ABSTRACT
Objective To analyze the cause of missing diagnosis for vertebral fracture on lateral chest radiography. Methods Lateral chest radiographies of 1638 hospitalized patients (871 males and 767 females) were retrospectively reviewed for identifying vertebral fractures. Their ages ranged from 50 to 91 years with the mean of 63.5 years. Complains and application for chest radiography in all patients were not related to osteoporosis and vertebral fracture. Vertebral fracture and fracture severity were evaluated using Genant's semiquantitative visual method, taking approximately a 20%-25% vertebral height reduction as mild grade,26%-40% as moderate grade and 41% or greater as severe grade. Evaluation results of the vertebral fracture, original X-ray reports, as well as medical records were compared for further analysis. Results Eighty-four in 1638 patients showed vertebral fractures on the lateral chest radiographies. Of them,vertebral fractures were reported in 30 cases and 54 patients were not reported on their original X-ray reports. There were 63 vertebral fractures in 54 un-reported patients, most of which were single fracture (75% or 47/63). Grade Ⅰ fracture accounted for 54% (34/63), Grade Ⅱ fracture 33% (21/63), while 13% presented grade Ⅲ fracture (8/63). In all 84 patients with vertebral fractures, only 5 cases (6%)underwent dual energy X-ray absorptiometry (DXA) measurement, 5 cases ( 6% ) were recorded to have vertebral fractures on the medical papers, as well as 15 cases ( 18% ) were prescribed drugs related to the osteoporosis when discharged from hospital All drugs prescribed for the 15 patients were limited only to calcium. Conclusions More attention should be paid to osteoporosis by doctors including radiologists.Vertebral fracture on lateral chest radiography should be completely diagnosed, which is helpful for both prevention and treatment.
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Objective To evaluate the feasibility of dual-source computed tomography(DSCT)coronary angiography in a population with premature heart-beats.Methods Seventy patients with suspected coronary artery disease and premature heart-beats were routinely imaged on a DSCT scanner(Somatom Definition,Siemens AG,Germany).The images were reconstructed before and after ECG editing.Two readers independently assessed image quality of all coronary segments using a four-point grading scale from excellent(1)to non-assessable(4).The results ofthe two groups were compared with a paired t-test,and a P value of less than 0.05 Was considered significant.Results The mean heart rate during examination ranged from 49 to 111 bpm[mean(70.7±12.4)bpm].Twenty-eight of 70 patients with relatively small variability of the heart rate[(41.0±18.4)bpm]got diagnostic image quality without ECG editing.In other 42 patients with larger variability of the heart rate[(71.4±28.7)bpm],the meal image quality scores were 2.09±1.27 and 1.50±0.79 before and after ECG editing,there Was a significant difference(t=13.764,P＜0.01).The proportion of non-assessable segments Was reduced from 24.8%(154/620)to 3.4%(21/620)through ECG editing(X2=121.846,P＜0.01).Finally,the diagnostic image accounted 98.0%(1014/1035)in all segments of 70 patients.Conclusion DSCT can provide diagnostic images for patients with premature heart-beats.The image quality in patients with larger variability of the heart rate can be significantly improved through ECG editing.
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Objective To explore the clinical application and value of percutaneous treatment of pancreatic pseudocysts guided by CT.Methods The percutaneous external draining of pancreatic pseudocyst caused by various causes was performed under CT guidance in 29 cases, including 21 males and 8 females, age from 22 to 71 years, average (48.2?13.6) years. After the point, the angle,and the depth of puncture were measured on CT images, pseudocyst puncture and catheterization of external draining were made and followed up. Results 30 procedures of puncture in 29 lesions were done, the successful rate was 100%. Puncture path included frontal in 17 cases(18 times of puncture), lateral in 8 cases ; back in 4 cases, and 30 drainage catheters were placed. All cases were followed up except one case, follow up time ranged from 1 to 20 months [average (8 07?4 04) months]. Following disappearance of pseudocyst, catheters were extracted in 19 cases except 2 cases with pseudocyst recurrance. Follow up time from 4 to 14 months[average (8.29?4.03) months]. 5 cases had surgerical operations again after draining 1-4 months, 4 cases were still being followed up. The effective rate of therapy was 65.52%(19/29). Conclusion The technique of percutaneous catheter external draining of pancreatic pseudocyst guided by CT is mildly invasive and simple, and has high successful rate.