RADIOGRAPHY

射线照相术
  • 文章类型: Case Reports
    肺轻链沉积病是一种罕见的实体,其特征是免疫球蛋白在肺实质内沉积,具有不同于肺淀粉样变性的病理特征。这里,作者介绍了临床表现,协会,4例患者肺轻链沉积病的影像学特征,并讨论其与淀粉样变性的区别。本病例系列强调了CT时囊肿和结节的频繁存在。临床上,淋巴瘤和/或自身免疫性疾病通常相关。
    Pulmonary light chain deposition disease is a rare entity characterized by immunoglobulin deposition within the lung parenchyma with pathologic features distinct from pulmonary amyloidosis. Here, the authors present the clinical presentation, associations, and radiologic features of pulmonary light chain deposition disease in a series of 4 patients as well as discuss the distinctions from amyloidosis. The present case series highlights the frequent presence of both cysts and nodules at CT. Clinically, lymphoma and/or autoimmune disease are often associated.
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  • 文章类型: Journal Article
    背景:为了装备放射技师应对气候变化的负面影响,提供有关行星健康和可持续性的深入教育至关重要。这项研究旨在以津巴布韦的一所高等教育机构为案例研究,以评估放射摄影专业学生对将可持续性纳入其课程的看法。
    方法:在哈拉雷的一所高等教育机构进行了一项使用问卷调查的定量横断面研究,津巴布韦,学生连续取样。使用频率和百分比描述分类变量。使用Stata13.1进行数据分析。
    结果:111名学生中共有96人参加,86%的反应率。大多数学生相信环保射线照相实践的重要性(90.62%),并认为可持续性对于更好的患者护理至关重要。虽然可持续性教学在课程中得到认可,许多学生在考试中对这个话题没有信心。对于可持续性教学的首选方法没有达成共识。专门研究气候相关领域的大学讲师被视为最适合进行可持续教育的教师。
    结论:课程反映了可持续发展教育的努力,但是学生的信心和对以气候为重点的研究单位的认识需要提高。持续教育对于将可持续发展意识与放射线照相的实际影响联系起来至关重要。未来的研究应研究量身定制的教学方法,以使学生有效地参与可持续的射线照相实践。
    结论:研究结果强调了持续开展教育和提高认识运动的重要性,以解决理解可持续性的重要性与在射线照相实践中有效实施可持续性之间的脱节。
    BACKGROUND: To equip radiographers to tackle the negative impacts of climate change, it is crucial to offer in-depth education on planetary health and sustainability. This study aimed to use a tertiary institution in Zimbabwe as a case study to assess radiography students\' views on the integration of sustainability into their curriculum.
    METHODS: A quantitative cross-sectional study using a questionnaire took place at a tertiary institution in Harare, Zimbabwe, where students were sampled consecutively. Categorical variables were described using frequencies and percentages. Data analysis was carried out using Stata 13.1.
    RESULTS: A total of 96 out of 111 students participated, with an 86% response rate. The majority of students believed in the importance of environmentally friendly radiography practices (90.62%) and felt that sustainability is crucial for better patient care. While sustainability teaching was acknowledged in the curriculum, many students were not confident about the topic in exams. There was no consensus on the preferred methods of teaching sustainability. University lecturers specializing in climate-related fields were seen as the most suitable teachers for sustainability education.
    CONCLUSIONS: The curriculum reflects efforts in sustainability education, but student confidence and awareness of climate-focused research units require improvement. Continuous education is crucial to link sustainability awareness with practical implications in radiography. Future studies should investigate tailored teaching methods to engage students effectively in sustainable radiography practices.
    CONCLUSIONS: The findings highlight the importance of ongoing education and awareness campaigns to address the disconnect between understanding the importance of sustainability and implementing it effectively in radiography practice.
