全景拼接软件在脊柱及下肢畸形患者矫形手术中的应用研究

目的：采用全景拼接软件对脊柱和下肢畸形患者数字化X线摄影（DR）进行拼接,对其临床应用价值进行探讨。方法回顾性分析我院自2013年5月至2013年10间收治的14例脊柱以及下肢畸形患者的病例。对患者进行常规的DR摄影,采用北京新网科技拼图软件工作站对图像进行拼接,获得患者的全景图像。结果经软件处理后,采用2~3张DR图就可以拼接出完整、清晰和连续的图像。结论全景拼接软件得到的全景图能有效满足脊柱和下肢畸形患者临床诊断需要,值得临床推广。     

DR全景脊柱X光片的应用体会

目的：探讨DR数字化X线摄影机在全脊柱摄影中的应用。方法美国锐珂DRXEVP04590全电动单板数字X线机及全脊柱专用立位摄影架,柯达KODAK8900激光相机。一次性摄取全脊柱正位、侧位及左右侧弯影像。结果影像经电脑处理及拼接后,形成一幅完整的全脊柱或双下肢图像,经激光机打印出胶片。结论 DR全脊柱双下肢摄影,一次按钮曝光,能在一张照片上显示双下肢及脊柱全景影像,图像可存储和传输,为临床医疗提供了更全面方便快捷的影像学资料。无缝连接的脊柱全景图像,满足了诊断与骨科矫形手术的需要。     

全脊柱DR与CR成像质量的对比分析

目的 探讨直接数字X线摄影(DR)在立位脊柱全长摄片中的应用.方法 177例患者按就诊时间先后分2组分别使用CR和DR技术拍摄全脊柱正侧位片,由放射科经验丰富的医师技师各2名对所有全脊柱影像进行评析.结果 (1)DR摄影成像的密度对比优于CR.(2)DR图像的拼接成功率低于CR.结论 使用DR进行全脊柱摄片,图像质量优于CR摄片.     

儿童脊柱侧弯与全脊柱摄影术的应用

目的 探讨全脊柱摄影技术对儿童特发性脊柱侧弯的临床应用价值.资料与方法 回顾性分析27例患儿的全脊柱摄影影像资料.采用Philips Dagital Diagnost型DR全脊柱摄影功能软件,获取全脊柱无缝拼接正侧位影像,经图像后处理后应用测量软件进行相关数据的测量.结果 获得的伞脊柱影像图像清晰,解剖形态无失真,测量数据完整可靠.结论 数字全脊柱成像技术,通过无缝拼接功能减少了拼接处理过程中的人为误差因素.为矫形治疗及疗效的动态观察提供了高质量的全脊柱解剖影像和精确的测量数据.     

CR全脊柱数字化成像技术的应用与比较

脊柱侧凸的常规检查方法是全脊柱X线正、侧位摄片,来反映脊柱侧凸畸形的状况。脊柱侧凸的X线检查要求每张脊柱正、侧位片,包含上自颈椎和双侧肩部,下至骨盆和髋关节在内的全脊柱,可以反映畸形的真实面貌和平衡情况。一张拼接好的X线片对青少年特发性脊柱侧凸进行手术前评估和脊柱侧凸三维矫形的预测有重要意义[1]。以前多采用超长感绿X线胶片(30 cm×61 cm)一次曝光[2];后采用多块IP板一次曝光,并将图像在计算机内进行拼接,但其拼接密度的均匀性和准确性不太理想。本院引进富士CR超长IP板,进行全脊柱一次曝光摄片。笔者就多块IP板一次…     

数字化立位全脊柱成像技术的研究

目的　探讨数字化立位全脊柱的成像技术。方法　在数字化X线设备上 ,分次采集全脊柱的影像数据 ,获得 2 2例受检者的正、侧位原图共 88幅 ,经图像工作站合成为 4 4张数字化全脊柱影像。选择同一体位的胸、腰椎片为配对组 ,测量每组图像的水平位移长度 ,分析其对脊柱侧凸角(Cobb角 )的影响。结果　每一配对组的胸、腰椎影像移位差异无显著性意义 (t =0 0 8～ 1 0 1,P >0 0 5 )。椎体移位每递增 1 7cm ,人体倾角 (α)发生± 1°的变化 ,对Cobb角影响极小 ,可以忽略不计。结论　在图像工作站实现数字化全脊柱的成像技术 ,对普及脊柱侧凸检查具有很好的推广应用价值。     

