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PubMed1986

Comparison of roentgenography and moiré topography for quantifying spinal curvature.

The purpose of this study was to compare roentgenography and moiré topography for identification, treatment, and prevention of scoliosis at an early age. Moiré topography was used as an assessment tool for the quantitative examination of 12 children with mild-to-moderate scoliosis receiving physical therapy during a three-month period. Each child's roentgenogram also was analyzed independently by orthopedic physicians and radiologists using the Cobb method of measuring spinal curvature. Rho correlations of Cobb angles and the spinal curvature angles based on moiré photographs taken at weeks 4, 8, and 12 were found to be +.94, +.96, and +.93, respectively. The moiré method, thus, may be used as an available, inexpensive, and easily interpreted diagnostic and treatment tool in physical therapy.

Child↗
PubMed1986

Value of chest ultrasonography versus decubitus roentgenography for thoracentesis.

Chest ultrasonography (CU) has been advocated as an effective tool for diagnosis and localization of pleural fluid. Studies to date supporting the technique have been anecdotal and nonrandomized. To determine if CU was beneficial when thoracentesis was performed by clinicians or house staff, we evaluated prospectively 205 patients presenting with pleural effusion at 2 community teaching hospitals. Decubitus roentgenograms were obtained on all patients, but CU with targeting by skin marker was performed on a randomized basis. Results were evaluated as to (1) whether the quantity of fluid obtained was sufficient for the intent of the procedure, (2) the number of needle insertions required to obtain the fluid, and (3) the incidence of complications such as pneumothorax. One hundred three effusions were evaluated by CU and 102 by roentgenography alone. The effusions in each group were stratified as small (obliteration of less than half of the hemidiaphragm on roentgenogram) or large. Small effusions were further stratified as free flowing or loculated (no layering of fluid on decubitus roentgenograms). By chi-square test, CU was significantly superior to decubitus roentgenograms alone for obtaining adequate fluid samples in small effusions (p less than 0.01). This was true regardless of whether the effusion was loculated (p less than 0.02) or free flowing (p less than 0.05). The technique had no such advantage in large effusions. We did not find that CU significantly reduced the need for multiple attempts nor incidence of complications in any group.

Drainage↗
PubMed1982

Assessment of activity in Sarcoidosis. Sensitivity and specificity of 67Gallium scintigraphy, serum ACE levels, chest roentgenography, and blood lymphocyte subpopulations.

The value of different factors are examined to assess activity in 60 patients with biopsy-proven sarcoidosis. In patients with active sarcoidosis (n = 35), 67Gallium scans proved to be the most sensitive method (94 percent sensitivity), followed by serum angiotensin I converting enzyme (S-ACE) levels, chest x-ray films, and lymphocyte assays. In patients with peripheral pulmonary lesions, chest x-ray films failed in 32 percent of cases to document activity (68 percent sensitivity) whereas 67Ga scans and S-ACE levels remained to give reliable results. Despite poor specificity, negative 67Ga scans together with normal ACE levels have a high predictive value for exclusion of active sarcoidosis. In patients with peripheral pulmonary lesions, chest roentgenography is of doubtful value for staging lung involvement and assessment of activity including monitoring and control of therapy.

Adolescent↗
PubMed1988

Portable chest roentgenography and computed tomography in critically ill patients.

Computed tomography (CT) of the chest offers improved resolution and sensitivity for evaluating chest pathologic conditions compared with other imaging techniques. Intensive care unit patients with portable chest findings that diverge from the clinical course may actually have severe intrathoracic disease that can be detected with CT. Our three patients demonstrate chest CT can aid in the diagnosis of significant intrathoracic pathologic conditions which have been significantly underestimated by portable chest roentgenography. We discuss the reasons for this improved detectability by CT, as well as suggest alternative techniques that can be performed at the bedside in patients whose initial portable chest roentgenogram and clinical course do not correlate.

Adult↗
PubMed1989

Immediate chest roentgenography following fiberoptic bronchoscopy.

