Background There has been an increasing recognition of the importance of sagittal spinopelvic alignment in patients with scoliosis as it relates to clinical outcomes. However, the changes seen in sagittal spinopelvic ...Background There has been an increasing recognition of the importance of sagittal spinopelvic alignment in patients with scoliosis as it relates to clinical outcomes. However, the changes seen in sagittal spinopelvic alignment in adult idiopathic scoliosis patients is poorly defined. This study was conducted to evaluate the sagittal alignment of pelvis and spine in adult idiopathic scoliosis patients.Methods The sagittal parameters of the spine and pelvis were analyzed in lateral standing radiographs of 124 patients （mean age 47.4 years） with adult idiopathic scoliosis, including thoracic kyphosis （TK）, thoracolumbar junction kyphosis （TLJ）, lumbar lordosis （LL）, pelvic incidence （PI）, sacrum slope （SS）, pelvic tilt （PT） and C7 plumb line （C7PL）. The patients were divided into three groups according to the age： 20-40 years, 41-64 years, and ≥65 years. The parameters were compared with those in normal adults and adolescent idiopathic scoliosis （AIS） patients. The relationship between all parameters as well as age and sagittal parameters were analyzed.Results The PI in patients with adult idiopathic scoliosis was 58.1°±13.0°, which was significantly higher than that in normal adults. The PT （19.9°±10.6°） was also higher than that in both normal adults and AIS patients, while the SS （38.1°±12.0°） was similar or smaller. As age increased, C7PL, PT and TJL increased while LL decreased. There was no relationship between age and both PI and TK. PT had the strongest statistical association with the C7PL.Conclusions PI is higher in adult idiopathic scoliosis than normal subjects. The PT is the most relevant pelvic parameter to the global sagittal alignment of the spine. Age significantly influences sagittal parameters of the spine and pelvis except the PI and TK.展开更多
Objective: To evaluate the effects of hyperbaric oxygen (HBO) therapy on patients with postbrain injury neural status. Methods: Two to 4 courses of HBO therapy and/or medications were used to treat 320 patients who we...Objective: To evaluate the effects of hyperbaric oxygen (HBO) therapy on patients with postbrain injury neural status. Methods: Two to 4 courses of HBO therapy and/or medications were used to treat 320 patients who were randomly divided into two groups. Assessment was made with 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) single photon emission computed tomography (SPECT) before and after treatment. Results: There was a significant difference between the HBO therapy group and the non-HBO therapy group. HBO therapy was superior to medication treatment alone in the recovery of clinical symptoms, control of epilepsy, and resolution of hydrocephalus (P< 0.01). Conclusions: HBO therapy has specific curative effects on patients with postbrain injury neural status, and 99m Tc-ECD SPECT could play an important role in diagnosing postbrain injury neural status and monitoring the therapeutic effects of HBO.展开更多
Background Triple-phase enhancement of multi-slice computed tomography (MSCT) has markedly improved the diagnostic accuracy of hepatocellular carcinoma (HCC), and MSCT angiography (MSCTA) has been proved useful in det...Background Triple-phase enhancement of multi-slice computed tomography (MSCT) has markedly improved the diagnostic accuracy of hepatocellular carcinoma (HCC), and MSCT angiography (MSCTA) has been proved useful in detecting vascular anatomy noninvasively. This study aimed to explore the value of MSCTA by triple-phase enhancement in preoperative evaluation of HCC.Methods Fifty-six consecutive cases of primary HCC scheduled for resection were studied with MSCTA by triple-phase enhancement. The raw data images were processed on a workstation for multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction. The findings after processing of the data were compared with those after surgery or intraoperative sonography. Results The false positive rate of MSCTA by triple-phase enhancement was 10.1% and its false negative rate was 4.3% in detecting HCC. No significant difference was observed in MSCTA and surgery or intraoperative sonography in detecting vascular anatomy anomalies and pathologic variations, whereas significant difference was found in detecting bile duct invasion with MSCT compared to intraoperative sonography.Conclusions MSCTA by triple-phase enhancement not only improves the detection of HCC, but also provides valuable preoperative information about hepatic vascular architecture and parenchyma. MSCTA by triple-phase enhancement is worthy of application as a non-invasive method in preoperative evaluation of HCC.展开更多
