Radiography

射线照相术
  • 文章类型: Journal Article
    为了确定临床表现,在我们的背景下,腺样体肥大儿童的影像学特征和结局。
    一项回顾性研究。
    埃努古一家私立医院的儿科诊所。
    51个孩子,2至108个月,具有暗示的临床特征和表现超过3年的腺样体肥大的影像学报告。
    从患者的病历中获得临床信息。数据分析了患者的临床特征,鼻后间隙(PNS)X线片上气道狭窄程度与治疗结果之间的关系。
    在PNS射线照片上测量的气道狭窄程度,治疗的类型和结果。
    腺样体肥大的发生率为男性(54.7%):女性(45.1%),平均发病年龄为31.50±3.64个月。嘈杂的呼吸是最常见的症状(94.1%);64.7%的病例中有过敏性鼻炎病史,45.1%的病例中有超过50%的气道狭窄病例仅通过医疗管理解决。
    在评估五岁以下儿童的上呼吸道时,应考虑腺样体肥大。儿科医生应熟悉诊断和管理上呼吸道阻塞的常见原因。
    没有声明。
    UNASSIGNED: To determine the clinical presentation, imaging features and outcomes of children with adenoid hypertrophy in our setting.
    UNASSIGNED: A retrospective study.
    UNASSIGNED: The paediatric clinic of a private hospital in Enugu.
    UNASSIGNED: 51 children, aged 2 to 108 months, with suggestive clinical features and radiographic report of adenoid hypertrophy who presented over 3 years.
    UNASSIGNED: Clinical information was obtained from the patient\'s medical records. Data was analysed for the clinical characteristics of the patients, the relationship between the degree of airway narrowing on a postnasal space (PNS) radiograph and treatment outcomes.
    UNASSIGNED: Degree of airway narrowing as measured on a PNS radiograph, the type of and outcomes of treatment.
    UNASSIGNED: There was an almost equal male (54.7%): female (45.1%) ratio in the occurrence of adenoid hypertrophy, with a mean age of occurrence of 31.50 ± 3.64 months. Noisy breathing was the commonest symptom (94.1%); history of atopic rhinitis in 64.7% of cases and hyperactive airway disease in 45.1% more than 50% of cases with airway narrowing resolved with medical management only.
    UNASSIGNED: Adenoid hypertrophy should be considered in evaluating the upper airway in children under five. Paediatricians should be conversant with diagnosing and managing this common cause of upper airway obstruction.
    UNASSIGNED: None declared.
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  • 文章类型: Journal Article
    成人退行性脊柱侧凸(ADS)是一种冠状面畸形,常伴有矢状面错位。手术矫正可能涉及主要和/或远端位置的分数曲线(FC)。FC的校正越来越被认为是改善局限于FC水平的神经根性疼痛的关键。本研究旨在总结有关ADS中FC校正原理的文献。系统审查了三个数据库,以确定所有报告纠正ADS中FC的理由的主要研究。如果文章是来自ADS(≥18岁)患者的主要数据的英文全文研究,则将其纳入。确定了74篇文章,其中12个是在全文审查后纳入的。研究结果表明,与植入the骨的构造相比,在L5处终止长段融合的FC矫正会增加远端交界变性的风险。此外,周向融合提供更大的FC校正,降低再操作风险,和较短的构造长度。微创手术(MIS)技术可以提供有效的影像学矫正,并改善与FC凹陷椎间孔狭窄相关的腿部疼痛。虽然经验有限。开放手术可能是必要的,以实现充分的矫正严重,高度僵硬的畸形。当前数据支持ASD中的主要曲线校正,其中FC凹度和截断偏移一致,这表明FC有助于患者的整体畸形。周向融合和支架杆的使用可以改善矫正并增强长结构的稳定性和耐久性。最后,MIS技术显示出轻度畸形的希望,但需要进一步研究。
    Adult degenerative scoliosis (ADS) is a coronal plane deformity often accompanied by sagittal plane malalignment. Surgical correction may involve the major and/or distally-located fractional curves (FCs). Correction of the FC has been increasingly recognized as key to ameliorating radicular pain localized to the FC levels. The present study aims to summarize the literature on the rationale for FC correction in ADS. Three databases were systematically reviewed to identify all primary studies reporting the rationale for correcting the FC in ADS. Articles were included if they were English full-text studies with primary data from ADS ( ≥ 18 years old) patients. Seventy-four articles were identified, of which 12 were included after full-text review. Findings suggest FC correction with long-segment fusion terminating at L5 increases the risk of distal junctional degeneration as compared to constructs instrumenting the sacrum. Additionally, circumferential fusion offers greater FC correction, lower reoperation risk, and shorter construct length. Minimally invasive