Diagnostic accuracy of new imaging techniques in breast diseases

During the last decade, the hypothetical carcinogenic effects of mammography have lead to new technical developments in X-ray diagnosis and to the use of other imaging techniques such as ultrasonography (US), transillumination, magnetic resonance imaging (MRI). Many preliminary studies were published but few clinical trials are really convincing. According to the definition of a diagnostic tool, none of these new modalities is supposed to supplant mammography in the diagnosis of breast cancer. Improvements are expected by digital mammography in the near future.     

三种无痛技术在纤维结肠镜检查中的对比观察

目的:评价3种无痛技术在无痛性肠镜检查中的麻醉效果及血液动力学变化。方法:90例ASAⅠ~Ⅱ级纤维结肠镜检查患者,随机分为3组,Ⅰ组为单用丙泊酚组;Ⅱ组,丙泊酚加芬太尼组;Ⅲ组,丙泊酚加氯胺酮;观察并记录麻醉效果、不良反应、清醒时间、用药量,以及患者在检查前、意识消失2 min、意识恢复后的平均动脉压、心率、呼吸、SPO2。结果:3种无痛技术麻醉效果基本相同。Ⅰ组的不良反应率最高,但苏醒时间最快;Ⅲ组苏醒时间慢。在麻醉后2 min,3组病人的MAP、HR、RR、SPO2均明显下降,其中Ⅰ组的MAP、HR下降尤为明显。结论:3种无痛技术可作为纤维结肠镜检选择的方法之一,但以芬太尼伍用丙泊酚麻醉效果最佳。     

Accelerated partial breast irradiation: a dosimetric comparison of three different techniques

PURPOSE: We report the first single-institutional dosimetric comparison of patients treated with three forms of accelerated partial breast irradiation: interstitial HDR brachytherapy, the MammoSite balloon apparatus, and 3D conformal external beam quadrant irradiation (3D-CRT). METHODS: A retrospective dosimetric comparison of interstitial HDR brachytherapy, MammoSite balloon brachytherapy, and 3D-CRT was performed. Thirty patients including 10 from each treatment technique were included for a dosimetric comparison of the dose received by the ipsilateral breast, PTV, heart, and ipsilateral lung. Interstitial patients were treated with 4 Gy in 8 fractions to 32 Gy, and the MammoSite patients were treated with 3.4 Gy in 10 fractions to 34 Gy. 3D-CRT patients were treated with 3.85 Gy in 10 fractions to 38.5 Gy using multiple isocentric beams. The CT images from simulation or implant evaluation were transferred into our 3D treatment planning software. The lumpectomy cavities were outlined for every patient, except the MammoSite patients, where the cavity was defined by the balloon edge. The PTV was constructed as a uniform expansion of 1.5 cm for all interstitial HDR patients, 1.0 cm for the MammoSite patients, and a 1.0 cm expansion in addition to the CTV expansion of 1.0 cm (n=2), and 1.5 cm (n=8) for the 3D-CRT patients. The CTV expansion for 3D-CRT and the PTV expansion for the brachytherapy patients were limited to the chest wall and skin. Normal structures including both ipsilateral lung and breast and heart for left-sided lesions were outlined. The lumpectomy cavity was subtracted from the PTV and normal breast tissue for evaluation. To evaluate dose to the ipsilateral breast and lung, PTV, and heart, a dose-volume histogram (DVH) analysis was performed. All histograms were normalized to the volume of the structure (i.e., expressed as percent volume). RESULTS: The average percentage of the breast receiving 100% and 50% of the prescribed dose (PD) was higher in the 3D-CRT group (24% and 48%, respectively) compared with the MammoSite (5% and 18%, respectively) and interstitial patients (10% and 26%, respectively). Improved coverage of the PTV was noted in the 3D-CRT plans compared with the MammoSite and interstitial HDR plans. With the interstitial HDR technique, 58% of the PTV received 100% of the PD compared with 76% with MammoSite and 100% with 3D-CRT techniques. The percentage of the PTV receiving 90% of the PD was 68%, 91%, and 100% for the interstitial HDR, MammoSite, and 3D-CRT patients, respectively. The ipsilateral lung V20 was slightly higher for 3D-CRT at 5% compared with 0% for both brachytherapy techniques. CONCLUSION: In those treated with 3D-CRT, coverage of the PTV was better with 3D-CRT but varied with the definition used. At the coverage at 90% of the PD, no difference was observed between 3D-CRT and MammoSite (which were both better than interstitial). 3D-CRT resulted in better coverage of the PTV compared with MammoSite or interstitial brachytherapy techniques. Better PTV coverage with 3D-CRT came at the cost of a higher integral dose to the remaining normal breast. Dosimetrically, the best partial breast irradiation technique appears to depend on the clinical situation. Of the brachytherapy techniques, MammoSite appears to be superior in PTV coverage. When comparing MammoSite vs. 3D-CRT PTV coverage at 90% of the PD, the difference was not significantly different.     