全脊柱CR单次曝光与多次曝光成像的比较

脊柱侧弯(或称脊柱侧凸)是青少年常见的躯干畸形,国内患病率为10.7‰~21‰[1~5]。脊柱侧弯不论在患病率普查,还是治疗方案的确定,Cobb角是非常重要的测量参数,而测量Cobb角需要摄脊柱全长X线片,但X线胶片的最长规格只有43 cm,要摄取全脊柱X线片,传统方法是分段拍摄,然后将多张片在观片灯上拼接读片,这样测量Cobb角会产生误差。在1张照片上摄取全脊柱X线影像,一直是临床脊骨科医生的迫切希望。我院应用计算机X线摄影(CR)图像,采用数字影像拼接技术,将多幅脊柱图像拼接成全脊柱片,成功地拼接了69例脊柱侧弯的全脊柱影像,效果不错,现报告如…     

Photoshop在数字化全下肢X线摄影图像后处理中的临床应用

目的探讨Photoshop在数字化全下肢X线摄影图像后处理中的作用,以获得更合理、精确的全下肢X线影像。方法由放射科医师和骨科医师通过34例由数字X线摄影(DR)摄影获取的全下肢X线片测量股骨头、膝关节、踝关节中心3点连线与股骨解剖轴线的夹角(Q角)。首先将34例患者的医学数字影像通信标准(DICOM)格式全下肢X线影像打印成激光胶片,手工拼接并用胶布固定后测量,所获结果为第1组;再将这些患者的X线片的DICOM格式分别转换为联合图片专家组标准(JEPG)格式,使用Adobe公司PhotoshopCS软件对JEPG格式的图像进行无缝拼接,然后打印在一张A4纸上测量,作为第2组。结果34例患者中,退行性膝关节炎19例25个膝关节(6例为双侧膝关节病变);类风湿性关节炎12例15个膝关节(3例病变累及双侧膝关节);膝关节畸形、创伤性膝关节炎、膝关节结核各1例;本组26例患者接受了人工全膝关节置换手术治疗。DICOM格式和JEPG格式图像测量的Q角平均值分别是(6.3±0.8)°和(6.1±0.3)°,经配对t检验,t=0.022,P>0.05,差异无统计学意义。结论利用Photoshop软件可以获得优化的、无缝拼接的全下肢影像,满足了诊断和骨科的需要。     

数字化大平板狭缝曝光技术在青少年特发性脊柱侧弯中的应用

目的：分析数字化大平板狭缝曝光（SLOT）技术在青少年特发性脊柱侧弯（AIS）中的应用。方法：选择在我院就诊的AIS患者84例,应用数字化大平板SLOT技术对脊柱全长行正侧位连续曝光,将采集图像通过PACS传至工作站,再经过SLOT Radiography软件对图像进行处理,得到全脊柱正侧位拼接图像,并对图像进行分析评价。结果：84例中27例为胸段侧弯,32例胸腰段侧弯,25例为腰段侧弯;S型侧弯37例,右侧弯25例,左侧弯22例;Cobb法测量侧弯角10°~19° 25例,20°~40° 41例,40°以上18例。经支具治疗34例,平均矫正15.8°;手术治疗13例,平均矫正33°。其中移行椎7例,合并胸椎畸形3例,肋骨畸形3例,骨盆倾斜2例。所有患者颈、胸、腰、骶尾椎均在一张X线胶片上显示,图像清晰、密度均匀、无拼接伪影,图像正位片优秀率达97.6%（82/84）,侧位片优秀率达92.9%（78/84）。结论：数字化大平板SLOT技术能使全脊柱图像显示在一张胶片上,去除以往拼接伪影,在观察AIS时中能满足临床对侧弯长度及侧弯角的测量要求,为临床选择矫形治疗方案及矫形后评估提供准确的影像学资料,具有较高的临床应用价值。     

三维CT在脊柱骨折脱位中的应用

目的：对三维CT在脊柱骨折脱位中的临床应用价值作一初步探讨。材料和方法：比较14例脊柱骨折脱位患者X线平片，CT扫描全部采用EBISC150XP型快速CT机，1．5m层厚。扫描所得断层资料通过网络传送至计算机工作站进行处理。采用WindowsNT3．51平台上Insight三维重建软件进行三维重建。结果：发现三维CT可通过三维空间内的任意旋转、切割，直观、清晰、精确地显示各种复杂脊柱骨折脱位的具体细节及椎体间空间关系的改变，特别是能清晰显示椎管有无狭窄受压，显示椎管内骨块的具体形态，较常规X线及CT有明显的优势。结论：三维CT在脊柱骨折脱位的诊断和治疗中有很大的应用价值。     

