低剂量数字化口腔全景摄影技术的探讨

目的:探讨低剂量数字化口腔全景摄影技术,以期提高口腔全景影像质量,降低被检者的辐射剂量。材料与方法:利用德国ORTHOPHOS XG型数字化口腔全景摄影机,对60例被检志愿者以机器自动给出的摄影参数和选定的摄影参数进行数字化口腔全景摄影,记录各自的X线量(mAs)并进行比较。结果:儿童及中等体形被检者以90kVp、6mA、14.1s摄影较机器自动给出的62kVp、8mA、14.1s摄影X线量可降低25%;较胖体形被检者以90kVp、12mA、14.1s摄影较机器自动给出的73kVp、15mA、14.1s摄影X线量可降低20%,以90kVp、6mA、14.1s摄影较90kVp、12mA、14.1s摄影X线量可降低50%,且影像质量无明显差异。结论:数字化口腔全景摄影应以较高千伏(90kVp)为宜,可降低被检者的辐射剂量。     

口腔曲面体层摄影在茎突综合征诊断中的价值

目的通过改良茎突投照方法,探讨茎突综合征在曲面体层摄影全景片的表现.方法收集有相关临床症状者68例经采用曲面体层摄影X线机投照.结果除2例茎突未发育外,一次投照成功率100%.茎突双侧长度≥3 cm(31/68);茎突单侧长度≥3 cm(22/68);茎突向前夹角异常(47/68).茎突发育完整型(44/68);分节型(17/68);发育不良型(5/68);未发育型(2/68).结论口腔曲面体层摄影技术能够在同一张片显示双侧茎突,充分暴露视野,茎突无重叠,病人容易配合,投照方法简单易行,经济方便,满足X线对诊断茎突综合征的要求.     

低剂量乳腺钼靶x线摄影技术的探讨

目的:探讨低剂量乳腺钼靶X线摄影技术,提高影像质量,降低被检者的曝光量.材料与方法:利用SIEMENS公司MAMMOMAT 1000型乳腺摄影机,对30例志愿者双侧乳腺对其一侧乳腺CC位和MLO位用50kV摄影,另一侧乳腺CC位和MLO位用35kV摄影,其它参数均相同,获得CC位和MLO位各60幅影像,分析对比影像质量,记录曝光量(mAs)值,并对其结果进行统计学分析.结果:35kV比30kV摄影曝光量值平均降低约2.2倍,且影像质量高;对CC位和MLO位30kV、35kV摄影时的曝光量值分别进行配对t检验,CC位t=4.03,p＜0.05,MLO位t=3.78,p＜0.05,均具有统计学意义.对2组影像质量进行X2检验,X2=10.8,P＜0.05,具有统计学意义.结论:低剂量乳腺钼靶X线摄影千伏应用35kV为宜,能够提高影像质量降低被检者的曝光量.     

DR合理曝光条件的研究

目的:探讨数字化X线摄影的合理曝光条件,以确保影像质量和降低X线曝光量。材料与方法:利用Philips DR系统对膝关节正位,腰椎正位,颈椎侧位各30例被检者(志愿者)分别以不同的kVp曝光,记录mAs值,分析对比影像质量。结果:适当的高kVp(90—102kVp)摄影,可以降低X线曝光量(mAs)约3—5倍,影像质量无明显差异。结论:DR应以高kVp摄影为宜,对降低被检者的曝光量非常有意义。     

螺旋CT多平面重建在诊断上颌埋伏牙中的应用--附19例报告

目的:探讨螺旋CT扫描后多平面重建对诊断上颌埋伏牙的应用价值.方法:回顾性分析比较19颗埋伏牙的单纯曲面体层摄影与曲面体层摄影结合螺旋CT扫描后多平面重建的图像.结果:曲面体层摄影只能二维观察19颗埋伏牙的大致情况,而曲面体层摄影结合螺旋CT扫描后多平面重建能清楚显示19颗埋伏牙的方向、位置和周围的阻力情况.结论:螺旋CT扫描后多平面曲面重建结合曲面体层摄影能准确地显示颌骨的情况,可多层面、多角度地观察牙齿及牙槽骨,立体感强,能为正畸治疗提供准确的资料,对上颌埋伏阻生牙的诊治有较高应用价值,值得推广.     