Diagnostic accuracy of 99mTc-sestamibi breast imaging: multicenter trial results.

Although mammography is well established as a first-line tool for breast cancer screening and detection, efforts to develop complementary procedures continue. Observation of 99mTc-sestamibi tumor uptake provided the impetus for its evaluation as an adjunctive technique. This trial's objectives were to determine in a multicenter trial the diagnostic accuracy of 99mTc-sestamibi in women with suspected breast cancer and to investigate factors influencing diagnostic accuracy. METHODS: Our multicenter trial enrolled 673 women (387 with nonpalpable abnormalities; 286 with palpable abnormalities) scheduled for excisional biopsy or mastectomy. Blinded and unblinded interpretations of scintigraphic images were compared with core laboratory established histopathologic diagnoses to define the diagnostic accuracy of 99mTc-sestamibi breast imaging. RESULTS: Blinded readers' diagnostic accuracy was 78%-81%. Inter-reader agreement was excellent, ranging from 95% to 100% (kappa = 0.82-0.99). Overall institutional sensitivity and specificity for 99mTc-sestamibi breast imaging were 75.4% and 82.7%, respectively. In this population with a 40.1% disease prevalence, the positive predictive value was 74.5% and the negative predictive value was 83.4%. The negative predictive value was 94% in patients with a 40% or lower mammographic likelihood of breast cancer. Sensitivity was higher for palpable abnormalities; specificity was higher for nonpalpable abnormalities. Sensitivity was decreased for tumors <1 cm in largest dimension but appeared not to be affected by patient's age. CONCLUSION: As an adjunct to current procedures, 99mTc-sestamibi breast imaging may contribute to patient management decisions in selected populations, including women with dense breasts, mammographically indeterminate lesions >1 cm, and palpable abnormalities.     

肺部疾病影像诊断分析

目的 评价X线胸片、CT及磁共振成像对几种常见肺疾患的诊断准确率及选择诊断方法的考虑。方法347例肺疾患包括肺炎97例、肺结核85例、肺癌108例、支气管扩张50例,以及其他7例,均经至少一种影像技术检查,其中,149例经手术病理证实,198例经临床验证。结果X线胸片对肺炎与肺结核的诊断准确率较高,分别为95％和80％,而CT对肺癌与支气管扩张的诊断准确率较高,分别为92．5％和100％。结论不同影像技术的诊断准确性随肺疾患的病种不同而异,这对合理选择诊断方法具有实际指导意义。通常,肺部炎症和结核多数以X线平片就能确诊,当平片上影像与临床不符或形态不典型,以及单靠平片难以确定时,则需借助于CT或核磁进一步观察病灶内结构及其与周围组织的关系,以获得准确诊断。     

Diagnostic accuracy of contrast-enhanced MR angiography in severe carotid stenosis: meta-analysis with metaregression of different techniques

Contrast-enhanced magnetic resonance angiography (CE-MRA) has become a well-established noninvasive imaging method for the assessment of severe carotid stenosis (70–99% by NASCET criteria). However, CE-MRA is not a standardised technique, but encompasses different concurrent techniques. This review analyses possible differences. A bivariate random effects meta-analysis of 17 primary diagnostic accuracy studies confirmed a high pooled sensitivity of 94.3% and specificity of 93.0% for carotid CE-MRA in severe carotid stenosis. Sensitivity was fairly uniform among the studies, while specificity showed significant variation (I ² = 73%). Metaregressions found significant differences for specificity with two covariates: specificity was higher when using not only maximum intensity projection (MIP) images, but also three-dimensional (3D) images (P = 0.01). Specificity was also higher with electronic images than with hardcopies (P = 0.02). The timing technique (bolus-timed, fluoroscopically triggered or time-resolved) did not result in any significant differences in diagnostic accuracy. Some nonsignificant trends were found for the percentages of severe carotid disease, acquisition time and voxel size. In conclusion, in CE-MRA of severe carotid stenosis the three major timing techniques yield comparably high diagnostic accuracy, electronic images are more specific than hardcopies, and 3D images should be used in addition to MIP images to increase the specificity.     

