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At least 595 records · Page 33Linked to original sources
PubMed1988

Efficacy of plain abdominal radiography in patients with gastrointestinal bleeding.

To assess the value of plain abdominal radiography in cases of gastrointestinal hemorrhage, the records of 100 such consecutive patients were reviewed. Seventy-eight of the patients had presented to the emergency department, and 22 were inpatients. The radiologic and clinical records were scrutinized to determine the actual effect of the radiologic examination on management of the patient. Three patients had pneumoperitoneum attributed to bowel perforation, and two had confirmed bowel obstruction. In each, the clinical findings suggested the diagnosis. We found no instance of silent gastrointestinal bleeding in which plain radiography contributed important diagnostic information. We conclude that gastrointestinal bleeding is not, in itself, a valid indication for abdominal radiography.

Evaluation Studies as Topic↗
PubMed1996

Chest radiography in the initial episode of bronchospasm in children: can clinical variables predict pathologic findings?

STUDY OBJECTIVE: To determine whether historical or clinical variables can accurately discriminate among children, experiencing a first episode of bronchospasm, with chest radiography findings that are normal, consistent with reactive airway disease (RAD), or pathologic. METHODS: We assembled a prospective case series of patients in our tertiary, academic, pediatric emergency department. All patients aged newborn to 18 years presenting to the ED with their initial episode of wheezing were enrolled. RESULTS: Six hundred thirty-three patients presented to the ED during the study period. Pathologic radiographic findings were identified in 39 (6.2%). Radiographs revealing normal findings and evidence of RAD were noted in 25.4% and 68%, respectively. No single variable accurately predicted all pathologic radiographs. Discriminant function analysis identified nine variables, which we combined into a model. The model failed to accurately discriminate among patients with radiographs revealing evidence of a pathologic condition, normal chest findings, and RAD. CONCLUSION: No clinical variables, isolated or combined into a model, accurately identify patients with pathologic radiography findings. Continued use of chest radiography as a diagnostic intervention in the initial episode of childhood bronchospasm is recommended.

Adolescent↗
PubMed2000

[Significance of simple radiography of the abdomen in nephritic colic].

BASIS: The utility of the abdominal plain film in the emergency department to evaluate urolithiasis is questionable. Between another things, there are influence of the different formation of distinct examinators. METHODS: A retrospective study in 65 patients referrals to urology in 1997 and 1998 by suspicion of renal colic was carried out. The radiography of abdomen took in the emergency room the day of the income is reviewed with a protocol, by a resident of Familiar and Community Medicine and by the urologist, separately and without information of the medical records. RESULTS: We have excluded three patients. At last, we diagnose 49 patients as renal colic with certainty, 6 patients with doubtful diagnosis and 7 patients with distinct diagnosis. The urologist achieved the most adequate reading in 11 cases; in 7 was best the resident, to equal in 31, and in 13 the differences were not important. The resident obtained of radiography a sensitivity of the 67% and a specificity of the 42% and the urologist 71% and 57% respectively. CONCLUSIONS: There are few differences of reading, at least when the resident dispose a protocol of interpretation. Despite to the almost null diagnostic utility of the radiography, supply additional ation, and permit to value the evolution with a few aggressive technique.

Adult↗
PubMed1998

Computed radiography.

In several medical centers computed radiography has almost completely replaced the use of conventional screen-film systems for general radiography. The aim of this paper is to explain the basic principles of the four most frequently numerical detectors used in the world, with emphasis on the phosphor plates, which are the most frequently used both in hospitals and by practitioners. The other two systems are based on a receptor with selenium. The fourth uses charged coupled device (CCD) detectors. The most important principles of digital processing are then described with concentration on unsharp mask filtering. In the future computed radiography will replace standard radiology and will create a system in medicine using the power of computers to archive--with more efficiency and less space--patient medical data. The transmission of data to workstations and the processing of this data is the topic of a new field in medicine.

Humans↗
PubMed2001

Quantifying the characteristics of unambiguous chest radiography reports in the context of pneumonia.