腹部低剂量数字化x线摄影的探讨

目的:探讨腹部数字化摄影的合理曝光条件,在保证影像质量的情况下,降低被检查者的辐射剂量.材料与方法:使用虎丘DR系统,对30例腹部前后位被检者(志愿者)分别以不同的kVp和mAs曝光,分析对比影像质量,对不同kVp时的mAs进行配对t检验做统计学分析.结果:适当的高kVp摄影,降低了X线曝光量(mAs),不同kVp时的mAs进行配对t检验,t=21.34,p＜0.0005,具有统计学意义,影像质量无明显差异.结论:腹部较高kVp摄影,降低了X线曝光量(mAs)值,降低了被检者的辐射剂量.     

婴幼儿胸部低剂量dr摄影的探讨

目的:探讨婴幼儿胸部低剂量DR( Digital Radiography)摄影的合理曝光技术条件,降低被检者的曝光量(mAs)及辐射剂量并保证影像质量.材料与方法:随机选取2011年7月-9月来我院进行胸部DR摄影的2岁以下婴幼儿60例作为研究对象,年龄3天-21个月,平均年龄5.5个月,性别随机;30例常规剂量组,采用系统设定的固定婴幼儿胸部摄影条件(65kV、4mAs、4.44 ms),30例低剂量组,采用90kV、AEC自动曝光模式进行自动曝光,自动曝光控制灵敏度均选择400.记录两组曝光参数并进行统计学处理.结果:90kV比65kV摄影曝光量最高降低5.37倍,最低降低2.61倍,平均降低3.69倍;剂量面积值(DAP)最高降低4.04倍,最低降低1.38倍,平均降低1.98倍;对两组mAs进行配对t检验,t=70.5,p＜0.0005,有显著统计学意义,对两组DAP进行配对t检验,t =52,p＜0.0005,有显著统计学意义;对两组影像质量进行x2检验,x2=0.6,p＞0.05,无统计学意义.结论:2岁以下婴幼儿胸部DR摄影千伏宜选用90kV,能降低被检者的mAs及辐射剂量,且影像质量和常规剂量组比较无明显差异.     

肺额倾体层摄影片的质量分析

肺额倾体层摄影能显示气管、主支气管、上下走行的叶和段支气管以及肺门大血管等结构的正位影像[1] 。把上述结构从重叠影像中清晰地显示出来 ,可以弥补胸部普通摄影的不足[2 ] ,从而为诊断和治疗疾病提供更丰富、更有价值的资料。因此 ,摄取高质量的肺门额倾体层片具有重要意义。作者选择本单位 2 0 0例肺门额倾体层摄影片进行质量分析。1　材料和方法1 1　材料　随机选择肺门额倾体层片 2 0 0例 ;所用机器为岛津多轨迹断层机 (ＨＬＺ 10 0 ) ;使用胶片为柯达 3 5 5 6ｃｍ× 3 5 .5 6ｃｍ(1ｃｍ =0 3 9英寸 )。1 2　评判方法　以首次体层…     

观察Slot双下肢全长摄影在全膝关节置换术中的应用

目的:探究Slot双下肢全长摄影在全膝关节置换术中的临床应用价值。方法:以2019年5月至2020年5月我院100例全膝关节置换术患者为研究对象,随机分为治疗组和对照组,每组50例,其中治疗组采用slot scan全景摄影,对照组采用DR双下肢全景摄影,对比两组患者术前、术后影像图片技术并进行图片质量评价。结果:两组患者均能顺利完成双下肢全长摄影,比较两组患者双下肢全景片,发现治疗组可借助软件进行自动拼接,对图片进行重建,所得的双下肢全长X片更为清晰、无形变,对照组需手动调节图像的比例,才可获得术前参考及测量图片,而且相较于治疗组,其图片不够清晰,存在拼接伪影,图片质量较差。结论:Slot双下肢全长摄影操作相对简便,成像速度快,所得图片精度高、失真度小,对于全膝关节置换术的后期诊疗具有重要的临床价值。     