It is a common practice for some clinicians to obtain a chest roentgenogram immediately following FOB in an attempt to detect complications of the procedure, particularly pneumothorax; however, the roentgenogram adds substantially to the cost of FOB. It was our clinical impression that the diagnostic and therapeutic value of immediate chest roentgenography was minimal. Therefore, we reviewed 130 chest roentgenograms taken immediately after bronchoscopy that were obtained over 36 months. One hundred fourteen (88 percent) were unchanged from the most recent roentgenogram before bronchoscopy. Ten (8 percent) showed an increase in alveolar infiltrate due to bronchoalveolar lavage or hemorrhage. Five (4 percent) had changes presumably unrelated to the procedure. Only one patient had a pneumothorax on the roentgenogram taken immediately after bronchoscopy; however, the patient was symptomatic, and the pneumothorax was detected by fluoroscopy prior to the chest roentgenogram. Management of the patient's condition was not altered in a single case based upon findings on the chest roentgenogram. We conclude that the immediately postbronchoscopic chest roentgenogram rarely provides clinically useful information or detects a complication that is not suspected clinically; furthermore, it appears to have minimal impact, if any, on the management of a patient's condition.

Bronchoscopy↗
PubMed1980

Intravenous pyelography versus radioisotope renography combined with plain roentgenography of the urinary tract in the follow-up of patients with ureteral calculi.

Isotope renography combined with plain roentgenography of the urinary tract was compared with intravenous pyelography in the follow-up of 50 patients with pyelographically confirmed, radiopaque ureteral stone. The combined method was as informative as intravenous pyelography regarding the site of the obstruction, and gave better information on the function of the renal parenchyma and the passage of urine. Since in the combined method the level of radiation to which the patient is exposed is much lower than in intravenous pyelography, and since no allergic reaction to the combined method has been reported, it would seem useful in the follow-up of patients with roentgenographically visualized ureteral stone.

Adolescent↗
PubMed1996

Necessity of routine chest roentgenography after thoracentesis.

OBJECTIVE: To determine the necessity of posteroanterior chest roentgenography for the identification of pneumothorax and other complications after thoracentesis. DESIGN: Prospective cohort study. SETTING: Tertiary care teaching hospital. PATIENTS: 67 men and 43 women (mean age +/- SD, 62.4 +/- 13.2 years). Exclusion criteria included age younger than 18 years, concurrent pleural biopsy, ultrasound guidance, and use of mechanical ventilation. MEASUREMENTS: 174 thoracenteses done between March 1991 and June 1993. RESULTS: 2 hemothoraces (1.2%) occurred, and 8 patients had a total of 9 pneumothoraces (5.2%). The roentgenograms obtained immediately after the procedures identified 8 pneumothoraces; the other pneumothorax was seen incidentally on a delayed roentgenogram obtained 3 days later. Pneumothorax was suspected in 5 of the 8 cases, and tube thoracostomy was done in 4 of these 5 cases. Patients with unsuspected pneumothorax identified on the roentgenogram obtained immediately after the procedure did not receive treatment for their pneumothoraces. Univariate analysis showed that the variables that correlated significantly with pneumothorax were aspiration of air during the procedure (relative risk ratio, 12.3; 95% CI, 3.7 to 41.4), number of passes with the thoracentesis needle (relative risk ratio, 6.1; CI, 1.6 to 23.3), history of thoracic radiation therapy (relative risk ratio, 10.5; CI, 2.5 to 44.4), and operator suspicion of pneumothorax (relative risk ratio, 25.9; CI, 8.6 to 78.5). CONCLUSION: Among hospitalized patients with pleural effusions, we identified subgroup of patients in whom the risk for pneumothorax is low enough (approximately 1%) with sufficiently minimal clinical consequences to justify the avoidance of about 60% of chest roentgenograms obtained after thoracentesis. These patients are clinically stable, have not previously received chest irradiation, had only one pass at thoracentesis attempted without the aspiration of any air, and give no other indication of pneumothorax.

Aged↗
PubMedDate not supplied

[The ID-03 X-ray dosimeter for monitoring the radiation parameters of X-ray equipment in roentgenography].

The paper presents an [symbol: see text]-03 X-ray dosimeter designed by the Research Institute of Introscopy, Spektr Moscow Research-and-Production Association, for monitoring the radiation parameters of X-ray plants at roentgenography. A Si(Li)-based semiconductor detector with the p-i-n structure is used as a detector of X-ray radiation. The technical data of the dosimeter are given.

Equipment Design↗
PubMed2000

[A study on dental and cranioficial structure of normal shanghai adults occlusion-I the craniofacial structure analysis with posterioanterior cephalometric roentgenography]

OBJECTIVE: To evaluate the characteristics of normal transverse craniofacial structure in Shanghai area and to establish the database of normal Shanghai adults occlusion for posterioanterior cephalometric roentgenography.METHODS:Posterioanterior-cephalometric of the 92 adults subjects with normalocclusion were measured and analysed by Jiffy orthodontic evaluation 5.0 software package.RESULTS:The database of normal Shanghai adults occlusion for posterioanterior cephalometric roentgenography was established. Transverse measurements were intercorrelated, no statistically significant gender differences were demonstrated in craniofacial width, while the molar overjet of male was larger than that of female.CONCLUSION:The normal transverse cranioficial structure in Shanghai area has its own characteristics. The established database would provide a foundation for the diagnosis and treatment of malocclusion.

