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Objective To explore the effects of different processing parameters of mobile digital radiography (DR) on image quality of bedside chest radiography.Methods Post processing parameter on 150 cases bedside DR chest image like multi frequency laplasse transform (MLT),image processing (IP) were modified,and the optimization scheme of post-processing parameters were analyzed and summarized.The paired sample t test was used to compare the difference of the imaging quality score and optical density between the default parameter group and the post processing parameter optimization group through measure the optical density of lung related area.Results Brightness,contrast and the low density in dynamic range were the main factors affecting the quality of bedside chest radiography.After modifying and optimizing the post-processing parameters,the density value of the second intercostal area was 1.68±0.04,the density value of the hilum was 0.77±0.46,the density value of pulmonary peripheral (near chest wall 1 cm and overlap with a single rib) was 0.62± 0.06,the density value of cardiac shadow was 0.44 ± 0.04,the density value of subphrenic was 0.37 ± 0.04,the lung markings was clearly showed in the lateral field of lung and was visible in the spine and heart shadow area which meet the diagnostic requirement.The density value of those parts before modify were lower than the modify value which was more closer to the reference density value,and the difference had statistically significant.The image quality score of the postprocessing parameter optimization group was 3.53 ± 0.14,which was higher than 3.02 ± 0.23 of the default parameter group,and the difference had statistically significant.Conclusion The appropriate post-processing parameters is the key to guarantee the reasonable density of lung areas image quality and the optimization post-processing parameter can improve the image quality of bedside chest radiography by the mobile DR.
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Objective To summarize the clinical experience of video-assisted thoracoscopic surgery (VATS) for thoracic diseases. Methods Clinical data of 207 patients receiving VATS form October 1997 to March 2004 were retrospectively analyzed. Among them, there were 155 cases of spontaneous pneumothorax treated by pulmonary bubble ligation or resection, 30 cases of spontaneous or traumatic hemopneumothorax treated by urgent exploration, 14 cases of pulmonary benign diseases undergoing pulmonary wedge resection and biopsy, and 8 cases of mediastinal tumor resection. Results Surgical procedures were completed thoracoscopically in 190 patients and were accomplished under thoracoscope with an additional mini-thoracotomy in 12 patients, while conversions to open surgery were required in 5 patients. The time of surgical procedures was 20~180 min (mean, 56 min). The postoperative hospital stay was 5~52 d (mean, 9 d). Postoperative complications occurred in 17 cases (8.2%, 17/207), including 9 cases of persistent air leakage, 6 cases of re-expansion pulmonary edema, and 2 cases of infection of thoracic cavity. Spontaneous pneumothorax reoccurred in 2 patients 3~4 months postoperatively. Conclusions VATS offers more advantages over traditional thoracotomy for the treatment of spontaneous pneumothorax pulmonary bubble, traumatic hemopneumothorax and selected chest benign diseases. The combination with mini-thoracotomy under certain circumstance may contribute to assuring the safety of this procedure.
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Objective To investigate the clinical application of subaxillary curved mini-incision thoracotomy in thoracic operations. Methods Through a subaxillary curved mini-incision between the latissimus dorsi muscle and the serratus anterior muscle (length of incision, 8~14 cm), thoracic operations were performed in 65 patients with thoracic diseases, including pneumothorax or hemopneumothorax (13 patients), pulmonary benign tumor (23 patients), mediastinal tumor (4 patients), and esophageal benign or malignant tumor and cardiac cancer (25 patients). Results All the patients were successfully operated on. No surgery-related deaths occurred. The incidence of complications was 6.2% (4/65), including pleural effusion in 1 patient, pulmonary infection in 2 patients, and anastomotic leakage of esophagogastrostomy in 1 patient.Conclusions Subaxillary curved mini- incision thoracotomy, characterized by minimal invasion, little blood loss, mild influence on cardiopulmonary functions, quick recovery, and good cosmetic outcomes, is an ideal option for the treatment of thoracic diseases.