Digital slot-scan charge-coupled device radiography versus AMBER and Bucky screen-film radiography: comparison of image quality in a phantom study

PURPOSE: To evaluate the image quality and performance of a chest digital radiography system and to compare this with the image quality and performance of advanced multiple-beam equalization radiography (AMBER) and Bucky screen-film radiography systems. MATERIALS AND METHODS: The chest digital radiography system is a digital charge-coupled device (CCD) chest imaging unit that uses slot-scan technology. A contrast-detail test object was used in combination with a phantom that simulates the primary and scatter transmission for the lungs and mediastinum. Twelve phantom images were obtained with each modality (ie, CCD digital radiography and AMBER and Bucky screen-film radiography) and were judged by six observers. CCD digital radiography soft-copy reading was compared with AMBER hard-copy reading. To measure image quality, contrast-detail curves were constructed from the observer data. The Wilcoxon signed rank test was used for statistical analysis. RESULTS: For the lung configuration, contrast-detail curves showed lower threshold depth for hard-copy images obtained with CCD digital radiography than for those obtained with Bucky screen-film radiography. For hard-copy images, the difference between contrast-detail curves for CCD digital radiography and those for Bucky screen-film radiography was statistically significant (P < .006). No significant difference was found between CCD digital radiography and AMBER for hard-copy images obtained in either the lung or mediastinum configuration. For the lung configuration, a lower threshold depth was observed for CCD digital radiography soft-copy reading than for AMBER hard-copy reading, with significantly different contrast-detail curves for CCD digital radiography soft copy and AMBER hard copy (P < .006). No significant difference was found between either system for the mediastinum configuration. CONCLUSION: Contrast-detail curves indicate that image quality for the CCD chest system provides a digital alternative to AMBER and Bucky screen-film radiography.     

Digital radiographic evaluation of the bile ducts

This study compares digital radiographic images of the bile ducts in dogs with images obtained using routine radiography. The dogs were infused with iodipamide (2 ml/minute for 30 minutes), and the bile ducts were imaged at 60 minutes using plain radiograph and five digital techniques: (1) dual-energy, (2) DSA-hybrid prepixel shift, (3) DSA-hybrid postpixel shift, (4) a dual-energy film system--Digirad, and (5) scan projection radiography using hybrid subtraction. Six radiologists who were not familiar with digital radiography evaluated the six different studies. The images were presented in a randomized order and each image was evaluated on a five-point scale. There was no difference between the plain radiographs and the dual-energy images. Both of these studies were rated significantly better (P less than .001) than the other four digital images. These results suggest that digital radiography during direct cholangiography may be easily accomplished using a 10% to 15% iodine solution.     

X线平片和CT在脊柱骨折诊断中的联合应用价值

目的：评价常规X线和CT扫描二种影像方法在脊柱骨折诊断中联合应用的价值。方法：对120例X线平片和CT扫描诊断为脊柱骨折的病例进行对照分析。结果：120例中椎体骨折共144个，76例X线侧位片椎体后缘连线（PVBL线）光滑，44例有不同程度异常。CT扫描稳定性骨折59例，不稳定性骨折61例，三柱骨折中椎管无狭窄10例，狭窄23例。结论：脊柱外伤性骨折影像诊断应注重常规X线平片和CT扫描检查的互补作用。X线片仍是首选检查方法，有利于多个椎体连续或跳跃性同时骨折的检出，发现有椎体骨折均应做CT扫描，以判断骨折的稳定性与半发症情况，有利于临床及正确处理。     

Clinical comparative study with a large-area amorphous silicon flat-panel detector: image quality and visibility of anatomic structures on chest radiography.