surgery (MIS) techniques may offer effective radiographic correction and improve leg pain associated with foraminal stenosis on the FC concavity, though experiences are limited. Open surgery may be necessary to achieve adequate correction of severe, highly rigid deformities. Current data support major curve correction in ASD where the FC concavity and truncal shift are concordant, suggesting that the FC contributes to the patient\'s overall deformity. Circumferential fusion and the use of kickstand rods can improve correction and enhance the stability and durability of long constructs. Last, MIS techniques show promise for milder deformities but require further investigation.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    虽然种植体周围粘膜炎仅依赖于临床参数,放射学评估对于诊断种植体周围炎是必不可少的。口内射线照相术,凭借其简单的应用,低辐射暴露,以及种植体周围结构的充分表现,作为即时和后续评估的护理标准。通过定制的放射学夹板进行标准化可以与以前的图像具有出色的可比性,并且可以确定植入物周围骨骼的轮廓和密度的微小变化。此外,全景X线摄影和锥形束计算机断层扫描(CBCT)等其他X线摄影方式可能为特定患者和临床病例提供有用的特征,同时也显示出先天的局限性.除了评估边缘种植体周围骨水平作为临床相关性的关键参数外,放射学评估可能会发现与假体修复本身有关的各种其他发现,它与植入物的配合精度,以及种植体周围的软组织和硬组织。由于这些发现对于评估种植体周围健康和种植体预后至关重要,建议采用系统的诊断评估途径进行全面评估,以从放射学成像中提取所有相关信息.本文还概述了种植体周围问题中不同成像方式的临床和时间适应症。
    While peri-implant mucositis relies solely on clinical parameters, radiological assessment becomes indispensable for diagnosing peri-implantitis. Intraoral radiography, with its simplicity of application, low radiation exposure, and adequate representation of peri-implant structures, stands out as the standard of care for both immediate and follow-up assessments. Standardization by custom-made radiologic splints allows for excellent comparability with previous images and allows for the determination of even small changes in contour and density of the peri-implant bone. Furthermore, other radiographic modalities like panoramic radiography and cone beam computed tomography (CBCT) may provide useful features for specific patients and clinical cases while also showing innate limitations. Beyond the assessment of the marginal peri-implant bone level as the crucial parameter of clinical relevance, radiologic assessment may reveal various other findings related to the prosthetic restoration itself, the precision of its fit to the implant, and the peri-implant soft and hard tissues. Since such findings can be crucial for the assessment of peri-implant health and the implants\' prognosis, a systematic diagnostic evaluation pathway for a thorough assessment is recommended to extract all relevant information from radiologic imaging. This article also provides an overview of the clinical and chronological indications for different imaging modalities in peri-implant issues.
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  • 文章类型: Journal Article
    这篇综述涵盖了急性外伤后常见的骨科损伤。对这些损伤进行彻底的身体检查和影像学检查是确保适当管理的关键。尽管许多损伤可能需要紧急或紧急的骨科咨询和管理,本综述的重点是低风险的损伤,适合在门诊骨科随访中进行夹板固定.这项审查涵盖了主要的身体检查特征,帮助提供者评估伤害的放射学发现,以及审查夹板的应用,以帮助促进在急性护理环境中快速管理这些损伤。
    UNASSIGNED: This review covers common orthopedic injuries seen after acute traumatic injury. A thorough physical examination and radiographic review of these injuries are key to ensuring appropriate management. Although many injuries may require urgent or emergent orthopedic consultation and management, this review focuses on injuries that are low-risk and amenable to splinting with outpatient orthopedic follow-up. This review covers key physical examination features, radiographic findings that help providers assess injuries, as well as reviewing splinting application to help facilitate rapid management of these injuries in the acute care setting.
