we agree on the technical quality of our chest X-rays? A radiologist, an expert in X-ray diagnosis, and a family doctor try to find out].

    PubMed

    Garófano-Jerez, J M; Quesada-Jiménez, F; Cabrerizo-Castro, J; Morales-Navarra, G; García-Ruiz, T; Lardelli-Claret, P

    2005-11-30

    To appraise the degree of concordance in the interpretation of the technical quality of chest x-rays at a health centre between an expert in x-ray diagnosis, a family doctor, and a radiologist. Transversal study. Setting. Primary care. Cartuja Health Centre, Granada, Spain. Patients at the Cartuja Health Centre who had a simple chest x-ray in 2002. 150 studies were chosen by simple randomised sampling. Two were rejected because they dealt with a repeat examination of the same patient and seven because they did not reach minimum quality. The final sample was 141 x-rays. The observers filled in independently, for each examination, an 11-item protocol on the technical quality of the images. The kappa index between pairs of observers was calculated for each item, as was the overall kappa index. 96% of the examinations were conducted with large x-ray plates (3543). There was only acceptable or good concordance between the 3 observers in 2 questions (kappa, 0.559-0.858). In 5 questions concordance was homogeneously low (kappa, 0.034-0.375). In some questions there was a strong discrepancy between the appraisal of the expert and that of the 2 other observers. General concordance can be considered low, although it is somewhat greater between the radiologist and the family doctor than between either of these and the expert. This poses the need to improve professional training in evaluation of the technical quality of images. In addition, there was unnecessary expense in large-size x-ray plates.

  8. Migrating Lobar Atelectasis of the Right Lung: Radiologic Findings in Six Patients

    PubMed Central

    Kim, Tae Sung; Hwang, Jung Hwa; Choo, In Wook; Lim, Jae Hoon

    2000-01-01

    Objective To describe the radiologic findings of migrating lobar atelectasis of the right lung. Materials and Methods Chest radiographs (n = 6) and CT scans (n = 5) of six patients with migrating lobar atelectasis of the right lung were analyzed retrospectively. The underlying diseases associated with lobar atelectasis were bronchogenic carcinoma (n = 4), bronchial tuberculosis (n = 1), and tracheobronchial amyloidosis (n = 1). Results Atelectasis involved the right upper lobe (RUL) (n = 3) and both the RUL and right middle lobe (RML) (n = 3). On supine anteroposterior radiographs (n = 5) and on an erect posteroanterior radiograph (n = 1), the atelectatic lobe(s) occupied the right upper lung zone, with a wedge shape abutting onto the right mediastinal border. On erect posteroanterior radiographs (n = 6), the heavy atelectatic lobe(s) migrated downward, forming a peri- or infrahilar area of increased opacity and obscuring the right cardiac margin. Erect lateral radiographs (n = 4) showed inferior shift of the anterosuperiorly located atelectatic lobe(s) to the anteroinferior portion of the hemithorax. Conclusion Atelectatic lobe(s) can move within the hemithorax according to changes in a patient's position. This process involves the RUL or both the RUL and RML. PMID:11752926

  9. 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; Ari