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Objective: To compare the clinical value of video-mediastinoscopy (VM) and standard mediastinoscopy(SM) in diagnosis of thoracic diseases. Methods: The clinical data of 100 patients with mediastinoscopy were studied retrospectively. Of them, 54 patients underwent VM, and 46 patients underwent SM. The operative parameters including operating time, complications and post-operative hospital stay, the diagnosis accuracy of undifferentiated mediastinal diseases and the accuracy of perioperative staging of lung cancer were compared. Results: The average operating time in VM group was (53.9?17.2) mins, which was less than that in SM group (69.4?24.7)mins (t=2.05,P
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Objective To discuss the value of video-assisted thoracoscopy plus minithoracotomy (VATM) in the management of thoracic diseases. Methods An 1.5 cm incision was made along the middle axillary line at the 7th costal interspace on the diseased side to introduce the thoracoscope. After the exploration of intrathoracic lesion, another incision 5~8 cm in length close to the lesion was made. The thoracic cavity was opened by way of the costal interspace. Surgical performance of exploration, dissection, hemostasis and suture was performed under thoracoscope and direct vision by using routine surgical instruments and thoracoscopic instruments. A total of 43 cases of VATM were carried out. Results The operation time was 40~150 min (mean, 67 min). The length of incision was 5~8 cm (mean, 6 cm). The chest drainage lasted 2~5 d. No postoperative complications occurred. The postoperative hospital stay was 5~8 d (mean, 6 d). Follow-up found no recurrence for 3~22 months in 18 cases of spontaneous pneumothorax and pleural effusion, and found no recurrence, distant metastasis or incision implantation for 5~20 months in 3 cases of lung cancer receiving either lobectomy or wedge resection. Simple biopsy of tumor was conducted in 6 cases of lung cancer, who obtained chemotherapy or gamma knife radiotherapy postoperatively and survived 5~21 months. Conclusions VATM is practical, minimally invasive and safe. By using routine surgical instruments it has an optimistic outlook.
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Objective To study the CT appearances in the atypical thoracic sarcoidosis Methods Chest CT findings of 43 patients with proven sarcoidosis were reviewed retrospectively Results 22 cases (51 16%) had atypical thoracic sarcoidosis findings at presentation The atypical patterns on CT included mediastinal adenopathy alone ( n =9) or in combination with unilateral hilar adenopathy ( n =6), and unilateral hilar adenopathy alone ( n =1) 6 patients had abnormal findings in the lung alone without adenopathy, and they all had been misdiagnosed 18 atypical cases (81 82%) occurred in patients older than 50 years, whereas 4 atypical cases (18 18%) occurred in patients younger than 50 years Conclusion Half patients with thoracic sarcoidosis have atypical CT appearances, it frequently occurs in elderly patients, and the diagnosis is easily mistaken on CT scan
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Objective To study the imaging findings of the chest disease due to intravenous heroin abuse. Methods Twenty five cases of clinically confirmed chest disease due to intravenous heroin abuse were retrospectively analyzed. 25 cases had conventional X ray film, 6 cases had CT scanning, and 6 cases had echocardiography scanning. Results On X ray and CT, the following signs were found: lung making manifold ( n =5), small patchy shadow ( n =15), pneumatocele ( n =16), small cavity ( n =16), small node ( n =7), pleural effusion ( n =8), pneumothorax ( n =2), hydropneumothorax ( n =6), pulmonary edema ( n =2), megacardia ( n =11), multiple shaped lesion ( n =20). On echocardiography, tricuspid vegetation ( n =4) and tricuspid insufficiency ( n =4) were found. Conclusion The X ray and CT manifestations of chest inflammation due to intravenous heroin abuse are multiple. The multiple small cavities and pneumatoceles sign are of some value in the diagnosis of lung inflammation due to intravenous heroin abuse among young patients.
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Two hunderd and seventy patients with thoracic lesions (including 10 patients with chest wall lesions, 36 with pleural lesions, 130 with intrapulmonary lesions, 81 with mediastinal lesions and 13 cases with partial or complete opacity of hemithorax) were evaluated by ultrasonography during a period of 58 months from January 1987 to October 1991. The value and limitation of ultrasonography in the diagnosis of thoracic lesions were discussed on the basis of comparison with radiographic diagnosis. In 125 of 270 patients percutaneous needle biopsies guided by ultrasonography were performed with an accuracy rate of 97.5%. Slight amount of pneumothorax occured in only two cases (1.60%) after the biopsy.