OBJECTIVE: The objective of this study was to compare clinical chest radiographs of a large-area, flat-panel digital radiography system and a conventional film-screen radiography system. The comparison was based on an observer preference study of image quality and visibility of anatomic structures. MATERIALS AND METHODS: Routine follow-up chest radiographs were obtained from 100 consecutive oncology patients using a large-area, amorphous silicon flat-panel detector digital radiography system (dose equivalent to a 400-speed film system). Hard-copy images were compared with previous examinations of the same individuals taken on a conventional film-screen system (200-speed). Patients were excluded if changes in the chest anatomy were detected or if the time interval between the examinations exceeded 1 year. Observer preference was evaluated for the image quality and the visibility of 15 anatomic structures using a five-point scale. RESULTS: Dose measurements with a chest phantom showed a dose reduction of approximately 50% with the digital radiography system compared with the film-screen radiography system. The image quality and the visibility of all but one anatomic structure of the images obtained with the digital flat-panel detector system were rated significantly superior (p < or = 0.0003) to those obtained with the conventional film-screen radiography system. CONCLUSION: The image quality and visibility of anatomic structures on the images obtained by the flat-panel detector system were perceived as equal or superior to the images from conventional film-screen chest radiography. This was true even though the radiation dose was reduced approximately 50% with the digital flat-panel detector system.     

Detection of small peripheral lung cancer by digital chest radiography. Performance of unprocessed versus unsharp mask-processed images.

PURPOSE: To clarify whether processed digital chest radiography can improve the detection rate for small peripheral lung cancer. MATERIAL AND METHODS: Five radiologists independently interpreted 54 digitized chest radiographs of 18 patients with small peripheral lung cancers measuring less than 20 mm, which were displayed following 3 types of digital processing: 1) an original version; 2) unsharp mask processing with a type 1 filter (very low-frequency-enhancing, mid-frequency-suppressing, and high-frequency-enhancing filter); and 3) unsharp mask processing with a type 2 filter (very low- and high-frequency-enhancing filter). A total of 1,620 pooled observations were evaluated by receiver operating characteristic (ROC) analysis. RESULTS: The mean area under the ROC curves was 0.68 for the type 1 filter, 0.68 for the type 2 filter, and 0.65 for the unprocessed (original) image. There were no statistically significant differences among these 3 kinds of image processing (p>0.05). In all types of images, the small lung cancer with an alveolar lining tumor growth was less visible than a solid tumor growth (p<0.01); the sensitivity increased with tumor size when the 3 groups of cancers, those measuring less than 10 mm, 11-15 mm, and 16-20 mm, were compared (p<0.01). CONCLUSION: Unsharp mask-image processing of digital chest radiography will not improve the detection rate of small peripheral lung cancer, probably due to a substantial drawback: the limited conspicuity of cancer lesions in the surrounding lung and superposition of structures.     

Clinical efficacy of image processing of grid detection and suppression (GDS) in computed radiography

In projection radiography, stationary grids are indispensable accessories to the improvement of diagnostic imaging. On the other hand, they are becoming one of the issues facing digital image processing. The lead foil that composes the grid can produce moiré on printed films and monitors according to the sampling interval at which the image is read by computed radiography (CR), creating a major obstacle to diagnosing images. The subject of this study on Grid Detection and Suppression (GDS) was the development of comprehensive image-processing software to detect and suppress grid lines automatically. Our results showed that applying GDS parameters 3 approximately 5 could provide a sufficient effect on suppression with little impact on images through the use of a multi-purpose grid (grid ratio 8:1, density 34 lp/cm) for general purposes. In projection radiography, it is expected that soft copy diagnosis will increase because the digital transition is proceeding, and the establishment of high-speed networks is becoming easier. Therefore, the digital environment is expected to improve and the choice of grids and monitors to expand, by using software such as GDS that does not require special skills.     

两种平板探测器X线摄影系统的成像剂量与成像质量的比较研究

目的 定量分析、比较非晶硅平板探测器X射线摄影系统与非晶硒平板探测器X射线摄影系统在不同成像剂量条件下成像质量的差别。方法 以非晶硅平板探测器系统和非晶硒平板探测器系统分别摄取对比度-细节体模CDRAD2.0在相近曝光剂量条件下的X射线影像,由4位独立观察者分别阅读影像,并计算所对应的曝光剂量下图像质量因子（image quality figure,IQF）,应用ANOVA分析两成像系统对比度及细节检测能力。使用X射线摄影统计学体模（TRG）测量两系统在不同曝光剂量条件下操作者特性曲线（receive operating characteristics,ROC）,应用Wilcoxon检验分析、比较两种成像技术的影像信息检测能力的差别。结果 在低曝光剂量条件下,两系统CDRAD体模影像IQF值及ROC曲线AZ值差别有显著意义,在对比度、组织细节检测能力上非晶硅平板探测器系统优于非晶硒平板探测器系统。在高曝光剂量条件下,两系统差异无统计学意义。结论 在低曝光剂量条件下,成像质量非晶硅平板探测器系统优于非晶硒系统。在获得相同的影像质量的前提下,使用前者进行X射线摄影可以降低被检者受照剂量。     

