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Objective:To analyze and compare the X-ray procedures and radiation dose composition of ophthalmic inpatients, and to explore the changes of the X-ray examination mode in recent years and the effect of optimization in imaging technology on the radiation dose level of the patients.Methods:The simple random sampling method was used to retrospectively select the imaging data of the ophthalmic inpatients in the Second Affiliated Hospital of Zhejiang University School of Medicine from July 1st to November 31st in 2019 and from July 1st to November 31st in 2020. A total of 516 cases were selected according to the imaging time, including 258 cases in 2019 and 258 cases in 2020. Based on our previous research and the related documents of low-dose CT screening, a series of optimizations on CT scanning parameters and process were carried out in 2020, including the frequency of DR and CT scanning, the number of examinations per capita, the composition ratio of CT and DR, and X-ray dose per capita.Results:In 2020, the average effective doses of chest CT and orbital CT for ophthalmic inpatients were (2.587±1.586) mSv and (0.877±0.733) mSv, significantly lower than those in 2019 ( F=0.52, 0.72, P<0.05), and decreased by 34.82% and 37.13%, respectively. There was no significant difference in the average effective dose of chest DR and head CT between 2020 and 2019 ( F=6.01, 1.81, P>0.05). The number of X-ray examination per capita increased by 0.15 times, and the effective dose increased by 1.44 times (1.589 mSv). Chest DR was the main type of X-ray examination, accounting for 68.79% of all examinations in 2019, while chest CT was the main type, accounting for 71.05% in 2020. The composition of chest CT in 2020 increased by 63.17% compared with 2019, and the compositions of chest DR, orbital CT and cranial CT were decreased by 53.88%, 5.79% and 2.89%, respectively. Conclusions:With dose optimization measures, the single CT dose of ophthalmic inpatients in 2020 was lower than that in 2019. Chest CT increased significantly in frequency, and became main X-ray examination instead of chest DR which made the effective dose of ophthalmic inpatients increasing significantly.
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Lung transplantation is the only effective therapeutic option for end-stage lung diseases, and postoperative rejection is the main factor affecting clinical prognosis of the recipients. Imaging examination can be utilized as a noninvasive tool to assist other examinations in monitoring rejection after lung transplantation. At present, multiple imaging examination methods have been reported. The advantages and disadvantages of various imaging examinations have been clarified, which may promote early diagnosis of rejection, deliver timely treatment for lung transplant recipients and improve the quality of life and clinical prognosis. In this article, the advantages, disadvantages and research progress upon different imaging examinations for rejection after lung transplantation were reviewed, aiming to provide reference for identifying the optimal noninvasive examination approach for rejection after lung transplantation and enhance the long-term survival of the recipients.
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Objective To explore the application value of modified closed biopsy technique in puncture biopsy of rabbit model of VX2 transplanted bone tumor. Methods VX2 tumor tissue was cut from rabbit with VX2 tumor and transplanted into the bilateral tibia of 30 rabbits through the tibial plateau to make the model of VX2 transplanted bone tumor. Seven days after modeling, the proximal tibia puncture biopsy was performed under the guidance of X-ray, and the biopsy specimen was examined pathologically. The left leg was biopsied with modified closed biopsy technique (experimental group), and the right leg was biopsied with hollow needle (control group). On the 14th day after modeling, all rabbits were executed after X-ray examination around the puncture hole, and the soft tissue around the puncture hole was taken for pathological examination. Results By the end of the experiment, a total of 3 rabbits died, and finally 27 rabbits were included in the study. Tumor cells were detected in all the intramedullary specimens obtained by puncture biopsy. On the 14th day after modeling, X-ray examination showed that, compared with control group, the incidence of periosteal reaction and extraosseous high density shadow around the puncture hole, and the tumor cell metastasis rate were lower [14.81%(4/27) vs. 40.74%(11/27); 29.63%(8/27) vs. 100.00%(27/27)], the differences were statistically significant (P<0.05). Conclusions Both the modified closed biopsy technique and puncture needle aspiration biopsy can provide sufficient biopsy tissue for diagnosis of VX2 transplanted bone tumor in rabbits. Meanwhile, the improved closed biopsy technique can prevent local metastasis of tumor cells along the puncture channel to some extent.