Journal Article↗
PubMed2000

[A Study On Dental and Craniofacial Structure Of Normal Shanghai Adults Occlusio-II The Dental Facial Symmetry Analysis with Posterioanterior Cephalometric Roentgenography]

OBJECTIVE:To evaluate the dental facial symmetry in normal Shanghai adults occlusion with posterioanterior cephalometric roentgenography. METHODS:Posterioanterior films of the 92 adults subjects with normal occlusion were measured. Five facial midlines commonly used in posterioanterior cephalometric were analyzed according to the middle structure index and side middle structure index. The midline deviations were measured. RESULTS:The middle line through ANS and perpendicular to zygomaticofrontal line has less mean of middle structure index and side middle structure index. There are midline deviations in population with normal occlusion.CONCLUSION:The facial midline mentioned above was suitable for posterioanterior cephalometrics, but the reliability is not absolute. Normal occlusion also has midline deviations. The asymmetry of face was larger than that of dental occlusion.

Journal Article↗
PubMedDate not supplied

Lateral roentgenography in the diagnosis and treatment of dysplasia/dislocation of the hip.

The author emphasizes the importance of true lateral and multiple-position roentgenograms in providing a more comprehensive demonstration of the pathology, the attainment of reduction and the surgical alterations which are necessary to maintain a congruous reduction. A simple convenient technique for lateral roentgenography of the hip in children is presented. A series of cases with roentgenograms is also presented to demonstrate the value of the lateral roentgenograms. The horizontal lateral roentgenogram simulates the position of the upright human stance, and thus, depicts malocclusion, which may be seen when anteversion is present. Even though the anterior view depicts sphericity and apparent coverage, the lateral roentgenogram may show malocclusion which may lead to degenerative changes later in life. It is the author's belief that the treatment of children's hip conditions will show improved long-term results if predicated on the comprehensive x-ray examination outlined in this article.

Child↗
PubMed1988

Fate of bone grafts in acetabular roof reconstructions assessed by roentgenography and scintigraphy.

Autogeneic bone grafts--26 femoral heads, four femoral and two iliac bone grafts--were used in 32 total hip arthroplasties, mainly on patients with complete dislocation of the hip, to reconstruct deficiencies of the acetabular roof by a standardized procedure. At the follow-up examination after 24 to 101 months (median, 52 months), roentgenography demonstrated lateral resorption of the graft in 20 of 32 hips, but resorption involved bone support of the socket in only three of the hips. Analysis of serial roentgenograms showed that resorption was not a function of time. Complete incorporation of the grafts was observed in 27 hips; partial incorporation was shown in three. Roentgenographically, two grafts were not incorporated. None of three grafts of a cortical nature was incorporated. Graft uptake of radioactive tracer was found by 99mTc-diphosphonate emission scintigraphy in 16 of 21 hips, but did not correlate with progressive bone resorption, nonunion, or loss of bone structure. High quality serial roentgenograms showing good bone detail provided the best information about the integrity of the acetabular roof reconstructions.

Acetabulum↗
PubMed1988

Relative usefulness of physical examination, urodynamics and roentgenography in the diagnosis of urinary stress incontinence.

Stress urinary incontinence is a common problem in women. Accurate diagnosis of this condition is necessary for successful surgical treatment. Currently, many tests are popular. The relative value of these tests, in terms of usefulness, accuracy and practicality, has not been tested in the past. With this aim, we have compared the results from three of the most commonly performed tests, namely physical examination, urodynamics and roentgenography. It is our opinion that physical examination in the standing position is the simplest and most accurate test. Cystometrogram is important, although the yield is small. We do not advise the routine use of urethral pressure profile. For accurate determination of anatomic deformity, roentgenographic examination is the most accurate test.

Adult↗
PubMed1987

Influence of spirometry and chest roentgenography on the management of pulmonary outpatients.