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  • 文章类型: Journal Article
    目的:健康技术评估(HTA)是一个系统过程,用于评估医疗技术在其预期用途范围内的特性和效果。本文介绍了HTA过程的采用,以评估EOSedge™系统在临床实践中的采用。
    方法:EOSedge™系统是一种数字射线照相系统,可提供全身,高质量的2D/3D双平面图像,涵盖全套的肌肉骨骼和骨科检查。使用EUnetHTACoreModel®3.0版选择了完整的HTA模型。HTA核心模型将信息组织成九个域。通过查阅制造商的用户手册来研究和获得信息,科学文献,和监管方面的机构网站。
    结果:EUnetHTACoreModel®的所有九个领域都帮助进行了EOSedge的HTA,包括(1)技术的描述和技术特征;(2)健康问题和当前临床实践;(3)安全性;(4)临床有效性;(5)组织方面;(6)经济评估;(7)对患者的影响;(8)道德方面;(9)法律方面。
    结论:EOS技术可能是常规射线照相的可行替代方案。EOSedge具有相同的预期用途和类似的使用适应症,技术特点,和操作原理作为EOS系统,与EOS系统相比,为整个脊柱成像提供了显着的剂量减少因子,而不会影响图像质量。关于EOS成像对患者预后的影响,大多数研究旨在建立技术能力,而不评估其改善患者预后的能力;因此,有必要对这方面进行更多的研究。
    OBJECTIVE: Health technology assessment (HTA) is a systematic process used to evaluate the properties and effects of healthcare technologies within their intended use context. This paper describes the adoption of HTA process to assess the adoption of the EOSedge™ system in clinical practice.
    METHODS: The EOSedge™ system is a digital radiography system that delivers whole-body, high-quality 2D/3D biplanar images covering the complete set of musculoskeletal and orthopedic exams. Full HTA model was chosen using the EUnetHTA Core Model® version 3.0. The HTA Core Model organizes the information into nine domains. Information was researched and obtained by consulting the manufacturers\' user manuals, scientific literature, and institutional sites for regulatory aspects.
    RESULTS: All nine domains of the EUnetHTA Core Model® helped conduct the HTA of the EOSedge, including (1) description and technical characteristics of the technology; (2) health problem and current clinical practice; (3) safety; (4) clinical effectiveness; (5) organizational aspects; (6) economic evaluation; (7) impact on the patient; (8) ethical aspects; and (9) legal aspects.
    CONCLUSIONS: EOS technologies may be a viable alternative to conventional radiographs. EOSedge has the same intended use and similar indications for use, technological characteristics, and operation principles as the EOS System and provides significant dose reduction factors for whole spine imaging compared to the EOS System without compromising image quality. Regarding the impact of EOS imaging on patient outcomes, most studies aim to establish technical ability without evaluating their ability to improve patient outcomes; thus, more studies on this aspect are warranted.
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  • 文章类型: Journal Article
    股骨和胫骨骨折可导致延迟愈合和骨不连。在骨科实践中提出了重大挑战。Ilizarov技术已成为管理这些复杂情况的有希望的解决方案。
    评估Ilizarov固定治疗胫骨和股骨骨折不愈合的影像学和功能结果。
    回顾性研究。
    大学附属医院。
    患者人口统计,断裂特征,我们分析了2015年10月至2022年9月期间使用Ilizarov固定器治疗胫骨和股骨骨不连的患者的治疗细节.使用Ilizarov方法研究和应用协会(ASAMI)标准进行临床和放射学评估。这项研究的重点是评估工会和框架移除的平均持续时间,骨结果,成功的工会率,和使用ASAMI标准的功能结果,从现有的医疗记录中获取数据,跨越治疗骨不连骨折的各种医疗设施。
    126名患者。
    联合和帧去除的平均持续时间为8个月,在60.32%的病例中观察到优异的骨效果。126名患者中,118取得了成功的工会,而有2例失败病例需要截肢(1.52%)。功能结果显示,39.68%的病例具有良好的预后。并发症包括针道感染,脚踝和膝盖僵硬,和肢体缩短。外固定架持续时间和感染根除与以往研究一致。强调技术的有效性。
    Ilizarov技术在治疗胫骨和股骨骨折方面非常有效,在工会方面提供有利的结果,感染控制,疼痛缓解,功能恢复。虽然优秀的骨骼结果并不能保证最佳功能,这种方法对于复杂情况仍然是一种可靠的方法。
    回顾性分析固有的潜在偏差,以及需要进一步的随机对照试验来全面比较治疗方式。
    UNASSIGNED: Femoral and tibial fractures may result in delayed union and nonunion, posing significant challenges in orthopedic practice. The Ilizarov technique has emerged as a promising solution for managing these complex cases.