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  • 文章类型: Journal Article
    上颌中隔和中隔大疱的解剖学变化可能在解释马头的X光片过程中产生挑战,并且难以准确识别受鼻窦疾病影响的部位。目前在科学文献中很少描述这些结构的射线照相外观。这项工作旨在描述马的上颌隔膜和上颌间隔大疱的解剖和影像学特征。使用了六个化学保存的马尸体头,在接受上颌骨皮瓣后,上颌中隔及其各自的大疱被确认。在这些结构上进行造影剂浸渍之前和之后的射线照相检查。上颌隔膜的位置在解剖标本之间以及同一标本的侧面之间有所不同。30°斜背腹侧外侧和外侧突出物可以识别上颌隔和中隔大疱。然而,下颌骨处于中立位置或下颌骨移位时,大疱仍然叠加在背腹突起的牙弓上。建议倾斜偏移射线照相定位,并证明对上颌间隔大疱的检查是有效的,下颌骨移位到要检查的大疱一侧,和射线照相光束在相同方向上倾斜。在骨瓣和对比射线照相检查允许其充分解释之后,可以通过宏观方式正确识别上颌隔膜及其大疱。大小和位置的变化被认为是马种的正常现象。
    The anatomical variations of the maxillary septum and the septal bullae can generate challenges during the interpretation of radiographs of the horses\' heads and make it difficult to accurately identify the sites affected in sinus disorders. The description of the radiographic appearance of these structures is currently scarce in the scientific literature. This work aims to describe the anatomical and radiographic characteristics of the maxillary septum and maxillary septal bullae in horses. Six chemically preserved equine cadaver heads were used which, after being submitted to the maxillary osseous flap, the maxillary septum and its respective bullae were identified. Radiographic examinations before and after contrast impregnation on these structures were performed. The positioning of the maxillary septum varied between the anatomical specimens and between the sides of the same specimen. The 30° oblique dorsoventral lateral and lateral projections allowed the identification of the maxillary septum and septal bullae. However, the bullae remained superimposed on the dental arches in the dorsoventral projections with the mandible in a neutral position or with the mandible displaced. The oblique offset radiographic positioning was suggested and proved effective for the examination of the maxillary septal bullae, where the mandible was displaced to the side of the bullae to be examined, and the radiographic beam inclined in the same direction. The maxillary septum and its bullae could be properly identified in a macroscopic way after the osseous flap and the contrasted radiographic examination allowed its adequate interpretation. Variations in size and position are considered normal for the equine species.
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  • 文章类型: Journal Article
    鉴于可能的辐射损伤和放射调查的不准确性,特别是在儿童中,在儿科患者中进行肢体延长时,超声和出色的微血管成像(SMI)可能提供评估新骨形成的替代方法。这项研究的目的是评估超声联合SMI在监测儿童肢体延长期间新骨形成中的应用。
    在这项回顾性队列研究中,每两周对30例接受肢体延长术的儿科患者进行超声和X光检查。超声用于监测新骨形成。将垂直血管的数量和血流阻力指数与普通X光片进行了比较。
    我们将新骨形成分为三个阶段:I期(早期延长),在X线照片和超声上没有明显的愈伤组织形成;II期(延长),其中X射线照片显示低密度愈伤组织形成,分布不均,在超声下可以识别出三个子阶段:在Ia中可见点状愈伤组织;在IIb中,有尚未连接的线性愈伤组织形成,在IIc中,有连续的线性愈伤组织。在第三阶段(治疗),骨端已经结合了,骨膜完好无损,愈伤组织消失了,正如在射线照片上所证实的,显示骨愈合。早期注意到垂直船只的数量逐渐增加,在IIb和IIc阶段达到峰值,随后逐渐下降(p<0.001)。延迟愈合涉及IIa期延长的患者或在延长期间从IIb或IIc期恢复到IIa期的患者。
    我们发现,当与放射学发现相结合时,可以使用超声可靠地评估接受肢体延长的儿科患者新骨的形成。这种组合可以改善对预后的评估,以及对延长协议的调整。虽然SMI提供了新骨骼中血管生成的额外见解,它的作用主要有助于了解微血管环境,而不是直接通知调整治疗。
    UNASSIGNED: Given the possible radiation damage and inaccuracy of radiological investigations, particularly in children, ultrasound and superb microvascular imaging (SMI) may offer alternative methods of evaluating new bone formation when limb lengthening is undertaken in paediatric patients. The aim of this study was to assess the use of ultrasound combined with SMI in monitoring new bone formation during limb lengthening in children.