RATIONALE AND OBJECTIVES: The purpose of this study was to statistically identify some characteristics of unambiguous (ie, clear) chest radiography reports in the context of acute bacterial pneumonia. MATERIALS AND METHODS: Seven physicians individually read 292 chest radiography reports to determine if they contained radiologic evidence of pneumonia. Unambiguous reports were defined as those that physicians unanimously classified as supporting or not supporting the diagnosis of pneumonia. Ambiguous reports were assigned degrees of ambiguity on the basis of how much disagreement they caused among the physicians. Characteristics of unambiguous reports as described in the literature were manually quantified and assigned to every report. To identify characteristics that statistically distinguished unambiguous from ambiguous reports, the authors performed an ordinal logistic regression analysis for which the dependent variable was the number of dissenting votes the report received and the independent variables were the quantified characteristics of the report. RESULTS: Six independent variables were statistically significantly associated with unambiguous reports (P < .05). Three were positively associated: an interpretation of whether findings supported the diagnosis of pneumonia in reports with pneumonia-related observations, short sentences, and redundancy of pneumonia-related observations. Three were negatively associated: high use of uncertainty modifiers for pneumonia-related observations, use of only descriptive terms to describe pneumonia-related observations, and insufficient amount of pneumonia-related information. CONCLUSION: The most influential characteristic of an unambiguous chest radiography report was an interpretation of whether the radiograph supported the diagnosis of pneumonia when findings could be indicative.

Diagnosis, Differential↗
PubMed1998

Mucoepidermoid carcinoma in the mandible: findings of panoramic radiography and computed tomography.

Six patients with mucoepidermoid carcinoma in the mandible were studied with both panoramic radiography and computed tomography. Lesion shape and margin were evaluated on panoramic radiography, and bony expansion and cortical plate destruction were evaluated on computed tomography. In addition, a possible correlation among radiographic findings, histologic findings, and prognosis was investigated. Lesions found on panoramic radiography were classified into three types; each type pertained to two of the six patients. The lesion types were as follows: cystic, characterized by a large, cystic radiolucent area; rarefying, characterized by rarefying changes of the trabeculae; and infiltrative, characterized by a central ill-defined area of bony destruction. The results show that computed tomography is useful in the identification of tumor extent, bony expansion, and cortical plate destruction resulting from tumors. None of the patients whose lesions were of the cystic or rarefying type showed evidence of disease after surgery. In contrast, both of the patients whose lesions were of the infiltrative type died of their tumors. Histologic findings of the cystic and rarefying types showed tumors that were well-differentiated or moderately well-differentiated, whereas findings of the infiltrative type showed poorly differentiated tumors. Radiographic findings correlated with histologic findings and prognosis of mucoepidermoid carcinoma in the mandible in this limited series.

Adult↗
PubMed2003

Radiography in the assessment of musculoskeletal conditions.

Plain film radiography is the most widely used imaging technique for diagnosing and monitoring the progression of chronic inflammatory and degenerative joint diseases. Advanced imaging techniques that are better suited for detecting soft-tissue inflammation are available, but they are more costly and some of them may expose the patient to higher doses of radiation. Plain film radiographs are inexpensive, easy to generate, can be compared with baseline and prospective films, and provide a permanent, reproducible record. Radiographs can easily detect the features that are specific to various rheumatological disorders, and serial radiography can be used to assess response to therapy by measuring erosions, joint space narrowing, and other disease-specific features. This chapter discusses the use of radiography for diagnosing and differentiating various rheumatic joint diseases, specifically rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and osteoarthritis. The most frequently used scoring systems that are used to assess and monitor the severity and progression of these disorders are briefly described.

Arthritis, Psoriatic↗
PubMed1999

An in-vitro evaluation of a dental subtraction radiography system using bone chips on dried human mandibles.

The aim of this in vitro study was to evaluate the ability of digital subtraction radiography to detect small differences in bone density between 2 dental images captured with the Digora radiographic imaging system. 5 dried human mandibles were held in a fixed position and cortical bone chips were superimposed on the alveolar bone between the 1st molar and 2nd premolar teeth. For each mandible, a reference image was obtained without bone chip placement. Subsequently, another image without a bone chip and a series of 10 images with bone chips ranging from 1.2 to 35.3 mg, were recorded. Each of the initial images of the 5 mandibles was then compared to the 11 subsequent images using digital subtraction radiography. The difference in density between the 2 images, at the site between the 1st molar and 2nd premolar, was calculated and represented as a volume equivalent of aluminium. Regression analysis demonstrated a close relationship between the weight of the bone chips and the aluminium equivalent density difference between the 2 radiographs (r2 = 0.96). Good results were obtained with the smaller bone chips that more closely resembled the dimensions of bone changes likely to be of clinical interest (1-8 mg). It is concluded that this subtraction radiography system is suitable for clinical investigations of localised small changes in alveolar bone and for the diagnosis and monitoring of destructive forms of periodontal diseases.

