X线摄影废片原因分析

随着放射技术质量控制的逐步实施，影像质量将直接影响到疾病的诊断。我科对各种废片进行了详细的统计和分析，总结出产生废片的原因主要有以下方面。     

乳腺X线摄影的废片分析

乳腺的X线检查是早期发现乳腺癌的重要手段之一.公认对乳腺的X线摄影应有严格的质量控制和质量保证[1-2].本研究的目的是明确乳腺摄影中产生废片的数量和原因,通过分析找出解决问题的方法,提高照片质量,同时减少重复拍片率.     

1240张普通X线摄影废片分析

普通X线摄影,是现代医学检查不可缺少的重要手段之一。一张优质的X线照片,可为临床放射学诊断提供较高的信息量,然而由于各种原因所致的废片,完全失去应有的诊断信息。作者几年来收集本院及部分外院普通X线摄影废片,共1240张,现做如下分析。一、1240张普通X线摄(?)废片统计(详见表1)     

数字化X线摄影及应用

随着计算机技术、网络技术及电子技术的迅速发展，数字化成像技术日益广泛应用于临床医学，尤其是医学影像学领域。医学影像的数字化将带给临床医学全新的视觉概念，促进临床医学的发展，使疾病的诊断更清晰、明确，减少漏诊及误诊。同时也减少技术人员的体力劳动，产生较大的经济与社会效益。先进的设备必然带来良好的效果，如何更好的应用先进设备，使其发挥最大的优势以获得高质量的影像图像，是当前医学影像科学化中一个非常重要的问题。     

A survey of digital chest radiography

The problems of chest radiography as they relate to digital systems are described, the current approaches to these problems are reviewed, and the utility of digital chest radiography is demonstrated.     

DR在地方性氟中毒病区氟骨症筛查的应用价值

地方性氟中毒是与地理环境密切相关的慢性氟中毒疾病,简称地氟病.根据最新报道[1-4],地氟病仍较严重地威胁着我国氟病区人群的身体健康.地氟病的主要病症是氟斑牙和氟骨症.氟骨症是地氟病的严重阶段和重要表现形式[5],其简单有效的明确诊断方法是 X线检查.数十年来,地氟病区地方性氟骨症的影像学筛查主要采用传统的 X线模拟成像技术[6-10],即胶片感光成像.数字 X线摄影(digital radiography,DR)是现代数字化成像技术的一种,随着医学影像技术的飞速发展,DR检查技术应用于临床,并得到了广泛的推广,目前已成为临床X线检查的主流技术.近年来,笔者在地方性氟中毒病区筛查氟骨症中开始应用DR数字成像技术.本文将地方性氟骨症筛查的传统胶片感光成像与 DR 的影像学资料对比分析,旨在探讨DR在地方性氟骨症筛查中应用价值.     

Chest radiography: comparison of high-resolution digital displays with conventional and digital film

This study was performed to compare the performances of observers using three display formats for chest radiography. The display formats were conventional radiographs, digitized radiographs (2,048 X 2,048 X 12 bits) printed on laser film, and digitized radiographs (2,048 X 2,048 X 12 bits) displayed on a high-resolution (2,560 X 2,048 X 12-bit) gray-scale display. The test set for the study consisted of 163 cases. Sixty-four of the cases were normal, whereas the 99 remaining cases demonstrated one or more common radiographic abnormalities. Nine abnormalities were selected for analysis: costophrenic angle blunting, interstitial disease, atelectasis, pneumothorax, parenchymal mass, consolidation, obstructive disease, hilar/mediastinal mass, and apical scarring. Six experienced general radiologists participated in the evaluation. Receiver operating characteristic curves were generated for each abnormality and display format. The results indicate that, while the three display formats are equivalent for the detection of some abnormalities, detectable differences in observer performance may be seen even at 2,048 X 2,048 X 12 bits for the detection of obstructive disease, pneumothorax, interstitial disease, and parenchymal masses.     

Perforation rate of intraoral barriers for direct digital radiography

Objectives:

This study aimed to assess the perforation rate of intraoral barriers for a direct digital sensor according to the barrier application.

