低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

低剂量CT肺动脉成像的实验研究

Objective To investigate the feasibility of reduced radiation dose for CT pulmonary angiography (CTPA) and the possible lowest radiation threshold by a phantom study.Methods The CT value difference between air within the trachea and the extracorporeal background region was measured in132 consecutive patients.A noise-measurement phantom and a pulmonary embolism (PE) phantom were made of phenol-formaldehyde, and both phantoms and a water phantom were scanned with standard and lower radiation doses as follow: 280, 200, 160, 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, and 10 mA respectively, at a fixed voltage of 120 kVp.Standard and soft tissue algorithms were used to reconstruct the images.Three experienced doctors independendy evaluate the image quality and the efficiency of detecting PE of the images with various doses.The Pearson correlation analysis, two-tailed paired t test, ANOVA, and Kappa test were employed for the statistical analysis.Results The CT value difference between air within the trachea and the extracorpereal background region in 132 consecutive patients ranged from 20.00 to 55.00 HU, which had a positive correlation with weight[(64.99±11.86) kg], weight-height ratio [(38.71±6.13) kg/m], and BMI[(23.11±3.38) kg/m2](r=0.228,0.374,0.449 respectively; P <0.01).The image noise level with soft-tissue reconstruction algorithm[(16.55±9.08), (16.42±9.40) HU]was significantly lower than that of the image with standard reconstruction algorithm[(22.43±11.25),(21.99±11.67) HU](F=4.316, P < 0.05).The image noise level with soft-tissue reconstruction algorithm at 100 mA was similar to that of the images with standard reconstruction algorithm at 280 mA, and the signal-w-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the image of PE phantom was 23.05 and 20.52 respectively, without any impairment in detectability of embolus.The image noise level with soft-tissue reconstruction algorithm at 60 mA was similar to that of the image with standard reconstruction algorithm at 160 mA, while the SNR and CNR was 18.01 and 15.97 respectively, also with acceptable detectability of embolus.When the tube current was reduced below 30 mA, the image quality decreased significantly, with the SNR and CNR was lower than 12.36 and 10.95 respectively, and the detectability of embolus was degraded.The consistency of the image quality grading by 3 observers was excellent(K=0.807,0.712,0.904 ,respectively; P < 0.01).Conclusions The 100 mA may potentially be the ideal low dose tube current setting, with radiation dose only equal to 36% of 280 mA (standard dose).The 30 mA may possibly be a minimum radiation dose for detecting PE.The soft-tiasue reconstruction algorithm was favorable in preserving the SNR when the radiation dose was reduced.     

数字化X线胸部摄影管电压选择对影像质量影响的研究

Objective To study the relationship between the selection of tube tension in digitalchest radiograph and image quality.Methods When tube current was fixed at 4 mAs, the choice of X-ray tube voltage changed from 60 to 120 kV.CDRAD2.0 contrast details phantom and normal human chest were exposed by X-ray system with 7 kinds of tube voltage (the difference between tube voltage was 10 kV) ,and the X-ray incidental dose of phantom surface was measured.Five radiologists with 3 years working experience evaluated the image quality on monitor and calculated the image quality factor (IQF) and image reading score.Statistics analysis was then performed by using ANOVA test and t test.According to the results, the optimum tube voltage range was determined.Results (1) The incidental dose of phantom surface increased with the higher tube voltage.(2)When the tube voltage was changed from 60 kV to 120 kV, the IQF value observed in CDRAD2.0 phantom image on monitor was 75.0±10.4,57.1±6.4,52.7±2.5,47.9±4.5, 46.0±3.8,46.0±2.8,45.2±3.5 ,there was significant statistical differences between groups(F=19.10, P<0.01).(3)The integrated score of the chest image quality in the tube voltage 90 kV and 120 kV were 12.4±0.9 and 13.0±0.7, respectively, and there was no statistical difference between two groups(t= 1.500,P>0.05).Conclusions (1)With the increase of tube tension,the display capacity of display device gradually strengthened.When the tube tension exceeded 90 kV, the increase of image quality on monitor was not evident.(2) With proper radiation dose, the value of tube tension in digital X-ray chest photograph was about 90 kV.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.