50例肋骨骨折的CR摄影技术回顾性分析

目的:通过对50例肋骨骨折的患者CR片分析,探讨肋骨骨折的CR摄影技术.材料与方法:50例肋骨骨折的患者进行常规位,改变体位的CR摄影,对影像进行后处理.结果:50例肋骨骨折的患者的CR摄影片,常规正斜位的摄片中38例膈上肋骨诊断明确,诊断符合率76%,另外的16%患者改变摄影方法,进行后处理技术,改变窗宽、窗位后可以做出明确诊断.结论:CR摄影技术是影像诊断肋骨骨折首选的、经济实惠检查方法.     

5-氟尿嘧啶化疗致口腔黏膜炎对生活质量的影响

目的调查5-氟尿嘧啶连续泵化疗致口腔黏膜炎的现状，针对性采取护理措施，以提高患者的生活质量。方法各疗程化疗开始时到化疗后15d时，对50例患者进行调查，采用口腔黏膜炎分度标准及日常生活观察指标，观察和评估口腔黏膜炎的程度和对日常生活的影响。结果50例5-氟尿嘧啶连续泵化疗致口腔黏膜炎发生14例，Ⅰ度6例，Ⅱ度4例，Ⅲ度3例，Ⅳ度1例；口腔黏膜炎不同程度影响患者进食、交流、睡眠，降低了患者生活质量。结论5-氟尿嘧啶连续泵化疗患者易发生口腔黏膜炎，严重影响患者生活质量，通过预防和对症护理，可以减少不适感觉。     

Vancomycin-induced elevation of liver enzyme levels

OBJECTIVE: To report a case of oral vancomycin-induced elevation of liver enzyme levels. CASE SUMMARY: A 57-year-old man with multiple medical conditions requiring systemic antibiotic therapy developed numerous Clostridium difficile-associated enterocolitis episodes. The patient did not respond adequately to oral metronidazole, as evidenced by his continuing diarrhea. He was treated with oral vancomycin on 5 separate occasions (with doses from 125 to 500 mg/day), each of which resulted in significant elevations in alanine aminotransferase (to 371 U/L) and aspartate aminotransferase (to 203 U/L) levels. The elevations resolved on each occasion with discontinuation of vancomycin. DISCUSSION: Vancomycin, a glycopeptide antibiotic, has primary activity against gram-positive bacteria. Oral vancomycin can be used for the treatment of C. difficile-associated enterocolitis in patients who fail to respond to or are intolerant to metronidazole therapy. Oral vancomycin has very poor bioavailability and, as of May 4, 2006, has not been associated with hepatic toxicity. Inflammatory bowel disease processes can result in increased absorption of oral vancomycin. CONCLUSIONS: This is the first reported case of oral vancomycin-induced elevation of hepatic enzyme levels. Use of the Naranjo probability scale indicated that this was a probable adverse drug-associated event.     

口腔种植定位术前评估中颌骨低剂量多层螺旋CT检查的应用

目的：探讨颌骨低剂量多层螺旋CT（muti-slice computed tomography, MSCT）成像技术在口腔种植定位术前评估中的临床价值。方法：将80例口腔种植术前的患者随机分为4组,每组20例,使用SIEMENS Definition AS40 CT机,在其他扫描参数相同的情况下分别采用60 mA、50 mA、40 mA的管电流进行颌骨MSCT扫描,并与常规管电流90 mA组（20例）进行对比,记录4组不同毫安的容积CT剂量指数（volume computed tomography dose index, CTDIv）和放射线剂量长度乘积（dose length product,DLP）,分析比较4组间的CTDIv、DLP及图像质量。结果：40 mA、50 mA、60 mA、90 mA 4组间比较,CTDIv、DLP存在差异（P<0.05）,而将4组进行两两组间比较,则除了60 mA组与90 mA组间的CTDIv、DLP差异无统计学意义（P>0.05）外,其余任意2组间的CTDIv、DLP差异均存在统计学意义（P<0.05）。4组间的图像质量差异无统计学意义（P>0.05）。结论：采用40 mA低剂量MSCT扫描既能保证图像质量,又能满足临床术前诊断的需求,并可大幅度（35.0%）降低患者所受辐射剂量。     

