CT的分叶征表现在肺内孤立结节影像诊断中的价值

目的探讨CT的分叶征表现在肺内孤立结节影像诊断的价值以及CT多平面重组（MPR）对此征检出的意义。方法观察病理证实的周围型小肺癌137例及良性肺内结节45例，将结节的边缘分为4型。对28例肺癌、22例良性结节行MPR，考察其显示分叶征的作用。引入可能性比值（likelihood ratios，LR）以量化良恶性病变在形态学上存在重叠的表现。结果Ⅰ型边缘结节对良性病变的特异性为83．3％（20／24），敏感性为44．4％（20／45）。Ⅳ型边缘结节对周围型小肺癌的特异性为97．6％（83／85），敏感性为60．7％（83／137）。表明Ⅰ型边缘是良性病变的特点；而Ⅳ型边缘是恶性病变的特征。Ⅳ型边缘的结节恶性病变在MPR重组图像上的检出率为64．3％（18／28），与横断面扫描差异有统计学意义（P〈0．01）。结论分叶征对肺内孤立结节的诊断有价值，MPR配合横断面薄层图像有助于提高该征的检出率。     

Short term correlates of the Neuro Emotional Technique for cancer-related traumatic stress symptoms: A pilot case series

Introduction As many as one quarter of all cancer survivors report traumatic stress symptoms from cancer-related experiences. While the majority of these patients do not meet the criteria for posttraumatic stress disorder (PTSD), there is growing evidence that subsyndromal symptoms can significantly contribute to functional impairment and negative health outcomes. Treatment options for the hallmark symptoms of traumatic stress—unpleasant, intrusive thoughts and avoidant behaviors—have not been well investigated for the cancer survivorship population. Materials and methods Seven female cancer survivors with traumatic stress symptoms from cancer-related experiences and no other major psychopathology, were enrolled to receive three sessions of Neuro-Emotional Technique (NET), a brief, targeted treatment that combines traditional desensitization principles with complementary modalities. Results Psychological outcome measures (Impact of Event Scale (IES) and Subjective Units of Distress (SUD) and physiological measures (Heart Rate (HR) and Skin Conductance Level (SCL) demonstrated the following changes: 71% on IES, 88% SUD, 74% on HR, and 65% on SCL following the intervention. Statistically significant changes were observed for all four parameters, and effect size g for proportion improved were 0.50 each for IES, SUD, and HR, and 0.20 for SCL. Conclusions These cases suggest feasibility of the NET intervention for cancer-related traumatic stress and the potential for change in symptoms and physiological reactivity. Further investigation is needed to determine the specific and long-term effects of such an approach. Implications for cancer survivors Traumatic stress from cancer-related experiences might represent a constellation of symptoms that are amenable to brief, targeted interventions. This study was supported by the O.N.E. Research Foundation     

Le traitement du signal en électromyographie: mise au point

Automatic analysis of electromyography (EMG) signals, first operated in 1950 with analogic machines, steeply expanded from 1980 when fast computers and worthwhile programs became available. On-line measurement of response area and latency, averaging of low amplitude waves, fast sorting of motor unit potential shape parameters, computation of the “jitter” between two muscle fibers, turns/amplitude and spectral analysis of interferential pattern records, are some examples of programs currently offered in modern EMG machines. Other techniques are still reserved for research purposes: scanning EMG, decomposition of nerve and muscle compound potentials, measurement of the threshold and firing rate of motor units, trace analysis using tracking models. Finally, the credit for artificial intelligence systems (knowledge based systems, fuzzy logic, neuronal networks) is still not clearly stated.     

Digital movement analysis,a new objective method of measuring tardive dyskinesia and drug-induced parkinsonian tremor: acceptability,reliability and validity

Digital movment analysis (DMA) is a new instrumental approach to assessing oral tardive dyskinesia (TD) by means of digital image processing of a video signal, tracking five paper dots placed around the patient's mouth. A total of 40 schizophrenic patients, 30 with and 10 without TD, were examined twice (with a 3-month interval) with this new device. The patients were further examined with two TD rating scales: the St. Hans Rating Scale for extrapyramidal syndromes (SHRS) and the Abnormal Involuntary Movement Scale (AIMS).The schizophrenic patients accepted the instrumental assessment without any anxiety or resistance. The internal relibility of the apparatus was high, with correlation coefficients of 0.80–0.99. The DMA TD values correlated with the SHRS and AIMS scores with correlation coefficients of 0.48–0.73 indicating an acceptable, although not strong, concurrent validity. Fluctuations occurred from the first to the second examination independent of medication. For these fluctuations no correlation was found between DMA values and rating scores. Finally, the DMA device was able to detect perioral tremor as a sign of parkinsonism.It has been concluded that DMA is a useful supplement to classical TD rating, although further validity evaluation is warranted.     