三种后路内固定手术治疗胸腰段骨折的生物力学对比

目的比较椎弓根螺钉经伤椎短节段、经伤椎三节段与跨伤椎长节段三种固定状态治疗胸腰段骨折的生物力学差异。方法选取新鲜家猪脊柱标本(T_(13)～L_5)16具,随机数字表法分为正常组、经伤椎短节段组、经伤椎三节段组和跨伤椎长节段组各4具,除正常组外均制备为L_2椎体爆裂性三柱骨折模型,而后使用椎弓根螺钉分别模拟经伤椎短节段固定、经伤椎三节段固定及跨伤椎长节段固定三种状态。使用脊柱三维运动试验机在四组模型上模拟人体脊柱前屈、后伸、侧屈和旋转活动,比较不同运动状态下四组伤椎上下相邻节段的运动范围(range of motion,ROM)及不同载荷下四组标本的轴向压缩刚度。结果经伤椎三节段组与跨伤椎长节段组在前屈[(1.19±0.27°)vs.(1.29±0.48)°]、后伸[(1.13±0.34)°vs.(1.02±0.46)°]、左右侧屈[(2.01±0.66)°vs.(1.94±0.61)°]及左右旋转[(2.48±0.50)°vs.(2.59±0.48)°]的ROM上差异均无统计学意义(P0.05);经伤椎三节段组与经伤椎短节段组在前屈[(1.19±0.27)°vs.(2.50±0.41)°]、后伸[(1.13±0.34)°vs.(1.70±0.44)°]、左右侧屈[(2.01±0.66)°vs.(3.44±0.85)°]及左右旋转[(2.48±0.50)°vs.(3.24±0.65)°]的ROM前者显著低于后者,差异均有统计学意义(P0.05)。经伤椎三节段组与跨伤椎长节段组的轴向压缩刚度[(194.12±99.83)N/mm vs.(238.36±96.01)N/mm)]差异无统计学意义(P0.05);经伤椎三节段组的轴向压缩刚度显著高于经伤椎短节段组[(194.12±99.83)N/mm vs.(157.91±52.87)N/mm)],差异有统计学意义(P0.05)。结论对于胸腰段爆裂性三柱骨折,经伤椎三节段固定与跨伤椎长节段固定均可获得良好的力学稳定性,但前者椎体固定数量少于后者,脊柱活动度更佳,值得临床推广。     

3种不同放疗技术在左侧乳腺癌保乳术后全乳腺放疗中的剂量学比较

目的 比较3种调强放疗技术在早期左侧乳腺癌保乳术后全乳腺放疗中的剂量学差异。 方法 回顾性分析2019年3月至8月在西安交通大学第一附属医院治疗的12例早期左侧乳腺癌保乳术后女性患者,年龄32~50（42.4±6.8）岁。分别设计基于固定角度适形调强放疗的混合调强（3DCRT+IMRT）、容积旋转调强放疗的混合调强（3DCRT+VMAT）和切线弧容积旋转调强放疗计划（t-VMAT）,并比较3种放疗计划的计划靶区、危及器官剂量参数以及治疗效率的差异。组间数据比较采用配对t检验。 结果 3种调强放疗计划的靶区剂量分布和危及器官受量均能满足临床要求。3DCRT+IMRT和t-VMAT两种计划相比,3DCRT+VMAT的靶区剂量学指标适形性指数（0.84±0.05对0.74±0.06对0.79±0.06）和均匀性指数（0.10±0.03对0.14±0.03对0.13±0.03）最优,差异均有统计学意义（t=−9.01~6.47,均P<0.05）;3DCRT+IMRT对患侧（左）肺的V5[（35.92±8.01）%对（49.33±12.05）%对（60.58±12.94）%]、V10[（25.50±6.91）%对(26.92±7.23）%对（41.25±10.37）%]、Dmean[（10.14±2.43）Gy对（11.07±2.88）Gy对（14.52±3.32）Gy]和健侧（右）肺的V5[（0.50±1.45）%对（2.17±3.76）%对（3.00±4.94）%]、Dmean[（0.55±0.21）Gy对（1.79±0.58）Gy对1.75±0.70）Gy]及健侧（右）乳腺的V5[（0.17±0.58）%对（1.92±4.10）%对（8.25±8.61）%]、Dmean[（0.86±0.38）%对（1.65±0.45）%对（2.46±0.86）%]的保护最好。3DCRT+VMAT的心脏V30[（4.50±2.88）%对（5.00±3.25）%对（8.42±2.78）%]、V40[（2.50±2.11）%对（3.25±2.53）%对（4.58±2.07）%]明显优于3DCRT+IMRT和t-VMAT,且差异均有统计学意义（t=−17.11~3.45,均P<0.05）。3DCRT+IMRT的平均机器跳数最小（280.90±52.18）,t-VMAT的治疗时间最短。 结论 3DCRT+IMRT在低剂量区（<20 Gy）对健侧肺、患侧肺,健侧乳腺等危及器官的保护比较好,3DCRT+VMAT在提高靶区的均匀性和适形性方面有明显优势,且在高剂量区（>20 Gy）对患侧肺及心脏保护更好,t-VMAT缩短了治疗时间,提高了治疗效率和患者舒适度。     