Digital radiography in dentistry: a survey of Indiana dentists

OBJECTIVES: The purpose of this study was to assess the number of Indiana dental practices that utilize digital radiography and to identify the reasons for using or not using digital radiography. METHODS: A questionnaire was sent to a random sample of 300 licensed dentists in the State of Indiana. Demographic, clinical and digital technology responses were obtained. The data were analysed using SPSS 12.0 (Statistical Package Social Sciences) software; t-tests and Pearson's chi(2) test were performed on several variables with significance levels set at P< 0.05. RESULTS: One hundred and fifty-two dental practices (51%) responded to the survey. Thirty dental practices (19.7%) used digital radiography in their office. Twenty-two (73%) of the dentists using digital radiography were general practitioners. The number of dentists in a practice was a significant factor in predicting the use of digital radiography (t=2.57, P=0.011). CONCLUSIONS: The results of this study indicate that digital radiography is more commonly used by general dentists in group practices.     

Digital slot-scan charge-coupled device radiography versus AMBER and Bucky screen-film radiography for detection of simulated nodules and interstitial disease in a chest phantom

PURPOSE: To evaluate the diagnostic performance of full-field slot-scan charge-coupled device (CCD)-based digital radiography in the detection of simulated chest diseases in clinical conditions versus that of two screen-film techniques: advanced multiple beam equalization radiography (AMBER) and Bucky radiography. MATERIALS AND METHODS: Simulated nodules and interstitial nodular and interstitial linear lesions were attached onto an anthropomorphic chest phantom. One hundred sixty-eight lesions were distributed over 25 configurations. A posteroanterior chest radiograph of each configuration was obtained with each technique. The images were presented to six observers. Each lesion was assigned one of two outcome scores: "detected" or "not detected." False-positive readings were evaluated. Differences between the imaging methods were analyzed by using a semiparametric logistic regression model. RESULTS: For simulated nodules and interstitial linear disease, no statistically significant difference was found in diagnostic performance between CCD digital radiography and AMBER. The detection of simulated interstitial nodular disease was better with CCD digital radiography than with AMBER: Sensitivity was 71% (77 of 108 interstitial nodular lesions) with CCD digital radiography but was 56% (60 of 108 lesions) with AMBER (P =.041). Better results for the detection of all lesion types in the mediastinum were observed with CCD digital radiography than with Bucky screen-film radiography: Sensitivity was 45% (227 of 504 total simulated lesions) with CCD digital radiography but was 24% (119 of 504 lesions) with Bucky radiography (P <.001). There were fewer false-positive observations with CCD digital radiography (35 [5.7%] of 609 observations) than with Bucky radiography (47 [9.5%] of 497 observations; P =.012). CONCLUSION: Differences were in favor of the full-field slot-scan CCD digital radiographic technique. This technique provides a digital alternative to AMBER and Bucky screen-film radiography.     

Digital chest radiography with a solid-state flat-panel x-ray detector: contrast-detail evaluation with processed images printed on film hard copy

PURPOSE: To evaluate and compare human observer performance in a contrast-detail test by using postprocessed hard-copy images from a digital chest radiography system and conventional screen-film radiographs. MATERIALS AND METHODS: The digital radiography system is based on a large-area flat-panel x-ray detector with a structured cesium iodide scintillator layer and an amorphous silicon thin-film transistor array for image readout. Images of a contrast-detail phantom were acquired at two exposure levels by using two standard thoracic screen-film systems and the digital system at matched dose. By using images of the phantom processed with standard chest image postprocessing techniques, a four-alternative forced-choice observer perception study was performed, and the number of detectable test signals (disk-shaped objects 0.3-4.0 mm in diameter) was determined for each image type. RESULTS: On average, observers detected more test signals on digital images than on screen-film radiographs at all diameters up to 2.0 mm and an equivalent number at larger diameters. Test signals with lower inherent subject contrast were detected more readily on digital images than on screen-film images, even when x-ray exposure levels for the digital system were reduced by 20%. CONCLUSION: Observer performance in a contrast-detail detection task can be improved by using images acquired with the flat-panel digital chest radiography system as compared with those acquired with state-of-the-art screen-film combinations.