Image quality in conventional chest radiography. Evaluation using the postprocessing tool Diamond View

The objective of this work was to evaluate the influence of the postprocessing tool Diamond View^® (Siemens AG Medical Solutions, Germany) on image quality in conventional chest radiography. Evaluation of image quality remains a challenge in conventional radiography. Based on the European Commission quality criteria we evaluated the improvement of image quality when applying the new postprocessing tool Diamond View^® (Siemens AG Medical solutions, Germany) to conventional chest radiographs. Three different readers prospectively evaluated 102 digital image pairs of chest radiographs. Statistical analysis was performed with a p value <0.05 considered as significant. Images were evaluated on basis of the modified imaging Quality Criteria by the Commission of the European Communities. Each of the 11 image quality criteria was evaluated separately using a five point classification. Statistical analysis showed an overall tendency for improved image quality for Diamond View^® (DV) for all criteria. Significant differences could be found in most of the criteria. In conclusion DV improves image quality in conventional chest radiographs.     

Localized air foci in the lower thorax in the patients with pneumothorax: Skip pneumothoraces

Purpose

To investigate the characteristics and imaging features of localized air foci in the lower thorax in patients with pneumothorax using thin-section multidetector computed tomography.

Materials and methods

Of 10,547 consecutive CT examinations comprising the chest, the CT scans of 146 patients with ordinary pneumothoraces were identified and retrospectively evaluated. The study group included 110 male and 36 female patients (mean age, 50 years; range, 1–93 years). All examinations were performed at our institution between January 2009 and December 2009. Cause of pneumothorax was classified as traumatic or non-traumatic. Localized air foci in the lower thorax were defined as being localized air collections in the lower thorax that did not appear to be adjacent to the lung. If these criteria were met, the shape, size, location laterality, and number of foci were evaluated. Associations with trauma, sex, severity of the pneumothorax, and laterality were evaluated using the χ² test. All P values <0.05 were considered significant.

Results

Localized air foci in the lower thorax presented as slit-like or small ovoid air collections in the lowest part of the pleural space. These foci were observed in 79/146 (54.1%) patients. The traumatic pneumothoraces group showed a higher prevalence of these features than the non-traumatic group. Some foci that were situated in the anterior part mimicked the appearance of free intraperitoneal air.

Conclusion

Patients with pneumothorax commonly had localized air foci in the lower thorax. Because such foci can mimic pneumoperitoneum, accurate recognition of them is required to avoid confusion with free intraperitoneal air, especially in traumatic cases.     

99Tcm-MDP骨显像胸部异常放射性摄取的原因分析

在99Tcm-MDP骨显像时除全身正常组织及病变骨组织显影外,骨外组织也常不同程度地摄取显像剂而显影,尤以胸部软组织最为常见。研究胸部骨与骨外组织摄取显像剂显像的不同原因,分析其可能蕴含的病变信息,给临床诊疗提供必要的帮助。笔者就近年来有关这方面国内外的研究进行综述。     

胎儿心胸径线及比值的测量与临床价值

目的　测量胎儿心脏面积及胸腔面积 ,了解胎儿心胸比值的范围和临床价值。　方法　采用实时超声对 75 0例妊娠 16～ 40周正常孕妇的胎儿心脏及胸腔径线的测量和面积计算 ,并得出每一孕龄组的胎儿心脏面积与胸腔面积的平均比值。　结果　胎儿心脏面积与胸腔面积均与孕龄呈高度正直线相关关系 ,每一孕龄组的胎儿心胸比值在 0 .2 0左右 ,不超过 0 .30。　结论　超声测量胎儿心脏面积与胸腔面积可作为推算胎儿孕龄、估计胎儿宫内生长发育的生物物理指标之一。胎儿的心胸比值一般不超过 0 .30 ,增大者可考虑胎儿先心病或胎儿水肿的可能。     

Radiological Findings of Extensively Drug-Resistant Pulmonary Tuberculosis in Non-AIDS Adults: Comparisons with Findings of Multidrug-Resistant and Drug-Sensitive Tuberculosis

Objective

This study was designed to describe the radiological findings of extensively drug-resistant (XDR) pulmonary tuberculosis (TB) and to compare the observed findings with findings of drug-sensitive (DS) and non-XDR multidrug-resistant (MDR) TB in non-AIDS patients.

Materials and Methods

From September 1994 to December 2007, 53 MDR TB patients (M:F = 32:21; mean age, 38 years) and 15 XDR TB non-AIDS patients (M:F = 8:7; mean age, 36 years) were enrolled in the study. All of the MDR TB patients had received no treatment or less than one month of anti-TB treatment. In addition, all XDR TB patients received either no anti-TB treatment or only first-line anti-TB drugs. In addition, 141 consecutive DS TB patients (M:F = 79:62; mean age, 51 years) were also enrolled in the study for comparison. Chest radiograph, CT and demographic findings were reviewed and were compared among the three patient groups.

Results

For patients with XDR TB, the most frequent radiographic abnormalities were nodules (15 of 15 patients, 100%), reticulo-nodular densities (11 of 15, 73%), consolidation (9 of 15, 60%) and cavities (7 of 15, 47%) that were located mainly in the upper and middle lung zones. As seen on radiographs, significant differences were found for the frequency of nodules and ground-glass opacity lesions (all p < 0.001) (more frequent in DS TB patients than in MDR and XDR TB patients). For the use of CT, significant differences (more frequent in MDR and XDR TB patients) were found for the frequency of multiple cavities, nodules and bronchial dilatation (p = 0.001 or p < 0.001). Patients with MDR TB and XDR TB were younger as compared to patients with DS TB (p < 0.001). Imaging findings were not different between patients with MDR TB and XDR TB.

