Chaperones in clinical photography – A review

The recent case of Dr Myles Bradbury, a paediatrician at Addenbrookes Hospital in the UK, has again brought the use and relevance of chaperones back into the minds of healthcare organisations. This paper outlines the recommendations of the report into the actions of Dr Bradbury along with previous reports concerning chaperones and that of professional guidelines on this subject. The use of chaperones specifically is also examined in relation to the historical recommendations and if any new practices should be included in revised policies and processes.     

采用儿童仿真模体研究胸部DR不同千伏照射下的有效剂量

目的 采用1岁儿童仿真模体计算胸部数字化摄影（DR）不同千伏条件下儿童各组织、器官的吸收剂量，估算并比较不同千伏下有效剂量。方法 塑料管分装的热释光剂量计（TLD）布放入儿童模体预留的插孔，在60、 70、80和90 kV时，自动曝光控制（AEC）模式下各曝光20次，然后回收TLD，回实验室测量。计算出不同千伏下组织、器官的吸收剂量，并分别估算出受照儿童模体全身有效剂量。结果 在60、70、80和90 kV时照射野范围内各组织、器官随千伏的增高吸收剂量逐渐降低。4个实验组中有效剂量分别为0.43、0.34、0.29和0.23 μSv。结论 儿童模体胸部摄影使用较高千伏可减少组织、器官的吸收剂量和全身有效剂量。     

髌骨轴位摄影角度与胫股角相关性回归方程的临床应用评价

目的探讨髌骨轴位摄影角度与胫股角相关性回归方程的临床应用价值。方法 100例患者分为两组,根据回归方程设计制作用于测量胫股角和选择摄影角度的角度测量板。实验组(n=50),按照角度测量板测量的胫股角和对应的摄影角度进行髌骨轴位摄影,测量髌股关节显示情况;对照组(n=50)对以往的髌骨轴位影像的髌股关节显示情况进行测量。测量髌骨轴位影像的髌骨后缘双边线间距。统计对照组和实验组的髌骨后缘双边线间距的均值,采用两独立样本t检验,评价两组均值是否存在统计学差异;按髌骨后缘双边线间距的大小统计两组的髌骨轴位影像的优、良、中、差等级百分比。结果对照组和实验组的髌骨后缘双边线间距的均值分别为(1.82+1.23)mm,(0.99+0.94)mm。对两组数据行两独立样本t检验,经Levene’s方差齐性检验,F=5.04,P=0.03,两组总体方差不齐,采用近似t检验t,=3.81,P=0.00,两总体均数的统计学存在显著性差异,实验组的髌骨后缘双边线间距比对照组要小。对照组和实验组的髌骨轴位影像的优、良、中、差等级百分比分别为14(28%)、15(30%)、14(28%)、7(14%);27(54%)、16(32%)、5(10%)、2(4%)。结论髌骨轴位摄影角度与胫股角相关性回归方程Y=60+0.6X可作为髌骨轴位摄影的角度选择方程。根据回归方程制作的髌骨轴位摄影角度测量板可准确确定摄影角度,方便、实用。     

四肢开放性骨折患者在急诊室行创面拍摄的实践

目的 探讨四肢开放性骨折患者急诊术前评估时通过创面照片拍摄,减少创面敷料反复多次打开的现象,从而减少并发症的发生.方法 将来我院急诊的存在四肢开放性骨折的创伤患者共47例分为两组,观察组(n=25)在创面敷料首次打开或未包扎前拍摄创面照片,并提供给手术医生参考,对照组(n=22)不拍摄创面照片.比较两组从急诊入院至送手术期间创面敷料打开次数、单次创面敷料打开暴露时间、创面敷料打开暴露总时间,以及术后两组手术医生的反馈意见.结果 观察组创面敷料单次打开暴露时间多于对照组,差异有统计学意义(P<0.05),但观察组创面敷料打开次数和创面敷料打开暴露总时间均少于对照组,差异有统计学意义(P均<0.05).两组手术医生在术中均未遇到因在术前创面评估中没有预料到而影响手术进程的问题.结论 对四肢开放性骨折患者的创面在急诊术前评估过程中进行照片拍摄,可以有效地减少创面敷料的打开次数及创面敷料打开暴露总时间,且对手术的进程并无不利影响.     

卵巢原发恶性肿瘤CT检查的价值

目的：探讨卵巢原发恶性肿瘤的CT表现,提高其诊断水平。方法：分析在我院行盆腔及或全腹部CT检查的63例患者,经手术病理证实,对这些病例的CT影像进行分析总结并与手术病理对照。结果：卵巢原发恶性肿瘤的CT表现有其特征,主要表现为囊实性,也可呈囊性或实性,增强实性肿块、囊壁及壁结节可见强化,囊性或者囊实性内分隔厚薄不均,可见壁结节。结论：CT检查对卵巢恶性肿瘤的诊断准确率较高,对肿瘤分期诊断有很重要的临床意义。     

Facial recognition and laser surface scan: a pilot study

Surface scanning of the face of a suspect is presented as a way to better match the facial features with those of a perpetrator from CCTV footage. We performed a simple pilot study where we obtained facial surface scans of volunteers and then in blind trials tried to match these scans with 2D photographs of the faces of the volunteers. Fifteen male volunteers were surface scanned using a Polhemus FastSCAN Cobra Handheld Laser Scanner. Three photographs were taken of each volunteer’s face in full frontal, profile and from above at an angle of 45° and also 45° laterally. Via special software (MIMICS^® and Photoshop^®) the surface scans were matched with the photographs in blind trials. The matches were graded as: a good fit; possible fit; and no fit. All the surface scans and photos were matched correctly, although one surface scan could be matched with two angled photographs, meaning that the discriminatory value was 86.7%. We also tested the surface scanner in terms of reliability in establishing point measures on skulls, and compared with physical measurements performed by calipers. The variation was on average 1 mm for five cranial measures. We suggest how surface scanning might be applied in forensic facial identification.     

踝关节过伸过屈摄影及伤侧康复程度模型构建

目的探讨踝关节过伸过屈位摄影技术,确定过伸过屈位功能角和功能夹角的测量方法,分析构建伤侧康复程度模型的临床意义。方法利用计算机数字摄影与数字图像处理技术,借鉴临床评定踝关节伤侧康复程度的方法,摄取踝关节过伸过屈位,测量健侧与伤侧功能夹角,进行比对分析。结果康复程度与伤侧功能夹角和健侧功能夹角之比值成正比。结论摄取踝关节过伸过屈位对评定踝关节伤侧康复程度有诊断价值。