Digital echocardiography in myocardial infarction

Probably the most under-utilised application of echocardiography is in patients with coronary artery disease (CAD). This under-utilisation is striking since echocardiography can be very valuable in evaluating the natural history and therapy of CAD. One reason why echocardiography is not being utilised to its fullest is because of the reliance on videotape to record and display echocardiograms. This medium is time consuming and inconvenient for clinicians to review studies, it is not ideal for detecting subtle wall motion abnormalities, and videotape is impractical for comparing serial studies. Recording and storing echocardiograms on a digital medium overcomes these difficulties. Digital cine loops of single cardiac cycles provide great versatility. Multiple views or studies can be displayed simultaneously, subtle changes in wall motion are more easily detected and different views, or serial studies, can be readily compared. Such images can be displayed on computers on the ward or in the coronary care unit (CCU) and be available 24 hours a day, seven days a week at the convenience of the clinician. One does not need to find a recording on a two hour videotape, which may be in the ultrasound instrument, and one can view the exam in 30 sec instead of 5 to 10 min. Regional and global left ventricular function is one of the most important manifestations of CAD. With new therapeutic efforts at restoring myocardial function and limiting infant expansion, assessing LV function is more important than ever. Digital echocardiography is an extremely practical and convenient way for clinicians to obtain this information.     

直接数字曲面体层摄影在涎腺造影中的临床价值

目的评价直接数字曲面体层摄影在涎腺造影中的临床价值。方法选择表现正常的腮腺造影数字化曲面体层影像(58侧)及传统曲面体层照片(44侧),评价主导管、腮腺腺泡及分支导管的显影情况。结果在显示腮腺主导管、第一级分支导管及腮腺腺泡方面,直接数字曲面体层与传统曲面体层胶片摄影无明显差异;数字成像显示细微解剖结构(第二、三级分支导管)的质量则明显优于胶片方式(P<0.01)。结论直接数字曲面体层摄影在涎腺造影中具有重要的临床价值。     

三维数字减影血管造影在颅内动脉瘤诊疗中的应用价值

目的：探讨3D—DSA在颅内动脉瘤诊断和治疗中的应用价值。方法：对蛛网膜下腔出血患者常规行DSA检查，发现病变或可疑病变后行3D—DSA检查。结果：26例颅内动脉瘤中检出动脉瘤31枚，其中后交通9枚，C1段3枚，C2段5枚，C3段3枚，前交通6枚，大脑中3枚。椎动脉动2枚。3例2D—DSA未见病变3D—DSA确诊，5例因血管重叠3D—DSA排除了动脉瘤。6枚GDC栓塞，5枚手术夹闭，2枚颈内动脉可脱性球囊封阻术。结论：3D—DSA极大提高了脑血管造影检查的准确性和可靠性，为动脉瘤的介入治疗和手术夹闭提供了可靠保障，在临床诊疗中具有很高的应用价值。     

肝动脉解剖变异影像学研究

目的用数字减影血管造影(DSA)和CT血管造影(CTA)进一步探讨肝动脉解剖变异的种类、发生率及特点。方法回顾分析1000例因肝脏疾病而行DSA检查患者的临床资料、肝动脉的DSA,以及其中的32例肝动脉解剖变异的CTA表现。观察肝动脉的起源、走行、分布情况,并分别统计其变异类型和发生率。结果1000例肝动脉造影中,正常型727例,占72.7%;肝动脉变异273例,占27.3%。273例肝动脉变异中属于Michels分型的148例,占14.8%。Michels分型未包括在内者为125例,占12.5%。其中肝总动脉分叉变异54例,占5.4%,肝动脉起源变异214例,占21.4%,肝总动脉分叉 肝动脉起源变异5例,占0.5%。以上变异合并多种变异共存21例,占2.1%。结论肝动脉解剖变异的种类具有多样性、复杂性。除DSA外,CTA亦可显示肝动脉解剖变异。肝胆外科和影像科医师了解肝动脉解剖变异对于术前制定手术方案、提高诊断准确性等有重要意义。     

Assessment of tardive dyskinesia by means of digital image processing

A wireless device for the assessment of tardive dyskinesia by means of digital image processing is presented. Four skin-cream dots placed around the subjects' mouth are recorded by a video camera. The image is passed to a framegrabber with a signal processor, where it is converted from analogue to digital. A fast spot-detecting algorithm implemented on the signal processor tracks the dots and passes the information to a personal computer, where a Fourier transformation is performed to calculate the frequency spectrum of the movements. The device provided detailed information on the magnitude and on the frequencies of the movements. Data from a longitudinal investigation suggest a higher sensitivity and reliability than conventional rating scales to detect and evaluate abnormal perioral movements. The device might be useful for the early detection, for the longitudinal assessment (p.e. clinical trials) and in some cases for the differential diagnosis of tardive dyskinesia, thus providing a tool for both research and clinical purposes.     