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Objective@#To analysis the clinical and image features of temporomandibular joint (TMJ) disc calcification. @*Methods@#The patients diagnosed with TMJ disc calcification treated in School and Hospital of Stomatology, Wuhan University in the latest 10 years were collected, clinical symptom and images of these cases were analyzed, and the published literatures of TMJ disc calcification were reviewed. @*Results @#Total 2 cases of TMJ disc calcification with complete clinical data were analyzed. The symptom included mouth opening limitation, TMJ pain, open bite of the affected side molar. Calcified body were found through X-ray examination. Joint disc perforation were found during the surgery. The discs showed calcified features. Collagen hyperplasia, cartilage cells generation and calcification were found in the disc through pathological examination.@*Conclusion @#The diagnosis of TMJ disc calcification should be combined the symptom, image features and the surgery, it should be differentiated with TMJ osteoma and synovial membrane chondromasis.
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The root canal system of mandibular second molar is complex.This article presents one case with type 1-2 mesial root canal of mandibular second molar.The canal was treated by warm gutta percha,and conformed by X-ray examination and dental operating microscopy.
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ObjectiveTo identify the reasons of missed diagnosis with ankle sprains by analyzing OAR in order to guide the rational use of OAR.MethodsOutpatient with sprained ankles were recruited from the surgical clinic in Sichuan Luzhou Medical College from Mar.2005 to Mar.2010.OAR was used for clinical diagnosis of ankle sprains.The accuracy of OAR diagnosis was examined within 24 h and at 15 d by X-ray.ResultsIn the 105 cases of ankle sprain,16 cases was diagnosed of fractures by OAR.X-ray results showed I case of missed diagnosis,with the rate of missed diagnosis of 6.2％.While both OAR and X-ray diagnosed 21 cases in 50 patients with sprained foot fractures,with a rate of missed diagnosis of 0.Conclusion OAR diagnosis for ankle sprains and fractures has high success rate although with the possibility of missed diagnosis which needs attention clinically.
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Objective To explore the value of ultrasound on the early bone erosion of finger joint in patients with rheumatoid arthritis (RA).Methods Sixty-three cases of RA patients (patients group) with 486 finger joints was examined by high-frequency ultrasound,X-ray films and MRI,and compared with 20 controls (control group).Results The ultrasound results were significant difference between two groups (P＜0.01).The positive rate was 84.2％(409/486) in high-frequency ultrasound,and 56.2％(273/486) in X-ray films,there was significant difference between the two (P ＜ 0.05 ).The positive rate by high-frequency ultrasound was 63.8％ (136/213) in X-ray check-negative patients,and 68.1％ (145/213) by MRI.The results of the MRI contrast sensitivity of 97.6％,specificity of 75％,accuracy of 96.5％ by high-frequency ultrasound.Conclusion The high-frequency ultrasound on the X-ray check-negative patients with rheumatoid hand early joint bone erosion have some diagnostic value.
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Objective To study the relevant factors and prevention of X-ray missed diagnosis in rib fracture.Methods 28 cases of rib fracture in the X-ray missed diagnosis were retrospectively reviewed. The relevant factors and preventive question of X-ray missed diagnosis were explored.Results Careless reading of film(n=3),wrong position of taking film(n=7),film of low quality(n=4),image of rib fracture concealed by other image (n=11) and improper time of taking film(n=3) were found as the cause of missed diagnosis.Conclusions The X-ray examination of chest is the most practical method in diagnosing rib fracture. The choice of position in taking film,quality assurance of film,the right time in taking film and carefulness in reading film may affect the diagnosis of rib fracture.
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Objective To study the immunological changes and clinical features of pachydermodactyly.Methods Thirteen cases of pachydermodactyly were studied and the literature about this disease was reviewed.Results The mean disease onset age was (16?3)years,11 of whom were male,2 were female;clinical feature was chronic non-inflammatory bulbous swelling of proximal interphalangeal joints,most of which distributed symmetrically;there were no abnormal results in immunological examination;X-ray showed only soft tissue swelling with no articular or bone damage.Conclusion Pachydermodactyly belongs to rheumatological diseases,and should be differentiated from other arthritis involving PIP joints.
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From March 1966 to July 1988, 22 patients were diagnosed as discitis among the 2106 operation with total or hemilaminectomy in Department of Neurosurgery of Catholic University Medical College. Main symptoms were severe low back(95%) and buttock pain(86%). Physical examination showed severe paravertebral spasm and tenderness. The erythrocyte sedimentation rate was always elevated in all cases and averaged to 43 mm/hr. X-ray examination of the lumbar spine showed typical findings of decreased intervertebral space, subchondral sclerosis and bony fusion. In bacterial culture staphylococcus aureus and streptococcus epididymis were grown. Good long-term results were seen in all cases.