Hepatic sonography: comparison of tissue harmonic and standard sonography techniques.

OBJECTIVE: This study was performed to compare tissue harmonic sonography of the liver with conventional sonography of the liver. SUBJECTS AND METHODS: Forty-eight patients underwent tissue harmonic and conventional sonography of the liver, using a randomized imaging sequence. Imaging parameters were standardized, but gain varied. Techniques were compared using predetermined impact analysis categories. If a finding was revealed by only one sonographic technique, additional confirmation was obtained by another imaging technique or by surgery. In a separate image quality analysis, masked images were reviewed by two experienced radiologists to evaluate fluid-solid differentiation, near-field, far-field, and overall image quality. Rankings were correlated with field of view of images and body habitus of patients as determined by body mass index. RESULTS: Tissue harmonic sonography provided the same information as conventional sonography in 34 patients (71%) and added information in 14 patients (29%). The findings from tissue harmonic sonography resulted in altered treatment in five patients (10%). Eight patients (17%) had lesions revealed by tissue harmonic sonography only. Four patients (8%) had inadequate far-field visualization by both techniques. Both observers ranked tissue harmonic sonography the same as or better than standard sonography in 46 patients (96%) for fluid-solid differentiation, in 46 patients (96%) for near-field image quality, and in 45 patients (94%) for overall image quality. For far-field image quality, one observer ranked tissue harmonic sonography the same as or better than conventional sonography in 40 patients (83%), and the second observer, in 41 patients (85%). Image quality ratings showed no correlation with body habitus of the patients or field of view of images. CONCLUSION: Tissue harmonic sonography of the liver provides more information and better image quality than does conventional sonography of the liver.     

Comparison of three deconvolution techniques in renography

The importance of comparing various deconvolution techniques on real patient data lies in the fact that there are two different approaches to that problem. One, which prefers general-purpose techniques, using a matrix algorithm (MA) and fast-Fourier transformation (FFT) with various smoothings, filters, etc., and another which prefers deconvolution techniques which have been modified for the particular application. The modification may be in requiring well defined input or assuming a smooth result of deconvolution. The aim of this paper is to compare the general-purpose deconvolution technique mostly used in analyzing patient data in nuclear medicine using MA and FFT with deconvolution based on Laplace transformation (LT). They have been compared on real patient data renograms in 36 cases. The comparison shows that although the LT technique requires a well defined input and for that reason needs more computing time than the FFT and MA technique, it gives impulse response functions (IRF) without negative values or with negligible ones. Even more, using LT, which has been incorporated in a model of distribution and transport of tracer, without taking blood samples one can assess some other useful clinical parameters such as inverse value of clearance time constant (ICTC) and effective renal plasma flow (ERPF).     

Comparison of three deconvolution techniques in renography

The importance of comparing various deconvolution techniques on real patient data lies in the fact that there are two different approaches to that problem. One, which prefers general-purpose techniques, using a matrix algorithm (MA) and fast-Fourier transformation (FFT) with various smoothings, filters, etc., and another which prefers deconvolution techniques which have been modified for the particular application. The modification may be in requiring well defined input or assuming a smooth result of deconvolution. The aim of this paper is to compare the general-purpose deconvolution technique mostly used in analyzing patient data in nuclear medicine using MA and FFT with devonvolution based on Laplace transformation (LT). They have been compared on real patient data renograms in 36 cases. The comparison shows that although the LT technique requires a well defined input and for that reason needs more computing time than the FFT and MA technique, it gives impulse response functions (IRF) without negative values or with negligible ones. Even more, using LT, which has been incorporated in a model of distribution and transport of tracer, without taking blood samples one can assess some other useful clinical parameters such as inverse value of clearance time constant (ICTC) and effective renal plasma flow (ERPF).     