数字化曲面全景X线系统造影在腮腺非肿瘤类疾病诊断中的应用

目的　本文报告普通X线机腮腺造影与数字化曲面X线机腮腺造影结果及其对比应用。方法　用3种不同的X线机对 3组腮腺非肿瘤类疾病患者进行腮腺造影 ,第 1组患者 10人应用普通 30 0mAX线机 ,第 2组患者 10人应用普通曲面全景X线机 ,第 3组患者 36人应用数字化曲面全景X线系统一套 ,分别行造影检查。结果腮腺造影侧位投照第 2组与第 1组末梢导管及腺泡有显著差异 (P <0 .0 5 ) ,第 3组与第 1组末梢导管及腺泡无显著差异 (P >0 .0 5 ) ,腮腺造影后前位投照第 2组与第 1、3组之间有显著差异 (P <0 .0 5 )。结论　本研究对比了 3种X线投照技术在腮腺非肿瘤性疾病造影诊断中的效果 ,用数字化曲面全景X线系统造影在诊断此类疾病中显示出较好的效果。     

动脉数字减影血管造影的临床应用

本文报告８０例动脉数字减影血管造影（ＩＡＤＳＡ）的初步经验，特别着重影像质量的评价。在本组病例，ＩＡＤＳＡ主要用于头颅、颈部、肺、腹部以及先天性心脏病的诊断。本组未发生重大并发症。ＩＡＤＳＡ的优点是：（１）影像质量好；（２）用于ＩＡＤＳＡ的剂量和浓度以及导管的直径均较用于常规血管造影的小得多，因此其副作用和并发症显著减少；（３）检查时间显著缩短，因此，ＩＡＤＳＡ对介入放射学治疗特别有用；（４）ＩＡＤＳＡ现已大部取代常规血管造影来诊断多种疾病。     

数字减影在经内镜胆管内取石术中的应用（附30例分析）

数字减影具有分辨率高、实时成像的特点，为经内镜胆管内结石顺利操作提供了方便。本文总结３０例用数字减影胆管内取石，认为术前病人应充分肠道准备，合理使用平滑肌松弛剂，术中多角度观察，ＥＲＣＰ复查，可望明显提高手术成功率。     

Digital subtraction arthrography in preoperative evaluation of painful total hip arthroplasty

 Objective. The objective of this clinical study was to define the diagnostic value of plain radiography, digital subtraction arthrography and two-phase bone scintigraphy in patients with clinically loose or infected hip prostheses. Design. Digital subtraction arthrograms, scintigrams and plain radiographs of 70 consecutive patients who underwent revision hip arthroplasty were scored individually and in masked fashion for the presence or absence of features indicating loosening of femoral and/or acetabular components. The operative findings acted as the gold standard. Results. Digital subtraction arthrography was best (P<0.001) for predicting a loose acetabular component, while no significant additional predictive value was found for plain radiographs (P=0.24) and scintigraphy (P=0.27). Digital subtraction arthrography was also the most important modality for predicting a loose femoral component (P=0.001), while the plain radiograph was of significant (P=0.04) additional value and scintigraphy was of no additional value (P=0.13) on multivariate analysis. Conclusion. Digital subtraction arthrography gives the best results in the prediction of loosening of acetabular and femoral components. Plain radiographs give additional information on loosening of the femoral component, but scintigraphy offers no additional advantage.     

Determination of left ventricular wall thickness and muscle mass by intravenous digital subtractionangiocardiography: validation of the method

Left ventricular (LV) wall thickness and muscle mass are importantmeasures of LV hypertrophy. In 24 patients LV end-diastolicwall thickness and muscle mass were determined (two observers)by digital subtraction angiocardiography (DSA) and conventionalLV angiocardiography (LVA). Wall thickness was determined overthe anterolateral wall of the left ventricle according to thetechnique of Rackley (method 1) or by planimetry (method 2).Seventeen patients were studied at rest and seven during dynamicexercise. Wall thickness correlated well between LVA and DSA;the best correlations were obtained by a combined subtractionmode using either method 1 or 2 (method 1, r0–80; method2,r0. 75). The standard error of estimate of the mean (SEE) wasslightly lower for method 2 ( 10%) than for method 1 ( 13%).DSA significantly overestimated wall thickness by 5–7%with method 1 and underestimated by 12–14% with method2. Muscle mass correlated well between LVA and DSA; the SEEwas 15% for method 1 and 12% for method 2. Overestimation ofmuscle mass by DSA was 7–11% with method 1 and underestimationwas 13–15% with method 2.It is concluded that LV wallthickness can be determined accurately by DSA with an SEE rangingbetween 10 and 13%. Determination of LV muscle mass is slightlyless accurate and the SEE is slightly larger ranging between13 to 17%. With method 1, wall thickness and muscle mass wereover estimated and with method 2 underestimated.