减少X线诊断中必要的辐射剂量

在对Ｘ线诊断的医疗价值进行评估的同时还必须考虑电脑辐射的生物学效应，医疗技术的进行和现代的胶片－增屏－系统的进展，在保证改善照片质量的前景下已经使必要的辐射剂显减少。     

某部新兵体检颈椎X线检查异常情况调查

目的：调查了解某部新兵体检中颈椎X线检查异常情况。方法：选择某部新兵40例,采用数字化X线摄影系统（DR）,对所有受检者摄立位颈椎正、侧位X线片。通过DR后处理系统进行颈椎测量判读,并结合临床症状进行分析。结果：本组40例中,颈椎X线检查异常27例,占67．5％,表现为曲度异常、序列异常及椎体后上缘骨质表面密度异常。曲度异常中,颈椎曲度变直5例,占总调查例数的12．5％;颈椎轻度反张18例,占45．0％;颈椎中重度反张4例,占10．0％．其中,第7颈椎棘突陈旧性骨折伴曲度反张1例,占总调查例数的2．5％。27例中均未发现椎间隙异常和颈椎融合情况。结论：某部新兵颈椎X线检查异常较常见,应加强颈椎健康教育,提高颈椎病一级预防水平。     

多功能X线影像测量仪的研制及应用

多功能Ｘ线影像测量仪的研制及应用赵洪全，周承涛，冯开梅，王庆义Ｘ线影像测量在Ｘ线诊断工作中有着广泛的应用。多功能Ｘ线影像测量仪（以下称测量仪）是我们研制的一种实用的专业测量工具。经查国内外文献未见同类报道，现介绍如下：一、结构及使用：本测量仪主体选用...     

江苏省新型冠状病毒肺炎X射线影像诊断感染控制策略

X射线影像是新型冠状病毒肺炎诊断的一个重要手段,但工作存在院内交叉感染的风险。通过分析X射线影像诊断的流程及其可能发生的感染因素,江苏省率先发布了新冠肺炎X射线影像诊断感染防控指南。该指南明确了X射线影像诊断过程中控制感染的基本要求、工作人员防护、人员和场所消毒以及受检者防护与消毒的具体办法,对现场工作具有指导意义。值得注意的是,在关注控制感染的同时,也不能忽视医疗照射的防护最优化原则。     

In vivo evaluation of early disease progression by X-ray phase-contrast imaging in the adjuvant-induced arthritic rat

Purpose To study the early change of bone matrix and soft tissue around articulation in adjuvant-induced arthritic (AIA) rats non-invasively by X-ray phase-contrast imaging (XPCI), a new imaging method. Materials and methods Adjuvant-induced arthritis was established in male Sprague–Dawley (SD) rats (n=6, age 40 days) by subcutaneous injection of Freund's complete adjuvant (FCA) into the left hindpaw. In vivo XPCI evaluation of the early soft tissue and bone changes in AIA rats was consecutively performed and correlated with changes in volumes of right hindpaws and body weights. In comparison, the changes in the AIA rats were also evaluated with absorption-contrast imaging using the same X-ray source as XPCI and conventional radiography at the same time. After the imaging evaluation, AIA rats were subjected to histological examination. Results There was significant difference between the score of XPCI and the other two methods in demonstrating soft tissue (P<0.01), bone details (P<0.01) and lesions (P<0.001). By day 10 after subcutaneous injection of FCA, bone changes in the right hindpaw were not obvious, but swelling of soft tissue appeared. By day 12, bone erosion in the articular facet and the area around the articular facet, was detected, along with osteoporosis, and swelling of soft tissue was aggravated. By day 14 bone erosions became fused and expanded, especially in the margin area around the articular facet. At day 16 bone erosion still existed. Joint interspaces seemed wider than normal, and swelling of soft tissue was significant. By day 18 periosteal new bone formation was seen definitely, destruction of bone decreased, bone density around the articular was enhanced, and swelling of soft tissue was relieved. XPCI could clearly distinguish all these alterations, which could not be demonstrated by absorption-contrast imaging and conventional radiography. During the test period, the volume of the right hindpaw and the body weight of the AIA rats also changed significantly compared with the normal rat. Histological examination confirmed that adjuvant-induced arthritis had occurred in all rats of the adjuvant group. Conclusion Osteoporosis, bone erosion and periosteal new bone formation take place at the early stage of adjuvant-induced arthritis. XPCI can evaluate non-invasively these subtle bone changes that are “blind areas” for conventional radiography.     