Background: Nosocomial infections have become a major challenge in healthcare facilities as they affect the quality of medical care. Radiological imaging plays a crucial role in medical diagnosis. However, the equipme...Background: Nosocomial infections have become a major challenge in healthcare facilities as they affect the quality of medical care. Radiological imaging plays a crucial role in medical diagnosis. However, the equipment and accessories used increase the risk of transmission of nosocomial bacteria. Objective: This study aims to reveal the extent and nature of microbiological contamination in four hospital diagnostic imaging departments to determine their potential role in the spread of nosocomial bacteria and to evaluate the effectiveness of routine daily disinfection practices in controlling microorganisms in diagnostic imaging departments. Methods & Results: In each department, swabs were taken from the surfaces of selected parts of the equipment and accessories three times a day (early morning, noon, and evening) for five consecutive days. Bacteria were isolated from 65 swabs (36.1% of all samples). The bacteria were isolated 3 times (4.6%) in the morning, 16 times (24.6%) at midday, and 46 times (70.7%) in the evening. The bacteria isolated were Escherichia coli (isolated 34 times;52.3%), Staphylococcus aureus (20 times;30.8%), Staphylococcus epidermidis (6 times;9.3%), and Klebsiella species (5 times;7.7%). Discussion & Conclusion: Findings demonstrated that radiology equipment and accessories are not free of bacteria and further improvements in the sterilization and disinfection of radiology equipment and accessories are needed to protect staff and patients from nosocomial infections.展开更多
Background Candidal esophagitis is the primary infection among all digestive tract opportunistic ones in acquired immunodeficiency syndrome （AIDS） cases. X-ray manifestation reports of it are still rare. This study ...Background Candidal esophagitis is the primary infection among all digestive tract opportunistic ones in acquired immunodeficiency syndrome （AIDS） cases. X-ray manifestation reports of it are still rare. This study aimed to conduct a retrospective analysis on the X-ray data of 6 AIDS cases complicated with candidal esophagitis, and to study the X-ray characteristics of it combined with the findings from gastroscopy.展开更多
Background：Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty （TKA）. We aimed to investigate the effect of femoral lateral bowing and rotatio...Background：Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty （TKA）. We aimed to investigate the effect of femoral lateral bowing and rotation on the radiographic measurements of distal femoral condyle resection thickness （DRT） and the distal femoral resection valgus angle （FVA）. Methods： We analyzed 246 three-dimensional femoral models generated from computed tomography images of 123 patients, acquiring projected contours in seven positions – 20° and 10° internal rotation; 0° rotation; 10°, 20°, 30°, and 40° external rotation – for each model. Medial and lateral condyle DRTs, femoral shaft lateral bowing angle （FBA）, and distal FVA were determined for each position. Linear mixed effect model was used to determine the effect of degree of femur rotation on repeated measurements of DRT or FVA. Results： FBA significantly affected the FVA and DRT （Pearson＇s R = 0.767 and -0.408, respectively; P 〈 0.000）. Samples were divided into three groups according to the FBA measured in neutral position： FBA 〈0°： DRT 3.75 ± 1.30 mm, FVA 4.53° ± 1.27°; FBA 〉0° but 〈3°： DRT 3.39 ± 1.31 mm, FVA 5.92° ± 1.31°; FBA 〉3°： DRT 2.22 ± 1.31 mm, FVA 7.37° ± 1.31°. From simulated 20° internal rotation to 40° external rotation in each femoral model, the average variation ranges of radiographically measured DRT, FVA, and FBA were 0.50 ± 0.28 mm, 2.93° ± 0.96°, and 10.33° ± 1.90°, respectively, with no significant differences among the FBA groups. The degree of femoral rotation significantly affected the FVA （F = 62.148, P 〈 0.000）, whereas there was no effect on condyle resection thickness （F = 0.4705, P = 0.494）. Conclusions： Axial femoral rotation has less effect on radiographic measurements of differences in the DRT than on those of the distal FVA.展开更多
AIM To examine effects of computed tomography(CT)image acquisition/reconstruction parameters on clot volume quantification in vitro for research method validation purposes.METHODS This study was performed in conforman...AIM To examine effects of computed tomography(CT)image acquisition/reconstruction parameters on clot volume quantification in vitro for research method validation purposes.METHODS This study was performed in conformance with HIPAA and IRB Regulations(March 2015-November 2016).A ten blood clot phantom was designed and scanned on a dual-energy CT scanner(SOMATOM Force,Siemens Healthcare Gm BH,Erlangen,Germany)with varying pitch,iterative reconstruction,energy level and slicethickness.A range of clot and tube sizes were used in an attempt to replicate in vivo