Absorptiometry, Photon↗
PubMed1995

Some factors affecting the standards of radiography in general dental practice.

This study had three aims. The first was to examine the influence of legislative and educational factors on facilities and equipment in dental practices, the second to find out if these and practice size affected standards and the third to assess the degree to which technique and other faults not connected with processing accounted for inadequate diagnostic quality in intra-oral radiography. Dentists from 62 practices returned questionnaires about the sizes of their practices, facilities and equipment for radiography and relevant updating, training and education of their staff. The quality of 305 radiographs taken in a sample of 11 practices was assessed. Ten examples of good radiographic practice were used to evaluate standards in the general practices. The 'good practice score' ranged from 2 (two practices) to 10 (one practice) with a mean of 6.2. Practices whose principals had engaged in the recommended educational activities scored more highly than those that had not (P < 0.05), and the mean scores in practices of two or more dentists were higher than in single-handed (P < 0.05). Of the 305 radiographs, the dentists, without the use of criteria to assess them, rejected 13.8%; with criteria they rejected 39.3% (P < 0.05). The researcher rejected 63.9% (P < 0.05). All films were processed under controlled conditions and it is likely that reject rates would have been higher under normal processing conditions. It is concluded that the use of criteria to assess radiographs and acceptance of postgraduate opportunities, particularly by single-handed practitioners, would improve the conduct of radiography. Further improvements might be gained by orienting updating courses and materials towards behavioural change.

Education, Dental, Continuing↗
PubMed1999

Detection of bone invasion by gingival carcinoma of the mandible: a comparison of intraoral and panoramic radiography and computed tomography.

OBJECTIVE: To assess the diagnostic accuracy of panoramic radiography (PR), panoramic radiography combined with intraoral radiography (PR+IR), and CT in detecting the supero-inferior extent of tumor invasion of the mandible by gingival carcinoma. METHOD: PR, PR+IR, and CT images of the mandible in 37 patients with gingival carcinoma were evaluated by five oral radiologists for the supero-inferior extent of bone invasion using ROC analysis. The mean ROC curve area (Az) of each observer for the different imaging modalities was analysed by nonparametric two-way ANOVA. P<0.05 was considered statistically significant. RESULTS: The mean Az for the detection of bone invasion were 0.88+/-0.03 for PR, 0.77+/-0.12 for PR+IR, and 0.87+/-0.03 for CT (P=0.0907). The mean Az for the detection of bone invasion beyond the alveolus was 0.89+/-0.07 for PR, 0.85+/-0.08 for PR+IR, and 0.83+/-0.06 for CT (P=0.5438). The mean Az for the detection of bone invasion beneath the mandibular canal were 0.94+/-0.04 for PR, 0.94+/-0.02 for PR+IR, and 0.91+/-0. 04 for CT (P=0.2466). No statistically significant differences were observed in Az between PR, PR+IR, and CT. CONCLUSION: We consider that PR+IR should be adopted as the initial imaging modality to determine the extent of supero-inferior invasion of the mandible in gingival carcinoma.

Analysis of Variance↗
PubMed2000

Intra-oral storage phosphor and conventional radiography in the assessment of alveolar bone structures.

OBJECTIVES: To compare storage phosphor (SP) with conventional film radiography for accuracy of linear measurements of the marginal alveolar bone and visibility of anatomical structures. METHODS: Linear measurements were made in paired SP and conventional images of dried human mandibles with a metal pin fixed 10 mm below the alveolar crest. One observer measured the distance from the alveolar crest to the reference point on the radiographs. The difference between the measured and the true distance was calculated. Two observers rated the visibility of bony structures (periodontal ligament space, periapical bone tissue, alveolar crest) in 51 paired digital and conventional images of 21 patients on a 3-point scale. Overall agreement and Kappa index were calculated. RESULTS: Accuracy of linear measurements was higher in digital radiography (mean difference 0.17 mm) than in conventional radiography (mean difference 0.59 mm). Overall, the two observers rated visibility higher in conventional radiographs. The Kappa indices for the periodontal ligament space and periapical bone indicated fair to almost perfect agreement (kappa = 0.38 and 0.5; kappa = 0.39 and 0.84) while for the alveolar crest there was only poor or moderate agreement (kappa = 0.2 and 0.5). CONCLUSIONS: The small differences in linear measurements indicate that the Digora system is suitable for clinical assessment of periodontal and peri-implant bone loss. The visibility of dental structures depends as much on the individual features assessed, as the radiographic system.