上海市医用X射线诊断应用频度调查

目的 通过对上海市49家医院的抽样调查，了解2016年度各种类型X射线诊断照射的分布和应用情况，为制定医疗照射的放射防护策略提供基础数据与参考。方法 按照医院级别，以典型抽样的方式抽取49家医院。通过从医院放射科信息系统读取、人工记录等方式，获取医院基本情况和各种类型放射诊断的人次信息。结果 调查的49家医院，配备的393台X射线诊断设备，X射线诊断人次共计4 442 662人次。受检者男女比例1：0.99。上海市2016年度X射线诊断频度估算值为1 228人次/千人口，其中CT扫描检查304人次/千人口，牙科摄影105人次/千人口。结论 全市X射线诊断医疗照射频度与"十一五"期间相比明显增加，CT检查频度增加尤为明显。     

Benchtop phase-contrast X-ray imaging

Clinical radiography has traditionally been based on contrast obtained from absorption when X-rays pass through the body. The contrast obtained from traditional radiography can be rather poor, particularly when it comes to soft tissue. A wide range of media of interest in materials science, biology and medicine exhibit very weak absorption contrast, but they nevertheless produce significant phase shifts with X-rays. The use of phase information for imaging purposes is therefore an attractive prospect. Some of the X-ray phase-contrast imaging methods require highly monochromatic plane wave radiation and sophisticated X-ray optics. However, the propagation-based phase-contrast imaging method adapted in this paper is a relatively simple method to implement, essentially requiring only a microfocal X-ray tube and electronic detection.

In this paper, we present imaging results obtained from two different benchtop X-ray sources employing the free space propagation method. X-ray phase-contrast imaging provides higher contrast in many samples, including biological tissues that have negligible absorption contrast.     

下颌骨牙源性角化囊肿X线影像分析

目的：提高对下颌骨牙源性角化囊肿X线征象的认识。方法：回顾性分析经病理证实的60例下颌骨牙源性角化囊肿的X线资料。结果：下颌骨牙源性角化囊肿X线征象有：①下颌骨磨牙升好发区，17例（28．3％）；②牙根斜面状吸收多见，93个（71％）；③沿长轴生长40例（66．7％）；④X线分为4型：单房型18例（30％），多房型30例（50％），多发型8例（13．3％）及综合征型4例（6．7％）。结论：牙源性角化囊囊的牙根斜面状吸收和沿长轴生长是特征性的。     

同步辐射相位对比X线成像技术的初步研究

目的 探讨同步辐射相位对比X线成像技术进行小鼠肝血管成像的试验研究。方法C57BL/6 小鼠6只, 3只开腹,直接结扎所有的进出肝脏的血管和胆管等结构,其余3只则通过门静脉灌注碘造影剂置换小鼠肝内的全部血液后,结扎肝脏的血管和胆总管,然后取出肝脏,所有制成的肝脏标本均放置在4%的甲醛溶液中。标本在北京高能物理研究所的同步辐射国家级实验室进行成像,主要使用同步辐射X线衍射增强成像技术。结果 同步辐射X线衍射增强成像技术在不使用造影剂的情况下即可以显示40μm左右直径的肝脏血管,可以显示血管主干及其8级以上的血管分支。结论 同步辐射X 线衍射增强成像技术具有很高的衬度分辨率和空间分辨率,而且其采用的折射成像机制,可以有效的减少X射线对人体的辐射损伤。     