Methods:

Four types of plastic barriers with different thicknesses and one type of latex finger cot were applied using six modified techniques. The perforations in barrier samples of six groups were examined by a water pressure test. The differences in the perforation rates among the six barrier applications were calculated.

Results:

The least perforation occurred in Group 4 (0.08-mm-thick single barrier, 22%) and the most in Group 1 (0.04-mm-thick single barrier, 58%). An ANOVA test revealed statistical differences in the perforation rate among the groups (p = 0.00; 95% confidence interval, 0.326–0.403).

Conclusions:

The use of double barriers can be helpful in reducing the perforation rate of intraoral barriers.     

直接数字X线摄影与传统高千伏胸部摄影对比分析

目的　评价直接数字X线摄影术 (DR)在胸部的应用。方法　抽取我院DR胸部影像和传统高kV胸片各 10 0 0例 ,由 3位放射学医师对影像进行分析 ,分别统计甲、乙、丙及废片率 ,同时对胸部的细微结构显示率进行评价。结果　 (1)DR影像 :甲片率 5 0 6% ,乙片率 3 8 5 % ,丙片率 10 9% ,废片率 0 %。 (2 )传统高kV胸片 :甲片率 41 1% ,乙片率 44 1% ,丙片率 13 3 % ,废片率 1 5 %。 (3 )肺内的细微结构显示率 :DR影像为 10 0 0 % ,传统高kV胸片为 78 6%。经统计学处理 ,差异有非常显著性意义 (χ2 =968 6,P <0 0 0 1)。结论　DR胸部影像的诊断图像质量好于传统高kV胸片。DR系统操作简单 ,成像快捷 ,有利于放射诊断     

如何有效降低影像废片率

目的：探讨如何提高成像质量,减少废片率,降低病人辐射剂量,从而减低医疗运行成本。方法：2007年－2013年,根据质控要求对每天的图片质量进行评估,结合用片量,算出废片率。定期对废片产生的原因进行分析,提出改进措施并在临床工作中执行。结果：2007年废片率为评定0．29％,2009年为0．12％,2009年比2007年降低17％;2010年为0．14％,2013年为0．06％,2013年比2010年降低8％;2007－2013年这7年的平均废片率为0．12％。结论：对技术工作严格管理,按质控标准操作,对废片产生的原因进行认真分析并进行改进,能有效降低废片率。     

直接数字化成像技术的临床应用

本文介绍了医学影像学出现的新技术一直接数字成像技术(DR)，作者分析了DR的主要技术优势和实际应用体现的特点。对DR和CR(间接数字成像系统一与DR不同原理功能相似的数字成像技术)技术进行了比较，阐述了双方在原理、性能和实用上的相似和不同点，便于读者理解和设备选型。医学影像设备的数字化，影像诊断的综合化，影像设备的网络化及影像科室逐渐实现无胶片化是目前影像学科发展的几个重要的方面。     

Film tomography compared with film and digital bitewing radiography for proximal caries detection

OBJECTIVES: The purpose of this study was to evaluate the efficiency of conventional tomography for proximal caries detection compared with conventional bitewing and digital intraoral radiography. METHODS: In this study, 48 extracted human posterior permanent teeth were used. Conventional bitewing radiographs, digital intraoral radiographs and conventional tomograms were obtained of the teeth. The presence or absence of caries was scored according to a five-point scale by two oral and maxillofacial radiologists. True caries depth was determined by histological examination. The diagnostic accuracy of each radiographic system was assessed by means of receiver operating characteristic (ROC) curve analysis. The mean of areas under the ROC curve (A(z)) was analysed by pairwise comparison of ROC curve. The interobserver agreement was evaluated using a t-test. RESULTS: The statistical analysis of A(z) scores has shown no significant difference for three imaging modalities (P>0.05). There was no statistically significant difference between interobserver agreement (P>0.05). CONCLUSIONS: This study has demonstrated that the diagnostic accuracy of conventional tomograms is comparable to that of conventional bitewing and digital intraoral radiographs for proximal caries detection.