Alveolar Process↗
PubMed2002

Radiation dose reduction in chest radiography using a flat-panel amorphous silicon detector.

AIM: The aim of this study was to evaluate the image quality and the potential for radiation dose reduction with a digital flat-panel amorphous silicon detector radiography system. MATERIAL AND METHODS: Using flat-panel technology, radiographs of an anthropomorphic thorax phantom were taken with a range of technical parameters (125kV, 200mA and 5, 4, 3.2, 2, 1, 0.5, and 0.25mAs) which were equivalent to a radiation dose of 332, 263, 209, 127, 58.7, 29, and 14 microGy, respectively. These images were compared to radiographs obtained by a conventional film-screen radiography system at 125kV, 200mA and 5mAs (equivalent to 252 microGy) which served as reference. Three observers evaluated independently the visibility of simulated rounded lesions and anatomical structures, comparing printed films from the flat-panel amorphous silicon detector and conventional x-ray system films. RESULTS: With flat-panel technology, the visibility of rounded lesions and normal anatomical structures at 5, 4, and 3.2mAs was superior compared to the conventional film-screen radiography system. (P< or =0.0001). At 2mAs, improvement was only marginal (P=0.19). At 1.0, 0.5 and 0.25mAs, the visibility of simulated rounded lesions was worse (P< or =0.004). Comparing fine lung parenchymal structures, the flat-panel amorphous silicon detector showed improvement for all exposure levels down to 2mAs and equality at 1mAs. CONCLUSION: Compared to a conventional x-ray film system, the flat-panel amorphous silicon detector demonstrated improved image quality and the possibility for a reduction of the radiation dose by 50% without loss in image quality.

Humans↗
PubMed2002

Accuracy of diagnosis of fractures by maxillofacial and accident and emergency doctors using plain radiography compared with a telemedicine system: a prospective study.

Ten facial radiographs with fractures and 10 without fractures were viewed by eight oral and maxillofacial surgery (OMFS) and eight accident and emergency (A&E) doctors who were each asked questions about the presence and site of any fractures as well as the quality of the images and diagnostic confidence. Each radiograph was then transmitted over a teleradiology link and viewed by the same OMFS doctors who answered the same questions. The position of the fracture was more accurately assessed using plain radiography. Diagnosis by OMFS doctors using telemedicine was broadly comparable with fracture diagnosis by A&E doctors using plain radiography. Poor quality radiographs and frontozygomatic and infraorbital rim fractures were poorly diagnosed by telemedicine. This telemedicine system was a useful tool to aid diagnosis of most facial fractures. The need for appropriate clinical information is vital. Diagnosis of frontozygomatic and infraorbital rim disruption using telemedicine is less reliable than plain radiography.

Diagnostic Errors↗
PubMed1977

[Sonography and conventional radiography for post-operative local infections in the upper abdomen (author's transl)].

The findings on sonography and radiography were compared in 32 patients with abscesses or empyemas in the upper abdomen following surgery. Sonography demonstrated each of eight liver abscesses, eleven of 21 upper abdominal empyemas and three abscesses or empyemas in other positions. Corresponding figures for radiography were five out of eight liver abscesses, 16 out of 21 upper abdominal empyemas and one of the remaining lesions. The methods are complimentary. Sonography demonstrates fluidfilled cavities, radiography shows particularly the presence of extraluminal gas. Recommendations are made for the proper sequence of these diagnostic measures.

Empyema↗
PubMed2005

[The role of projectional radiography in the detection of primary malignant and indeterminate bone neoplasms].