emboli found within central and segmental branches of the pulmonary arteries in patients with pulmonary emboli.Clot volume was the measured parameter and was analyzed by a single image analyst using a semi-automated region growing algorithm implemented in the FDA-approved Siemens syngo.via image analysis platform.Mixed model analysis was performed on the data.RESULTS On the acquisition side,the continuous factor of energy showed no statistically significant effect on absolute clot volume quantification(P=0.9898).On the other hand,when considering the fixed factor of pitch,there were statistically significant differences in clot volume quantification(P<0.0001).On the reconstruction side,with the continuous factor of reconstruction slice thickness no statistically significant effect on absolute clot volume quantification was demonstrated(P=0.4500).Also on the reconstruction side,with the fixed factor of using iterative reconstructions there was also no statistically significant effect on absolute clot volume quantification(P=0.3011).In addition,there was excellent R^2 correlation between the scale-measured mass of the clots both with respect to the CT measured volumes and with respect to volumes measure by the water displacement method.CONCLUSION Aside from varying pitch,changing CT acquisition parameters and using iterative reconstructions had no significant impact on clot volume quantification with a semi-automated region growing algorithm.展开更多
AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis wa...AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.展开更多
Pediatric and adult spinal cord injuries (SCI) are distinct entities.Children and adolescents with SCI must suffer from lifelong disabilities,which is a heavy burden on patients,their families and the society.There ar...Pediatric and adult spinal cord injuries (SCI) are distinct entities.Children and adolescents with SCI must suffer from lifelong disabilities,which is a heavy burden on patients,their families and the society.There are differences in Chinese and foreign literature reports on the incidence,injury mechanism and prognosis of SCI in children and adolescents.In addition to traumatic injuries such as car accidents and falls,the proportion of sports injuries is increasing.The most common sports injury is the backbend during dance practice.Compared with adults,children and adolescents are considered to have a greater potential for neurological improvement.The pathogenesis and treatment of pediatric SCI remains unclear.The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion,hyperextension,longitudinal distraction and ischemia.We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery.In addition,the complications of pediatric SCI are also worthy of attention.New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis.This article reviews the epidemiology,pathogenesis,imaging,clinical characteristics,treatment and complications of SCI in children and adolescents.Although current treatment cannot completely restore neurological function,patient quality of life can be enhanced.Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.展开更多
文摘Background There has been an increasing recognition of the importance of sagittal spinopelvic alignment in patients with scoliosis as it relates to clinical outcomes. However, the changes seen in sagittal spinopelvic alignment in adult idiopathic scoliosis patients is poorly defined. This study was conducted to evaluate the sagittal alignment of pelvis and spine in adult idiopathic scoliosis patients.Methods The sagittal parameters of the spine and pelvis were analyzed in lateral standing radiographs of 124 patients （mean age 47.4 years） with adult idiopathic scoliosis, including thoracic kyphosis （TK）, thoracolumbar junction kyphosis （TLJ）, lumbar lordosis （LL）, pelvic incidence （PI）, sacrum slope （SS）, pelvic tilt （PT） and C7 plumb line （C7PL）. The patients were divided into three groups according to the age： 20-40 years, 41-64 years, and ≥65 years. The parameters were compared with those in normal adults and adolescent idiopathic scoliosis （AIS） patients. The relationship between all parameters as well as age and sagittal parameters were analyzed.Results The PI in patients with adult idiopathic scoliosis was 58.1°±13.0°, which was significantly higher than that in normal adults. The PT （19.9°±10.6°） was also higher than that in both normal adults and AIS patients, while the SS （38.1°±12.0°） was similar or smaller. As age increased, C7PL, PT and TJL increased while LL decreased. There was no relationship between age and both PI and TK. PT had the strongest statistical association with the C7PL.Conclusions PI is higher in adult idiopathic scoliosis than normal subjects. The PT is the most relevant pelvic parameter to the global sagittal alignment of the spine. Age significantly influences sagittal parameters of the spine and pelvis except the PI and TK.