Evaluation of scoliosis today: examination, X-rays and beyond

PURPOSE: The purpose of this paper is to provide an overview of the techniques of evaluation of patients, suffering from idiopathic scoliosis. METHODS: The presentation is provided, concerning the medical history, clinical examination, conventional radiography, stereo-radiography, surface topography, ultrasounds, computer tomography, and magnetic resonance imaging, focusing on the points specific for the pathology of idiopathic scoliosis. RESULTS: Use of the scoliometer became systematic in the clinical evaluation. Quality of life questionnaires, including those endorsed by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), oriented towards scoliotic patients, gain on popularity and are extremely helpful to objectively evaluate the disability related to scoliosis. Classical radiography serves as the basic exam to determine the curve type and magnitude. Ultrasounds, computer tomography and magnetic resonance imaging are indicated in precisely defined clinical situations. Stereo-radiography and surface topography seem to be the most promising techniques, however requiring standardisation. CONCLUSIONS: Apart from sophisticated measurements, the experience of a physician cannot be underestimated. High standard clinical evaluation will probably continue to serve as a reference for other methods of assessment of patients with scoliosis. Stereo-radiography and surface topography deserve common use, after standardization is achieved.     

Oral cholecystography: Comparison of conventional screen-film with photostimulable imaging plate radiographs

Oral cholecystography was performed on ultrasonically proven cases of cholelithiasis. The conventional screen/film system and computed radiography (CR) using the imaging plate were used under practically identical conditions. The diagnostic accuracy of the two techniques was assessed objectively, and the image quality was assessed subjectively. The CR image proved to be better than the conventional screen/film image, even with the low-dose exposure. This paper describes our experience in the area of the biliary tract system with CR — a digital radiographic system using photostimulable phosphor.     

Use of thin-section,multidetector row helical CT images for coronal oblique reformations for optimal visualization of structures in the hepatoduodenal ligament

Multidetector row computed tomography (CT) can acquire abdominal images of unprecedented thinness in a single breath-hold. This study investigated whether acquiring source axial images at 1.25 mm as opposed to 2.5 mm would result in a perceptible difference in image quality for coronal oblique reformations. Similarly, the hypothesis that a slice pitch of 3:1 would be superior to 6:1 was evaluated. Twenty-nine CT studies were retrospectively evaluated. The images were divided into four groups: 1.25-mm axial images, pitch 3:1; 2.5-mm axial images, pitch 3:1; 1.25-mm axial images, pitch 6:1; and 2.5-mm axial images, pitch 6:1. Three radiologists evaluated by consensus the coronal oblique reformations for overall image quality and image quality of structures in the hepatoduodenal ligament and of nodal groups. Use of 1.25-mm rather than of 2.5-mm source axial images resulted in statistically significant better scores for overall image quality and visualization of the hepatic artery, portal vein, pancreatic duct, and nodal groups. However, a pitch of 3:1 rather than of 6:1 did not result in significant differences in ratings of image quality. Use of 1.25-mm rather than of 2.5-mm source axial images improves image quality when creating coronal oblique reformations for abdominal anatomy.     

Cost-effectiveness of oral ibandronate versus IV zoledronic acid or IV pamidronate for bone metastases in patients receiving oral hormonal therapy for breast cancer in the United Kingdom