Diagnostic accuracy of a stereotaxically guided vacuum-assisted large-core breast biopsy program in Canada.

OBJECTIVE: To assess the accuracy rate associated with 11-gauge vacuum assisted large-core breast biopsy (VALCBB) at our institution. METHODS: 673 consecutive VALCBBs performed between September 1997 and March 2000 were evaluated. For most of the benign VALCBB specimens, accuracy was determined by the stability of the lesions on follow-up mammography. When possible, histological results of specimens obtained from VALCBB and of specimens obtained from surgical excision were compared. Modified accuracy rates were calculated. RESULTS: Of the 673 biopsies, 499 (74%) were benign; for the 315 benign lesions for which complete follow-up information was available, a greater than 99% modified accuracy rate was obtained. The modified accuracy rate for the 174 nonbenign lesions was 95%. Thus, VALCBB yielded an overall modified accuracy for both benign and nonbenign lesions of 97.9%. CONCLUSION: VALCBB provides accurate histological results for biopsy of suspicious lesions of the breast.     

Imaging techniques of the breast in 1991. 1]

Today, there is an increase in breast radiology practise. To realize good investigations with the lowest X ray dose absorbed, the authors accurate the technical specifications of each unit of the mammograph. They insist on the necessary quality control. They definite the technical mammography practice and the ultrasound technology, as a complementary and often indispensable technology after mammography. The association clinical examination-mammography-ultrasound technology, is performed in upper 97% of breast lesion diagnoses. However, other technologies, as complementaries one are sometimes useful to assure the diagnosis.     

Comparison of three different purification methods for the routine preparation of [11C] Metomidate.

PET with (R)-[O-methyl-11C] metomidate ([11C] MTO) is an attractive method for the characterisation of adrenal masses discriminating lesions of adrenal cortical origin from noncortical lesions. [11C] MTO was prepared by the reaction of [11C] methyliodide with the corresponding free acid. Three purification methods have been compared. The method of choice uses preparative HPLC with a ready-to-use weak acidic solvent.     

Diagnostic accuracy of different imaging modalities in detection of proximal caries

Objective

The purpose of this study was to assess the in vitro diagnostic ability of visual inspection, film, charge-coupled device (CCD) sensor, photostimulable phosphor (PSP) sensor and cone beam CT in the detection of proximal caries in posterior teeth compared with the histological gold standard.

Methods

Visual inspection, film, CCD, PSP and cone beam CT images were used to detect proximal caries in the mesial and distal surfaces of 138 teeth (276 surfaces). Visual inspection and evaluation of all intraoral digital and conventional radiographs and cone beam CT images were performed twice by three oral radiologists. Weighted kappa coefficients were calculated to assess intra- and interobserver agreement for each image set, and scores were compared with the histological gold standard using receiver operating characteristic (ROC) analysis to evaluate diagnostic ability.

Results

Intraobserver kappa coefficients calculated for each observer for each method of detecting caries ranged from 0.739 to 0.928. Strong interobserver agreement ranging from 0.631 to 0.811 was found for all detection methods. The highest Az values for all three observers were obtained with the cone beam CT images; however, differences between detection methods were not statistically significant (P > 0.05).

Conclusion

Visual inspection, film, CCD, PSP plates and cone beam CT performed similarly in the detection of proximal caries.     

Diagnostic accuracy of MRI textural analysis in the classification of breast tumors

ObjectiveTo investigate whether textural analysis (TA) of MRI heterogeneity may play a role in the clinical assessment and classification of breast tumors.Materials and methodsFor this retrospective study, patients with breast masses ≥1 cm on contrast-enhanced MRI were obtained in 69 women (mean age: 51 years; range 21–78 years) with 77 masses (38 benign, 39 malignant) from 2006 to 2018. The selected single slice sagittal peak post-contrast T1-weighted image was analyzed with commercially available TA software [TexRAD Ltd., UK]. Eight histogram TA parameters were evaluated at various spatial scaling factors (SSF) including mean pixel intensity, standard deviation of the pixel histogram (SD), entropy, mean of the positive pixels (MPP), skewness, kurtosis, sigma, and Tx_sigma. Additional statistical tests were used to determine their predictiveness.ResultsEntropy showed a significant difference between benign and malignant tumors at all textural scales (p < 0.0001) and kurtosis was significant at SSF = 0–5 (p = 0.0026–0.0241). The single best predictor was entropy at SSF = 4 with AUC = 0.80, giving a sensitivity of 95% and specificity of 53%. An AUC of 0.91 was found using a model combining entropy with sigma, which yielded better performance with a sensitivity of 92% and specificity of 79%.ConclusionTA of breast masses has the potential to assist radiologists in categorizing tumors as benign or malignant on MRI. Measurements of entropy, kurtosis, and entropy combined with sigma may provide the best predictability.     