文摘Objective: To evaluate the effects of hyperbaric oxygen (HBO) therapy on patients with postbrain injury neural status. Methods: Two to 4 courses of HBO therapy and/or medications were used to treat 320 patients who were randomly divided into two groups. Assessment was made with 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) single photon emission computed tomography (SPECT) before and after treatment. Results: There was a significant difference between the HBO therapy group and the non-HBO therapy group. HBO therapy was superior to medication treatment alone in the recovery of clinical symptoms, control of epilepsy, and resolution of hydrocephalus (P< 0.01). Conclusions: HBO therapy has specific curative effects on patients with postbrain injury neural status, and 99m Tc-ECD SPECT could play an important role in diagnosing postbrain injury neural status and monitoring the therapeutic effects of HBO.
文摘Background Triple-phase enhancement of multi-slice computed tomography (MSCT) has markedly improved the diagnostic accuracy of hepatocellular carcinoma (HCC), and MSCT angiography (MSCTA) has been proved useful in detecting vascular anatomy noninvasively. This study aimed to explore the value of MSCTA by triple-phase enhancement in preoperative evaluation of HCC.Methods Fifty-six consecutive cases of primary HCC scheduled for resection were studied with MSCTA by triple-phase enhancement. The raw data images were processed on a workstation for multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction. The findings after processing of the data were compared with those after surgery or intraoperative sonography. Results The false positive rate of MSCTA by triple-phase enhancement was 10.1% and its false negative rate was 4.3% in detecting HCC. No significant difference was observed in MSCTA and surgery or intraoperative sonography in detecting vascular anatomy anomalies and pathologic variations, whereas significant difference was found in detecting bile duct invasion with MSCT compared to intraoperative sonography.Conclusions MSCTA by triple-phase enhancement not only improves the detection of HCC, but also provides valuable preoperative information about hepatic vascular architecture and parenchyma. MSCTA by triple-phase enhancement is worthy of application as a non-invasive method in preoperative evaluation of HCC.
文摘Background: Nosocomial infections have become a major challenge in healthcare facilities as they affect the quality of medical care. Radiological imaging plays a crucial role in medical diagnosis. However, the equipment and accessories used increase the risk of transmission of nosocomial bacteria. Objective: This study aims to reveal the extent and nature of microbiological contamination in four hospital diagnostic imaging departments to determine their potential role in the spread of nosocomial bacteria and to evaluate the effectiveness of routine daily disinfection practices in controlling microorganisms in diagnostic imaging departments. Methods & Results: In each department, swabs were taken from the surfaces of selected parts of the equipment and accessories three times a day (early morning, noon, and evening) for five consecutive days. Bacteria were isolated from 65 swabs (36.1% of all samples). The bacteria were isolated 3 times (4.6%) in the morning, 16 times (24.6%) at midday, and 46 times (70.7%) in the evening. The bacteria isolated were Escherichia coli (isolated 34 times;52.3%), Staphylococcus aureus (20 times;30.8%), Staphylococcus epidermidis (6 times;9.3%), and Klebsiella species (5 times;7.7%). Discussion & Conclusion: Findings demonstrated that radiology equipment and accessories are not free of bacteria and further improvements in the sterilization and disinfection of radiology equipment and accessories are needed to protect staff and patients from nosocomial infections.
文摘Background Candidal esophagitis is the primary infection among all digestive tract opportunistic ones in acquired immunodeficiency syndrome （AIDS） cases. X-ray manifestation reports of it are still rare. This study aimed to conduct a retrospective analysis on the X-ray data of 6 AIDS cases complicated with candidal esophagitis, and to study the X-ray characteristics of it combined with the findings from gastroscopy.