    UNASSIGNED: Evaluate the radiographic and functional results of Ilizarov fixation in the treatment of nonunion of tibia and femur fractures.
    UNASSIGNED: Retrospective.
    UNASSIGNED: Hospitals affiliated with a university hospital.
    UNASSIGNED: Patient demographics, fracture characteristics, and treatment details were analyzed for the period from October 2015 to September 2022 in patients who were treated for nonunion of the tibia and femur using the Ilizarov fixator. Clinical and radiological assessments were performed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria. The study focused on assessing the average duration for union and frame removal, bone results, successful union rates, and functional results using the ASAMI criteria, obtaining data from the existing medical records, spanning various medical facilities treating nonunion fractures.
    UNASSIGNED: 126 patients.
    UNASSIGNED: The average duration for union and frame removal was 8 months, with excellent bone results observed in 60.32% of cases. Out of 126 patients, 118 achieved successful union, while there were 2 failure cases necessitating amputation (1.52%). Functional results revealed excellent outcomes in 39.68% of cases. Complications included pin tract infections, ankle and knee stiffness, and limb shortening. External fixation duration and infection eradication were consistent with previous research, emphasizing the technique\'s effectiveness.
    UNASSIGNED: The Ilizarov technique proved highly effective in managing nonunion tibia and femur fractures, offering favorable outcomes in terms of union, infection control, pain relief, and functional recovery. While excellent bone outcomes do not guarantee optimal function, this method remains a reliable approach for complex cases.
    UNASSIGNED: Potential biases inherent in retrospective analyses and the need for further randomized controlled trials to comprehensively compare treatment modalities.
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  • 文章类型: Case Reports
    方法:我们报告一例19岁女性肌肉内大腿血管瘤,有无创伤大腿疼痛病史。她的初级保健医生获得的X光片显示了骨膜骨反应,促使转诊到骨科肿瘤科。患者使用普萘洛尔成功进行了对症治疗。
    结论:该病例突出了诊断和潜在的治疗方法。在逐步治疗有症状的良性血管病变的方法中,普萘洛尔已被证明是治疗有症状的血管瘤的有效一线治疗方案.
    METHODS: We report a case of an intramuscular thigh hemangioma in a 19-year-old woman with a several year history of atraumatic thigh pain. Radiographs obtained by her primary care physician demonstrated periosteal bone reaction, prompting referral to Orthopaedic Oncology department. The patient had successful symptomatic management with propranolol.
    CONCLUSIONS: The case highlights the diagnosis and potential treatments. In a stepwise approach to care for symptomatic benign vascular lesions, propranolol has been a proven therapeutic option and may be a useful first-line therapy for symptomatic hemangiomas.
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  • 文章类型: Journal Article
    目标:我们为非编程医生创建了无代码机器学习(NML)平台的基础架构,以创建NML模型。我们通过创建NML模型来对X射线照片进行分类以确定锁骨骨折的存在与否来测试平台。
    方法:我们的IRB批准的回顾性研究包括2039例患者的4135例锁骨X光片(平均年龄52±20岁,F:M1022:1017)来自13家医院。每位患者都有两视锁骨X光片,带有轴向和前后投影。X线片阳性的锁骨骨折移位或非移位。我们将NML平台配置为通过DICOM对象的Web访问,使用医院虚拟网络档案中的系列唯一标识自动检索合格考试。平台训练模型,直到验证损失平台。一旦测试完成,该平台提供了接收机工作特性曲线和混淆矩阵,用于估计灵敏度,特异性,和准确性。
    结果:NML平台成功检索了3917张射线照片(3917/4135,94.7%),并对其进行了解析,以便在训练中创建具有2151张射线照片的ML分类器,100张用于验证的射线照片,和测试数据集中的1666张X光照片(772张锁骨骨折的X光照片,894无锁骨骨折)。该网络以90%的灵敏度识别锁骨骨折,87%的特异性,和88%的准确性,AUC为0.95(置信区间0.94-0.96)。
    结论:NML平台可以帮助医生从多中心成像数据集创建和测试机器学习模型,例如我们研究中根据锁骨骨折的存在对X射线照片进行分类的模型。
    OBJECTIVE: We created an infrastructure for no code machine learning (NML) platform for non-programming physicians to create NML model. We tested the platform by creating an NML model for classifying radiographs for the presence and absence of clavicle fractures.