    UNASSIGNED: In this retrospective cohort study, ultrasound and radiograph examinations were performed every two weeks in 30 paediatric patients undergoing limb lengthening. Ultrasound was used to monitor new bone formation. The number of vertical vessels and the blood flow resistance index were compared with those from plain radiographs.
    UNASSIGNED: We categorized the new bone formation into three stages: stage I (early lengthening), in which there was no obvious callus formation on radiographs and ultrasound; stage II (lengthening), in which radiographs showed low-density callus formation with uneven distribution and three sub-stages could be identified on ultrasound: in Ia punctate callus was visible; in IIb there was linear callus formation which was not yet connected and in IIc there was continuous linear callus. In stage III (healing), the bone ends had united, the periosteum was intact, and the callus had disappeared, as confirmed on radiographs, indicating healed bone. A progressive increase in the number of vertical vessels was noted in the early stages, peaking during stages IIb and IIc, followed by a gradual decline (p < 0.001). Delayed healing involved patients with a prolonged stage IIa or those who regressed to stage IIa from stages IIb or IIc during lengthening.
    UNASSIGNED: We found that the formation of new bone in paediatric patients undergoing limb lengthening could be reliably evaluated using ultrasound when combined with the radiological findings. This combination enabled an improved assessment of the prognosis, and adjustments to the lengthening protocol. While SMI offered additional insights into angiogenesis within the new bone, its role primarily contributed to the understanding of the microvascular environment rather than directly informing adjustments of treatment.
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  • 文章类型: Journal Article
    据报道,多达30%的儿童成功支撑治疗婴儿发育性髋关节发育不良(DDH)的放射性残余髋臼发育不良(RAD)。预测那些将解决和可能需要矫正手术的人对于优化后续协议很重要。在这项研究中,我们旨在确定支撑后两年和五年RAD的患病率和预测因子。
    这是一个单中心,使用已发表的DDH管理的婴儿的前瞻性纵向队列研究,2012年1月至2016年12月标准化Pavlik线束协议。使用髋臼指数-外侧边缘(AI-L)和髋臼指数-sourcil(AI-S)在平均随访两年时测量RAD,在使用AI-L的五年时间里,AI-S,中心边缘角(CEA),和髋臼深度比(ADR)。每个髋关节都是根据公布的标准值进行分类的,边界线(1到2个标准偏差(SDs)),或基于性别的发育不良(>2个SDs),年龄,和偏侧性。
    在完成方案的202名婴儿中,181人(90%)接受了两年和五年的随访X光片。两年后,在304个最初的病态臀部中,RAD(发育不良)患病率为10%,RAD(临界)患病率为30%.五年后,RAD(发育不良)降低至1%至3%,RAD(临界)降低至<1%至2%。在逻辑回归中,在2年时没有变量可预测RAD.只有两年的AI-L可以预测五年的RAD(p<0.001)。如果两个臀部在两年的随访中都是正常的(n=96),五年后都保持正常。在那些在两年时(n=21)有双侧临界臀部的人中,五年时只有两个是临界线,都没有发育不良。在那些在两年(n=26)患有临界发育不良或双侧发育不良的患者中,3人(12%)在5年时出现发育不良。
    大多数RAD患者在支架治疗后两年,自发解决了五年。因此,支具治疗后两年X光片正常的儿童可以出院。在两年内对AI-L异常的患者进行有针对性的随访,将确定在五年后可能从手术矫正中受益的少数人。
    UNASSIGNED: Radiological residual acetabular dysplasia (RAD) has been reported in up to 30% of children who had successful brace treatment of infant developmental dysplasia of the hip (DDH). Predicting those who will resolve and those who may need corrective surgery is important to optimize follow-up protocols. In this study we have aimed to identify the prevalence and predictors of RAD at two years and five years post-bracing.