Magnetic resonance angiography of the carotid arteries using three different techniques: accuracy compared with intraarterial x-ray angiography and endarterectomy specimens

PURPOSE: To compare three different magnetic resonance angiography (MRA) techniques with x-ray angiography and endarterectomy specimens. MATERIALS AND METHODS: Twenty-one patients underwent x-ray angiography, three-dimensional time-of-flight (TOF) focusing on the carotid bifurcation, high-resolution (HR) contrast-enhanced (CE) MRA, and time-resolved CE MRA. Stenoses of internal carotid arteries were evaluated by three independent observers on identical projection of x-ray angiography and MRA. Maximum stenosis grades on MRA were assessed additionally and correlated with endarterectomy specimens in 12 cases. RESULTS: Sensitivity for the detection of severe stenoses was excellent (100%) for all MRA techniques, and specificity was superior for three-dimensional TOF (96.7%) compared with HR CE MRA (80.6%) and time-resolved CE MRA (83.9%). The correlation between x-ray angiography and MRA for all stenoses was slightly superior for three-dimensional TOF and HR CE MRA compared with the time-resolved technique (kappa = 0.87 and 0.86 vs. 0.84). The same trend was seen for the interobserver agreement and for the correlation with endarterectomy specimens. Eleven up to 17 stenoses (depending on the MRA technique) were graded higher using additional projections. CONCLUSION: Three-dimensional TOF MRA yielded even more accurate results than HR CE MRA in grading of stenoses near the carotid bifurcation. Therefore, a combination of both methods seems to be advantageous.     

Comparison of observer variability and accuracy of different criteria for lung scan interpretation.

Different criteria have been advocated for the interpretation of ventilation/perfusion (V/Q) lung scans in patients with suspected pulmonary embolism (PE). Besides these predefined criteria, many physicians use an integration of the different sets of criteria and their own experience-the so-called Gestalt interpretation. The purpose of this study was to evaluate interobserver variability and accuracy of 3 sets of criteria: the Hull and PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) criteria and the Gestalt interpretation. METHODS: Two experienced observers interpreted V/Q scans of all 328 patients according to the 3 different schemes. The diagnostic classification obtained for the different sets of criteria was analyzed against the presence or absence of PE. RESULTS: The interobserver variabilities as assessed by the kappa statistics of the PIOPED and Hull criteria and for the Gestalt interpretation were 0.70 (95% confidence interval [CI], 0.64-0.76), 0.79 (95% CI, 0.73-0.85), and 0.65 (95% CI, 0.58-0.72), respectively. The differences in kappa values between the Hull and PIOPED criteria and between the Hull criteria and Gestalt interpretation were statistically significant (P < 0.05 and P < 0.001, respectively). For 16 patients (14 without PE) with a normal lung scan result according to the Hull criteria, the result according to the PIOPED criteria was low probability. For 21 patients (12 with PE), the scans were intermediate probability according to the PIOPED criteria, whereas the result with the Hull criteria was high probability. Analysis of receiver-operating-characteristic curves yielded a comparable area under the curve for all sets of criteria (0.87-0.90). CONCLUSION: The Hull, PIOPED, and Gestalt interpretation of V/Q lung scans all have a good accuracy and interobserver variability. However, the reproducibility of the Hull criteria is superior in comparison with that of the other sets of criteria.     

输液制剂三种质量指标的考察

目的 :探讨自制输液与GMP认证企业生产输液存在的差异及改进措施。方法 :对不同厂家输液制剂 pH值、含量、不溶性微粒的检测结果进行比较。结果 :不同厂家输液制剂都在《中国药典》2 0 0 0年版规定合格范围之内 ,但仍存在内在差异。结论 :自制输液制剂要随时注意环节质量 ,以期达到内在质量与企业厂家生产输液制剂的质量完全一致。