BACKGROUND: Oral ibandronate is a single-nitrogen bisphosphonate whose efficacy is similar to that of IV ibandronate for the treatment of bone metastases. OBJECTIVE: The aim of this study was to compare the cost-effectiveness of oral ibandronate with zoledronic acid and generic pamidronate (both administered by IV) for the treatment of bone metastases in patients with breast cancer receiving oral hormonal therapy in the United Kingdom. METHODS: A global economic model was adapted to the UK National Health Service. Patients were assumed to receive oral hormonal therapy for 50% of their projected 14.3-month survival. The primary outcome was incremental cost per quality-adjusted life-year (QALY). Bisphosphonate efficacy data for relative risk reduction of skeletal-related events (SREs) were obtained from clinical trials. Resource use data and costs associated with IV bisphosphonate infusions were derived from published studies and a unit cost database; monthly drug acquisition costs were obtained from the British National Formulary. Utility scores were applied to time with or without an SRE to adjust survival for quality of life. Therefore, differences in QALYs were driven by utility weights rather than survival time. Model design and inputs were validated through expert UK clinician review. The absence of comparative efficacy and safety data from clinical trials for the different bisphosphonates was a model limitation that we addressed by supporting our assumptions with UK expert clinician opinion and with expert clinician opinion outside of the United Kingdom, and by conducting sensitivity analyses. RESULTS: The projected total cost per patient was pound307 less with oral ibandronate compared with zoledronic acid, and pound158 less compared with the use of generic pamidronate (due to a reduction in staff time for infusions, avoidance of renal safety monitoring visits, and, in the case of IV generic pamidronate, a reduction in the number of SREs). Oral ibandronate was estimated to lead to a gain of 0.02 QALY, making it the economically dominant treatment option. CONCLUSIONS: In this study, we found that oral ibandronate was cost-effective for the management of bone metastases from breast cancer among patients receiving oral hormonal therapy in the United Kingdom. Oral ibandronate provided effective SRE and bone-pain management while avoiding resource use and costs associated with regular IV bisphosphonate infusions. Due to uncertainty surrounding the model assumptions, it would be valuable to repeat the analyses using data from comparative bisphosphonate trials, once they become available.     

18氟标记脱氧葡萄糖心肌正电子发射型计算机断层扫描显像仪心肌代谢显像检查的方法学研究

目的探讨应用18氟标记脱氧葡萄糖心肌正电子发射型计算机断层扫描显像仪(18F-DGPET/CT)心肌代谢显像检查的方法学。方法 32例心肌梗死患者和40例健康对照组健康人中的20例行葡萄糖负荷法,另20例对照组健康人空腹,72例均行18F-FDG PET检查。对葡萄糖负荷法后心肌显影失败者,行口服葡萄糖耐量试验(OGTT)及胰岛素、C-肽检查。结果未行葡萄糖负荷的健康对照组心肌整体显影良好5例(25%),行葡萄糖负荷的健康对照组显影良好17例(85%);两者比较,采用χ2检验,P<0.05。葡萄糖负荷法后心肌整体显影失败5例,其中4例胰岛素、C-肽释放曲线异常。4例80岁以上的老年人,2例显影良好,2例显影失败。结论 18F-FDG PET/CT心肌代谢显像程度与空腹血糖浓度无关,为获得有意义的心肌代谢显影图像,必须先行血糖调控。糖尿病患者可行胰岛素干预等方法提高显影质量。80岁以上的老人不考虑用此方法评估心肌活性。     

Magnetic resonance imaging of the postoperative hip

Magnetic resonance imaging (MRI) of the postoperative hip for delineation of various pathological conditions has been established in addition to conventional radiography and computed tomography. MRI provides superior soft-tissue contrast than the other imaging modalities, and it can be used for visualization of structures and pathological entities that cannot be depicted by conventional radiography and computed tomography. These entities include bone marrow changes such as bone marrow edema and avascular necrosis, and infiltration of the bone marrow by tumor recurrence or infections after insertion of metallic osteosynthetic material. The image quality of MRI, which is reduced as result of artifacts caused by metal alloys, can be optimized by using spin-echo or fast spin-echo sequences, and by adapting phase- and frequency-encoding directions in cases where metallic osteosynthetic materials were used. MRI, in addition to computed tomography and conventional radiography, appears to be a valuable tool for imaging the different pathological conditions of the postoperative hip, including after implantation of metallic osteosynthetic material.     

缺血性脑卒中患者口腔健康相关生活质量现状及其影响因素分析

目的 探讨缺血性脑卒中患者口腔健康相关生活质量现状及其影响因素,为改善患者口腔健康相关生活质量提供理论依据.方法 采用便利抽样方法,选取2020年6-9月徐州市某三甲医院神经内科病房308例缺血性脑卒中患者为研究对象,应用一般资料问卷、蒙特利尔认知评估量表、改良Rankin量表、口腔健康影响程度量表(oral heal...