Spirometry and chest roentgenography are frequently employed to evaluate patients with respiratory problems. To determine their impact on the management of outpatients with lung disease, both tests were performed on 100 consecutive patients (40 men and 60 women; mean age, 52 +/- 15 years) who returned for reevaluation 16 +/- 9 weeks after their previous clinic visit. Patients with obstructive (n = 45), restrictive (n = 35), and mixed (n = 20) lung diseases were initially assessed by history and physical examination and classified clinically as improved, stable, or worse. A clinical management plan (CMP) was formulated based on this initial evaluation. Changes in the proposed CMP due to spirographic or roentgenographic results were then noted. None of the 19 patients who were clinically improved and only two (3%) of the 64 clinically stable patients had a change in CMP. In contrast, five (29%) of the 17 patients whose conditions deteriorated clinically had their proposed CMP modified after review of the spirograms and roentgenograms. Therapy was intensified in three of the seven patients whose CMPs were modified, while in the other four, treatment was withheld because results of both tests were unchanged. These results indicate that routine spirograms and chest films have little influence on the CMP of clinically stable patients. However, unexpected roentgenographic and spirometric findings frequently alter the management of the individual whose condition has clinically deteriorated.

Adult↗
PubMed1978

Limitations of portable roentgenography of the chest in patients with acute respiratory failure.

The ability of the portable roentgenography of the chest to define the amount of physiologic shunting and the severity of noncardiogenic pulmonary edema was evaluated in 37 observations of 11 patients. Ten of the 11 patients had acute respiratory failure. The roentgenologic assessment of the amount of pulmonary edema and the severity of left ventricular failure was compared with the physiologic shunt fraction, tracer measured lung water and the pulmonary arterial wedge pressure. The roentgenologic scores for edema did not predict the shunt fraction or tracer measured lung water. The roentgenologic score for congestive heart failure correlated with the wedge pressure but not well enough to be clinically useful. Five per cent of the roentgenograms were false-positive and 11 per cent were false-negative. Roentgenologic findings lagged behind physiologic derangements. Thus, the roentgenogram could predict the shunt value of the preceding day. Results indicate that it is hazardous to accept a portable roentgenographic diagnosis of congestive heart failure as a cause of pulmonary edema.

Acute Disease↗
PubMed1984

Comparison of AP supine vs PA upright methods of chest roentgenography in infants and young children.

Various arguments have been advanced for preferring either the AP recumbent projection or the PA upright projection in chest roentgenography of infants and young children. One prominent argument for PA projection is that it shows less magnification.In a search of the literature, no study could be identified that statistically compares the cardiothoracic ratios in a series of patients with simultaneous PA upright and AP supine chest roentgenograms. This study addresses that point and also examines other factors in the two different projections.A survey of pediatric radiology departments in the United States shows an overall preference for the AP supine projection by a factor of 2:1. Statistical analysis of the two methods in this study demonstrates no significant difference in the cardiothoracic ratios. All other factors considered, the authors are of the opinion that the AP supine projection is more desirable in the infant and young child.

Child↗
PubMed1978

Routine chest roentgenography in pregnancy.

In an effort to determine if routine prenatal chest roentgenograms were of practical value, the records of 12,109 consecutive deliveries at the Mayo Clinic were reviewed retrospectively. The roentgenograms were obtained during the first or second prenatal visit and additionally when warranted by notable symptoms or physical findings in subsequent prenatal visits. Forty-eight patients had appreciable roentgenographic abnormalities. The findings of the general medical examination (which was routinely done at the first prenatal visit) were reviewed to determine if the chest abnormalities would have been suspected from the results of physical examination alone. In every case, a positive history or abnormal physical finding would have suggested the presence of the major abnormality or of the need for roentgenography to be performed.

Adolescent↗
PubMed1982

Static and dynamic roentgenography in the diagnosis of degenerative disc disease: a review and comparative assessment.

The use of static-postural and dynamic-bending roentgenography by the medical and chiropractic professions was reviewed and a retrospective study of 30 symptomatic subjects was conducted to compare the diagnostic discrimination of dynamic lateral bending (DLB) procedures to that of a previously-reported static-postural method (Farfan) in determining the lumbar spine level which is most predisposed to the eventual development of degenerative disc disease. The level of correspondence in the sample was not found to be statistically significant and it was concluded, with some reservations regarding sample size, that present chiropractic DLB analysis of lumbosacral instability does not match the reliability of static analysis of morpho-anatomical configurations in predicting the eventual site of a degenerative disc disorder. The characteristics of vertebral motion segment (VMS) abnormalities are discussed, a refined DLB analysis scoring system is provided, and suggestions for improvement in such studies are given.

Adult↗