    METHODS: Our IRB-approved retrospective study included 4135 clavicle radiographs from 2039 patients (mean age 52 ± 20 years, F:M 1022:1017) from 13 hospitals. Each patient had two-view clavicle radiographs with axial and anterior-posterior projections. The positive radiographs had either displaced or non-displaced clavicle fractures. We configured the NML platform to automatically retrieve the eligible exams using the series\' unique identification from the hospital virtual network archive via web access to DICOM Objects. The platform trained a model until the validation loss plateaus. Once the testing was complete, the platform provided the receiver operating characteristics curve and confusion matrix for estimating sensitivity, specificity, and accuracy.
    RESULTS: The NML platform successfully retrieved 3917 radiographs (3917/4135, 94.7 %) and parsed them for creating a ML classifier with 2151 radiographs in the training, 100 radiographs for validation, and 1666 radiographs in testing datasets (772 radiographs with clavicle fracture, 894 without clavicle fracture). The network identified clavicle fracture with 90 % sensitivity, 87 % specificity, and 88 % accuracy with AUC of 0.95 (confidence interval 0.94-0.96).
    CONCLUSIONS: A NML platform can help physicians create and test machine learning models from multicenter imaging datasets such as the one in our study for classifying radiographs based on the presence of clavicle fracture.
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  • 文章类型: Journal Article
    肱骨远端透明骨骨折通常见于3岁以下的儿童,被认为是Salter-HarrisI型表皮松解术。新生儿肱骨远端经锁骨损伤极为罕见。它通常是由于在难产期间的创伤而发生的,但也可以在虐待儿童之后看到。由于新生儿肱骨远端由软骨组织组成,用直接射线照相很难做出诊断。患者常被诊断为肘关节脱位。然而,肘关节脱位在3岁以下几乎从未见过。在困难的正常分娩过程中,为了分娩婴儿而进行的操作可以看到透明骨折。在剖腹产后也可以看到肱骨通伤,虐待儿童并摔倒在过度伸展的手臂上。临床症状包括疼痛,肿胀,肘部瘀斑和起皱。假性麻痹是由于疼痛而存在的。在有分娩困难或外伤史的儿童中,最初应进行直接射线照相评估。射线照相上放射状线扭曲,肘关节出现半脱位。新生儿输血性肱骨骨折的治疗方法多种多样。应该记住,这个年龄段的患者具有巨大的治愈能力。在保守治疗中,复位后用长臂夹板进行2-4周的随访就足够了。此外,根据骨折的移位量,可以采用闭合复位内固定或切开复位内固定。Cubitusvarus,骨坏死,生长扰动,运动范围减小,筋膜室综合征,神经血管损伤和感染是输液性肱骨骨折后的主要并发症。
    Transphyseal fractures of the distal humerus are usually seen in children younger than 3 years of age and are considered as Salter-Harris Type I epiphysiolysis. Neonatal transphyseal distal humerus injuries are extremely rare. It usually occurs due to trauma during difficult labour but can also be seen after child abuse. Since the distal humerus is composed of cartilaginous tissue in newborns, it is difficult to make a diagnosis with direct radiography. Patients are often diagnosed with elbow dislocation. However, elbow dislocation is almost never seen under the age of 3 years. Transphyseal fractures can be seen as a result of manoeuvres performed to deliver the baby during difficult normal delivery. Transphyseal humeral injuries can also be seen after caesarean section, child abuse and falling on the hyperextended arm. Clinical symptoms include pain, swelling, ecchymosis and crepitation at the elbow. Pseudoparalysis is present due to pain. In children with a history of difficult birth or trauma, evaluation with direct radiography should be performed initially. Radiocapitellar line is distorted on radiographs and the elbow joint appears subluxated. The treatment algorithm for transfusional humeral fractures in neonates is varied. It should be remembered that patients in this age group have a tremendous healing capacity. In conservative treatment, 2-4 weeks of follow-up with a long-arm splint after reduction is sufficient. In addition, closed reduction-internal fixation or open reduction-internal fixation can be applied according to the amount of displacement of the fracture. Cubitus varus, osteonecrosis, growth disturbance, decreased range of motion, compartment syndrome, neurovascular injury and infection are the main complications seen after transfusional humeral fractures.