    UNASSIGNED: This was a single-centre, prospective longitudinal cohort study of infants with DDH managed using a published, standardized Pavlik harness protocol between January 2012 and December 2016. RAD was measured at two years\' mean follow-up using acetabular index-lateral edge (AI-L) and acetabular index-sourcil (AI-S), and at five years using AI-L, AI-S, centre-edge angle (CEA), and acetabular depth ratio (ADR). Each hip was classified based on published normative values for normal, borderline (1 to 2 standard deviations (SDs)), or dysplastic (> 2 SDs) based on sex, age, and laterality.
    UNASSIGNED: Of 202 infants who completed the protocol, 181 (90%) had two and five years\' follow-up radiographs. At two years, in 304 initially pathological hips, the prevalence of RAD (dysplastic) was 10% and RAD (borderline) was 30%. At five years, RAD (dysplastic) decreased to 1% to 3% and RAD (borderline) decreased to < 1% to 2%. On logistic regression, no variables were predictive of RAD at two years. Only AI-L at two years was predictive of RAD at five years (p < 0.001). If both hips were normal at two years\' follow-up (n = 96), all remained normal at five years. In those with bilateral borderline hips at two years (n = 21), only two were borderline at five years, none were dysplastic. In those with either borderline-dysplastic or bilateral dysplasia at two years (n = 26), three (12%) were dysplastic at five years.
    UNASSIGNED: The majority of patients with RAD at two years post-brace treatment, spontaneously resolved by five years. Therefore, children with normal radiographs at two years post-brace treatment can be discharged. Targeted follow-up for those with abnormal AI-L at two years will identify the few who may benefit from surgical correction at five years\' follow-up.
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  • 文章类型: Journal Article
    背景技术先天性拇指发育不全IV型,也被称为浮动拇指,是一种情况,其中2个小指骨与薄皮肤桥连接到手上。这种情况的手术治疗选择从截肢到皮瓣重建各不相同。材料与方法这项回顾性研究分析了11例先天性IV型拇指发育不全的婴儿,这些婴儿使用改良的血管化多趾皮瓣进行了手术重建。该研究包括6名男性和5名女性婴儿,6至24个月。术后进行功能评估和影像学检查。结果11例患者均接受了完整的手术方案。在初始手术过程中进行了成功的血管和神经吻合,确保足够的血液供应和神经连接到转移的脚趾。第二次手术显示了有希望的结果,包括拇指对立的改进,把握力量,和整体功能。术后评估显示,在随访期间,放射学检查令人满意,并且没有重大并发症。结论改良的血管化多指拇指皮瓣重建是治疗婴儿IV型先天性拇指发育不全的可行手术选择。这种技术有效地恢复了拇指的反对,把握力量,和整体手部功能,具有令人满意的射线照相对准和最小的并发症。研究结果支持这种手术方法在解决这种罕见的先天性异常方面的有效性和安全性。
    BACKGROUND Congenital hypoplasia of the thumb type IV, also known as floating thumb, is a condition in which 2 small phalanges are attached to the hand with a thin skin bridge. Surgical management options for this condition vary from amputation to flap reconstruction. MATERIAL AND METHODS This retrospective study analyzed 11 infants with congenital hypoplasia of the thumb type IV who underwent surgical reconstruction using a modified vascularized polydactylous hallux flap. The study included 6 male and 5 female infants, aged 6 to 24 months. Functional evaluations and radiographic studies were conducted postoperatively. RESULTS All 11 patients underwent the complete surgical protocol. Successful vascular and nerve anastomoses were performed during the initial procedure, ensuring sufficient blood supply and neural connectivity to the transferred toes. The second operation showed promising outcomes, including improvements in thumb opposition, grasp strength, and overall function. Postoperative assessments demonstrated satisfactory radiographic alignment and no major complications during the follow-up period. CONCLUSIONS The modified vascularized polydactylous hallux flap reconstruction is a viable surgical option for managing congenital hypoplasia of the thumb type IV in infants. This technique effectively restores thumb opposition, grasp strength, and overall hand function, with satisfactory radiographic alignment and minimal complications. The study findings support the efficacy and safety of this surgical approach in addressing this rare congenital anomaly.