UK population dose from medical X-ray examinations

Objective: To assess the annual per caput and collective effective dose to the United Kingdom population from medical and dental X-ray examinations. Method: The results of a detailed survey of the frequency of X-ray examinations during the financial year 1997/1998 were combined with contemporary data on the effective doses typically received by patients. The resulting per caput and collective dose for 1997/1998 was updated to 2001/2002 by using annual statistics on the total numbers of computed tomography (CT), interventional and conventional examinations collected by the English Department of Health. Results: The annual per caput effective dose for the UK in 2001/2002 was estimated at 0.38 mSv. Over the last 10 years CT has more than doubled its contribution and is now responsible for 47% of the collective dose from medical X-rays. The contribution from conventional radiographic and fluoroscopic examinations has nearly halved to about 34%. Interventional and angiographic procedures together contribute the remaining 19%. Conclusions: The annual per caput effective dose of 0.38 mSv is low in comparison with other countries having similarly developed systems of health-care. This is due to both a lower frequency of X-ray examinations per head of population and generally lower doses in the UK than in other developed countries.     

Fourier domain image fusion for differential X-ray phase-contrast breast imaging

X-Ray Phase-Contrast (XPC) imaging is a novel technology with a great potential for applications in clinical practice, with breast imaging being of special interest. This work introduces an intuitive methodology to combine and visualize relevant diagnostic features, present in the X-ray attenuation, phase shift and scattering information retrieved in XPC imaging, using a Fourier domain fusion algorithm. The method allows to present complementary information from the three acquired signals in one single image, minimizing the noise component and maintaining visual similarity to a conventional X-ray image, but with noticeable enhancement in diagnostic features, details and resolution. Radiologists experienced in mammography applied the image fusion method to XPC measurements of mastectomy samples and evaluated the feature content of each input and the fused image. This assessment validated that the combination of all the relevant diagnostic features, contained in the XPC images, was present in the fused image as well.     

Validation of diagnostic imaging based on repeat examinations. An image interpretation model

Purpose: To develop an interpretation model, based on repeatedly acquired images, aimed at improving assessments of technical efficacy and diagnostic accuracy in the detection of small lesions.

Material and Methods: A theoretical model is proposed. The studied population consists of subjects that develop focal lesions which increase in size in organs of interest during the study period. The imaging modality produces images that can be re-interpreted with high precision, e.g. conventional radiography, computed tomography, and magnetic resonance imaging. At least four repeat examinations are carried out.

Results: The interpretation is performed in four or five steps: 1. Independent readers interpret the examinations chronologically without access to previous or subsequent films. 2. Lesions found on images at the last examination are included in the analysis, with interpretation in consensus. 3. By concurrent back-reading in consensus, the lesions are identified on previous images until they are so small that even in retrospect they are undetectable. The earliest examination at which included lesions appear is recorded, and the lesions are verified by their growth (imaging reference standard). Lesion size and other characteristics may be recorded. 4. Records made at step 1 are corrected to those of steps 2 and 3. False positives are recorded. 5. (Optional) Lesion type is confirmed by another diagnostic test.

Conclusion: Applied on subjects with progressive disease, the proposed image interpretation model may improve assessments of technical efficacy and diagnostic accuracy in the detection of small focal lesions. The model may provide an accurate imaging reference standard as well as repeated detection rates and false-positive rates for tested imaging modalities. However, potential review bias necessitates a strict protocol.     

X线观察直肠前突的手术疗效

目的:X线观察直肠前突的手术疗效。方法:对60例直肠前突(RP)手术前后排粪造影进行画线测量并进行比较。结果:60例直肠前突患者力排时其RP≤1.5~3.0cm。肛门直肠角(ARA)在84°~95°之间,肛管变细变长。排便动作结束后囊内有钡剂残留,术后RP较术前对比有不同程度的缩浅,ARA力排时增至110°,肛管宽扩大到3~3.5cm,长缩短到≤3.5~4cm,钡剂排出的速度与正常无显著差异。结论:通过排粪造影和画线测量得出的RP给手术提供了可靠的资料,采取相应术式,疗效理想。