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  • 文章类型: Case Reports
    鼻咽是一种罕见的解剖位置,异物在摄入或吸入后可能会滞留。我们正在介绍一例罕见的鼻咽异物嵌塞病例,该病例已错过了将近一年。这名儿童有右侧恶臭的鼻涕史,打鼾和嘴巴呼吸。鼻后空间的X线软组织侧视图显示不规则的部分不透射线的鼻咽异物。异物的取出在全身麻醉下成功进行。鼻咽中的异物撞击很容易被错过,在处理吸入或摄入的异物丢失时,重要的是要记住这个区域。
    The nasopharynx is a rare anatomical location where a foreign body may become lodged after being ingested or inhaled. We are presenting a rare case of nasopharyngeal foreign body impaction in a two-and-a-half-year-old child that had been missed for almost a year. The child presented with a history of right-sided foul-smelling nasal discharge, snoring and mouth breathing. An X-Ray soft tissue lateral view of the post-nasal space showed an irregular partially radiopaque nasopharyngeal foreign body. The removal of the foreign body was performed under general anaesthesia successfully. Foreign body impaction in the nasopharynx can easily be missed and it is important to keep this region in mind when dealing with missing inhaled or ingested foreign bodies.
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  • 文章类型: Journal Article
    背景:全髋关节置换术(THA)是保守治疗失败后终末期骨关节炎患者的金标准。数字模板通常用于THA的术前准备,并对其结果做出积极贡献。然而,Coxavalga和antetorta(CVA)构型对茎大小预测准确性的影响仍未报告。先前的研究表明,小转子(LT)的大小可用于确定骨盆X光片上的股骨前倾。这项研究调查了术前数字模板在预测CVA患者无骨水泥THA中茎大小方面的准确性。
    方法:对620例无骨水泥THA患者的术前X线片进行回顾性调查。对患者站立和腿部内部旋转15°的放射线照相进行了标准化。建立了CVA组,其中包括CCD角度大于140°的患者,男性小转子(LT)尺寸至少为10mm,女性为8mm。对于对照组,选择了CCD角度为125-135°的X射线照片,男性的LT尺寸为3-10mm,女性的LT尺寸为3-8mm。术前模板使用mediCAD进行。为了减少混杂因素,对BMI和身高进行病例对照匹配.
    结果:病例对照匹配后,共分析了31个匹配项.CVA中74%(23/31)的茎大小被低估,对照组为13%(4/31)(p<0.001)。此外,与对照组相比,CVA患者更有可能被低估两个大小(p<0.004).相比之下,在对照组中,精确的茎大小更频繁地预测(p<0.001)。
    结论:CVA配置患者的茎大小在使用数字模板时存在被低估的高风险。这些发现对于指导术中决策和降低与尺寸过小的股骨部件相关的并发症的风险可能是有价值的。
    BACKGROUND: Total hip arthroplasty (THA) is the gold standard procedure for patients with end-stage osteoarthritis after failed conservative therapy. Digital templating is commonly employed in preoperative preparation for THA and contributes positively to its outcome. However, the impact of coxa valga and antetorta (CVA) configurations on stem size prediction accuracy remains not reported. Previous studies demonstrated that the size of the lesser trochanter (LT) can be used to determine femoral anteversion on pelvis radiographs. This study investigates the accuracy of preoperative digital templating in predicting stem size in patients with CVA undergoing cementless THA.