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  • DOI:
    文章类型: Journal Article
    本文旨在回顾当前描述的主要线条和角度,并将其收集在单个文章中,并以系统的方式进行安排,以促进对小儿足部畸形的评估过程。
    这篇综述是一篇范围界定的文献综述。电子数据库网站,如PubMed,欧洲PMC,科克伦图书馆,和谷歌学者除了一些关于解剖学和人体运动生物力学的书籍,诊断放射学,和骨科为本综述的主题搜索相关文章。本综述未应用统计学分析。
    本评论中包含的30篇文章的数据被安排到不同的副标题中。在前后视图(AP)中,后足偏离的评估是通过AP距骨-跟骨角度(风筝角度);前足和中足外展和内收对齐是通过AP距骨-第一跖骨角度,距骨第二跖骨角,跟骨-第二跖骨角,跟五角;前足和中足旋转是通过观察meta骨轴线的正常近端会聚。在侧视图中,后足矢状平面对齐的评估是通过胫骨-跟骨外侧角度进行的;后足内翻或外翻通过距骨-跟骨外侧角度进行的;距骨对齐通过距骨倾角和胫骨-距骨角度进行的;跟骨对齐通过跟骨倾角和胫骨-跟骨角度进行的;足底弓的中足和前足矢状平面通过外侧距骨-迈里角对齐,跟骨倾角,和外侧跟骨-Hibbs-角;通过观察the轴的重叠阴影并绘制其轴线,前足和中足旋转对齐。
    用系统的方法绘制某些线条和角度来评估儿童射线照相胶片中足部的不同区域,可以促进对足部(作为一个整体)畸形的评估过程。
    UNASSIGNED: This article aimed to review the main currently described lines and angles and gather them in a single article and arrange them in a systematic way to facilitate the process of assessment of the pediatric foot for deformities.
    UNASSIGNED: The review was a scoping literature review. Electronic database websites such as PubMed, Europe PMC, Cochrane Library, and Google Scholar in addition to some books on anatomy and human movements biomechanics, diagnostic radiology, and orthopedics were searched for relevant articles for the topic of the present review. No statistical analysis was applied in this review.
    UNASSIGNED: Data from thirty articles included in this review were arranged into different subheadings. In the anteroposterior view (AP), assessment of the hindfoot deviation was by the AP talo-calcaneal angle (Kite\'s angle); the forefoot and midfoot for abduction and adduction alignment was by the AP talo-first metatarsal angle, the talo-second metatarsal angle, the calcaneo-second metatarsal angle, the calcaneofifth metatarsal angle; the forefoot and midfoot rotation was by observing the normal proximal convergence of the metatarsal bones axes. In the lateral view, assessment of the hindfoot sagittal plane alignment was by the lateral tibio-calcaneal angle; hindfoot varus or valgus deviation by the lateral talo-calcaneal angle; talus bone alignment by talar declination angle and the tibio-talar angle; calcaneal bone alignment by the calcaneal inclination angle and the tibio-calcaneal angle, the midfoot and forefoot sagittal plane alignment for the plantar arch by the lateral talo-first metatarsal -Meary\'s- angle, the calcaneal inclination angle, and the lateral calcaneofirst metatarsal -Hibbs- angle; forefoot and midfoot rotational alignment by observing the overlap shadows of the metatarsals\' shafts and drawing their axes.
    UNASSIGNED: Drawing certain lines and angles with a systematic approach to assess different regions of the foot in the radiographic films of children can facilitate the process of assessment of the foot (as a whole) for deformities.
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