发音状态下口周软组织移动量的测量

目的引入动态的图象测里概念，进行口周软组织移动量的测量。方洁利用已开发的计算机图象处理系统．对三种测定条件下口腔周围软组织的移动量进行测量研究。结果（1）发／mo／时，口唇突出，上唇的测定点向上内前方．下唇的测定点向下内前方动作，因此．唇上三角形面积变化的大小依次为M3相似文献   

家禽加工流水线作业工人颈肩腕疾患的调查

对１４９名家禽加工厂作业女工的颈肩腕疾患进行了调查。结果表明：观察组职业性颈肩腕疾患ＯＣＤ，（肩周炎、尺管综合征、腕管综合征、腱鞘炎、肱骨内外髁炎）的总发生率为３９．６０％，与对照组相比差异有非常显著意义（Ｐ＜０．０１），其发生率与工龄、年龄及工种别有关。我们认为ＯＣＤ发生的职业危险因素主要是上肢反复用力活动、静力作业、不合理的操作姿势，而且低温、高温的作业环境对ＯＣＤ的发生也起到一定的促进作用。     

计算机X线摄影适宜照射线量的探讨

目的以噪声的频率特性评价计算机X线摄影系统(computed radiography, CR)的适宜曝光量.方法在相同摄影条件下获得中速 CaWO4屏-Fuji片组合照片和CR照片,以此为基础,改变mAs,获得不同照射剂量下的CR影像,经相同的后处理条件输出它们的CR照片.用显微密度计依次对这些照片进行扫描,每张获得10万个密度值,作为离散随机信号来处理,用快速傅立叶变换计算威纳频谱(Wiener spectrum, WS),测试CR照片噪声的WS与中速CaWO4屏-Fuji片组合的照片噪声WS值相等的曝光量值.结果 (1)在照射剂量均为5.61μGy、照片密度均为1.0的情况下,在空间频率(ω)=0.1 LP/mm处,CR系统的WS值为 23.1×10 -6 mm2,屏-片系统的为20.1×10 -6 mm2;在ω=0.5 LP/mm处,CR系统的WS值为 9.73×10 -6 mm2,屏-片系统的为8.41×10 -6 mm2 .(2)当ω=0.1 LP/mm时,照射剂量为5.61μGy的CR照片的WS值分别是照射剂量为1.40、2.80、8.76、13.67、21.11μGy CR片的0.53、0.75、1.14、1.44、1.80倍;当空间频率为0.5 LP/mm时,照射剂量为5.61μGy的CR片的WS值分别是照射剂量为1.40、2.80、8.76、13.67、21.11μGy CR片的0.40、0.58、1.26、1.47、2.16倍.(3)在ω=0.5 LP/mm时,与照射剂量为5.61μGy的屏-片组合有相当的噪声水平的CR照片照射剂量大致为7.70 μGy左右.结论相同摄影条件下CR照片的噪声要比中速 CaWO4屏-Fuji片组合的大;随着照射量的增加CR系统总WS将减小,噪声下降;如想获得和屏-片相同噪声的影像,应适当增大CR系统的照射量.     

胸部螺旋CT最大密度投影重建的参数优化

目的探讨胸部螺旋CT最大密度投影(MIP)重建合理的扫描和重建参数。方法6例煤工的尸检离体肺脏制成充气固定肺标本,分别行不同参数组合的螺旋CT扫描,包括层厚1.5mm,2mm,4mm及8mm,重建间隔1mm,3mm,5mm;曝光量150mA,100mA;螺距1.5;滤过算法包括标准、锐利和平滑3种。每组图像均行MIP重建,重建厚度为12.5mm～13mm,比较不同参数MIP重建图像对支气管血管束的显示。结果a)曝光量对MIP重建图像的影响甚微,150mA、100mA两组剂量MIP无显著性差异(P>0.05);b)重建算法对MIP重建无显著影响。c)扫描层厚影响MIP图像,以薄层(1.5mm)扫描重建为最佳,1.5mm、2mm、4mm层厚MIP图像之间无显著性差异(P>0.05),8mm层厚与前4者MIP图像有显著性差异(P<0.01)。d)重建间隔影响MIP重建效果,8mm层厚扫描,1mm和5mm重建间隔重建图像MIP之间有显著性差异(P<0.05)。结论影响MIP重建的参数主要为扫描层厚和重建间隔,薄层扫描可获得理想的MIP图像,随层厚的增加,减小重建间隔有利于获得理想的MIP图像。建议以中等层厚(4mm)扫描,小重建间隔(1.5mm,2mm)行MIP重建。     

应用多层螺旋CT多方位重建技术诊断急性阑尾炎的价值

目的探讨多层螺旋CT多方位重建(MPVR)诊断急性阑尾炎的价值。方法2002年2月至2003年9月临床疑诊阑尾炎收治入院手术患者39例,术前均作了常规扫描和MPVR重建2种CT检查,术后31例确诊为阑尾炎,从阑尾充血、水肿至阑尾脓肿共分5级(正常阑尾为0级)。结果对照手术病理,MPVR重建诊断急性阑尾炎准确率872%,敏感度903%,特异度75%,阳性预测值933%,阴性预测值667%。常规CT检查诊断急性阑尾炎准确度385%,敏感度387%,特异度375%,阳性预测值706%,阴性预测值136%。28例确诊急性阑尾炎的MPVR重建片所示5种主要征象及出现频率如下阑尾肿大(管腔直径>6mm)(964%),阑尾结石(267%),回盲部肥厚(367%),阑尾周围炎(714%),脓肿(107%)。结论多层螺旋CTMPVR重建技术显著提高了CT对临床症状模棱两可、临床疑诊急性阑尾炎患者的术前诊断能力,并可减少重型阑尾炎病例的发生。     

维纳滤波器在数字化X射线影像中的应用

介绍了一种简单有效的维纳滤波器设计过程,并采用该过程对数字化X射线影像进行滤波,试验表明:维纳滤波器能在去除图像噪声的同时较好地保留图像细节,具有实际应用价值。