Conclusion

By observation of multiple cavities, nodules and bronchial dilatation as depicted on CT in young patients with acid-fast bacilli (AFB) positive sputum, the presence of MDR TB or XDR TB rather than DS TB can be suggested. There is no significant difference in imaging findings between patients with XDR TB and MDR TB.     

Dumbbell-shaped thoracic hibernoma: computed tomography and magnetic resonance imaging findings

Hibernoma is an uncommon, benign soft tissue tumor that arises in brown adipose tissue. The computed tomography (CT) and magnetic resonance imaging (MRI) findings of hibernomas are similar to those of well-differentiated liposarcoma or angiolipoma. We report the unique appearance of a rare thoracic wall hibernoma, which appeared as a dumbbell-shaped lipomatous tumor across an intercostal region. A dynamic contrast-enhanced study on MRI revealed early enhancement, which corresponded to the branching low-signal intensity on T2-weighted images of the mass.     

急性胸部创伤的X线表现

目的 进一步提高对急性胸部创伤的X线诊断水平。方法 回顾性分析135例急性胸外伤患者的胸部X线表现及其产生的病理基础。结果 肋骨骨折90例,皮下及绷隔积气35例,单纯性气胸5例,单纯性血胸11例,血气胸35例,肺纹理增粗89例,多发斑片影42例,舌片状实变影36例,肺血肿15例,血气囊肿6例,急性肺膨胀4例,结论 急性胸部创伤的X线表现多种多样,伤后连续的X线复查对提高诊断的准确性很有帮助。     

胸部手术后胸腔引流管的应用探讨

目的探讨胸部手术后常规引流管与改进后的引流管的引流效果。方法将2002年6月~2004年6月收治的胸外科患者随机分为两组,改进组134例,对照组106例,关胸后分别施行改进的和常规的胸腔引流方法。改进组的胸腔引流管长约60 cm,一端剪2个侧孔,置于病变处,于肋膈角处再剪一侧孔,引出体外接引流瓶。结果改进组发现胸腔局灶积液11例(8.2%),经1~2次定位穿刺抽吸后消失。而对照组发现胸腔局灶性积液42例(39.6%),其中33例经一次定位穿刺抽吸后消失,7例多次定位穿刺抽吸后消失,18例患者发热持续1周以上。结论两组并发胸腔积液率有显著差异(P<0.01)。改进后的胸腔引流管优于常规引流管。     

Evaluation of thorax computed tomographic findings in COVID-19 variant cases

BackgroundBecause of genetic mutations occurring during viral replication, new SARS-CoV-2 variants will continue to emerge. Throughout the COVID-19 pandemic, thorax computed tomographic (CT) findings have played a crucial role in the diagnosis and follow-up of patients with COVID-19. In this study, we compared the thorax CT findings of patients infected with SARS-CoV-2 variants (variant group) with those of patients infected with the non-variant strain (non-variant group) to assess if thorax CT findings may be utilized to discriminate between the groups. Furthermore, we compared demographic and laboratory data between the groups.MethodsThe study comprised a total of 77 patients who presented to our hospital with a preliminary diagnosis of COVID-19 based on clinical symptoms, a positive oropharyngeal/nasopharyngeal swab RT-PCR testing, and thorax CT examinations. Patients' laboratory and demographic features as well as thorax CT findings were retrospectively evaluated, and the results were grouped according to RT-PCR results.ResultsThere were 42 patients in the non-variant group and 35 patients in the variant group. The average age of patients infected with the non-variant strain, alpha variant, and gamma variant was 63.52 ± 14.87 years, 54.86 ± 14.31 years, and 59.4 ± 17.79 years, respectively. The average age of the variant group was significantly lower than that of the non-variant group. There was no significant difference in thorax CT findings between the groups, and consolidation, ground glass densities, and cobblestone pattern in the bilateral lower lobes and peripheral areas were the most common thorax CT findings in both the groups.ConclusionThere is no significant difference in thorax CT findings between the variant and non-variant groups. Therefore, clinical and laboratory characteristics should take precedence over thorax CT findings for distinguishing between patients infected with SARS-CoV-2 variants and the non-variant strain.     

胸腔出入口区CT研究

目的：探讨胸腔出入口区的正常CT解剖和CT对该区病变的诊断及鉴别诊断价值。方法：回顾性分析经病理及临床证实的117例胸腔出入口区病变的CT表现，对50例正常对照组在CT上分为5个解剖区：1区（甲状腺区）；2区（甲状腺内侧区）；3区（甲状腺外侧区）；4区（甲状腺后区）；5区（甲状腺前区）。结果：在117例中，1区11例（9．40％），2区8例（6．84％），3区72例（61．54％），4区1例（0．85％），5区3例（2．56％），跨1，3，5区15例（12．8％），跨1，2，3区7例（5．98％）。病变主要分布在3区，其中以淋巴结病变最为多见（55例）；甲状腺病变（33例）主要分布在1区和跨区生长。结论：在CT上对胸腔出入口区合理的划分5个解剖区，有利于病变的定位和定性1诊断，具有重要的临床应用价值。