文摘Background：Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty （TKA）. We aimed to investigate the effect of femoral lateral bowing and rotation on the radiographic measurements of distal femoral condyle resection thickness （DRT） and the distal femoral resection valgus angle （FVA）. Methods： We analyzed 246 three-dimensional femoral models generated from computed tomography images of 123 patients, acquiring projected contours in seven positions – 20° and 10° internal rotation; 0° rotation; 10°, 20°, 30°, and 40° external rotation – for each model. Medial and lateral condyle DRTs, femoral shaft lateral bowing angle （FBA）, and distal FVA were determined for each position. Linear mixed effect model was used to determine the effect of degree of femur rotation on repeated measurements of DRT or FVA. Results： FBA significantly affected the FVA and DRT （Pearson＇s R = 0.767 and -0.408, respectively; P 〈 0.000）. Samples were divided into three groups according to the FBA measured in neutral position： FBA 〈0°： DRT 3.75 ± 1.30 mm, FVA 4.53° ± 1.27°; FBA 〉0° but 〈3°： DRT 3.39 ± 1.31 mm, FVA 5.92° ± 1.31°; FBA 〉3°： DRT 2.22 ± 1.31 mm, FVA 7.37° ± 1.31°. From simulated 20° internal rotation to 40° external rotation in each femoral model, the average variation ranges of radiographically measured DRT, FVA, and FBA were 0.50 ± 0.28 mm, 2.93° ± 0.96°, and 10.33° ± 1.90°, respectively, with no significant differences among the FBA groups. The degree of femoral rotation significantly affected the FVA （F = 62.148, P 〈 0.000）, whereas there was no effect on condyle resection thickness （F = 0.4705, P = 0.494）. Conclusions： Axial femoral rotation has less effect on radiographic measurements of differences in the DRT than on those of the distal FVA.
文摘AIM To examine effects of computed tomography(CT)image acquisition/reconstruction parameters on clot volume quantification in vitro for research method validation purposes.METHODS This study was performed in conformance with HIPAA and IRB Regulations(March 2015-November 2016).A ten blood clot phantom was designed and scanned on a dual-energy CT scanner(SOMATOM Force,Siemens Healthcare Gm BH,Erlangen,Germany)with varying pitch,iterative reconstruction,energy level and slicethickness.A range of clot and tube sizes were used in an attempt to replicate in vivo emboli found within central and segmental branches of the pulmonary arteries in patients with pulmonary emboli.Clot volume was the measured parameter and was analyzed by a single image analyst using a semi-automated region growing algorithm implemented in the FDA-approved Siemens syngo.via image analysis platform.Mixed model analysis was performed on the data.RESULTS On the acquisition side,the continuous factor of energy showed no statistically significant effect on absolute clot volume quantification(P=0.9898).On the other hand,when considering the fixed factor of pitch,there were statistically significant differences in clot volume quantification(P<0.0001).On the reconstruction side,with the continuous factor of reconstruction slice thickness no statistically significant effect on absolute clot volume quantification was demonstrated(P=0.4500).Also on the reconstruction side,with the fixed factor of using iterative reconstructions there was also no statistically significant effect on absolute clot volume quantification(P=0.3011).In addition,there was excellent R^2 correlation between the scale-measured mass of the clots both with respect to the CT measured volumes and with respect to volumes measure by the water displacement method.CONCLUSION Aside from varying pitch,changing CT acquisition parameters and using iterative reconstructions had no significant impact on clot volume quantification with a semi-automated region growing algorithm.
基金Canadian Institute of Health Science(CIHR)and Zimmer,Warsaw,United States
文摘AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.
文摘Pediatric and adult spinal cord injuries (SCI) are distinct entities.Children and adolescents with SCI must suffer from lifelong disabilities,which is a heavy burden on patients,their families and the society.There are differences in Chinese and foreign literature reports on the incidence,injury mechanism and prognosis of SCI in children and adolescents.In addition to traumatic injuries such as car accidents and falls,the proportion of sports injuries is increasing.The most common sports injury is the backbend during dance practice.Compared with adults,children and adolescents are considered to have a greater potential for neurological improvement.The pathogenesis and treatment of pediatric SCI remains unclear.The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion,hyperextension,longitudinal distraction and ischemia.We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery.In addition,the complications of pediatric SCI are also worthy of attention.New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis.This article reviews the epidemiology,pathogenesis,imaging,clinical characteristics,treatment and complications of SCI in children and adolescents.Although current treatment cannot completely restore neurological function,patient quality of life can be enhanced.Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.