    METHODS: Preoperative radiographs of 620 patients undergoing cementless THA were retrospectively investigated. Radiographs were standardized with patients standing and the leg internally rotated by 15°. A CVA group was established including patients with a CCD angle greater than 140° and a lesser trochanter (LT) size of at least 10 mm for men and 8 mm for women. For the control group, radiographs with a CCD angle ranging from 125-135° and LT size 3-10 mm for men and 3-8 mm for women were selected. Preoperative templating was performed using mediCAD. To reduce confounding factors, case-control matching was carried out for BMI and body height.
    RESULTS: After case-control matching, a total of thirty-one matches were analyzed. Stem size was underestimated in 74% (23/31) in the CVA and 13% (4/31) in the control group (p < 0.001). Moreover, patients with CVA were more likely to be underestimated by two sizes compared to controls (p < 0.004). In contrast, the exact stem size was predicted more frequently in the control group (p < 0.001).
    CONCLUSIONS: Stem size in patients with a CVA configuration are at high risk of being underestimated when using digital templating. These findings can be valuable for guiding in intraoperative decisions and lowering the risk of complications associated with an undersized femoral component.
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  • 文章类型: Case Reports
    背景:当初始成像和检查提供的信息有限时,评估孤立的四肢不适可能是具有挑战性的。尽管微妙的患者病史提示通常是隐匿性病理的基础,良性症状经常被错误地归类为特发性。
    方法:我们在影像学上介绍了一例残留玻璃模糊为急性钙化性周关节炎的病例。一名48岁的白人男性,患有模糊的第五掌指关节疼痛,但检查未发现,但是X光片显示关节周围钙化与炎症有关。手术探查意外地发现一个包裹的玻璃碎片侵蚀了骨头。进一步的历史发现了十年前被遗忘的玻璃撕裂。异物被移除,解决症状。
    结论:该病例揭示了非特异性四肢疼痛的两个必要诊断原则:(1)高级影像学缺乏特异性,无法区分炎性关节病与其他关节内过程,例如异物,(2)模糊的患者病史问题揭示了指导准确诊断的因果关系。虽然最初的扫描显示急性钙化性关节炎,详尽的重新审视患者的微妙的十年历史的玻璃切割被证明是关键的,在阐明潜在的驱动因素的症状。
    结论:我们的研究结果强调了成像的严重局限性,以及细致的病史记录在澄清模糊的慢性肢体表现方面的重要作用。当症状似乎与致病事件脱节时,他们强调了探索甚至远处创伤的必要性。此病例加强了对所有细微患者线索的综合评估,这是阐明难以捉摸的四肢疼痛病因的关键。
    BACKGROUND: Evaluating isolated extremity discomfort can be challenging when initial imaging and exams provide limited information. Though subtle patient history hints often underlie occult pathologies, benign symptoms are frequently miscategorized as idiopathic.
    METHODS: We present a case of retained glass obscuring as acute calcific periarthritis on imaging. A 48-year-old White male with vague fifth metacarpophalangeal joint pain had unrevealing exams, but radiographs showed periarticular calcification concerning inflammation. Surgical exploration unexpectedly revealed an encapsulated glass fragment eroding bone. Further history uncovered a forgotten glass laceration decade prior. The foreign body was removed, resolving symptoms.
    CONCLUSIONS: This case reveals two imperative diagnostic principles for nonspecific extremity pain: (1) advanced imaging lacks specificity to differentiate inflammatory arthropathies from alternate intra-articular processes such as foreign bodies, and (2) obscure patient history questions unearth causal subtleties that direct accurate diagnosis. Though initial scans suggested acute calcific periarthritis, exhaustive revisiting of the patient\'s subtle decade-old glass cut proved pivotal in illuminating the underlying driver of symptoms.
    CONCLUSIONS: Our findings underscore the critical limitations of imaging and the vital role that meticulous history-taking plays in clarifying ambiguous chronic limb presentations. They spotlight the imperative of probing even distant trauma when symptoms seem disconnected from causative events. This case reinforces the comprehensive evaluation of all subtle patient clues as key in illuminating elusive extremity pain etiologies.
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