PURPOSE: To evaluate the role of projectional radiography in the detection of primary and potentially malignant bone neoplasms. MATERIALS AND METHODS: We retrospectively reviewed the images and medical records of 80 patients (42 male, 38 female; range: 6 to 73 years; mean: 33 years) with pathologically proven primary or indeterminate bone tumors. RESULTS: The most common symptom was local pain (84 %). In 69 of 80 patients (86 %), projectional radiography was the first imaging modality, which correctly identified the malignant character of the bone lesion in 60 of these 69 patients (87 %). In 2 patients, bone neoplasms were overlooked due to diagnostically inadequte image quality. The false-diagnosis rate was not significantly different between board-certified radiologists working in hospitals and radiologists in outpatient facilities (p > 0.05). Bone tumors predominantly affecting adults, such as chondrosarcomas, needed a longer time for the diagnosis than bone tumors mainly found in childhood, such as osteosarcomas. The median age of patients with delayed imaging work-up because of attempted conservative therapy (45 years +/- 20 years) was significant higher than the median age of patients with immediate radiographic work-up (27 years +/- 16 years). CONCLUSION: Projectional radiography is the most common initial imaging method for bone pain and continues to play an important role to reduce the time gap between first onset of symptoms and definitive treatment. In unremitting focal bone pain, bone neoplasms should be taken into consideration not only in children but also in patients beyond adolescence.

Adult↗
PubMed1986

The influence of diagnostic radiography on the incidence of breast cancer and leukemia.

Little accurate information is available on the influence of diagnostic radiography on the incidence of cancer in the general population, largely because of a lack of knowledge of the numbers and the age distributions of patients undergoing radiographic examinations. We used such information from a closed population in Maine that was followed for a year, along with data from the literature on the absorbed dose from typical examinations and a mathematical model linking dose to the incidence rate of cancer, to estimate the numbers of cases of radiologically induced cancer of the bone marrow and breast. Our data indicate that about 1 percent of all cases of leukemia and less than 1 percent of all cases of breast cancer result from diagnostic radiography. In addition, such tumors generally occur late in life; the incidence of radiation-induced leukemia was highest at 69 years, and the incidence of radiation-induced breast cancer was highest at 76 years. Thus, diagnostic radiography has only a small influence on the occurrence of leukemia and breast cancer.

Adolescent↗
PubMedDate not supplied

Dual-energy digital subtraction chest radiography: technical considerations.

In the evaluation of asbestos-related pulmonary and pleural abnormalities, conventional chest radiography has been shown to have a low sensitivity for the detection of lung nodules and subtle interstitial disease. Pleural plaques may simulate pulmonary nodules, and interstitial processes can be masked by adjacent pleural abnormalities. Dual-energy digital subtraction chest radiography may enable investigators to characterize asbestos-related pulmonary and pleural abnormalities with greater accuracy. "Soft-tissue" images, designed to remove pleural calcifications, may allow for better evaluation of the lung parenchyma. "Bone" images, designed to remove soft-tissue structures, may enhance the detection of pleural calcifications. In this pictorial essay we illustrate the methods, technical considerations, and limitations of dual-energy digital subtraction chest radiography performed with global subtraction weighting factors.

Adult↗
PubMed2002

Comparative study of clinical manifestation, plain-film radiography, and computed tomographic scan in arteriovenous malformations of the jaws.

OBJECTIVE: The purpose of this study was to summarize the clinical manifestation, plain-film radiography, and computed tomographic (CT) scan features of arteriovenous malformations (AVMs) of the jaws on the basis of a series of 12 patients. STUDY DESIGN: This study group comprised twelve patients with AVM of the jaws from February 1996 to February 2001. Seven cases were located in the mandible, and 5 in the maxilla. Both plain-film radiography and CT scan were available for all cases. For the patients with lesions in the mandible, panoramic, posterioanterior, and lateral mandibular views were applied. Waters' position view and panoramic radiography were indicated for AVMs of the maxilla. RESULTS: Each patient with AVM of the maxillary bone had involvement of adjacent soft tissues. Various radiographic signs were noted, including erosion, coarse trabeculae, and apparent lack of any radiographic change, and CT scans featured cystic expansion of alveolar process with broken cortex. The radiographic signs and CT scan features of AVMs in the mandible were related to involvement of surrounding soft tissues. If involvement of the adjacent soft tissues was found, "soap bubble" radiolucency was shown radiographically and osteolytic expansion with perforation of cortex was present on CT scan. In cases without surrounding soft tissue involvement, the various radiographic signs included multilocular or unilocular radiolucency or coarse trabeculae; osteolytic expansions with intact cortex were found on CT scan. CONCLUSION: AVMs of the jaws showed intraosseous osteolytic expansion on CT scan but had variable appearance on plain-film radiographs.

Adolescent↗